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Johns Hopkins Center for Population Health Information Technology




The center is committed to promoting the importance of adapting state-of-the-art Health IT and help lead policies regarding Population Health IT.

Featured Articles Led by or Contributed to by the CPHIT Team

Trends and Patterns of Social History Data Collection Within an Electronic Health Record. 2023. Population Health Management.

Development and assessment of a natural language processing model to identify residential instability in electronic health records’ unstructured data: a comparison of 3 integrated healthcare delivery systems. 2022. Jamia Open. 

Assessing the Added Value of Vital Signs Extracted from Electronic Health Records in Healthcare Risk Adjustment Models. 2022. Risk Management and Healthcare Policy.

Impact of Social Needs in Electronic Health Records and Claims on Healthcare Utilization and Costs Risk-Adjustment Models Within Medicaid Population. 2022. Population Health Management. 

Impact of Social Determinants of Health on Improving the LACE Index for 30-Day Unplanned Readmission Prediction. 2022. Jamia Open.

Automated Patient Self-Scheduling: Case Study. 2022. JAMIA. 

Comparing Person-Level Matching Algorithms to Identify Risk Across Disparate Datasets Among Patients With a Controlled Substance Prescription: Retrospective Analysis. 2022. JAMIA Open.

Outcomes of In-Person and Telehealth Ambulatory Encounters During COVID-19 Within a Large Commercially Insured Cohort. 2022. JAMA Netw Open. 

Comparing and Validating Medication Complexity from Insurance Claims Against Electronic Health Records. 2022. J Manag Care Spec Pharm.

Assessing the Added Value of Blood Pressure Information Derived from Electronic Health Records in Predicting Healthcare Cost and Utilization. 2021. Population Health Management.

Internet Access, Social Risk Factors, and Web-Based Social Support Seeking Behavior: Assessing Correlates of the “Digital Divide” Across Neighborhoods in The State of Maryland. 2021. J Med Syst.

Development of Measurable Criteria to Identify and Prioritize Patients for Inclusion in Comprehensive Medication Management Programs within Primary Care Settings. 2021. JMCP.

Differential Impact of Mitigation Policies and Socioeconomic Status on COVID-19 Prevalence and Social Distancing in the United States. 2021. BMC Public Health. 

Assessing the Impact of Social Needs and Social Determinants of Health on Healthcare Utilization: Using Patient-and Community-Level Data. 2021. Population Health Management. 

Social and Behavioral Variables in the Electronic Health Record: A Path Forward to Increase Data Quality and Utility. 2021. Population Health Management.

In-Person and Telehealth Ambulatory Contacts in a Large US Insured Cohort Before and During the COVID-19 Pandemic. 2021. JAMA Network Open.

Comparing the Predictive Effects of Patient Medication Adherence Indices in Electronic Health Record and Claims-Based Risk Stratification Models. 2021. Population Health Management.

Early Relaxation of Community Mitigation Policies and Risk of COVID-19 Resurgence in the United States. 2021. Preventative Medicine.

Performance of a Predictive Model versus Prescription-Based Thresholds in Identifying Patients at Risk of Fatal Opioid Overdose. 2021. Substance Use & Misuse. 

Geriatric Syndrome Risk Factors Among Hospitalized Postacute Medicare Patients. 2020. AJMC.

The Impact of Various Risk Assessment Time Frames on the Performance of Opioid Overdose Forecasting Models. 2020. Medical Care.

Integrating E-Prescribing and Pharmacy Claims Data for Predictive Modeling: Comparing Costs and Utilization of Health Plan Members Who Fill Their Initial Medications with Those Who Do Not. 2020. JPMC.

Assessing the Impact of Neighborhood Socioeconomic Characteristics on COVID-19 Prevalence Across Seven States in the United States. 2020. Frontiers.

Including Social and Behavioral Determinants in Predictive Models: Trends, Challenges, and Opportunities. 2020. JMIR.

A Revised Classification Algorithm for Assessing Emergency Department Visit Severity of Populations. 2020. AJMC.

Predictors of Overdose Death Among High-Risk Emergency Department Patients With Substance-Related Encounters: A Data Linkage Cohort Study. 2020. Annals of Emergency Medicine.

