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Articles by Jan Greene
Kaiser Permanente receives $12 million award for suicide prevention study
Division of Research–led study will evaluate multiple strategies to reach patients struggling with suicidal thoughts Kaiser Permanente researchers and clinical partners have received a $12 million, 5-year award from the Patient-Centered Outcomes Research Institute (PCORI) to evaluate strategies to overcome common challenges patients face when struggling with suicide risk.
Autism study supports role of elevated blood sugar in pregnancy
Kaiser Permanente analysis finds female children could have higher likelihood of autism if their mother had a metabolic disorder early in pregnancy A new analysis of Kaiser Permanente Northern California mothers and children adds to evidence that maternal blood sugar metabolism in pregnancy could play a role in the likelihood a child has of being diagnosed with a neurodevelopmental disorder.
Uterine fibroid incidence differs by race, ethnicity
Kaiser Permanente study offers new, more detailed information about Asian subgroup rates Women in several Asian subgroups are more likely than white women to be diagnosed with uterine fibroids, according to new Kaiser Permanente research. The study, published in JAMA Network Open, also confirmed the known, much higher fibroid rates among Black women.
STI prevention method shows promise in curbing infections in groups at high risk
Study finds less syphilis, chlamydia, and gonorrhea in Kaiser Permanente Northern California patients who used doxycycline Taking the antibiotic doxycycline after sexual exposures for prevention of sexually transmitted infections (STIs) — a method known as doxyPEP — was effective in reducing cases of syphilis, chlamydia and gonorrhea in patients at risk for STIs, according to a new study of Kaiser Permanente patients.
More women, young adults being diagnosed with autism
Health systems, doctors need to be prepared for more autistic patients of all ages, Kaiser Permanente authors suggest Updated Nov. 5, 2024 A large analysis of autism spectrum disorder diagnoses over more than 10 years finds significant increases in young adults, women, and children in some racial or ethnic groups. The study was led by Kaiser Permanente researchers and was published in JAMA Network Open.
Pharmacists help people with serious mental illness overcome barriers to good health
Research finds innovative Kaiser Permanente program promotes behaviors that protect health for people with schizophrenia, bipolar disorder Telehealth visits with a specially trained pharmacist resulted in better medication adherence and diabetes screening for people with serious mental illness who are enrolled in an innovative Kaiser Permanente Northern California (KPNC) program, according to a study published in the Journal of Clinical Psychiatry.
Autism-related traits more likely in children of mothers with prenatal depression
Kaiser Permanente investigators say more research is needed to explain the connection An analysis of parents and their children in communities across the country finds a greater likelihood of autism-related traits in children of mothers who experienced depression while they were pregnant. The Kaiser Permanente-led study used data from the federally funded Environmental influences of Child Health Outcomes (ECHO) program and was published August 1 in Autism Research.
No serious side effects for mRNA COVID-19 vaccines in young children
Kaiser Permanente researchers led analysis of large, diverse group of young children, mostly age 4 and under By Jan Greene A review of more than 245,000 doses of mRNA COVID-19 vaccines given to young children (most of them age 4 and younger) found no indications of serious side effects. The study, published June 6 in Pediatrics, was led by the Kaiser Permanente Division of Research in partnership with the Centers for Disease Control and Prevention.
Public health group honors Kaiser Permanente researcher with Young Professional Award
Cannabis, Maternal/infant health, Perinatal health, Uncategorized Researcher and psychologist Kelly Young-Wolff recognized by American Public Health Association Maternal and Child Health Section By Jan Greene Kelly Young-Wolff, PhD, MPH, a clinical psychologist and Kaiser Permanente Division of Research investigator who studies substance use among vulnerable populations, including pregnant women, was awarded the 2022 Young Professional Award by the American Public Health Association (APHA)...
