James D. Ralston, MD, MPH

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.

Research interests and experience

Health Informatics

eHealth; hypertension; diabetes
Chronic Illness Management

Health informatics; hypertension; diabetes; health behaviors; multiple chronic conditions
Behavior Change

Self-management support
Health Services & Economics

Health care disparities

Recent publications

Blasi PR, Scrol A, Anderson ML, Gray MF, Tiffany B, Fullerton SM, Ralston JD, Leppig KA, Henrikson NB. Feasibility, acceptability, and limited efficacy of health system-led familial risk notification: protocol for a mixed-methods evaluation. Pilot Feasibility Stud. 2022 Aug 9;8(1):174. doi: 10.1186/s40814-022-01142-9. PubMed

Miller-Rosales C, McCloskey J, Uratsu CS, Ralston JD, Bayliss EA, Grant RW. Associations between different self-reported social risks and neighborhood-level resources in Medicaid patients. Med Care. 2022 Aug 1;60(8):563-569. doi: 10.1097/MLR.0000000000001735. Epub 2022 May 30. PubMed

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]. PubMed

Leppig KA, Rahm AK, Appelbaum P, Aufox S, Bland ST, Buchanan A, Christensen KD, Chung WK, Wright-Clayton E, Crosslin D, Denny J, DeVange S, Gordon A, Green RC, Hakonarson H, Harr MH, Henrikson NB, Hoell C, Holm IA, Kullo IJ, Jarvik GP, Lammers PE, Larson EB, Lindor NM, Marasa M, Myer MF, Perez E, Peterson JF, Pratap S, Prows CA, Ralston JD, Rasouly HM, Roden DM, Sharp RR, Singh R, Shaibi G, Smith ME, Sturm A, Thiese HA, Van Driest SL, Williams J, Williams MS, Wynn J, Zawatsky CL, Weisner GL. The reckoning: the return of genomic results to 1444 participants across the eMERGE3 Network. Genet Med. 2022 May;24(5):1130-1138. doi: 10.1016/j.gim.2022.01.015. Epub 2022 Feb 23. PubMed

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;23(1):25. doi: 10.1186/s12875-022-01633-x. PubMed

McCloskey JK, Ellis JL, Uratsu CS, Drace ML, Ralston JD, Bayliss EA, Grant RW. Accounting for social risk does not eliminate race/ethnic disparities in COVID-19 infection among insured adults: a cohort study. J Gen Intern Med. 2022 Feb 2:1-8. doi: 10.1007/s11606-021-07261-y. [Epub ahead of print]. PubMed

Haas CB, Ralston J, Fullerton SM, Scrol A, Henrikson NB. Environmental scan of family chart linking for genetic cascade screening in a U.S. integrated health system. Front Genet. 2022 Aug 11;13:886650. doi: 10.3389/fgene.2022.886650. eCollection 2022. PubMed

Tuzzio L, O'Meara ES, Holden E, Parchman ML, Ralston JD, Powell JA, Baldwin LM. Barriers to implementing cardiovascular risk calculation in primary care: alignment with the Consolidated Framework for Implementation Research. Am J Prev Med. 2021 Feb;60(2):250-257. doi: 10.1016/j.amepre.2020.07.027. Epub 2020 Dec 3. PubMed

Berry AB, Lim CY, Liang CA, Hartzler AL, Hirsch T, Ferguson DM, Bermet ZA, Ralston JD. Supporting collaborative reflection on personal values and health. Proc ACM Hum Comput Interact. 2021 Oct;5(CSCW2):1-39. doi: 10.1145/3476040. Epub 2021 Oct 18. PubMed

Bell SK, Bourgeois F, DesRoches CM, Dong J, Harcourt K, Liu SK, Lowe E, McGaffigan P, Ngo LH, Novack SA, Ralston JD, Salmi L, Schrandt S, Sheridan S, Sokol-Hessner L, Thomas G, Thomas EJ. Filling a gap in safety metrics: development of a patient-centred framework to identify and categorise patient-reported breakdowns related to the diagnostic process in ambulatory care. 2022 Jul;31(7):526-540. doi: 10.1136/bmjqs-2021-013672. Epub 2021 Oct 16. PubMed