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Seattle-Denver Center of Innovation (COIN)


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COIN Investigators & Staff

COIN Investigators


Karin M. Nelson, MD, MSHS
Title: Professor of Medicine, Adjunct Professor of Health Services, University of Washington
Location: Seattle
University of Washington webpage
See Dr. Nelson's Dimensions profile that includes: publications, grants, datasets, patents and clinical trials
Karin (“Kari”) Nelson, MD, MSHS, is a general internist and health services researcher at the VA Puget Sound Health Care System. She is a Professor of Medicine in the University of Washington (UW) School of Medicine, Adjunct Professor in the UW School of Public Health and core investigator at the Seattle Health Services Research & Development (HSR&D) Center of Innovation (COIN).
Dr. Nelson is the director of the Primary Care Analytics Team (PCAT) for the VHA’s Office of Primary Care. As an investigator for the PACT national evaluation, she won the 2015 VHA HSR&D’s Best Research Paper of the Year Award for Nelson, et al. “Implementation of the Patient Centered Medical Home (PCMH) in the Veterans Health Administration (VHA)” published in JAMA Internal Medicine. Her primary research focus is in improving disease self-management, focusing on peer support interventions. She actively mentors many junior faculty and is Co-Director for the MD fellowship program in the Seattle HSR&D COIN. She is a primary care physician at the VA Puget Sound. Dr. Nelson received her medical degree from the University of Minnesota, and her Masters in Health Services from UCLA.

The following images visualize Dr. Nelson's work. The word cloud is drawn from publication titles. The research collaboration map shows research relationships (click the image to enlarge):

Dr. Nelson's publication titles indicate primary work is Veteran care
Word cloud from pub titles
Dr. Nelson's collaborations are primarily from the University of Washington
Research collaboration map
The following research fields have been used to summarize Dr. Nelson's publications and grants. The categories are based on 154 publications and 5 grants.
Publications Grants
Clinical Research Health Services
Health Services Clinical Research
Behavioral and Social Science Prevention
Prevention Cost Effectiveness Research
Mental Health Behavioral and Social Science
Cardiovascular Clinical Trials and Supportive Activities
Nutrition Comparative Effectiveness Research
Diabetes Cervical Cancer
Aging Cardiovascular
Clinical Trials and Supportive Activities Nutrition

