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

Schuttner L, Coleman K, Ralston J, Parchman M. The role of organizational learning and resilience for change in building quality improvement capacity in primary care. Health Care Manage Rev. 2021;46(2):E1-E7. doi: 10.1097/HMR.0000000000000281. PubMed

Henrikson NB, Scrol A, Leppig KA, Ralston JD, Larson EB, Jarvik GP. Preferences of biobank participants for receiving actionable genomic test results: results of a recontacting study. LID - 10.1038/s41436-021-01111-2 [doi] Genet Med. 2021 Feb 18. doi: 10.1038/s41436-021-01111-2 [Epub ahead of print] PubMed

Makhnoon S, Bowen DJ, Shirts BH, Fullerton SM, Larson EB, Ralston JD, Leppig KA, Crosslin DR, Veenstra D, Jarvik GP. The FamilyTalk randomized controlled trial: patient-reported outcomes in clinical genetic sequencing for colorectal cancer. Cancer Causes Control. 2021 Feb 16. doi: 10.1007/s10552-021-01398-1. [Epub ahead of print]. PubMed

Bowen DJ, Makhnoon S, Shirts BH, Fullerton SM, Larson E, Ralston JD, Leppig K, Crosslin DR, Veenstra D, Jarvik GP. What improves the likelihood of people receiving genetic test results communicating to their families about genetic risk? Patient Educ Couns. 2021 Jan 7:S0738-3991(21)00001-X. doi: 10.1016/j.pec.2021.01.001. Online ahead of print. 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. 2020 Dec 2:S0749-3797(20)30392-5. doi: 10.1016/j.amepre.2020.07.027. [Epub ahead of print]. PubMed

Grant RW, McCloskey J, Hatfield M, Uratsu C, Ralston JD, Bayliss E, Kennedy CJ. Use of latent class analysis and k-Means clustering complex patient profiles. JAMA Netw Open. 2020 Dec 1;3(12):e2029068. doi: 10.1001/jamanetworkopen.2020.29068. PubMed

Penfold RB, Thompson EE, Hilt RJ, Kelleher KJ, Schwartz N, Beck A, Clarke G, Ralston JD, Hartzler AL, Coley RY, Akosile M, Vitiello B, Simon GE. Safer Use of Antipsychotics in Youth (SUAY) pragmatic trial protocol. Contemp Clin Trials. 2020 Oct 19:106184. doi: 10.1016/j.cct.2020.106184. Online ahead of print. PubMed

Makhnoon S, Bowen DJ, Shirts BH, Fullerton SM, Meischke HW, Larson EB, Ralston JD, Leppig K, Crosslin DR, Veenstra D, Jarvik GP. Relationship between genetic knowledge and familial communication of CRC risk and intent to communicate CRCP genetic information: insights from FamilyTalk eMERGE III. Transl Behav Med. 2020 Jun 24:ibaa054. doi: 10.1093/tbm/ibaa054. [Epub ahead of print]. PubMed

Lynch JA, Sharp RR, Aufox SA, Bland ST, Blout C, Bowen DJ, Buchanan AH, Halverson C, Harr M, Hebbring SJ, Henrikson N, Hoell C, Holm IA, Jarvik G, Kullo IJ, Kochan DC, Larson EB, Lazzeri A, Leppig KA, Madden J, Marasa M, Myers MF, Peterson J, Prows CA, Kulchak Rahm A, Ralston J, Milo Rasouly H, Scrol A, Smith ME, Sturm A, Stuttgen K, Wiesner G, Williams MS, Wynn J, Williams JL. Understanding the return of genomic sequencing results process: content review of participant summary letters in the eMERGE Research Network. J Pers Med. 2020;10(2):E38. doi: 10.3390/jpm10020038. PubMed

Wiesner GL, Kulchak Rahm A, Appelbaum P, Aufox S, Bland ST, Blout CL, Christensen KD, Chung WK, Clayton EW, Green RC, Harr MH, Henrikson N, Hoell C, Holm IA, Jarvik GP, Kullo IJ, Lammers PE, Larson EB, Lindor NM, Marasa M, F Myers M, Peterson JF, Prows CA, Ralston JD, Milo Rasouly H, Sharp RR, Smith ME, Van Driest SL, Williams JL, Williams MS, Wynn J, Leppig KA. Returning results in the genomic era: initial experiences of the eMERGE Network. J Pers Med. 2020;10(2). pii: jpm10020030. doi: 10.3390/jpm10020030. PubMed

 

Research

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VITAL Study

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The Valuing Important Things in Active Lives (VITAL) study is a three-year project funded by the Agency for Healthcare Research and quality.

Learn about the VITAL study.

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Patients may not be telling their doctors what matters to them most

KPWHRI’s VITAL study discovers six domains that people with chronic illness too rarely discuss with their care providers.

Read about it & watch the video in News and Events.