Robert Penfold, PhD

“I do research designed to improve real-world mental health care.” 

Robert Penfold, PhD

Associate Investigator, Kaiser Permanente Washington Health Research Institute

Areas of focus:

Biography

Robert Penfold, PhD, is a health services research and health policy expert whose work focuses on developing and testing strategies to optimize behavioral health care delivery and patient outcomes—particularly in children and adolescents. His research addresses practical issues, such as how to reduce unnecessary use of antipsychotic medications in youth. He also studies the effects of cost-control policies on how clinicians deliver care, how people use care, and how those changes can promote or worsen their health.

Dr. Penfold is a co-investigator in the Mental Health Research Network (MHRN), a resource for studies on mental health conditions ranging from autism to postnatal depression. He leads the MHRN’s child and adolescent scientific interest group. He is also investigating reasons why similar patients receive different mental health treatment, such as different medications, depending on where they live or receive care.

His other recent and ongoing projects include:

  • A Targeted Approach to a Safer Use of Antipsychotics in Youth (SUAY), a $10 million, five-year National Institutes of Health clinical trial that is developing and testing new ways to support clinicians and families in choosing safer treatments for behavioral disorders in youth age 5 to 17.
  • Assisted Identification and Navigation of Early Mental Health Symptoms in Youth. A National Institute of Mental Health (NIMH)-funded clinical trial designed to increase the early identification and treatment of youth with mental health symptoms and complaints.
  • Automated Outreach for Depression, a NIMH-funded study to decrease premature dropout from depression treatment.
  • STAR Caregivers—Virtual Training and Follow-up, a National Institute on Aging funded clinical trial to improve the behavioral and psychological symptoms of dementia and reduce caregiver burden without the use of antipsychotic medications.

Dr. Penfold has extensive experience gathering and analyzing information from large health databases, including those of Medicare, Medicaid, and the Health Care Systems Research Network’s Virtual Data Warehouse. These data and analyses allow rapid information sharing among Kaiser Permanente Washington and participating sites, which improves patient safety and timely access to effective, cutting-edge therapies.

He has also conducted several novel pragmatic clinical trials using the Epic electronic health record system.  

Before joining KPWHRI in 2010, Dr. Penfold held research and teaching positions at Nationwide Children's Hospital in Columbus, Ohio; the Winnipeg Regional Health Authority; the Manitoba Centre for Health Policy; and most recently, at Harvard Medical School in the Department of Population Medicine and Harvard Pilgrim Health Care Institute.

Research interests and experience

  • Mental Health

    Children and adolescents; anti-psychotics and anti-depressants; bipolar disorder, and depression

  • Health Services & Economics

    Comparative effectiveness; consumer-directed health plans; patient outcomes; costs of chronic illnesses; Medicare and Medicaid 

  • Biostatistics

    Space-time surveillance;  interrupted time series analysis

 

 

Recent publications

Simon GE, Shortreed SM, Coley RY, Penfold RB, Rossom RC, Waitzfelder BE, Sanchez K, Lynch FL. Assessing and minimizing re-identification risk in research data derived from health care records. EGEMS (Wash DC). 2019;7(1):6. doi: 10.5334/egems.270. PubMed

Simon GE, Johnson E, Lawrence JM, Rossom RC, Ahmedani B, Lynch FL, Beck A, Waitzfelder B, Ziebell R, Penfold RB, Shortreed SM. Predicting suicide attempts and suicide deaths following outpatient visits using electronic health records. Am J Psychiatry. 2018 May 24:appiajp201817101167. doi: 10.1176/appi.ajp.2018.17101167. [Epub ahead of print]. PubMed

Lu CY, Penfold RB, Toh S, Sturtevant JL, Madden JM, Simon G, Ahmedani BK, Clarke G, Coleman KJ, Copeland LA, Daida YG, Davis RL, Hunkeler EM, Owen-Smith A, Raebel MA, Rossom R, Soumerai SB, Kulldorff M. Near real-time surveillance for consequences of health policies using sequential analysis. Med Care. 2018 May;56(5):365-372. doi: 10.1097/MLR.0000000000000893. PubMed

Simon GE, Stewart C, Yarborough BJ, Lynch F, Coleman KJ, Beck A, Operskalski BH, Penfold RB, Hunkeler EM. Mortality rates after the first diagnosis of psychotic disorder in adolescents and young adults. JAMA Psychiatry. 2018 Jan 31. pii: 2670697. doi: 10.1001/jamapsychiatry.2017.4437. [Epub ahead of print]. PubMed

Simon GE, Stewart C, Hunkeler EM, Yarborough BJ, Lynch F, Coleman KJ, Beck A, Operskalski BH, Penfold RB, Carrell DS. Care pathways before first diagnosis of a psychotic disorder in adolescents and young adults. Am J Psychiatry. 2018 May 1;175(5):434-442. doi: 10.1176/appi.ajp.2017.17080844. Epub 2018 Jan 24. PubMed

 

research into action

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Healthy Hearts Northwest helps small clinics improve care

A new study shows how a little supplemental support can result in big gains, especially in managing patients’ blood pressure.

caregiving

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Training for caregivers of people with dementia: How to scale up

Dr. Rob Penfold leads pragmatic trial of new online version of proven program developed by UW colleagues.

advance care planning

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How can we make advance care planning easier for patients and families?

Dr. Robert Penfold talks about how his father’s death inspired him to work on advance care planning for people with mild cognitive impairment.

Read about it in Healthy Findings.

new research

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TEST To prevent gun suicides, new study seeks to improve primary care intervention

Julie Richards’ research project is one of the first three funded by Kaiser Permanente’s Firearm Injury Prevention Task Force.

Read more in Recent News.

kpwhri in the media

Esketamine: How to assess new antidepressant’s efficacy

Bloomberg Businessweek, Feb. 5, 2019