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

Luers B, Klasnja P, Murphy S. Standardized effect sizes for preventive mobile health interventions in micro-randomized trials. Prev Sci. 2018 Jan 9. pii: 10.1007/s11121-017-0862-5. doi: 10.1007/s11121-017-0862-5. [Epub ahead of print]. PubMed

Edwards ST, Helfrich CD, Grembowski D, Hulen E, Clinton WL, Wood GB, Kim L, Rose DE, Stewart G. Task delegation and burnout trade-offs among primary care providers and nurses in Veterans Affairs Patient Aligned Care Teams (VA PACTs). J Am Board Fam Med. 2018;31(1):83-93. doi: 10.3122/jabfm.2018.01.170083. PubMed

Toh S, Rasmussen-Torvik LJ, Harmata EE, Pardee R, Saizan R, Malanga E, Sturtevant JL, Horgan CE, Anau J, Janning CD, Wellman RD, Coley RY, Cook AJ, Courcoulas AP, Coleman KJ, Williams NA, McTigue KM, Arterburn D, McClay J for the PCORnet Bariatric Study Collaborative. The national Patient-Centered Clinical Research Network (PCORnet) bariatric study cohort: rationale, methods, and baseline characteristics. JMIR Res Protoc. 2017 Dec 5;6(12):e222. doi: 10.2196/resprot.8323. PubMed

Darnell D, Dorsey CN, Melvin A, Chi J, Lyon AR, Lewis CC. A content analysis of dissemination and implementation science resource initiatives: what types of resources do they offer to advance the field? Implement Sci. 2017;12(1):137. doi: 10.1186/s13012-017-0673-x. PubMed

Milani CJ, Rundell SD, Jarvik JG, Friedly J, Heagerty PJ, Avins A, Nerenz D, Gold LS, Turner JA, Annaswamy T, Nedeljkovic SS, Suri P. Associations of race and ethnicity with patient-reported outcomes and health care utilization among older adults initiating a new episode of care for back pain. Spine. 2017 Nov 20. doi: 10.1097/BRS.0000000000002499. [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)