Opioid Agonist Treatment And Fatal Overdose Risk In A State-Wide US Population Receiving Opioid Use Disorder Services. 2020. Addiction.

Characterizing Inpatient Hospitalizations for Hidradenitis Suppurativa In The United States. 2020. JAAD.

Healthcare Costs and Utilization among Patients Hospitalized for Malignant Pleural Effusion. 2020. Respiration.

Health Education Serious Games Targeting Health Care Providers, Patients, and Public Health Users: Scoping Review. 2020. JMIR.

Use of Opioid Overdose Deaths Reported in One State’s Criminal Justice, Hospital, and Prescription Databases to Identify Risk of Opioid Fatalities. 2019. JAMA Internal Medicine.

A Predictive Risk Model for Nonfatal Opioid Overdose In A Statewide Population Of Buprenorphine Patients. 2019. Drug and Alcohol Dependence.

Assessing the Availability of Data on Social and Behavioral Determinants in Structured and Unstructured Electronic Health Records: A Retrospective Analysis of a Multilevel Health Care System. 2019. JMIR Medical Informatics.

Integrating Social and Behavioral Determinants of Health into Population Health Analytics: A Conceptual Framework and Suggested Road Map. 2019. Population Health Management.

Exploring the Use Of Machine Learning For Risk Adjustment: A Comparison Of Standard And Penalized Linear Regression Models In Predicting Health Care Costs In Older Adults. 2019. PloS one.

Identifying Vulnerable Older Adult Populations By Contextualizing Geriatric Syndrome Information In Clinical Notes Of Electronic Health Records. 2019. JAMIA.

Comorbidity Characterization Among eMERGE Institutions: A Pilot Evaluation with the Johns Hopkins Adjusted Clinical Groups® System. 2019. AMIA.

Comparing Survey-Based Frailty Assessment to Medicare Claims in Predicting Health Outcomes and Utilization in Medicare Beneficiaries. 2019. Journal of Aging and Health.

A Public Health Perspective On Using Electronic Health Records To Address Social Determinants Of Health: The Potential For A National System Of Local Community Health Records In The United States. 2019. International Journal of Medical Informatics.

Methods and Risks of Bias in Natural Experiments in Obesity: Opportunities for the Future Informed by a Systematic Review. 2019. Obesity.

Discovering the Unclassified Suicide Cases Among Undetermined Drug Overdose Deaths Using Machine Learning Techniques. 2019. Suicide & Life-Threatening Behavior.

Assessing the Availability of Data on Social and Behavioral Determinants in Structured and Unstructured Electronic Health Records: A Retrospective Analysis of a Multilevel Health Care System. 2019. JMIR.

Comparing the Trends of Electronic Health Record Adoption Among Hospitals of the United States and Japan. 2019. Journal of Medical Systems.

Evaluation of Multidisciplinary Collaboration in Pediatric Trauma Care Using EHR Data. 2019. JAMIA.

Extraction of Geriatric Syndromes from Electronic Health Record Clinical Notes: Assessment of Statistical Natural Language Processing Methods. 2019. JMIR.

The Impact of Social Determinants of Health on Hospitalization in the Veterans Health Administration. 2019. American Journal of Preventative Medicine.

The PsyTAR Dataset: From Patients Generated Narratives To A Corpus Of Adverse Drug Events And Effectiveness Of Psychiatric Medications. 2019. Data Brief.

A Systematic Approach for Developing A Corpus Of Patient Reported Adverse Drug Events: A Case Study For SSRI And SNRI Medications. 2019. Journal of Biomedical Informatics.




More Publications by CPHIT Faculty and Staff

Lemke, K. W., Gudzune, K. A., Kharrazi, H., & Weiner, J. P. (2018). Assessing markers from ambulatory laboratory tests for predicting high-risk patientsAm J Manag Care24(6), e190-e195.

Kan, H. J., Kharrazi, H., Leff, B., Boyd, C., Davison, A., Chang, H. Y., ... & Lasser, E. C. (2018). Defining and assessing geriatric risk factors and associated health care utilization among older adults using claims and electronic health records. Medical care56(3), 233-239.