Intervening with at-risk adolescents shows long-term benefits
Kaiser Permanente study followed teens’ substance use, mood disorders for 7 years after brief intervention, referral to treatment By Jan Greene A long-term Kaiser Permanente study following 1,851 adolescents who reported substance use or mood problems at a pediatric clinic found those who had access to a brief intervention and referral to treatment were less likely to have a related diagnosis 7 years later, in their 20s.
Study offers reassurance to pregnant patients using biologic medications for autoimmune disorders
Kaiser Permanente research finds no increase in reactions to certain childhood vaccinations among their children By Jan Greene A new study led by Kaiser Permanente researchers provides reassurance about vaccinating infants whose mothers took biologic medications for an autoimmune disorder during pregnancy. Increasing numbers of women are taking biologic response modifiers (BRMs) during pregnancy for conditions such as rheumatoid arthritis, psoriasis, and inflammatory bowel disease.
Alameda Main Library Opens New Retail Bookstore
Alameda has a new place to purchase used books, and it’s inside the library. The Friends of the Alameda Free Library (FAL) has opened a small space near the café in the Main Library where patrons can find donated books for sale. FAL converted a donated books sorting space in the Main Library into a retail space. The new space is called Books for Friends (BFF). The selection in BFF is curated by longtime professional bookseller Philip Barry.
New tool for early identification of COVID-19 surges
Kaiser Permanente develops simple method to help hospitals and communities identify early signs of a large community spread of infectious diseases By Jan Greene Health systems could use data from routine clinical care to identify the onset of upcoming COVID-19 surges as many as 6 weeks before they occur, Kaiser Permanente researchers found in a study published in the journal BMJ Open.
Study finds no link between autism and common antidepressant when used in pregnancy
Kaiser Permanente analysis does find more autism among children of women with psychiatric conditions By Jan Greene Mothers with psychiatric conditions such as depression and anxiety were more likely to have a child with autism than mothers without such conditions, new research led by Kaiser Permanente investigators finds. But the analysis found no association between use of common antidepressants by pregnant women and likelihood of autism in their children.
Mental health treatment rate rose early in pandemic
Kaiser Permanente analysis finds 7% increase in visits over same period in 2019 By Jan Greene A detailed analysis of mental health treatment trends during the COVID-19 pandemic found a 7% increase in visits during the initial shelter-in-place period in 2020, compared with the same 3-month period in 2019. The study, published in The Journal of Clinical Psychiatry March 3, examined patient visits for psychiatric diagnoses among members of Kaiser Permanente Northern California.
Kaiser Permanente data key to nation’s COVID-19 vaccine surveillance strategy
Vaccine Study Center to lead effort searching medical records for serious reactions By Jan Greene Senior Communications Consultant New vaccines recently approved to protect against COVID-19 disease were developed at record speed. To support public confidence in the massive vaccination effort under way throughout the country, it will be particularly important to track any potential serious reactions in patients who are inoculated.
Kaiser Permanente Northern California deepens its COVID-19 research agenda
Division of Research investigators examine the pandemic’s effects from all angles By Jan Greene Looking back at the first 6 months of the COVID-19 pandemic, it may seem an eternity to those whose lives have been upended by stay-at-home orders. But medical researchers see the passage of time differently, with their work sped up to an unprecedented rate by the urgency of learning how to treat and prevent COVID-19 disease. Alan S.
Teens, parents, physicians support screening young people for gender identity, study suggests
Kaiser Permanente physician researchers say screening could improve care for gender diverse adolescents By Jan Greene Teenagers who question their gender identity may not feel comfortable bringing up the issue with their doctors. New research suggests that adding gender identity questions to a pre-visit screening could make those conversations easier. Kaiser Permanente adolescent medicine specialist Josephine Lau, MD In a study published Sept.
Study identifies geographic clusters of pregnant women who missed flu shots
Women with fewer prenatal visits less likely to get vaccinated while pregnant, Kaiser Permanente research finds. By Jan Greene A Kaiser Permanente analysis of women who did not get flu shots during their pregnancies found the women clustered in geographic “hot spots.” These women tended to have fewer prenatal medical visits and live in low-income neighborhoods.
Clinicians need to build bridges to transition care for young adults with autism
Kaiser Permanente research also finds young people with autism use more health care services By Jan Greene Autism spectrum disorder is usually diagnosed in childhood, but the behavioral and communication challenges typically continue into adulthood. People with autism often have accompanying medical and psychiatric conditions, making for a complex history to pass on when transitioning from pediatric to adult care.
Genetic regions associated with corneal thickness identified by Kaiser Permanente researchers
Study offers insights into eye disease risk, particularly for African Americans By Jan Greene A new Kaiser Permanente study identifies regions of the human genome related to central corneal thickness (CCT), offering new insights into risk for certain eye diseases. The research finds people with greater African ancestry are more likely to have thinner corneas, which could put them at risk for the progressive eye disease keratoconus.
Work-based diabetes prevention programs in San Francisco show promising results
Both in-person and online programs helped people at risk for diabetes lose weight, Kaiser Permanente analysis finds By Jan Greene A Kaiser Permanente randomized controlled trial comparing an in-person diabetes prevention program with an online version found both helped San Francisco City and County employees at risk for developing diabetes to lose weight. Assiamira Ferrara, MD, PhD.
Telephone coaching helped pregnant women with overweight or obesity manage gestational weight gain
Participants in a Kaiser Permanente trial also improved key diabetes-related health metrics By Jan Greene Pregnant women with overweight or obesity better controlled their weight gain and improved health behaviors when they received a series of telephone sessions with a registered dietician, a new study from Kaiser Permanente finds. They were also better able manage their hormone levels related to insulin resistance, a potential precursor to diabetes.
People with medical conditions more likely to abstain from drinking heavily
But those with certain chronic conditions are more likely to have unhealthful alcohol use, Kaiser Permanente analysis finds By Jan Greene An analysis of 2.7 million Kaiser Permanente patients with one or more of 26 medical conditions finds that overall, they are less likely to drink alcohol heavily than people without those medical conditions.
COVID-19 clinical studies ramp up quickly at Kaiser Permanente Northern California
Drug clinical trials and blood plasma program are in place in multiple KPNC hospitals By Jan Greene In the race to find safe and effective treatments for seriously ill patients with COVID-19, Kaiser Permanente Northern California (KPNC) is enrolling patients in nationwide clinical trials and participating in an expanded access program of a novel treatment strategy that uses blood plasma from recovered patients. KPNC is expected to add additional clinical trials in coming weeks.
Depressed pregnant women more likely to eat poorer diets, Kaiser Permanente analysis finds
Poor nutrition during pregnancy can increase the risk of adverse health outcomes for mother and child By Jan Greene Pregnant women with depression were more likely to eat poor diets with a higher intake of empty calories and lower intake of greens, beans, and fruit, according to an analysis of 1,160 adult pregnant women who were treated at Kaiser Permanente Northern California. Of the study participants, 14% had depression.
Investigator pursues compelling questions about a poorly understood killer of hospital patients
$4 million in federal, foundation dollars support Kaiser Permanente physician-researcher’s work on sepsis By Jan Greene Sepsis is a stealthy killer of people of all ages who are hospitalized, regardless of illness. It can advance quickly; in a matter of hours, a patient can rapidly decline from mildly ill to suffering severe organ failure.
Women with colorectal cancer fare better if they have social support
Kaiser Permanente research suggests clinicians should ask about cancer patients’ support systems By Jan Greene New research from Kaiser Permanente finds that post-menopausal women with colorectal cancer were more likely to die from their disease or from any cause if they had low social support before diagnosis.
Chronic disease prevalence varies by Asian subgroup, Kaiser Permanente research finds
Findings suggest value in identifying Asian patients’ ethnic backgrounds in medical records By Jan Greene Asian-Americans from different parts of Asia have very different cardiovascular risk factors and chronic conditions such as diabetes, hypertension, and heart disease, research from the Kaiser Permanente Division of Research suggests.
