A5082659251- Primary Care and Health Outcomes
- Chronic Disease Management Strategies
- Marine animal studies overview
- Healthcare Policy and Management
- Migration, Aging, and Tourism Studies
- Patient Satisfaction in Healthcare
- Arctic and Antarctic ice dynamics
- Cryospheric studies and observations
- Health Systems, Economic Evaluations, Quality of Life
- Geriatric Care and Nursing Homes
- Healthcare Systems and Technology
- Diabetes Management and Education
- Pharmaceutical and Antibiotic Environmental Impacts
- Global Cancer Incidence and Screening
- Environmental Toxicology and Ecotoxicology
- Microwave Engineering and Waveguides
- BRCA gene mutations in cancer
- Patient-Provider Communication in Healthcare
- Cervical Cancer and HPV Research
- Intergenerational Family Dynamics and Caregiving
- Aging, Elder Care, and Social Issues
- Assembly Line Balancing Optimization
- Toxic Organic Pollutants Impact
- Frailty in Older Adults
- Wildlife-Road Interactions and Conservation
York University
2021-2025
Environment and Climate Change Canada
2023
Flinders University
2019-2023
University of Manitoba
2023
Aboriginal Affairs Northern Dev Canada
2023
Crown-Indigenous Relations and Northern Affairs Canada
2023
Mississippi State University
2022
The University of Sydney
2019
Kaiser Permanente Washington Health Research Institute
2012-2018
Group Health Cooperative
2008-2015
The HMO Research Network (HMORN) Virtual Data Warehouse (VDW) is a public, non-proprietary, research-focused data model implemented at 17 health care systems across theUnited States. HMORN has created governance structure and specified policies concerning the VDW’s content, development, implementation, quality assurance. extracted from VDW have been used by thousands of studies published in peer-reviewed journal articles. Advances software supporting delivery claims processing availability...
Decision aids are evidence-based sources of health information that can help patients make informed treatment decisions. However, little is known about how decision affect care use when they implemented outside randomized controlled clinical trials. We conducted an observational study to examine the associations between introducing for hip and knee osteoarthritis rates joint replacement surgery costs in a large system Washington State. Consistent with prior trials, our introduction was...
Climate warming is causing global biodiversity loss, with impacts to ecosystem function. Warming in the Arctic outpaces averages, and projected declines Arctic-sea ice have led predictions of local extirpations for ice-associated species. Polar bears (Ursus maritimus Phipps, 1774) exemplify these challenges as they rely on sea much their life cycle. Further, polar are harvested throughout range, increasing importance robust population monitoring face climate warming. We conducted an aerial...
Diagnostic test sets are a valuable research tool that contributes importantly to the validity and reliability of studies assess agreement in breast pathology. In order fully understand strengths weaknesses any study, however, methods should be reported. this paper we provide step-by-step description used create four complex for study diagnostic among pathologists interpreting biopsy specimens. We use newly developed Guidelines Reporting Reliability Agreement Studies (GRRAS) as basis report...
<h3>PURPOSE</h3> The patient-centered medical home (PCMH) is being rapidly deployed in many settings to strengthen US primary care, improve quality, and control costs; however, evidence supporting this transformation still lacking. We describe the Group Health experience attempting replicate effects on health care use seen a PCMH prototype clinic via systemwide spread using Lean as change strategy. <h3>METHODS</h3> used an interrupted time series analysis with patient-month unit of over...
To assess the impact on health care cost and quality among seniors of a patient-centered medical home (PCMH) pilot at Group Health Cooperative, an integrated system in Washington State.A prospective before-and-after evaluation experience receiving primary services 1 clinic compared with enrolled remaining 19 clinics owned operated by Health. Analyses secondary data were conducted for 1,947 PCMH 39,396 control clinics. Patient was based survey collected from 487 668 2 specific that selected...