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Recent Publications



O'Connor AW, Wong ES, Nelson KM, Sears JM, Helfrich CD. Patient Enrollment Growth and Burnout in Primary Care at the Veterans Health Administration. J Gen Intern Med. 2023 Jan 25. doi: 10.1007/s11606-023-08034-5. Epub ahead of print. PMID: 36697928
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O'Connor AW, Helfrich CD, Nelson KM, Sears JM, Singh H, Wong ES. Changes in electronic notification volume and primary care provider burnout. Am J Manag Care. 2023 Jan;29(1):57-63. doi: 10.37765/ajmc.2023.89304. PMID: 36716155
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Spece LJ, Weppner WG, Weiner BJ, Collins M, Adamson R, Berger DB, Nelson KM, McDowell J, Epler E, Carvalho PG, Woo DM, Donovan LM, Feemster LC, Au DH, Au DH, Sayre G. Primary Care Provider Experience With Proactive E-Consults to Improve COPD Outcomes and Access to Specialty Care. Chronic Obstr Pulm Dis. 2022 Dec 5. doi: 10.15326/jcopdf.2022.0357. Epub ahead of print. PMID: 36472622.
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Gray KE, Silvestrini M, Ma EW, Nelson KM, Bastian LA, Voils CI. Gender differences in social support for diabetes self-management: A qualitative study among veterans. Patient Educ Couns. 2022 Nov 23;107:107578. doi: 10.1016/j.pec.2022.107578. Epub ahead of print. PMID: 36463824.
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Schuttner L, Lee JR, Hockett Sherlock S, Ralston JD, Rosland AM, Nelson K, Simons C, Sayre GG. Primary Care Physician Perspectives on the Influence of Patient Values, Health Priorities, and Preferences on Clinical Decision-Making for Complex Patients with Multimorbidity: A Qualitative Study. Risk Manag Healthc Policy. 2022 Nov 16;15:2135-2146. doi: 10.2147/RMHP.S380021. PMCID: PMC9675988. PMID: 36415219.
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Deeds SA, Moore CB, Gunnink EJ, Wheat CL, Robinson AE, Bomsztyk MD, Geyer JR, Chen A, Godbout RM, Nelson KM, Dominitz JA, Reddy A. Implementation of a mailed faecal immunochemical test programme for colorectal cancer screening among Veterans. BMJ Open Qual. 2022 Nov;11(4):e001927. doi: 10.1136/bmjoq-2022-001927. PMCID: PMC9670919. PMID: 36384879
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Callegari L, Benson S, Mahorter S, Nelson K, Arterburn D, Hamilton A, Taylor L, Hunter-Merrill R, Gawron L, Dehlendorf C, Borrero S. Evaluating the MyPath web-based reproductive decision support tool in VA primary care: Protocol for a pragmatic cluster randomized trial. Contemp Clin Trials. 2022 Sep 27:106940. doi: 10.1016/j.cct.2022.106940. Epub ahead of print. PMID: 36179982
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Hagan S, Nelson K. Are Current Guidelines Perpetuating Weight Stigma? A Weight-Skeptical Approach to the Care of Patients with Obesity. J Gen Intern Med. 2022 Sep 22. doi: 10.1007/s11606-022-07821-w. Epub ahead of print. PMID: 36138274
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Chen A, Beste LA, Strack K, Geyer J, Wheat C, Nelson K, Reddy A. COVID-19 Vaccinations Among US Veterans with Mental Illness: a Retrospective Cohort Study. J Gen Intern Med. 2022 Aug 15. doi: 10.1007/s11606-022-07763-3. Epub ahead of print. PMID: 35970960
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Medich M, Rose D, McClean M, Nelson K, Stewart G, Ganz DA, Yano EM, Stockdale SE. Predictors of VA Primary Care Clerical Staff Burnout Using the Job Demands-Resources Model. J Ambul Care Manage. 2022 Aug 4. doi: 10.1097/JAC.0000000000000431. Epub ahead of print. PMID: 35943358
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Stockdale SE, Rose DE, McClean M, Rosland AM, Chang ET, Zulman DM, Stewart G, Nelson KM. Factors Associated With Patient-Centered Medical Home Teams' Use of Resources for Identifying and Approaches for Managing Patients With Complex Needs. J Ambul Care Manage. 2022 Jul-Sep 01;45(3):171-181. doi: 10.1097/JAC.0000000000000418. PMID: 35612388.
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Schuttner L, Hockett Sherlock S, Simons CE, Johnson NL, Wirtz E, Ralston JD, Rosland AM, Nelson K, Sayre G. My Goals Are Not Their Goals: Barriers and Facilitators to Delivery of Patient-Centered Care for Patients with Multimorbidity. J Gen Intern Med. 2022 May 23:1–8. doi: 10.1007/s11606-022-07533-1. Epub ahead of print. PMCID: PMC9126696. PMID: 35606644.
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Leung LB, Rubenstein LV, Jaske E, Wheat CL, Nelson KM, Felker BL. Contrasting Care Delivery Modalities Used by Primary Care and Mental Health Specialties in VA's Telehealth Contingency Staffing Program During the COVID-19 Pandemic. J Gen Intern Med. 2022 Apr 19:1–4. doi: 10.1007/s11606-022-07527-z. Epub ahead of print. PMCID: PMC9017959. PMID: 35441301
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Au DH, Collins MP, Berger DB, Carvalho PG, Nelson KM, Reinke LF, Goodman RB, Adamson R, Woo DM, Rise PJ, Coggeshall SS, Plumley RB, Epler EM, Moss BR, McDowell JA, Weppner WG. Health System Approach to Improve COPD Care After Hospital Discharge: Stepped Wedge Clinical Trial. Am J Respir Crit Care Med. 2022 Mar 25. doi: 10.1164/rccm.202107-1707OC. Epub ahead of print. PMID: 35333140.
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Gray KE, Rao M, Gunnink E, Eschenroeder L, Geyer JR, Nelson KM, Reddy A. Home Telehealth in the Veterans Health Administration: Trends and Correlates of Length of Enrollment from 2010 to 2017. J Gen Intern Med. 2022 Mar 1:1–8. doi: 10.1007/s11606-022-07452-1. Epub ahead of print. PMCID: PMC8886698. PMID: 35230624
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Edmonds AT, Rhew IC, Jones-Smith J, Chan KCG, Nelson K, Williams EC. Patient-centered primary care and receipt of evidence-based alcohol-related care in the national Veterans Health Administration. J Subst Abuse Treat. 2022 Feb 2:108709. doi: 10.1016/j.jsat.2021.108709. Epub ahead of print.
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Leung LB, Rubenstein LV, Jaske E, Taylor L, Post EP, Nelson KM, Rosland AM. Association of Integrated Mental Health Services with Physical Health Quality Among VA Primary Care Patients. J Gen Intern Med. 2022 Feb 9. doi: 10.1007/s11606-021-07287-2. Epub ahead of print. PMID: 35141854.
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Moldestad M, Sayre G, Rinne S, Kaboli PJ, Reddy A, Sanders KM, Mao J, Henrikson NB, Sterling R, Nelson KM, Wong ES. Perspectives on Training and Working in the VHA: Implications for Primary Care Physician Recruitment and Retention. Acad Med. 2022 Feb 8. doi: 10.1097/ACM.0000000000004619. Epub ahead of print. PMID: 35139527.
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Schuttner L, Hockett Sherlock S, Simons C, Ralston JD, Rosland AM, Nelson K, Lee JR, Sayre G. Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study. BMC Prim Care. 2022 Feb 5;23(1):25. doi: 10.1186/s12875-022-01633-x. PMID: 35123398.
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Hysong SJ, Arredondo K, Hughes AM, Lester HF, Oswald FL, Petersen LA, Woodard L, Post E, DePeralta S, Murphy DR, McKnight J, Nelson K, Haidet P. An evidence-based, structured, expert approach to selecting essential indicators of primary care quality. PLoS One. 2022 Jan 18;17(1):e0261263. doi: 10.1371/journal.pone.0261263. PMCID: PMC8765671. PMID: 35041671.
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Schuttner L, Haraldsson B, Maynard C, Helfrich CD, Reddy A, Parikh T, Nelson KM, Wong E. Factors Associated With Low-Value Cancer Screenings in the Veterans Health Administration. JAMA Netw Open. 2021 Oct 1;4(10):e2130581. doi: 10.1001/jamanetworkopen.2021.30581. PMID: 34677595.

