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Health Care Delivery and Policy Studies

 

Hospital Alternatives (HALT)

The SRI team will (a) assess results of previous internal and external deployments of alternatives to hospitalization, (b) define strategies to quantify the potential pool of Kaiser Permanente Northern California patients who would be eligible for such al...
Funder: Kaiser Foundation Hospitals
Investigator: Escobar, Gabriel

Reducing Treatment Risk in Older Patients with Diabetes: Comparative Effectiveness of Academic Detailing with and without Pre-Visit Patient Preparation

This study will compare the effect of two proven strategies (academic detailing alone versus academic detailing along with patient pre-visit preparation) on insulin de-prescribing rates among older patients with type 2 diabetes at high risk for insulin-re...
Funder: Patient-Centered Outcomes Research Institute
Investigator: Gilsanz, Paola; Grant, Richard

Complex Patients: DOR Research Team

Kaiser Permanente Northern California (KPNC) is implementing an intensive care management model (Care Plus) that integrates primary care providers with social workers, pharmacists, and care coordinators to improve health outcomes of medically and socially...
Funder: Kaiser Foundation Health Plan
Investigator: Grant, Richard

Use of Digital Information Technologies and Health Information Resources by Limited English Proficient Latino and Chinese Adult Members

The goal of this research ...
Funder: Garfield Memorial Fund
Investigator: Gordon, Nancy

Comparative Effectiveness of Real-Time Continuous Glucose Monitoring (CGM) Among Insulin-Treated Diabetes Patients from Kaiser Permanente Northern California

This study will characterize type 1 and type 2 diabetes patients initiating newly prescribed continuous glucose monitors and evaluate the impact of that initiation on key clinical and utilization-based outcomes, and whether that impact differs across clin...
Funder: Dexcom
Investigator: Karter, Andrew

Sepsis on FHIR

Overall goal is to define and refine the current epidemiology, clinical characteristics, and treatment practices in respiratory failure in late and moderately preterm infants. Specific aims are to determine that incidence and epidemiology of respiratory f...
Funder: Moore Foundation
Investigator: Liu, Vincent

Understanding and Informing Early Hospital Antibiotic Prescribing for Potential Infection

The goals of this study are to (1) examine temporal trends in early hospital antibiotic prescribing patterns over the past 5 years, to assess for unintended consequences associated with earlier antibiotics in severe sepsis/septic shock; (2) quantify the p...
Funder: Agency for Healthcare Research and Quality
Investigator: Liu, Vincent

Development, Reevaluation, and Implementation of Outcome/Efficiency Measures for Hospital and Eligible Clinicians

The goal of this project is to assist with measure development and testing for the Hospital-Wide Mortality (HWM) hybrid and HWM claims-only measures. This includes providing consulting support to the Yale Center for Outcomes Research and Evaluation team a...
Funder: Centers for Medicare and Medicaid Services
Investigator: Escobar, Gabriel

Metformin Initiation and Early Adherence among Kaiser Permanente Northern California Members with Newly Diagnosed Type 2 Diabetes

Aim 1: Identify patient-level predictors of metformin treatment during the year following type 2 diabetes diagnosis. Examined factors will include: demographics, such as age, race/ethnicity, gender, and rural versus urban; clinical characteristics...
Funder: Northern California Community Benefit Programs
Investigator: Gopalan, Anjali

Care System Analytics to Support Primary Care Patients with Complex Medical and Social Needs

This study will leverage the rich electronic data sources within Kaiser Permanente to create pragmatic tools for improving health and equity among primary care patients with the highest medical and social needs. Aim 1: Use advanced analytic methods to...
Funder: Agency for Healthcare Research and Quality
Investigator: Grant, Richard

Optimizing Medical Decision-Making for Older Patients with Type 2 Diabetes

Medicare-age patients with type 2 diabetes are projected to double in the next 25 years and have high rates of complications and adverse drug events. However, older patients are largely excluded from the major clinical trials of diabetes care. This lack o...
Funder: National Institute on Aging
Investigator: Karter, Andrew

Health Outcomes of Interest Validation of Serious Infections Among an Immunocompromised Population

Kaiser Permanente Northern California will participate with the FDA Sentinel to validate the diagnosis of health outcomes of interest.
Funder: U.S. Food and Drug Administration
Investigator: Herrinton, Lisa

Understanding Housing Insecurity and Risk for Homelessness in the Kaiser Permanente Northern California Member Population

This project will examine patient and community-level correlates of housing instability and homelessness using observational data sources. These formative analyses will develop variables to operationalize housing instability using administrative and clini...
Funder: Northern California Community Benefit Programs
Investigator: Schmittdiel, Julie

