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, this research is supplying valuable evidence that is helping shape federal policy and guiding innovative redesign of health care.

“We’re working to understand how to make health IT practical so patients and care teams find it useful and engaging,” explained Kaiser Permanente Washington Health Research Institute (KPWHRI) Senior Investigator 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 that focus on needs, use, and usability, KPWHRI researchers inform the design of health IT with direct participation from users.

Groundbreaking methodological work by KPWHRI health informatics researchers includes developing natural language processing (NLP) to analyze text such as notes and written reports in electronic health records (EHRs). Assistant Investigator David Carrell, PhD, leads in the area of using NLP and machine learning to identify patient phenotypes, or specific health characteristics such as possible heart disease, risk of opioid overdose, or suggestion of colon cancer. This information can assist researchers in studying how genetics and other factors influence disease.

Other examples of KPWHRI health informatics research include projects using EHRs and secure electronic communications such as:

  • using a patient-shared EHR to improve care for chronic illnesses such as depression, diabetes, hypertension, and heart disease;
  • understanding the effects of technologies such as OpenNotes, which gives patients access to notes that their doctors write during office visits;
  • understanding and addressing differences in patient use of online health care services that could lead to disparities in care;
  • testing NLP to target mentions of specific words and phrases in EHRs to supplement or replace skilled chart abstraction—providing faster access to “big data” and actionable information about patients who may need follow up.

Examples of KPWHRI research in mobile health (mHealth) and user-centered design include:

  • evaluating mHealth smartphone tools: 1) to improve primary care for alcohol use disorders, 2) to support patients after bariatric surgery, and 3) to change smoking behavior;
  • the VITAL and Seeing Priorities studies to apply user-centered processes to learn how health care providers can elicit and honor what is most important to patients living with multiple chronic health conditions;
  • the REMIND project applying user-centered methods to redesign clinical reminders and notifications for patients with chronic and preventive health care needs;
  • the landmark Electronic Communications and Blood Pressure (eBP) study of home blood pressure monitoring and web-based care to increase hypertension control without office visits.

“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 Senior Investigator Beverly B. Green, MD, MPH.

Recent publications on Health Informatics

Bradley R, Booth-LaForce C, Hanes D, Scott C, Sherman KJ, Lin YS, Zwickey H. Design of a multidisciplinary training program in complementary and integrative health clinical research: building research across interdisciplinary gaps. J Altern Complement Med. 2019 Feb 13. doi: 10.1089/acm.2018.0454. [Epub ahead of print]. PubMed

McClure JB, Anderson ML, Krakauer C, Blasi P, Bush T, Nelson J, Catz SL. Impact of a novel oral health promotion program on routine oral hygiene among socioeconomically disadvantaged smokers: results from a randomized semi-pragmatic trial. Transl Behav Med. 2019 Feb 12. pii: 5316179. doi: 10.1093/tbm/ibz009. [Epub ahead of print]. PubMed

Trinidad SB, Shaw JL, Dirks LG, Ludman EJ, Burke W, Dillard DA. Perceptions of alcohol misuse among Alaska Native health care system stakeholders: a qualitative exploration. J Ethn Subst Abuse. 2019 Feb 4:1-24. doi: 10.1080/15332640.2018.1556766. [Epub ahead of print]. PubMed

Masters ET, Ramaprasan A, Mardekian J, Palmer RE, Gross DE, Cronkite D, Von Korff M, Carrell DS. Natural language processing-identified problem opioid use and its associated health care costs. J Pain Palliat Care Pharmacother. 2019 Jan 31:1-10. doi: 10.1080/15360288.2018.1488794. [Epub ahead of print]. PubMed

Muntner P, Einhorn PT, Cushman WC, Whelton PK, Bello NA, Drawz PE, Green BB, Jones DW, Juraschek SP, Margolis KL, Miller ER 3rd, Navar AM, Ostchega Y, Rakotz MK, Rosner B, Schwartz JE, Shimbo D, Stergiou GS, Townsend RR, Williamson JD, Wright JT Jr, Appel LJ; 2017 National Heart, Lung, and Blood Institute Working Group. Blood pressure assessment in adults in clinical practice and clinic-based research: JACC scientific expert panel. J Am Coll Cardiol. 2019;73(3):317-335. doi: 10.1016/j.jacc.2018.10.069. PubMed

Researchers in Health Informatics

James D. Ralston, MD, MPH

Senior Investigator
206-287-2076
James.D.Ralston@kp.org

Curriculum vitae (CV)

Jennifer B. McClure, PhD

Director of Research, Faculty, & Development; Senior Investigator
206-287-2737
Jennifer.B.Mcclure@kp.org

Curriculum vitae (CV)

Beverly B. Green, MD, MPH

Senior Investigator
206-287-2997
Bev.B.Green@kp.org

Curriculum vitae (CV)

Katharine A. Bradley, MD, MPH

Senior Investigator
206-287-2151
Katharine.A.Bradley@kp.org

Curriculum vitae (CV)

Eric B. Larson, MD, MPH, MACP

Senior Investigator and former Executive Director, Kaiser Permanente Washington Health Research Institute; Former Vice President for Research and Health Care Innovation, Kaiser Permanente Washington
206-287-2988
Eric.B.Larson@kp.org

Curriculum vitae (CV)

Paula Lozano, MD, MPH

Senior Investigator, KPWHRI; Associate Medical Director for Research and Translation & Physician, Pediatrics, Washington Permanente Medical Group
206-287-2113
Paula.Lozano@kp.org

Curriculum vitae (CV)

Predrag Klasnja, PhD

Associate Investigator, KPWHRI; Assistant Professor of Information, University of Michigan School of Information
206-442-5207
Predrag.V.Klasnja@kp.org

Curriculum vitae (CV)

David S. Carrell, PhD

Assistant Investigator
206-287-2705
David.S.Carrell@kp.org

Curriculum vitae (CV)

Cara C. Lewis, PhD, HSPP

Associate Investigator
206-442-4076
Cara.C.Lewis@kp.org

Curriculum vitae (CV)

Yates Coley, PhD

Assistant Investigator
206-287-2071
Rebecca.Y.Coley@kp.org

Curriculum vitae (CV)

Lynn DeBar, PhD

Senior Investigator
(206) 287-2942
Lynn.Debar@kp.org

Curriculum vitae (CV)