Beste LA, Chen A, Geyer J, Wilson M, Schuttner L, Wheat C, Rojas J, Nelson K, Reddy A. Best Practices for an Equitable Covid-19 Vaccination Program. NEJM Catal Innov Care Deliv. 2021 Sep 15;2(10):10.1056/CAT.21.0238. doi: 10.1056/CAT.21.0238. PMCID: PMC8443122.

Gray KE, Hoerster KD, Taylor L, Krieger J, Nelson KM. Improvements in physical activity and some dietary behaviors in a community health worker-led diabetes self-management intervention for adults with low incomes: results from a randomized controlled trial. Transl Behav Med. 2021 Aug 23:ibab113. doi: 10.1093/tbm/ibab113. Epub ahead of print. PMID: 34424331.

Apaydin EA, Rose DE, McClean MR, Yano EM, Shekelle PG, Nelson KM, Stockdale SE. Association between care coordination tasks with non-VA community care and VA PCP burnout: an analysis of a national, cross-sectional survey. BMC Health Serv Res. 2021 Aug 13;21(1):809. doi: 10.1186/s12913-021-06769-7. PMCID: PMC8361617. PMID: 34384398

Sterling R, Rinne ST, Reddy A, Moldestad M, Kaboli P, Helfrich CD, Henrikson NB, Nelson KM, Kaminetzky C, Wong ES. Identifying and Prioritizing Workplace Climate Predictors of Burnout Among VHA Primary Care Physicians. J Gen Intern Med. 2021 Jul 29:1–8. doi: 10.1007/s11606-021-07006-x. Epub ahead of print. PMCID: PMC8321506. PMID: 34327656