<h3>PURPOSE</h3> Telephone- and Internet-based communication are increasingly common in primary care, yet there is uncertainty about how these forms of affect demand for in-person office visits. We assessed whether use copay-free secure messaging telephone encounters was associated with visit a population diabetes. <h3>METHODS</h3> used an interrupted time series design patient-quarter unit analysis. Secondary data from 2008–2011 spanned 3 periods before, during, after patient-centered...
The patient-centered medical home model relies on team-based care for meaningful practice transformation. This article adds to the literature importance of teams in primary by exploring barriers and facilitators establishing high functioning during a transformation process.
<b>PURPOSE</b> Improving patient-doctor continuity is one goal of the medical home, but achieving this may require physicians to reduce panel size. This article examines impact on patient experience and utilization Group Health Cooperative's process reassigning patients new as part their home demonstration project. <b>METHODS</b> work represents a subanalysis pilot evaluation. Study participants include 8,005 adults who received primary care in 2006 2007 at an urban practice owned operated...
Health care leaders and policymakers are turning to the patient-centered medical home (PCMH) model contain costs, improve quality of care, create a more positive primary work environment. We describe how Group Health, an integrated delivery system, developed implemented PCMH intervention that included standardized structural practice level changes. This was spread diverse set 26 practices in 14 months using Lean Management principles. Health's experience provides valuable insights can be...
In a pair of randomized controlled trials in the Kaiser Permanente delivery system Colorado 1990s, group visits for older adults (monthly non-disease-specific medical appointments cohort patients led by primary care teams) were proven to reduce costs, decrease hospitalizations, and improve patient provider satisfaction. As part translational effort, this visit intervention was replicated Seattle, Washington, log total healthcare costs measured first year intervention. Utilization physician...
Health systems increasingly recognize the impact of social determinants health such as access to housing, transportation, and nutritious food. Lay workers have been used address patients' through resource referral goal setting in targeted populations, individuals with diabetes. However, we know no studies that evaluate this type role for a general primary care population.To assess implementation Community Resource Specialist (CRS) Kaiser Permanente Washington.We analyzed data from staff...
BACKGROUND To the authors' knowledge, few studies to date have examined adherence recommended guidelines for follow‐up and outcomes after an unsatisfactory Papanicolaou (Pap) test (UPT) with liquid‐based technologies. METHODS Within 4 US health plans, median time percentage of patients testing by 120 days was calculated a UPT. Multivariable analyses evaluated association between clinical factors testing. The authors compared risk diagnosis cervical intraepithelial neoplasia type 2 or worse...
Background: Chemotherapy data are important to almost any study on cancer prognosis and outcomes. However, chemotherapy obtained from tumor registries may be incomplete, abstracting directly medical records can expensive time consuming. Methods: We evaluated the accuracy of using automated clinical capture administrations in a cohort 757 ovarian patients enrolled 7 health plans HMO Cancer Research Network. calculated sensitivity specificity with 95% confidence intervals extracted 3 sources...
Understanding how animals use information about their environment to make movement decisions underpins our ability explain drivers of and predict animal movement. Memory is the cognitive process that allows species store experienced landscapes, however, remains an understudied topic in ecology. By studying select for familiar locations, visited recently past, we can gain insight they local multiple memory types. In this study, analyzed movements a migratory mule deer ( Odocoileus hemionus )...
BACKGROUND Cervical cancer screening and follow‐up guidelines have changed considerably in recent years, but to the authors' knowledge few published reports exist estimate impact of these changes community‐based settings. The authors examined patterns results cervical testing over a decade 4 geographically diverse US health care systems inform future evaluation resulting from increased uptake human papillomavirus (HPV) vaccination. METHODS studied women aged 21 65 years who were members one...
BACKGROUND Papanicolaou (Pap) testing has transitioned from conventional preparations (CPs) to liquid‐based (LBPs) because of the perceived superiority LBPs. Many studies conclude that LBPs reduce unsatisfactory Pap tests; however, some believe evidence substantiating this claim is weak. The authors studied effect transition CPs on proportion tests in 4 health care systems United States participating National Institutes Health‐funded Screening Effectiveness and Research Community‐Based...