Health Informatics

“Our goal is to understand how to make health information technology practical in ways that directly engage patients and providers.”

James D. Ralston, MD, MPH
Kaiser Permanente Washington Health Research Institute Associate Investigator
Washington Permanente Medical Group, Internal Medicine 

Research overview

Research on health informatics at Kaiser Permanente Washington focuses on developing and using health information technology (IT) to transform health care delivery. By testing new paradigms of care that provide more opportunities to engage patients outside of in-person visits, this research is supplying valuable evidence that is helping shape federal policy and guiding innovative redesign of health care.

“Our goal is to understand how to make health IT practical in ways that directly engage patients and providers,” explained Kaiser Permanente Washington Health Research Institute (KPWHRI) Associate Investigator and lead health IT researcher James Ralston, MD, MPH. “We want to find ways to use information technologies to support patients and providers together, both inside and outside the office.”

Integral to this support is designing technologies that are user-friendly and meet the needs of both patients and providers. By applying human-centered methods, new Assistant Investigator Andrea Hartzler, PhD, informs the design of health IT by focusing on needs, use, and usability through direct input from users.

With health IT playing a pivotal role in health care reform, understanding how to maximize its effectiveness has never been more important. Dr. Ralston’s research on secure messaging between patients and providers showed that it increased patient satisfaction with care. His team’s findings influenced Kaiser Permanente Washington’s organization-wide rollout of the patient-centered medical home—and were later cited in federal rules requiring hospitals and health care professionals to use secure messaging to receive incentive payments for meaningful use of electronic health records.

Other areas of focus for the research include:

  • using Web-based care and a patient-shared electronic medical record to improve care for chronic illnesses, such as depression, diabetes, and heart disease;
  • understanding the effects of new technologies such as OpenNotes, which gives patients access to notes that their doctors write during office visits (see 2012 news release);
  • testing “natural language processing” (NLP) to target mentions of specific words and phrases in electronic medical records and supplement skilled chart abstraction—providing faster access to “big data,” according to Clinical Data Scientist David Carrell, PhD, who leads KPWHRI’s work on NLP (see feature story: ‘Teaching’ computers to read doctors’ notes promises gains in research efficiency); and
  • evaluating how well mobile health applications—including Kaiser Permanente Washington’s award-winning Mobile MyKaiser Permanente Washington—meet the needs of traditionally underserved populations.

“Our studies on using health IT to improve care are showing that we can achieve better outcomes when we shift care from the doctor’s office to where people live: in their homes—and online,” said Associate Investigator and Kaiser Permanente Washington Family Physician Beverly B. Green, MD, MPH.

Recent publications on Health Informatics

Lu CY, Penfold R, Toh D, Sturtevant J, Madden J, Simon G, Ahmedani BK, Clarke G, Hunkeler EM, Waitzfelder B, Owen-Smith A, Davis R, Raebel MA, Rossom R, Coleman KJ, Copeland LA, 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

Owen-Smith A, Mayhew M, Leo MC, Varga A, Benes L, Bonifay A, DeBar L. Automating collection of pain-related patient reported outcomes to enhance clinical care and research. J Gen Intern Med. 2018 Apr 9. doi: 10.1007/s11606-018-4326-9. [Epub ahead ofprint]. PubMed

Tan WK, Hassanpour S, Heagerty PJ, Rundell SD, Suri P, Huhdanpaa HT, James K, Carrell DS, Langlotz CP, Organ NL, Meier EN, Sherman KJ, Kallmes DF, Luetmer PH, Griffith B, Nerenz DR, Jarvik JG. Comparison of natural language processing rules-based and machine-learning systems to identify lumbar spine imaging findings related to low back pain. Acad Radiol. 2018 Mar 28. pii: S1076-6332(18)30121-1. doi: 10.1016/j.acra.2018.03.008. [Epub ahead of print]. PubMed

Lewis CC, Stanick C, Lyon A, Darnell D, Locke J, Puspitasari A, Marriott BR, Dorsey CN, Larson M, Jackson C, Thayer J, Bailey CW, Lengnick-Hall R, Dorsey S, Landes SJ. Proceedings of the fourth biennial conference of the Society for Implementation Research Collaboration (SIRC) 2017: implementation mechanisms: what makes implementation work and why? part 1. Implement Sci. 2018;13(Suppl 2):30. doi: 10.1186/s13012-018-0714-0. PubMed

Rose SE, Frankowski H, Knupp A, Berry BJ, Martinez R, Dinh SQ, Bruner LT, Willis SL, Crane PK, Larson EB, Grabowski T, Darvas M, Keene CD, Young JE. Leptomeninges-derived induced pluripotent stem cells and directly converted neurons from autopsy cases with varying neuropathologic backgrounds. J Neuropathol Exp Neurol. 2018 Feb 21. pii: 4895572. doi: 10.1093/jnen/nly013. [Epub ahead of print]. PubMed

Researchers in Health Informatics

James D. Ralston, MD, MPH

Senior Investigator
206-287-2076
ralston.j@ghc.org

Curriculum vitae (CV)

Jennifer B. McClure, PhD

Director of Research, Faculty, & Development; Senior Investigator
206-287-2737
mcclure.j@ghc.org

Curriculum vitae (CV)

Beverly B. Green, MD, MPH

Associate Investigator
206-287-2997
green.b@ghc.org

Curriculum vitae (CV)

Katharine A. Bradley, MD, MPH

Senior Investigator
206-287-2151
bradley.k@ghc.org

Curriculum vitae (CV)

Eric B. Larson, MD, MPH, MACP

Vice President for Research and Health Care Innovation, Kaiser Foundation Health Plan of Washington; Executive Director & Senior Investigator, Kaiser Permanente Washington Health Research Institute
206-287-2988
larson.e@ghc.org

Curriculum vitae (CV)

Paula Lozano, MD, MPH

Sr Investigator, Kaiser Permanente Washington Health Research Institute; Associate Medical Director for Research and Translation & Physician, Pediatrics, Washington Permanente Medical Group
206-884-8241
lozano.p@ghc.org

Curriculum vitae (CV)

Paula R. Blasi, MPH

Research Associate
206-287-2094
blasi.p@ghc.org

Curriculum vitae (CV)

Predrag Klasnja, PhD

Associate Investigator
206-442-5207
klasnja.p@ghc.org

Curriculum vitae (CV)

David S. Carrell, PhD

Assistant Investigator
206-287-2705
carrell.d@ghc.org

Curriculum vitae (CV)

Cara C. Lewis, PhD, HSPP

Associate Investigator
206-442-4076
lewis.cc@ghc.org

Curriculum vitae (CV)

Rebecca Y. Coley, PhD

Assistant Investigator
206-287-2071
coley.r@ghc.org

Curriculum vitae (CV)

Lynn DeBar, PhD

Senior Investigator
(206) 287-2942
debar.l@ghc.org

Curriculum vitae (CV)