James D. Ralston, MD, MPH

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“My work focuses on helping patients who live with common chronic health conditions.”

James D. Ralston, MD, MPH

Senior Investigator, Kaiser Permanente Washington Health Research Institute
Physician, Washington Permanente Medical Group, Internal Medicine

Biography

James Ralston MD, MPH, is an internal medicine physician and senior investigator in health services and health informatics. His research mission is improving the health and care of patients living with common ongoing illnesses. His current areas of emphasis include understanding and honoring the priorities of patients living with multiple chronic conditions.

Dr. Ralston’s research focuses on developing and evaluating communication technologies that foster continuous care and a closer connection between patients and primary care teams. His commitment to finding effective ways to redesign care spans all stages of research, from project development to complete translation of results into clinical practice.

Examples of Dr. Ralston’s research projects include:

  • The Valuing Important Things in Active Lives (VITAL) study to improve care for people with multiple chronic conditions including diabetes, heart disease, and arthritis. VITAL uses participatory design methods with patients and providers to design and evaluate interactive care plans.
  • The Seeing Priorities study to build and test a single, trusted tool for individuals with multiple chronic conditions that illuminates connections between personal values and chronic illness management. The tool helps visualize, track, and share what matters most for self-management and care. 
  • Understanding and addressing differences in patient use of online health care services that could lead to care disparities.
  • Testing online care management of blood sugar control using an electronic health record shared with patients with type 2 diabetes. Control improved in patients receiving online care management in addition to usual care.
  • Validating and evaluating a clinical tool to identify patients with type 2 diabetes at risk of severe low blood sugar. This national collaboration uses Kaiser Permanente and Veterans Administration electronic health record data and machine learning methods.
  • Testing innovative engagement methods such as photos taken by study participants to document their values to ensure that patient priorities guide self-management plans and clinical care.
  • Working with primary care teams and clinics in rural and underserved areas to improve the care of their patients with chronic conditions.

Dr. Ralston is also a University of Washington affiliate professor in health services and biomedical informatics, where he serves on the committees of PhD and master’s degree students.

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Research interests and experience

Recent publications

Grembowski D, Anderson ML, Conrad DA, Fishman PA, Larson EB, Martin DP, Ralston JD, Carrell D, Hecht J. Evaluation of the Group Health Cooperative Access Initiative: study design challenges in estimating the impact of a large-scale organizational transformation. Qual Manag Health Care. 2008;17(4):292-303. PubMed

Tufano JT, Ralston JD, Martin DP. Providers' experience with an organizational redesign initiative to promote patient-centered access: a qualitative study. J Gen Intern Med. 2008;23(11):1778-83. Epub 2008 Sep 4. PubMed

Conrad D, Fishman P, Grembowski D, Ralston J, Reid R, Martin D, Larson E, Anderson M. Access intervention in an integrated, prepaid group practice: effects on primary care physician productivity.  Health Serv Res. 2008;43(5 Pt 2):1888-905. Epub 2008 Jul 25. PubMed

Green BB, Cook AJ, Ralston JD, Fishman PA, Catz SL, Carlson J, Carrell D, Tyll L, Larson EB, Thompson RS. Effectiveness of home blood pressure monitoring, Web communication, and pharmacist care on hypertension control: a randomized controlled trial.  JAMA. 2008;299(24):2857-67. PubMed

Arsand E, Tufano JT, Ralston JD, Hjortdahl P. Designing mobile dietary management support technologies for people with diabetes.  J Telemed Telecare. 2008;14(7):329-32. PubMed

Green BB, Ralston JD, Fishman PA, Catz SL, Cook A, Carlson J, Tyll L, Carrell D, Thompson RS. Electronic communications and home blood pressure monitoring (e-BP) study: design, delivery, and evaluation framework. Contemp Clin Trials. 2008;29(3):376-95. Epub 2007 Sep 26. PubMed

Ralston JD, Carrell D, Reid R, Anderson M, Moran M, Hereford J. Patient web services integrated with a shared medical record: patient use and satisfaction. J Am Med Inform Assoc. 2007;14(6):798-806. Epub 2007 Aug 21. PubMed

Carrell D, Ralston J. Variation in adoption rates of a patient web portal with a shared medical record by age, gender, and morbidity level.  AMIA Annu Symp Proc. 2006;871. PubMed

Ralston J, Carrell D. Use and satisfaction of a patient Web portal with a shared medical record between patients and providers.  AMIA Annu Symp Proc. 2006;1070. PubMed

Greene SM, Larson EB, Boudreau DM, Johnson K, Ralston J, Reid R, Fishman P. The Coordinated Clinical Studies Network: a multidisciplinary alliance to facilitate research and improve care. The Permanente Journal. 2005;95(4):33-5. PubMed

 

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