Spring 2002 - Volume 6 Number 2

Original Research

A Clinical Information System Research Landscape
Dean F Sittig, PhD; Brian L Hazlehurst, PhD; Ted Palen, MD, PhD; John Hsu, MD; Holly Jimison, PhD; Mark C Hornbrook, PhD
This is the first of two articles on the development of a research agenda for clinical information systems. In Part I, the authors describe a framework for identifying key questions that will impact the delivery of care and improve outcomes for patients.

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Clinical Contributions

Pain Management and Chronic Disease Self-Management Programs Win James A Vohs Awards
Catherine Steadman
The Annual James A Vohs Award for Quality recognizes quality-of-care and service achievements within KP. This introduction is an overview of the award and this year's winners.

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Vohs Award Winner- Multiple-Region Category: Chronic Disease Self-Management Program: From Development to Dissemination
David S Sobel, MD, MPH; Kate R Lorig, RN, DrPH; Mary Hobbs, MPH
Since the Chronic Disease Self-Management Program was developed in 1990, it has been extended to multiple KP regions. Success is shown in improvement of care and reduced costs. This article describes the formation, implementation and evaluation of this first-ever multiregional winner of the Vohs Award.

Vohs Award Winner- Single-Region Category: KPNW Integrated Pain Management Program
Marilee Donovan, RN, PhD; Paul O Jacobs, MD; Martha Blake, MBA
The KPNW Regional Operations Group chartered the Integrated Pain Management Project in 1995. This comprehensive and successful program is described in detail with data supporting improvements in multiple areas.

Corridor Consult: What a Busy Primary Care Provider Wants to Know About Pain Management
Paul O Jacobs, MD
Recent advances in science have dramatically changed the field of pain management and our long-held beliefs in appropriate treatment options. This article offers guidelines for primary care physicians to consider and sheds some light upon these complex decisions.

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Multidisciplinary Group Intervention for Fibromyalgia: A Study of Psychiatric Symptom and Functional Disability Outcomes
BArne Beck, PhD; George Breth, MD; Jennifer Ellis, MBA; Rob Hays, MD, MA; Colleen Miller, RNP; Noah Reaven, PhD
A multidisciplinary group clinic model for patients with FMS that may effectively improve outcomes in both mental health and functional status is described.

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Evidence-Based Clinical Vignettes from the Care Management Institute: Alzheimer's Disease and Dementia
Richard D Della Penna, MD; Kate S Heumann, MPP; Glenn Gade, MD; Ingrid Venohr, PhD, RN

Based on the Care Management Institute and Interregional Guideline Steering Committee-approved Guideline for the Diagnosis and Treatment of Dementia, this article presents a case example highlighting key points in screening, diagnosis and treatment of patients with dementia.
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Strengthening Self-Care, Self-Management, and Shared Decision-Making Practices Throughout Kaiser Permanente
Laurie Doyle, MPH, CHES; Jodi S Joyce, BS, BSN, MBA; William Caplan, MD; Pamela Larson, MPH

This position paper was written for use at an interregional symposium in September 2001. The paper is excerpted in this article with tables summarizing key aspects from various viewpoints.
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Kaiser Permanente Medicine 50 Years Ago: The Development of Sex
Edgar J Schoen, MD

In 1959, Dr Schoen wrote of disorders in sex differentiation from the perspective of the scientific advances made in the previous decade. This Commentary, written by the original author, details the scientific advances since he wrote the original article.
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Health Systems

CPC Corner: Improving Satisfaction for Physicians and Patients: Managing Patients' Perceptions of Appointment Time
Barbra E Miner, MA; Edward C Wang, MD; Noachim S Marco, MD

Based on physicians' experience and patient feedback, this "quick-tips" guide has been created to assist in managing patients' perception of their time with their physician and to improve the quality of interactions with patients.
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Innovative KP Research in Clinician-Patient Communication: Deepening our Understanding of the Clinician-Patient Relationship.
Sue Hee Sung, MPH; Terry Stein, MD

This article describes the four programs selected to study the effectiveness of various educational programs and services designed to improve clinician-patient communication.
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Commentary

Shame-Based Versus Pride-Based Reporting.
Kristen Hannum Gregory, PhD

Performance reporting can be described on a continuum from "shame-based" to "pride-based." This commentary describes the impact performance reporting systems have on an individual and on an organization's culture.
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Editors' Comments

Using Performance Reports to Build a Winning Team
Lee Jacobs, MD, Associate Editor
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Abstracts

Abstracts of articles authored or coauthored by Permanente clinicians
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Letters to the Editor

Letters from our readers

Book Reviews

What are you feeling, Doctor? Identifying and avoiding defensive patterns in the consultation
John Salinsky & Paul Sackin
Book review by Albert Ray, MD
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Whatever Happened to Daddy's Little Girl? The Impact of Fatherlessness on Black Women
Jonetta Rose Barras.
Book review by Paul Jimenez
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Blind Eye: How The Medical Establishment Let A Doctor Get Away With Murder
James B Stewart.
Book review by KM Tan, MD
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Soul of the Healer

A Reflection
John H Cochran, Jr, MD
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"Vanessa"
Don Wissusik, MA, MS
Art

"Martinez Waterfront"
Natalya Nicoloff, NP
Art

"Flowers in a Copper Vase"
Anna Marie Aguiar
Art

"Cloistered"
Anna Marie Aguiar
Art

"Be Sun Smart"
Judith Schiffner, MD
Art

Notes from the Valley of the Shadow
Shelley Sewall, PhD
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The Lighter Side of Medicine

The Humerus Zone