Reddy A, Nelson KM, Wong ES. Primary Care Spending in the Veterans Health Administration in 2014 and 2018. JAMA Netw Open. 2021 Jul 1;4(7):e2117533. doi: 10.1001/jamanetworkopen.2021.17533. PMID: 34279651

Nelson K, Reddy A, Stockdale SE, Rose D, Fihn S, Rosland AM, Stewart G, Denietolis A, Curtis I, Mori A, Rubenstein L. The Primary Care Analytics Team: Integrating research and clinical care within the Veterans Health Administration Office of Primary Care. Healthc (Amst). 2021 Jun;8 Suppl 1:100491. doi: 10.1016/j.hjdsi.2020.100491. Epub 2021 Jun 23. PMID: 34175100

Callegari LS, Nelson KM, Arterburn DE, Dehlendorf C, Magnusson SL, Benson SK, Schwarz EB, Borrero S. Development and Pilot Testing of a Patient-Centered Web-Based Reproductive Decision Support Tool for Primary Care. J Gen Intern Med. 2021 Feb 4. doi: 10.1007/s11606-020-06506-6. Epub ahead of print. PMID: 33538956



Slightam C, Risbud R, Guetterman TC, Nevedal AL, Nelson KM, Piette JD, Trivedi RB. Patient, caregiving partner, and clinician recommendations for improving heart failure care in the Veterans Health Administration. Chronic Illn. 2020 Oct 28:1742395320966366. doi: 10.1177/1742395320966366. Epub ahead of print. PMID: 33115281

Deeds SA, Hagan SL, Geyer JR, Vanderwarker C, Grandjean MW, Reddy A, Nelson KM. Leveraging an electronic health record note template to standardize screening and testing for COVID-19. Healthc (Amst). 2020 Sep;8(3):100454. doi: 10.1016/j.hjdsi.2020.100454. Epub 2020 Jul 22. PMCID: PMC7375319. PMID: 32919584

Simonetti JA, Clinton WL, Taylor L, Mori A, Fihn SD, Helfrich CD, Nelson K. The impact of survey nonresponse on estimates of healthcare employee burnout. Healthc (Amst). 2020 Sep;8(3):100451. doi: 10.1016/j.hjdsi.2020.100451. Epub 2020 Aug 2. PMID: 32919589

Reddy A, Gunnink E, Deeds SA, Hagan SL, Heyworth L, Mattras TF, Nelson KM. A rapid mobilization of 'virtual' primary care services in response to COVID-19 at Veterans Health Administration. Healthc (Amst). 2020 Dec;8(4):100464. doi: 10.1016/j.hjdsi.2020.100464. Epub 2020 Aug 18. PMCID: PMC7434426. PMID: 32992109

Schuttner L, Wong ES, Rosland AM, Nelson K, Reddy A. Association of the Patient-Centered Medical Home Implementation with Chronic Disease Quality in Patients with Multimorbidity. J Gen Intern Med. 2020 Oct;35(10):2932-2938. doi: 10.1007/s11606-020-06076-7. Epub 2020 Aug 6. PMCID: PMC7572962. PMID: 32767035

Chang ET, Zulman DM, Nelson KM, Rosland AM, Ganz DA, Fihn SD, Piegari R, Rubenstein LV. Use of General Primary Care, Specialized Primary Care, and Other Veterans Affairs Services Among High-Risk Veterans. JAMA Netw Open. 2020 Jun 1;3(6):e208120. doi: 10.1001/jamanetworkopen.2020.8120. PMCID: PMC7324956. PMID: 32597993

Yoon J, Leung LB, Rubenstein LV, Nelson KM, Rose DE, Chow A, Stockdale S. Greater Patient-Centered Medical Home Implementation Was Associated with Lower Attrition from VA Primary Care. Healthcare. 2020 Jun;8(2):100429. doi: 10.1016/j.hjdsi.2020.100429. Epub 2020 May 11. PMID: 32553525

Batten AJ, Augustine MR, Nelson KM, Kaboli PJ. Development of a novel metric of timely care access to primary care services. Health Serv Res. 2020 Apr;55(2):301-309. doi: 10.1111/1475-6773.13255. Epub 2020 Jan 14. PMCID: PMC7080389. PMID: 31943208

