Group Health Research Institute hosts regular seminars where our scientists and collaborators present their research findings.


All are welcome.

Upcoming Seminars and Events

Tuesday, Dec. 2, 2014

Scientific seminar
A review of the long-term benefits and risks of bariatric surgery

Presented by David Arterburn, MD, MPH

2 – 3 p.m., Room 1509A, Group Health Research Institute, 1730 Minor Ave., Seattle.


In the last 10 years there has been a marked increase in data on the short- and long-term outcomes of bariatric surgery. The objective of this seminar is to summarize recent evidence related to the safety, efficacy, and metabolic outcomes of bariatric surgery to guide clinical decision making. 

Dr. Arterburn will discuss the challenges of randomized and observational trials in the area of bariatric surgery and present data and conclusions from the 2013 National Institutes of Health Symposium on the Long-Term Outcomes of Bariatric Surgery. He will also specifically focus on a review of the sparse data on bariatric outcomes among older adults.


A national leader in obesity research, Dr. Arterburn joined Group Health Research Institute in 2006 to forge a new program of research spanning behavioral, pharmaceutical, and bariatric surgical care. Before joining GHRI, he published important findings on the epidemic nature and rising cost of obesity in the United States.

Because tackling the obesity crisis requires a menu of treatment options, Dr. Arterburn's current research covers a broad range, including policy-level interventions for health plans, pharmaco-epidemiology, pharmacogenetics, the long-term outcomes of bariatric surgery, and shared decision making related to elective surgery. With the support of the Informed Medical Decisions Foundation, for which he serves as a medical editor, he has collaborated with Group Health's specialty leadership to implement and evaluate a new initiative to promote shared decision making around elective surgical care with video-based patient decision aids. The approach shows great promise for simultaneously improving the quality and lowering the costs of health care.

Tuesday, Dec. 9, 2014

Scientific seminar
Patient visit times: why do they matter for analyses of electronic medical records data and what can we do about them?

Presented by Jane Lange, PhD

4 – 5 p.m., Room 1509A, Group Health Research Institute, 1730 Minor Ave., Seattle.


Electronic medical records (EMR) data have the potential to provide rich longitudinal information about a patient’s disease history. The focus here is when this history can be described by a trajectory through different discrete states, corresponding to states of health and clinically relevant stages in a disease. Standard approaches define times of transitioning between states on via clinically observable quantities, such as the time of a positive biopsy, or the time a patient has a particular clinical measurement exceeding some value. However, it is often fruitful to conceptualize the patient’s history as having a latent trajectory, in which individuals transition between states at unobserved times.

In this sense, clinic visits provide snapshots of this process at particular time points. Modeling such data requires consideration of the patient visit times. Visits are typically irregularly spaced and may be a combination of visits that are scheduled in advance or patient-initiated, based on symptoms. The latter type of visits cannot be ignored without inducing bias in parameter estimates. Jane Lange will describe an approach using joint models of informative visit time process and the underlying disease trajectory. This model also accommodates potentially misclassified observations of the disease process at clinic visits. She will illustrate the model using Breast Cancer Surveillance Consortium mammography and biopsy data to estimate the cumulative incidence of mammographically detectable secondary breast cancer in women with a personal history of the disease. 


Jane Lange received her PhD in biostatistics from the University of Washington in 2014 and is currently a post-doctoral fellow at GHRI. Her methodology interests include multistate modeling, longitudinal data analysis, and methods suitable for observation data. Currently, her post-doctoral fellowship is funded mainly via the Breast Cancer Surveillance consortium, but her interests include behavioral medicine as well as cancer epidemiology. 

Past Seminars and events

Tuesday, Nov. 11, 2014

Scientific seminar
The patient as agent: Examining the role of the "activated patient" in chronic illness care

Presented by Mark Sullivan, MD, PhD, UW professor of psychiatry and adjunct professor of bioethics and humanities

4 – 5 p.m., Room 1509A, Group Health Research Institute, 1730 Minor Ave., Seattle.


Patient-centered care for chronic illness is founded upon the informed and activated patient, but we are not clear what this means. We must understand patients as subjects who know things and as agents who do things. Bioethics has urged us to respect patient autonomy, but it has understood this autonomy narrowly in terms of informed consent for treatment choice.

In chronic illness care, the ethical and clinical challenge is to not just respect, but to promote patient autonomy, understood broadly as the patients’ overall agency or capacity for action. The primary barrier to patient action in chronic illness is not clinicians dictating treatment choice, but clinicians dictating the nature of the clinical problem.

