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

Berry A, Lim C, Hartzler AL, Hirsch T, Ludman E, Wagner EH, Ralston J. Creating conditions for patients’ values to emerge in clinical conversations: perspectives of health care team members. DIS (Des Interact Syst Conf). 2017 Jun;2017:1165-1174. doi: 10.1145/3064663.3064669. PubMed

Berry ABL, Lim C, Hartzler AL, Hirsch T, Ludman E, Wagner EH, Ralston JD. Eliciting values of patients with multiple chronic conditions: evaluation of a patient-centered framework.  AMIA Annu Symp Proc. 2018 Apr 16;2017:430-439. eCollection 2017.  PubMed

Crane HM, Crane PK, Tufano JT, Ralston JD, Wilson IB, Brown TD, Davis TE, Smith LF, Lober WB, McReynolds J, Dhanireddy S, Harrington RD, Rodriguez CV, Nance RM, Delaney JA, Safren SA, Kitahata MM, Fredericksen RJ. HIV provider documentation and actions following patient reports of at-risk behaviors and conditions when identified by a web-based point-of-care assessment. AIDS Behav. 2017 Feb 15. doi: 10.1007/s10461-017-1718-5. [Epub ahead of print]. PubMed

Leppig K, Thiese H , Carrell D, Crosslin D , Dorschner M, Gordon A, Hartzler A, Ralston J, Larson E, Jarvik G. Building a family network from genetic testing. Mol Genet Genomic Med. 2016 Dec 29;5(2):122-129. doi: 10.1002/mgg3.259. eCollection 2017. PubMed

Peikes D, O'Malley AS, Wilson C, Crosson J, Gaddes R, Natzke B, Day TJ, Cromp D, Keith R, Little J, Ralston J. Early experiences engaging patients through patient and family advisory councils. J Ambul Care Manage. 2016 Oct-Dec;39(4):316-24. doi: 10.1097/JAC.0000000000000150. PubMed

Grembowski D, Ralston JD, Anderson ML. Health outcomes of population-based pharmacy outreach to increase statin use for prevention of cardiovascular disease in patients with diabetes.  J Manag Care Spec Pharm. 2016;22(8):909-17. doi: 10.18553/jmcp.2016.22.8.909.  PubMed

O’Leary KO, Liu L, McClure JB, Ralston J, Pratt W. Persuasive reminders for health self-management. AMIA Annu Symp Proc. 2017 Feb 10;2016:994-1003. eCollection 2016. PubMed

Eschler J, Meas PL, Lozano P, McClure JB, Ralston JD, Pratt W. Integrating the patient portal into the health management work ecosystem: user acceptance of a novel prototype. AMIA Annu Symp Proc. 2017 Feb 10;2016:541-550. eCollection 2016. PubMed

Tieu L, Schillinger D, Sarkar U, Hoskote M, Hahn KJ, Ratanawongsa N, Ralston JD, Lyles CR. Online patient websites for electronic health record access among vulnerable populations: portals to nowhere? J Am Med Inform Assoc. 2017 Apr 1;24(e1):e47-e54. doi: 10.1093/jamia/ocw098. PubMed

Bayliss EA, McQuillan DB, Ellis JL, Maciejewski ML, Zeng C, Barton MB, Boyd CM, Fortin M, Ling SM, Tai-Seale M, Ralston JD, Ritchie CS, Zulman DM. Using electronic health record data to measure care quality for individuals with multiple chronic medical conditions. J Am Geriatr Soc. 2016 Jul 7. doi: 10.1111/jgs.14248. [Epub ahead of print]. PubMed

 

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