Simonetti JA, Piegari R, Maynard C, Brenner LA, Mori A, Post EP, Nelson K, Trivedi R. Characteristics and Injury Mechanisms of Veteran Primary Care Suicide Decedents with and without Diagnosed Mental Illness. J Gen Intern Med. 2020 Mar 26. doi: 10.1007/s11606-020-05787-1. Online ahead of print. PMID: 32219647

Hoerster KD, Tanksley L, Simpson T, Saelens BE, Unützer J, Black M, Greene P, Sulayman N, Reiber G, Nelson K. Development of a Tailored Behavioral Weight Loss Program for Veterans With PTSD (MOVE!+UP): A Mixed-Methods Uncontrolled Iterative Pilot Study. Am J Health Promot. 2020 Jul;34(6):587-598. doi: 10.1177/0890117120908505. Epub 2020 Mar 12. PMCID: PMC7478932. PMID: 32162528

Hernandez SE, Sylling PW, Mor MK, Fine MJ, Nelson KM, Wong ES, Liu CF, Batten AJ, Fihn SD, Hebert PL. Developing an Algorithm for Combining Race and Ethnicity Data Sources in the Veterans Health Administration. Mil Med. 2020 Mar 2;185(3-4):e495-e500. doi: 10.1093/milmed/usz322. PMID: 31603222

Reddy A, Gunnink E, Taylor L, Wong E, Batten AJ, Fihn SD, Nelson KM. Association of High-Cost Health Care Utilization With Longitudinal Changes in Patient-Centered Medical Home Implementation. JAMA Netw Open. 2020 Feb 5;3(2):e1920500. doi: 10.1001/jamanetworkopen.2019.20500. PMID: 32022880

Liu CF, Hebert P, Wong ES, Nelson K, Maynard C. Midlife mortality in White non-Hispanic male veterans enrolled in Department of Veterans Affairs primary care, 2003-2014. Heliyon. 2020 Jan 31;6(1):e03328. doi: 10.1016/j.heliyon.2020.e03328. PMCID: PMC7002889. PMID: 32051882

Schuttner L, Gunnink E, Sylling P, Taylor L, Fihn SD, Nelson K. Components of the Patient-Centered Medical Home Associated with Perceived Access to Primary Care. J Gen Intern Med. 2020 Jun;35(6):1736-1742. doi: 10.1007/s11606-020-05668-7. Epub 2020 Jan 28. PMCID: PMC7280463. PMID: 31993947

Schuttner L, Reddy A, Rosland AM, Nelson K, Wong ES. Association of the Implementation of the Patient-Centered Medical Home with Quality of Life in Patients with Multimorbidity. J Gen Intern Med. 2020 Jan;35(1):119-125. doi: 10.1007/s11606-019-05429-1. Epub 2019 Oct 30. PMCID: PMC6957610. PMID: 31667750

Trivedi RB, Post EP, Piegari R, Simonetti J, Boyko EJ, Asch SM, Mori A, Arnow BA, Fihn SD, Nelson KM, Maynard C. Mortality Among Veterans with Major Mental Illnesses Seen in Primary Care: Results of a National Study of Veteran Deaths. J Gen Intern Med. 2020 Jan;35(1):112-118. doi: 10.1007/s11606-019-05307-w. Epub 2019 Oct 30. PMCID: PMC6957595. PMID: 31667746



Hatef E, Kharrazi H, Nelson K, Sylling P, Ma X, Lasser EC, Searle KM, Predmore Z, Batten AJ, Curtis I, Fihn S, Weiner JP. The Association Between Neighborhood Socioeconomic and Housing Characteristics with Hospitalization: Results of a National Study of Veterans. J Am Board Fam Med. 2019 Nov-Dec;32(6):890-903. doi: 10.3122/jabfm.2019.06.190138. PMID: 31704758

Maynard C, Nelson K. Compensation for Veterans With Service Connected Disabilities: Current Findings and Future Implications. Journal of Disability Policy Studies. Sept 2020;31(1):57-62. doi:10.1177/1044207319875070

Trivedi RB, Slightam C, Nevedal A, Guetterman TC, Fan VS, Nelson KM, Rosland AM, Heidenreich PA, Timko C, Asch SM, Piette JD. Comparing the Barriers and Facilitators of Heart Failure Management as Perceived by Patients, Caregivers, and Clinical Providers. J Cardiovasc Nurs. 2019 Sep/Oct;34(5):399-409. doi: 10.1097/JCN.0000000000000591. PMID: 31365440.