More families are seeking care for gender-questioning children and teens
Kaiser Permanente pediatric transgender clinic sees the evidence in sharp rise in referrals By Jan Greene The number of children and teens referred for care at a Kaiser Permanente Northern California pediatric transgender clinic rose fourfold between 2015 and 2017 and continued to rise in 2018, new research shows.
Circle of Life honoree handles palliative challenges on Southern border
As a safety net hospital near the southern U.S. border, University Hospital in San Antonio, Texas, serves a complex patient population whose needs bring unique challenges, especially at the end of life. The teaching hospital has built a comprehensive palliative care program that brings culturally sensitive care to all its patients regardless of funding, residency, or citizenship.
EDs Getting Ready To Step Into Value-based Payment Waters
Emergency physicians are in an awkward spot when it comes to the value-based payment revolution. The emergency department is a potent symbol of old-fashioned, fee-for-service medicine—it’s expensive to run and it’s there, in part, to funnel patients into the hospital. These attributes have no place in the utopian vision of an efficient, high-quality, caring system that de-emphasizes expensive inpatient care and is supposed to swap out volume for value.
Even Small Employers Are Striking Out on Their Own
Stacie Gilles, human resources director for a 120-employee manufacturing company in Evansville, Ind., has been hearing for years that the runaway train of health insurance premiums was slowing. But her company had experienced no such relief, seeing their insurance bill go up by double digits each year, in part because of a few employees with serious and expensive health problems.
Interopera-impossibility?
It’s been a decade since Congress pledged $35 billion to drag America’s health care system into a digital 21st century by paying for thousands of hospital and physician practices to dump their walls of paper files and move the data into computers. A big chunk of that federal cash went to states to set up information exchanges to share patient data less clunkily. And yet, the fax machine, that relic from the 1980s, still clutters the counters of most medical practices.
Air Ambulance Turbulence: Consolidation, Cost Shifting, and Surprise Billing
The news has been replete with anecdotes about people suffering medical emergencies in rural places and needing to be airlifted out, and later facing gigantic bills for the helicopter transport to a hospital. A North Dakota woman who had a bad spill from a horseback ride owed $41,000. A Massachusetts woman received a jaw-dropping $474,725 bill for a medical Learjet ride from Kansas, where she got sick while attending a family wedding, back to Boston.
The Growing Appeal of On-the-job Health Care
Large employers are increasingly setting up health clinics on-site or near workplaces to encourage workers to keep on top of basic and chronic health problems in hopes of keeping medical costs down. A 2018 Mercer survey found a third of employers with 5,000 or more employees had clinics, up from a quarter in 2012.
U.S. Women’s Health: Not So Great
The U.S. health care system places some unique burdens on women, who use more health care services than men and manage most of the bills for their families, researchers at the Commonwealth Fund found when they crunched some numbers about women’s health for 11 industrialized countries.
HRT Has an Uncertainty Problem. Does Compounding Make It Worse?
JoAnn Pinkerton, MD, a gynecologist whose medical practice focuses on women’s midlife issues, worries about the millions of women who have sought out hormone therapy for their menopause symptoms from alternative practitioners because of fear of, disdain for, or distrust of Big Pharma and traditional hormone replacement therapy. Pinkerton tells of a 65-year-old patient whose naturopath put her on an estrogen product and an alternative anti-aging protocol for years.
Health Insurers in the House at HIMSS ’16 Meet
Among the nearly 42,000 people thronging the halls of the HIMSS meeting in Las Vegas this week are relative handfuls of folks from the nation’s health insurance industry. Presumably drawn by the increasing role of health IT in payers managing their members’ health and health costs, several companies were particularly prominent on the registration roster.
Why drug prices will continue to roil the waters-and why Scott Gottlieb, MD, will be in the center of the action
Throughout 2018, drug prices kept going up and outrage about it followed close behind. President Trump was one of the loudest voices complaining about rising prices on brand name prescription drugs and eye-popping price tags on new specialty drugs as they reached the market. And yet the list of potential fixes issued by the administration in May 2018 was long but did not include any price controls likely to draw significant fire from the influential pharmaceutical industry.
Why employers are offering more choices in health plans next year
American employers may have to juggle uncertainties, some good, some bad—an unpredictable White House, a limited labor force, a volatile stock market. But one thing they can count on: Health benefit costs will go up. Next year appears to be on track for more of the same. Employer surveys show a modest but steady uptick in employer health benefit spending for the coming year—about 5% on average. Much of that increase will go toward specialty drugs, the benefit with the biggest price hikes.
Nurse practitioners provide quality primary care at a lower cost than physicians
The growing need for primary care providers, particularly in rural areas, has opened the door for nurse practitioners to fill the void. Nursing students are rushing to get nurse practitioner degrees, and researchers are working to keep pace with studies. Most of the results provide evidence for expanded use of nurse practitioners in a variety of settings and perhaps especially in rural areas with a scarcity of primary care physicians.
Palliative care improves quality of life and symptoms
Offering emotional and physical comfort to seriously ill and dying people—the heart of palliative care—certainly seems like the right thing to do. Advocates think so and there’s now a body of evidence to support the provision of palliative care services, especially in hospitals.
Nurse Practitioners to Docs, Lawmakers: Give Us Our Independence
There is a map of Oklahoma color coded by the counties designated as medically underserved. The areas that don’t have enough doctors are green and those that do are gray. The map is pretty much all green, with a few gray patches around Oklahoma City and Tulsa. It’s a state with wide expanses of flat, grassy landscape dotted with cows and oil rigs but not many people and even fewer doctors. Many parts are so rural they don’t even have broadband internet.
Naloxone “Moral Hazard” Debate Pits Economists Against Physicians
An economics research article arguing that naloxone distribution has had unintended consequences, such as increased crime because opioid users didn’t die from their overdoses, prompted an emotional response from advocates for people with opioid use disorder and criticism about research methods from physicians. The authors’ conclusions were bold and strongly worded.
Blood Sugar Control Limbo: How Low To Go?
Reasonable minds can differ, and interpreting clinical evidence is no exception to the rule. But the stakes are particularly high when interpretations differ on evidence for treating diabetes, a condition affecting 30 million Americans and costing $245 billion annually, the CDC estimates. In March, the American College of Physicians (ACP) released a guideline recommending clinicians aim to achieve an HbA1c between 7% and 8% for most patients with type 2 diabetes.
Fall Prevention Hits Stumbling Blocks
A bad fall can become that disastrous inflection point of old age, the swerve into dependence, expensive care, and declining health. Numerous studies have suggested modest and inexpensive ways that falls can be prevented. Late last year, a meta-analysis published in JAMA that included more than 50 randomized trials showed that two interventions—exercise and vision correction—reduced the chances of falling by 38%.
When Value Is in the Eye Of the Patient
What is quality in medical care, and how do you measure it? To a physician, doing the job well may mean following practice guidelines carefully. To a patient, it could mean something quite different—whether the physician listens well or provides important test results promptly.
A Tall Order From a Cautionary Tale
Mistreated is a comprehensive and brilliant analysis of American health care by Robert Pearl, the CEO of the Kaiser Permanente Medical Group. The book’s subtitle aptly summarizes the author’s point of view: “Why We Think We’re Getting Good Treatment–and Why We’re Usually Wrong.” Pearl is unswerving about the necessity of preserving what is best—and even sacred—about the patient–physician relationship.
The Pap Test: 20th Century Success Story, 21st Century Has-Been
For women of a certain age, the Pap test is a yearly ritual to endure but also a chance to visit with their gynecologist and talk about the other lumps, bumps, and indignities of womanhood. And as uncomfortable as the exam may be, surely the women who have benefited from early detection of cervical cancer are grateful to the test’s inventor, George Papanicolaou, and those who championed his test into a major public health success story of the 20th century.
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