Patients contribute not only values to clinical decisions, but facts about how illness impairs their capacity for action. The patient’s perspective on clinical problems is now often added to the objective-disease perspective of clinicians as health-related quality of life (HRQL). But HRQL is merely a hybrid transitional concept between disease-focused and health-focused goals for clinical care.

Truly patient-centered care requires a sense of patient-centered health that is perceived by the patient and defined in terms of the patient’s vital goals. Patient action is an essential means to this patient-centered health, as well as an essential component of this health. This action is not extrinsically motivated adherence, but intrinsically motivated striving for vital goals. Modern pathophysiological medicine has trouble understanding both patient action and health. The self-moving and self-healing capacities of patients can be understood only if we understand their roots in the biological autonomy of organisms. We must bridge between patients’ personal processes and impersonal disease processes without recourse to mind vs body dualism or the mysterious forces of vitalism.

Finally, we come to the policy implications of taking the patient as the primary definer, perceiver, and producer of health.

  1. Care will become patient-centered only when the patient is the primary customer of care.
  2. Professional health services are not the principal source of population health, and may lead to clinical, social and cultural iatrogenic injury.
  3. Health capability has many sources outside disease-focused health services, including exercise, education, and safe neighborhoods.
  4. Social justice demands equity in health capability more than equal access to health services.

Dr. Mark Sullivan received his MD and his PhD in Philosophy from Vanderbilt University. After completing an internship in Family Medicine at University of Missouri, he completed a residency in Psychiatry at the University of Washington in 1988. He is now Professor of Psychiatry and Adjunct Professor of Anesthesiology and Pain Medicine and Adjunct Professor of Bioethics and Humanities at the University of Washington. He has served as attending physician in the UW Center for Pain Relief for 25 years, where he is Co-Director of Behavioral Health Services. He has published more than 225 peer-reviewed articles, many on the interaction of mental health and physical health. He is currently completing a book, The Patient as Agent, for Oxford University Press.

Tuesday, Oct. 28, 2014

Scientific seminar
Sustainable well-being: Fixing a fragmented health care system using technology

Presented by Marc West, Consultant, Innovation Strategy, Group Health Physicians

4 – 5 p.m., Room 1509A, Group Health Research Institute, 1730 Minor Ave., Seattle.


The U.S. ranks last nationally in the Long, Healthy Productivity Lives metric in the Commonwealth Fund. Building on his vast experience in health care and his now personal experience with telehealth, Marc has envisioned a new way for coordinated care systems to support complex chronically ill, and ultimately other patients, to live full lives using technology to link providers and patients in new ways.

The Telehealth Accountable Care Organization (T-ACOTM) vision may provide a route for Washington state to improve the health care system and even close budget gaps by leveraging technology in progressive and pioneering ways, combined with proven population management tactics.

This presentation will outline the vision for the T-ACOTM, and demonstrate some of the technological components of the Imagine Telecommunication Telehealth System (ITTS), its technology bundle. It will consider data on potential target populations and impacts to cost of care, current regulatory requirements and research on the use of telehealth in health care to-date, and imagine how this vision could inform the future of health care, health information technology, and telecommunications in our state and beyond.


Marc West is currently working as a Consultant for Innovation Strategy for Group Health Physicians. He was diagnosed with ALS in 2011, and was the first recipient of the Inspirational Leadership Award in 2013. Marc served as executive vice president of Group Health Physicians (GHP) from 2005–2012, during which time his responsibilities also included Executive Vice President of Care Systems Development for Group Health Cooperative.

As the EVP of Group Health Physicians, Marc provided long-range strategic guidance to the GHP Board and led the Administrative Team in areas of Finance, Human Resources, and Information Technology. In his leadership role in Care Systems Development he was responsible for partnering with the health plan, group practice, and other divisions as they developed and implemented improvements in Group Health’s integrated care system. Prior to his current roles, Marc was chief financial and administrative officer for GHP and served in a variety of positions within Group Health Cooperative, including director of Regional Finance and Planning, manager of Business Systems, and regional cost consultant. He earned a bachelor's degree in business administration and accounting from the University of Washington in 1990, and completed a CPA certificate program in 1992. He completed his MBA degree from Kaplan University in April of 2011.

Monday, Oct. 20, 2014

Data and Analytics Fair

All are welcome at Group Health's Data and Analytics Fair, to be held at Group Health Cooperative Headquarters at 320 Westlake Avenue North in Seattle. The event will take place from 1:30 – 4 p.m. in rooms W281, W283, and W285. Registration is now closed for posters and presentations. For more information about the event, please contact Christopher Mack.

Tuesday, October 14, 2014

“Applying the Tools of Health Services and Operations Research to Designing and Evaluating the Patient-Centered Medical Home”

Room 1509A, Metropolitan Park East, 1730 Minor Ave., Seattle, WA 98101-1448: Paul Fishman, PhD, Senior Investigator at Group Research Institute and  Affiliate Associate Professor at the University of Washington's School of Public Health and Community Medicine. 

Abstract: Health services are financed, produced and delivered through a complex and multi-layered system whose constituent parts too often act independently of one other.  The lack of integrated and coordination among elements of the health services sector results in inefficiencies that lead to increased costs to producers and consumers and errors in care that effect patient health and safety.  In response to the challenges created or amplified by the way in which health services have been organized as well as by incentives contained in legislation at the federal and state levels the industry is attempting to recreate itself and build more financial and clinical integration between and among health services providers.  The industry has little evidence about how to effect this transformation and there are experiments throughout the country attempting to find ways to create a more efficient, safer and productive health care sector that is responsive to patient needs.

We present a research framework and initial results of collaboration between the economists, health services and operations researchers designed to identify and test opportunities for achieving the triple aims of lower cost, improved quality and better patient satisfaction that has been established as the outcome of a successful reform of the US health care system.  We present results of a model that capture the manner in which patients transition through the health care system that allows us to test for the impact of alternative delivery system design principles and identify opportunities for improved cost results and health outcomes.

Sept. 28–30, 2014

1st Seattle Symposium on Health Care Data Analytics: Confronting statistical challenges of using health record data to conduct health research.
Hosted by GHRI and the University of Washington Department of Biostatistics.

June 10, 2014

“On the front lines of a paradigm shift: The value of qualitative perspectives for the emerging field of Patient Centered Outcomes Research (PCOR).”

Clarissa Hsu, PhD, Research Associate/Research Program Manager, Center for Community Health and Evaluation (CCHE), Group Health Research Institute

Abstract: Patient centered care and patient centered research has received increasing attention as a result of the Affordable Care Act’s (ACA) focus on the Triple Aim of improving the quality of patient care, advancing population-based health and cost containment. By prescribing the formation of the Patient Centered Outcomes Research Institute (PCORI) and related funds for dissemination of PCOR results, the ACA is supporting the emergence of PCOR as a new approach to health care research. PCOR asks both researchers and those delivering care to fundamentally rethink their assumptions and values regarding what they know and the methods used to gather evidence to inform future innovations aimed at improving health and health care.

Qualitative methods use open-ended inquiry and observation to learn about lived experiences and how people make sense and derive meaning from those experiences. As such, these methods offer unique perspectives and approaches that are well suited to gaining new insights about what matters to patients and how patients and clinical staff experience health care processes.

This presentation will explore the different ways that qualitative work can inform both the way we conceptualize PCOR and insights that are generated in this emerging field. Dr. Hsu will highlight several projects she has led or worked on that have an explicit focus on PCOR and/or patient perspectives. Her goal is to provide concrete examples of how our work at GHRI is intersecting with the field of PCOR and launch a dialog around how researchers at GHRI can continue to be leaders and innovators in this exciting new area of research.

May 8, 2014

15th Annual Hilde and Bill Birnbaum Endowed Lecture and Panel Discussion
“Affordable health care for all: How will our nation and region deliver on the promise?”

April 17–Fri. April 18, 2014

2014 Latino Health Conference
Seattle, Wash.

Mon., Feb. 3, 2014

“Development and evaluation of prognostic models in chronic heart failure.”
Benjamin French, PhD, Assistant Professor, Biostatistics and Epidemiology, University of Pennsylvania

Abstract: Recent clinical research regarding chronic heart failure has focused on identifying prognostic models to predict future morbidity and mortality. Accurate models could be used to counsel patients more effectively and to guide personalized treatment strategies over time. Development of a prognostic model typically requires specification of an appropriate statistical model and is most frequently achieved using standard regression methods such as Cox regression. The prognostic model can be evaluated using time-dependent receiver operating characteristic methods, or risk reclassification methods adapted for censored survival outcomes. In this seminar, Dr. French will

  • illustrate the application of these methods to derive a multi-biomarker risk score and evaluate its prediction accuracy for terminal events in chronic heart failure: death, cardiac transplantation, and placement of a ventricular assist device.
  • compare the performance of alternative model accuracy methods using simulations, both to evaluate power and to quantify the potential loss in accuracy associated with use of a sub-optimal regression model to derive the multi-marker score.
  • discuss ongoing research directions, including the development of new methods to evaluate prediction accuracy for recurrent events (e.g., hospitalization) and their linked outcomes (e.g., total cost and length of hospital stay).

2013 events