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

Powell BJ, Fernandez ME, Williams NJ, Aarons GA, Beidas RS, Lewis CC, McHugh SM, Weiner BJ. Enhancing the impact of implementation strategies in healthcare: a research agenda.  Front Public Health. 2019 Jan 22;7:3. doi: 10.3389/fpubh.2019.00003. eCollection 2019.  PubMed

Lapham GT, Campbell CI, Yarborough BJH, Hechter RC, Ahmedani BK, Haller IV, Kline-Simon AH, Satre DD, Loree AM, Weisner C, Binswanger IA. The prevalence of Healthcare Effectiveness Data and Information Set (HEDIS) initiation and engagement in treatment among patients with cannabis use disorders in 7 US health systems. Subst Abus. 2019 Jan 18:1-10. doi: 10.1080/08897077.2018.1544964. [Epub ahead of print]. PubMed

Nichols C, Kunkel LE, Baker R, Jelstrom E, Addis M, Hoffman KA, McCarty D, Korthuis PT. Use of single IRBs for multi-site studies: a case report and commentary from a national drug abuse treatment clinical trials network study. Contemp Clin Trials Commun. 2019 Jan 7;14:100319. doi: 10.1016/j.conctc.2019.100319. eCollection 2019 Jun. PubMed

Smith-Bindman R, Wang Y, Chu P, Chung R, Einstein AJ, Balcombe J, Cocker M, Das M, Delman BN, Flynn M, Gould R, Lee RK, Yellen-Nelson T, Schindera S, Seibert A, Starkey J, Suntharalingam S, Wetter A, Wildberger JE, Miglioretti DL. International variation in radiation dose for computed tomography examinations: prospective cohort study.  BMJ. 2019;364:k4931. doi: 10.1136/bmj.k4931.  PubMed

Williams MS, Taylor CO, Walton NA, Goehringer SR, Aronson S, Freimuth RR, Rasmussen LV, Hall ES, Prows CA, Chung WK, Fedotov A, Nestor J, Weng C, Rowley RK, Wiesner GL, Jarvik GP, Del Fiol G. Genomic information for clinicians in the electronic health record: lessons learned from the Clinical Genome Resource Project and the Electronic Medical Records and Genomics Network. Front Genet. 2019 Oct 29;10:1059. doi: 10.3389/fgene.2019.01059. eCollection 2019.  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)