Kharrazi, H., Chang, H. Y., Heins, S. E., Weiner, J. P., & Gudzune, K. A. (2018). Assessing the Impact of Body Mass Index Information on the Performance of Risk Adjustment Models in Predicting Health Care Costs and UtilizationMedical care56(12), 1042-1050.

Gamache, R., Kharrazi, H., & Weiner, J. P. (2018). Public and population health informatics: The bridging of big data to benefit communities. Yearbook of medical informatics27(01), 199-206.

Kharrazi, H., & Weiner, J. P. (2018). A practical comparison between the predictive power of population-based risk stratification models using data from electronic health records versus administrative claims: setting a baseline for future EHR-derived risk stratification modelsMedical care56(2), 202-203.

Kharrazi, H., Anzaldi, L. J., Hernandez, L., Davison, A., Boyd, C. M., Leff, B., ... & Weiner, J. P. (2018). The value of unstructured electronic health record data in geriatric syndrome case identificationJournal of the American Geriatrics Society66(8), 1499-1507.

Chang, H., Kharrazi, H., Bodycombe, D., Weiner, J. P., & Alexander, G. C. (2018). Health Care Costs and Utilization Associated with High Risk Prescription Opioid use. Value in Health21, S123.

Chang, H. Y., Murimi, I., Faul, M., Rutkow, L., & Alexander, G. C. (2018). Impact of Florida's prescription drug monitoring program and pill mill law on high?risk patients: A comparative interrupted time series analysis. Pharmacoepidemiology and drug safety27(4), 422-429.

Kan, H. J., Dyagilev, K., Schulam, P., Saria, S., Kharrazi, H., Bodycombe, D., ... & Curtis, J. R. (2018). Factors associated with physicians’ prescriptions for rheumatoid arthritis drugs not filled by patientsArthritis research & therapy20(1), 79.

Durojaiye, A. B., Puett, L. L., Levin, S., Toerper, M., McGeorge, N. M., Webster, K. L., ... & Gurses, A. P. (2018). Linking Electronic Health Record and Trauma Registry Data: Assessing the Value of Probabilistic Linkage. Methods of information in medicine.

Kharrazi, H., Gonzalez, C. P., Lowe, K. B., Huerta, T. R., & Ford, E. W. (2018). Forecasting the maturation of electronic health record functions among US hospitals: retrospective analysis and predictive model. Journal of medical Internet research20(8).

Karami, A., Dahl, A. A., Turner-McGrievy, G., Kharrazi, H., & Shaw Jr, G. (2018). Characterizing diabetes, diet, exercise, and obesity comments on TwitterInternational Journal of Information Management38(1), 1-6.

Kharrazi, H., Lasser, E. C., Yasnoff, W. A., Loonsk, J., Advani, A., Lehmann, H. P., ... & Weiner, J. P. (2017). A proposed national research and development agenda for population health informatics: summary recommendations from a national expert workshop. Journal of the American Medical Informatics Association24(1), 2-12.

Hatef, E., Kharrazi, H., VanBaak, M. F., Ferris, L., Mertz, K., Perman, C., ... & Weiner, J. P. (2017). A state-wide health IT infrastructure for population health: building a community-wide electronic platform for Maryland’s all-payer global budgetOnline journal of public health informatics9(3).

Hatef, Elham, Jonathan P. Weiner, and Hadi Kharrazi. "A Public Health Perspective on Using Electronic Health Records to Address Social Determinants of Health: The Potential for a National System of Local Community Health Records in the United States." International Journal of Medical Informatics(2019). Click link for PDF

Anzaldi LJ*, Davison A, Boyd C, Leff B, Kharrazi H. Comparing clinician descriptions of frailty and geriatric syndromes using electronic health records: A retrospective cohort study. BMC Geriatrics. 2017; 17(247): 1-7 (doi: 10.1186/s12877-017-0645-7)

Bae J, Ford EW, Kharrazi H, Huerta TR. Electronic medical record reminders and smoking cessation activities in primary care. Addictive Behaviors. 2017; 16(77): 203-209 (doi: 10.1016/j.addbeh.2017.10.009)

