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

Penfold RB, Carrell DS, Cronkite DJ, Pabiniak C, Dodd T, Glass AM, Johnson E, Thompson E, Arrighi HM, Stang PE. Development of a machine learning model to predict mild cognitive impairment using natural language processing in the absence of screening.  BMC Med Inform Decis Mak. 2022 May 12;22(1):129. doi: 10.1186/s12911-022-01864-z. PubMed

Lapham GT, Matson TE, Carrell DS, Bobb JF, Luce C, Oliver MM, Ghitza UE, Hsu C, Browne KC, Binswanger IA, Campbell CI, Saxon AJ, Vandrey R, Schauer GL, Pacula RL, Horberg MA, Bailey SR, McClure EA, Bradley KA. Comparison of medical cannabis use reported on a confidential survey vs documented in the electronic health record among primary care patients.  JAMA Netw Open. 2022 May 2;5(5):e2211677. doi: 10.1001/jamanetworkopen.2022.11677. PubMed

Kirwan JP, Courcoulas AP, Cummings DE, Goldfine AB, Kashyap SR, Simonson DC, Arterburn DE, Gourash WF, Vernon AH, Jakicic JM, Patti ME, Wolski K, Schauer PR. Diabetes remission in the Diabetes Remission in the Alliance of Randomized Trials of Medicine Versus Metabolic Surgery in Type 2 Diabetes (ARMMS-T2D). Diabetes Care. 2022 Mar 23:dc212441. doi: 10.2337/dc21-2441. [Epub ahead of print]. PubMed

Mangione-Smith R, Robinson JD, Zhou C, Stout JW, Fiks AG, Shalowitz M, Gerber JS, Burges D, Hedrick B, Warren L, Grundmeier RW, Kronman MP, Shone LP, Steffes J, Wright M, Heritage J. Fidelity evaluation of the dialogue around respiratory illness treatment (DART) program communication training. Patient Educ Couns. 2022 Jul;105(7):2611-2616. doi: 10.1016/j.pec.2022.03.011. Epub 2022 Mar 14. PubMed

Chipidza W, Krewson C, Gatto NM, Akbaripourdibazar E, Gwanzura T. Ideological variation in preferred content and source credibility on Reddit during the COVID-19 pandemic. Big Data Soc. 2022 Mar 9;9(1):20539517221076486. doi: 10.1177/20539517221076486. eCollection 2022 Jan. 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, Investigative Science
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)

Paula Lozano, MD, MPH

Senior Investigator; Director, ACT Center
206-287-2113
Paula.Lozano@kp.org

Curriculum vitae (CV)

Yates Coley, PhD

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

Curriculum vitae (CV)

Brian D. Williamson, PhD

Assistant Biostatistics Investigator
206-287-2024
Brian.D.Williamson@kp.org

Curriculum vitae (CV)

Annie Hoopes, MD, MPH

Acting Assistant Investigator
Andrea.J1.Hoopes@kp.org

Curriculum vitae (CV)

Claire Allen, MPH

Manager, Collaborative Science
Claire.L.Allen@kp.org

Curriculum vitae (CV)

Annie Piccorelli, PhD

Senior Collaborative Biostatistician
Annie.V.Piccorelli@kp.org

Curriculum vitae (CV)