Nelson KM, Chang ET, Zulman DM, Rubenstein LV, Kirkland FD, Fihn SD. Using Predictive Analytics to Guide Patient Care and Research in a National Health System. J Gen Intern Med. 2019 Aug;34(8):1379-1380. doi: 10.1007/s11606-019-04961-4. PMID: 31011959. PMC6667597

Browne KC, Hoerster KD, Piegari R, Fortney JC, Nelson KN, Post EP, Fihn SD, Mori AM, Trivedi RB. Clinical Care Quality Among Veterans Health Administration Patients With Mental Illness Following Medical Home Implementation. Psychiatr Serv. 2019 Sep 1;70(9):816-823. doi: 10.1176/ Epub 2019 Jul 16. PMID: 31310189.

Augustine MR, Nelson KM, Wong ES. Low and Higher Wage Workers Report No Differences in Four Barriers to Primary Care Access. Popul Health Manag. 2020 Apr;23(2):115-123. doi: 10.1089/pop.2019.0028. Epub 2019 Jul 9. PMID: 31287772.

Hatef E, Predmore Z, Lasser EC, Kharrazi H, Nelson K, Curtis I, Fihn S, Weiner JP. Integrating social and behavioral determinants of health into patient care and population health at Veterans Health Administration: a conceptual framework and an assessment of available individual and population level data sources and evidence-based measurements. AIMS Public Health. 2019 Jul 3;6(3):209-224. doi: 10.3934/publichealth.2019.3.209. PMID: 31637271; PMCID: PMC6779595.

Hoerster KD, Campbell S, Dolan M, Stappenbeck CA, Yard S, Simpson T, Nelson KM. PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among U.S. veterans. Prev Med Rep. 2019 Jun 28;15:100930. doi: 10.1016/j.pmedr.2019.100930. eCollection 2019 Sep. PMID: 31338278. PMC6627033

Augustine MR, Nelson KM, Fihn SD, Wong ES. Patient-Reported Access in the Patient-Centered Medical Home and Avoidable Hospitalizations: an Observational Analysis of the Veterans Health Administration. J Gen Intern Med. 2019 Aug;34(8):1546-1553. doi: 10.1007/s11606-019-05060-0. Epub 2019 Jun 3. PMID: 31161568. PMC6667567

Hatef E, Searle KM, Predmore Z, Lasser EC, Kharrazi H, Nelson K, Sylling P, Curtis I, Fihn SD, Weiner JP. The Impact of Social Determinants of Health on Hospitalization in the Veterans Health Administration. Am J Prev Med. 2019 Jun;56(6):811-818. doi: 10.1016/j.amepre.2018.12.012. Epub 2019 Apr 17. PMID: 31003812.

Callegari LS, Tartaglione EV, Magnusson SL, Nelson KM, Arteburn DE, Szarka J, Zephyrin L, Borrero S. Understanding Women Veterans' Family Planning Counseling Experiences and Preferences to Inform Patient-Centered Care. Womens Health Issues. 2019 May-Jun;29(3):283-289. doi: 10.1016/j.whi.2019.03.002. Epub 2019 Apr 10. PMID: 30981559.

Maynard C, Nelson K, Fihn SD. Characteristics of younger women Veterans with service connected disabilities. Heliyon. 2019 Mar 1;5(3):e01284. doi: 10.1016/j.heliyon.2019.e01284. PMID: 30886930; PMCID: PMC6401532.

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Grants & Funding


Telehealth-delivered peer support to improve quality of life among Veterans with multimorbidity


NIH Reporter for complete information

Developing a New Method to Improve Primary Care Workforce Management

NIH Reporter for complete information

Vet-COACH (Veteran peer Coaches Optimizing and Advancing Cardiac Health)

NIH website: