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

Dumitrescu L, Ritchie MD, Denny JC, El Rouby NM, McDonough CW, Bradford Y, Ramirez AH, Bielinski SJ, Basford MA, Chai HS, Peissig P, Carrell D, Pathak J, Rasmussen LV, Wang X, Pacheco JA, Kho AN, Hayes MG, Matsumoto M, Smith ME, Li R, Cooper-DeHoff RM, Kullo IJ, Chute CG, Chisholm RL, Jarvik GP, Larson EB, Carey D, McCarty CA, Williams MS, Roden DM, Bottinger E, Johnson JA, de Andrade M, Crawford DC. Genome-wide study of resistant hypertension identified from electronic health records. PLoS One. 2017 Feb 21;12(2):e0171745. doi: 10.1371/journal.pone.0171745. PubMed

Watson NL, Heffner JL, McClure JB, Mull KE, Bricker JB. Differential prevalence of established risk factors for poor cessation outcomes among smokers by level of social anxiety. Am J Addict. 2017 Feb 13. doi: 10.1111/ajad.12509. [Epub ahead of print]. PubMed

Keith RE, Crosson JC, O'Malley AS, Cromp D, Taylor EF. Using the Consolidated Framework for Implementation Research (CFIR) to produce actionable findings: a rapid-cycle evaluation approach to improving implementation. Implement Sci. 2017 Feb 10;12(1):15. doi: 10.1186/s13012-017-0550-7. PubMed

Sanderson SC, Brothers KB, Mercaldo ND, Clayton EW, Antommaria AH, Aufox SA, Brilliant MH, Campos D, Carrell DS, Connolly J, Conway P, Fullerton SM, Garrison NA, Horowitz CR, Jarvik GP, Kaufman D, Kitchner TE, Li R, Ludman EJ, McCarty CA, McCormick JB, McManus VD, Myers MF, Scrol A, Williams JL, Shrubsole MJ, Schildcrout JS, Smith ME, Holm IA. Public attitudes toward consent and data sharing in biobank research: a large multi-site experimental survey in the US. Am J Hum Genet. 2017 Feb 4. pii: S0002-9297(17)30021-6. doi: 10.1016/j.ajhg.2017.01.021. [Epub ahead of print]. PubMed

Wagner EH, Flinter M, Hsu C, Cromp D, Austin BT, Etz R, Crabtree BF, Ladden MD. Effective team-based primary care: observations from innovative practices. BMC Fam Pract. 2017 Feb 2;18(1):13. doi: 10.1186/s12875-017-0590-8. 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)

Andrea Hartzler, PhD

Assistant Investigator
206-287-2030
hartzler.a@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
klasnja.p@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
coley.r@ghc.org

Curriculum vitae (CV)