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

Karter AJ, Warton EM, Lipska KJ, Ralston JD, Moffet HH, Jackson GG, Huang ES, Miller DR Development and Validation of a Tool to Identify Patients With Type 2 Diabetes at High Risk of Hypoglycemia-Related Emergency Department or Hospital Use 2017 Oct;177(10):1461-1470. doi: 10.1001/jamainternmed.2017.3844. PubMed

Lim CY, Berry ABL, Hirsch T, Hartzler AL, Wagner EH, Ludman EJ, Ralston JD Understanding What Is Most Important to Individuals with Multiple Chronic Conditions: A Qualitative Study of Patients' Perspectives 2017 Aug 28 doi: 10.1007/s11606-017-4154-3. PubMed

Berry ABL, Lim C, Hartzler AL, Hirsch T, Ludman E, Wagner EH, Ralston JD Creating Conditions for Patients' Values to Emerge in Clinical Conversations: Perspectives of Health Care Team Members 2017 Jun;2017:1165-1174. doi: 10.1145/3064663.3064669. PubMed

Leppig KA, Thiese HA, Carrel D, Crosslin DR, Dorschner MO, Gordon AS, Hartzler A, Ralston J, Scrol A, Larson EB, Jarvik GP Building a family network from genetic testing 2017 Mar;5(2):122-129. doi: 10.1002/mgg3.259. Epub 2016-12-29. 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 2017 Jan;2017:430-439. Epub 2018-04-16. 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

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

Bell SK, Mejilla R, Anselmo M, Darer JD, Elmore JG, Leveille S, Ngo L, Ralston JD, Delbanco T, Walker J. When doctors share visit notes with patients: a study of patient and doctor perceptions of documentation errors, safety opportunities and the patient-doctor relationship. BMJ Qual Saf. 2017 Apr;26(4):262-270. doi: 10.1136/bmjqs-2015-004697. Epub 2016 May 18. PubMed