Hatef E, Lasser EC, Kharrazi H, Perman C, Montgomery R, Weiner JP. A population health measurement framework: evidence-based metrics for assessing community-level population health in the global budget context. Population Health Management. 2017; (doi: 10.1089/pop.2017.0112) [in-press]

Chang HY, Richards TM, Shermock KM, Elder-Dalpoas S, Kan H, Alexander CG, Weiner JP, Kharrazi H. Evaluating the impact of prescription fill rates on risk stratification model performance. Medical Care. 2017; (doi: 10.1097/MLR.0000000000000825) [in-press]

Kharrazi H, Chi W, Chang HY, Richards TM, Gallagher JM, Knudson SM, Weiner JP. Comparing population-based risk-stratification model performance using data extracted from electronic health records versus administrative claims. Medical Care. 2017; 55(8): 789-796 (doi: 10.1097/MLR.0000000000000754)

Kotz, David, Carl A. Gunter, Santosh Kumar, and Jonathan P. Weiner., "Privacy and Security in Mobile Health: A Research Agenda", Computer, vol.49, no. 6, pp. 22-30, June 2016, doi:10.1109/MC.2016.185

Kharrazi, H., Lasser, EC., Yasnoff, WA., Loonsk, J., Advani, A., Lehmann, HP., Chin, DC., Weiner, JP., A proposed National Research and Development Agenda for Population Health Informatics: Summary Recommendations from a National Expert Workshop. JAMIA 2016;0; 1-12 Click for link to this paper

Lehmann HP, Dixon BE, Kharrazi H. Public Health and Epidemiology Informatics: Recent Research and Trends in the United States. Yearb Med Inform 2015 Aug 13;10(1):199-206.  PubMed PMID: 26293869.

Swain MJ, Kharrazi H.  Feasibility of 30-day Hospital Readmission Prediction Modeling based on Health Information Exchange data.  Int J Med Inform. 2015 Sep 14. PMID: 26412010

Jones, JB, Weiner, JP, Shah, NR, Stewart, WF. The Wired Patient: Patterns of Electronic Patient Portal Use Among Patients with Cardiac Disease or Diabetes., JMIR Vol 17, No2 (2015) February

Kharrazi H, and Weiner, JP.  IT-enabled Community Health Interventions: Challenges, Opportunities, and Future Directions. eGEMs (Generating Evidence & Methods to improve patient outcomes). 2014. Vol. 2: Iss. 3, Article 1. DOI: Available at:

Pfoh ER, Mojtabai R, Bailey J, Weiner JP, Dy SM. Conformance to Depression Process Measures of Medicare Part B Beneficiaries in Primary Care Settings. J Am Geriatr Soc. 2015 Jun 26.

Pollack CE, Lemke KW, Roberts E, Weiner JP. Patient sharing and quality of care: measuring outcomes of care coordination using claims data. Med Care. 2015 Apr;53(4):317-23.

Jones JB, Weiner JP, Shah NR, Stewart WF. The wired patient: patterns of electronic patient portal use among patients with cardiac disease or diabetes. J Med Internet Res. 2015 Feb 20;17(2):e42. doi: 10.2196/jmir.3157. PubMed PMID: 25707036; PubMed Central PMCID: PMC4376207.

Adrion ER, Aucott J, Lemke KW, Weiner JP. Health care costs, utilization and patterns of care following Lyme disease. PLoS One. 2015 Feb 4;10(2):e0116767. doi: 10.1371/journal.pone.0116767. eCollection 2015. PubMed PMID: 25650808; PubMed Central PMCID: PMC4317177.

Kharrazi H, Weiner JP. IT-enabled Community Health Interventions: Challenges, Opportunities, and Future Directions. EGEMS (Wash DC). 2014 Oct 30;2(3):1117.