Comparative Effectiveness of Virtual Care in Dermatology for Diagnosing Rash

The benefit of teledermatology for triaging skin rashes is not adequately understood. The study will assess how implementation of teledermatology (technology and staffing) improves the effectiveness and efficiency of diagnosis, including wait time to diag...
Funder: The Permanente Medical Group
Investigator: Herrinton, Lisa

Targeting Cardiovascular Events to Improve Patient Outcomes After Sepsis

Sepsis is the most common illness leading to hospitalization in the United States, affecting more than 1 million Americans each year. While short-term mortality has improved over prior decades, sepsis survivors face numerous post-hospital sequelae that ne...
Funder: National Heart, Lung, and Blood Institute
Investigator: Liu, Vincent

Using EHR Audit Logs to Capture Diagnostic Pathways and Time to Diagnosis

Rapid expansions in the use of electronic health record (EHR) systems also contribute to large expansions in the availability of metadata. These highly granular metadata may prove particularly useful for understanding how frontline clinicians interact wit...
Funder: Gordon and Betty Moore Foundation
Investigator: Liu, Vincent

Assessing and Optimizing the Impact of an Electronic Clinical Decision Support Tool for Chest Pain Risk Stratification in the Emergency Department STEWARD Project (Phase 3)

Conducted with co-investigator Dustin G. Mark, MD, this study helps emergency physicians with estimates of individual patient risk for patients with chest pain. The research team will evaluate impacts on guideline-supported acute coronary syndrome evaluat...
Funder: The Permanente Medical Group
Investigator: Reed, Mary

It Takes a Network: A Network Science- and Command Center-Based Approach to Hospital Error Detection, Prevention, and Mitigation

​This project aims to develop a set of algorithms for generic error detection, prevention, and mitigation in the hospital setting. The goal is to develop algorithms that can operate in real time so as to support an existing infrastructure (the eHospita...
Funder: Kaiser Foundation Hospitals
Investigator: Escobar, Gabriel

The Initial Care of Younger Adults with Newly Diagnosed Type 2 Diabetes

​In a population of adults with newly diagnosed, early onset type 2 diabetes, this study will identify patient-, provider-, and system-level predictors of inadequate glycemic control within one year following diagnosis. A longitudinal, retrospective co...
Funder: National Institute of Diabetes and Digestive and Kidney Diseases
Investigator: Gopalan, Anjali

Similarities and Differences in Health Indicators and Health Care Use Among Asian Ethnic Groups

​This study will examine whether significant differences across Asian ethnic groups in prevalence of chronic diseases, behavioral/psychosocial risk factors, preventive service use, and patient portal use are masked when statistics are reported for “Asi...
Funder: Northern California Community Benefit Programs
Investigator: Gordon, Nancy

CORAL Meaningful Outcomes & Missed Opportunities

​A relatively small proportion of patients with complex needs represent a major source of cost and utilization. The fundamental principle that distinguishes complex needs patients from other high-cost patients with well-defined medical issues is that &...
Funder: Garfield Memorial Fund
Investigator: Grant, Richard

T32 Training Program in Diabetes Translational Research

Diabetes remains a leading cause of morbidity and mortality, and it is a significant burden to the U.S. health care system, patients, and their families. The knowledge and skills necessary to overcome the final translational block from evidence into pract...
Funder: National Institute of Diabetes and Digestive and Kidney Diseases
Investigator: Grant, Richard; Schmittdiel, Julie

Supplement to T32 Training Program in Diabetes Translational Research

This administrative supplement solicited by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) will provide two to six medical students with summer training opportunities in translational research. This supplement allows the exis...
Funder: National Institute of Diabetes and Digestive and Kidney Diseases
Investigator: Grant, Richard; Schmittdiel, Julie

Predicting and Reducing Future Health Disparities for U.S. Adults with Diabetes

​The clinical and financial impact of diabetes-related interventions and policies may not be quantifiable without the use of simulation models that reflect the long-term course of disease and its complications. Models of diabetes complications are used...
Funder: National Institute on Minority Health and Health Disparities
Investigator: Karter, Andrew

Identifying Pre-Sepsis Opportunities for Early, Targeted Intervention

​This project is designed to pursue pre-sepsis opportunities to identify patients at high-risk for sepsis and develop risk prediction models to mitigate the impact of impending sepsis by leveraging granular electronic health record data.


Funder: National Institute of General Medical Sciences
Investigator: Liu, Vincent
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