Devaraj S, Sharma S, Fausto D, Viernes S & Kharrazi H. Barriers and Facilitators to Clinical Decision Support System Adoption: A Systematic Review. Journal of Business Administration Research . July 2014. Vol 3, No. 2. Available at:

Schulam P, Wigley F, and Saria S. Clustering Longitudinal Clinical Marker Trajectories from Electronic Health Data: Applications to Phenotyping and Endotype Discovering. Conference on Artificial Intelligence (AAAI). 2015. Available at:

Bates DW, Saria S, Ohno-Machado L, Shah A, Escobar G. Big data in health care: Using analytics to identify and manage high-risk and high-cost patients. Health Aff (Millwood). 2014 Jul;1;33(7):1123-31 PMID: 25006137

Kharrazi H, Wang C, Scharfstein D. Prospective EHR-based clinical trials: the challenge of missing data. J Gen Intern Med. 2014;29(7):976-8. PMID: 24839057

Segal JB, Bridges JF, Chang HY, et al. Identifying possible indicators of systematic overuse of health care procedures with claims data. Med Care. 2014;52(2):157-63. PMID: 24374418+

Schmittdiel JA, Adams SR, Segal J, et al. Novel use and utility of integrated electronic health records to assess rates of prediabetes recognition and treatment: brief report from an integrated electronic health records pilot study. Diabetes Care. 2014;37(2):565-8. PMID: 24271190

Bates DW, Saria S, Ohno-machado L, Shah A, Escobar G. Big data in health care: using analytics to identify and manage high-risk and high-cost patients. Health Aff (Millwood). 2014;33(7):1123-31. PMID: 25006137

Kharrazi H, Wang C, Scharfstein D. Prospective EHR-based clinical trials: the challenge of missing data. J Gen Intern Med. 2014;29(7):976-8. PMID: 24839057

Paul MJ, Dredze M. Discovering health topics in social media using topic models. PLoS ONE. 2014;9(8):e103408. PMID: 25084530

Buttorff C, Tunis SR, Weiner JP. Encouraging value-based insurance designs in state health insurance exchanges. Am J Manag Care. 2013;19(7):593-600. PMID: 23919422

Chang HY, Richards TM, Clark JM, Weiner JP, Segal JB. Change in claims-based diabetes medications is a diabetes improvement indicator. Am J Manag Care. 2013;19(7):572-8. PMID: 23919420

Lu AS, Kharrazi H, Gharghabi F, Thompson D. A Systematic Review of Health Videogames on Childhood Obesity Prevention and Intervention. Games Health J. 2013 Jun;2(3):131-141. Review. PubMed PMID: 24353906; PubMed Central PMCID: PMC3833378.

Mehrabi S, Mohammadi I, Kunjan K, Kharrazi H. Effects of data transformation methods on classification of patients diagnosed with myocardial infarction. Stud Health Technol Inform. 2013;192:1203. PubMed PMID: 23920977.

Weiner JP. A conversation with Jonathan P. Weiner, DrPH. Information technology required. Interview by John Marcille. Manag Care. 2013;22(6):33-7. PMID: 23837288

Davidoff AJ, Zuckerman IH, Pandya N, et al. A novel approach to improve health status measurement in observational claims-based studies of cancer treatment and outcomes. J Geriatr Oncol. 2013;4(2):157-65. PMID: 23795223

Weiner JP, Goodwin SM, Chang HY, et al. Impact of bariatric surgery on health care costs of obese persons: a 6-year follow-up of surgical and comparison cohorts using health plan data. JAMA Surg. 2013;148(6):555-62. PMID: 23426865

Segal JB, Bridges JF, Chang HY, et al. Identifying possible indicators of systematic overuse of health care procedures with claims data. Med Care. 2014;52(2):157-63. PMID: 24374418+

Chang HY, Bodycombe DP, Huang WF, Weiner JP. Risk-Adjusted Resource Allocation: Using Taiwan's National Health Insurance as an Example. Asia Pac J Public Health. 2013; PMID: 23343643

Pollack CE, Weissman GE, Lemke KW, Hussey PS, Weiner JP. Patient sharing among physicians and costs of care: a network analytic approach to care coordination using claims data. J Gen Intern Med. 2013;28(3):459-65. PMID: 22696255

Wu AW, Kharrazi H, Boulware LE, Snyder CF. Measure once, cut twice--adding patient-reported outcome measures to the electronic health record for comparative effectiveness research. J Clin Epidemiol. 2013;66(8 Suppl):S12-20. PMID: 23849145

Ellaway RH, Graves L, Greene PS. Medical education in an electronic health record-mediated world. Med Teach. 2013;35(4):282-6. PMID: 23464893

Payne TH, Bates DW, Berner ES, et al. Healthcare information technology and economics. J Am Med Inform Assoc. 2013;20(2):212-7. PMID: 22781191

Paxton C, Niculescu-mizil A, Saria S. Developing predictive models using electronic medical records: challenges and pitfalls. AMIA Annu Symp Proc. 2013;2013:1109-15. PMID: 24551396

Chang HY, Weiner JP, Richards TM, Bleich SN, Segal JB. Validating the adapted Diabetes Complications Severity Index in claims data. Am J Manag Care. 2012;18(11):721-6. PMID: 23198714

Weiner JP. Doctor-patient communication in the e-health era. Isr J Health Policy Res. 2012;1(1):33. PMID: 22929000

Weiner JP, Fowles JB, Chan KS. New paradigms for measuring clinical performance using electronic health records. Int J Qual Health Care. 2012;24(3):200-5. PMID: 22490301

Barry CL, Weiner JP, Lemke K, Busch SH. Risk adjustment in health insurance exchanges for individuals with mental illness. Am J Psychiatry. 2012;169(7):704-9. PMID: 22581274

Chang HY, Weiner JP, Richards TM, Bleich SN, Segal JB. Predicting costs with diabetes complications severity index in claims data. Am J Manag Care. 2012;18(4):213-9. PMID: 22554010

Wharam JF, Weiner JP. The promise and peril of healthcare forecasting. Am J Manag Care. 2012;18(3):e82-5. PMID: 22435964

Weiner JP, Trish E, Abrams C, Lemke K. Adjusting for risk selection in state health insurance exchanges will be critically important and feasible, but not easy. Health Aff (Millwood). 2012;31(2):306-15. PMID:22323160

Lemke KW, Weiner JP, Clark JM. Development and validation of a model for predicting inpatient hospitalization. Med Care. 2012;50(2):131-9. PMID: 22002640

Kharrazi H, Chisholm R, Vannasdale D, Thompson B. Mobile personal health records: an evaluation of features and functionality. Int J Med Inform. 2012;81(9):579-93. PMID: 22809779

Sockolow PS, Bowles KH, Lehmann HP, Abbott PA, Weiner JP. Community-based, interdisciplinary geriatric care team satisfaction with an electronic health record: a multimethod study. Comput Inform Nurs. 2012;30(6):300-11. PMID: 22411417

Nichols GA, Desai J, Elston lafata J, et al. Construction of a multisite DataLink using electronic health records for the identification, surveillance, prevention, and management of diabetes mellitus: the SUPREME-DM project. Prev Chronic Dis. 2012;9:E110. PMID: 22677160

Sockolow PS, Weiner JP, Bowles KH, Lehmann HP. A new instrument for measuring clinician satisfaction with electronic health records. Comput Inform Nurs. 2011;29(10):574-85. PMID: 21543972

Chang HY, Lee WC, Weiner JP. Comparison of alternative risk adjustment measures for predictive modeling: high risk patient case finding using Taiwan's National Health Insurance claims. BMC Health Serv Res. 2010;10:343. PMID: 21172009

Clark JM, Chang HY, Bolen SD, Shore AD, Goodwin SM, Weiner JP. Development of a claims-based risk score to identify obese individuals. Popul Health Manag. 2010;13(4):201-7. PMID:20443968

Gibbons MC, Wilson RF, Samal L, et al. Impact of consumer health informatics applications. Evid Rep Technol Assess (Full Rep). 2009;(188):1-546. PMID: 20629477

Jensen RE, Chan KS, Weiner JP, Fowles JB, Neale SM. Implementing electronic health record-based quality measures for developmental screening. Pediatrics. 2009;124(4):e648-54. PMID: 19786425

Weiner JP, Yeh S, Blumenthal D. The impact of health information technology and e-health on the future demand for physician services. Health Aff (Millwood). 2013;32(11):1998-2004. PMID: 24191092

Dambita N, Streshley L, Ajayi O, Lehmann H. Leveraging IT to deliver primary care -- the case of the Democratic Republic of the Congo (age-old problem, new paradigm). AMIA Annu Symp Proc. 2008;:919.