James D. Ralston, MD, MPH

Ralston_James_D_205x293.jpg

“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.

​​​​​​​

Research interests and experience

Recent publications

Tchesnokova V, Larson L, Basova I, Sledneva Y, Choudhury D, Solyanik T, Heng J, Bonilla TC, Pham S, Schartz EM, Madziwa LT, Holden E, Weissman SJ, Ralston JD, Sokurenko EV. Increase in the community circulation of ciprofloxacin-resistant Escherichia coli despite reduction in antibiotic prescriptions. Commun Med (Lond). 2023 Aug 12;3(1):110. doi: 10.1038/s43856-023-00337-2. PubMed

Hoopes AJ, Cushing-Haugen KL, Coley RY, Fuller S, White C, Ralston JD, Mangione-Smith R. Characteristics of adolescents who use secure messaging on a health system's patient portal. Pediatrics. 2023 Jul 1;152(1):e2022060271. doi: 10.1542/peds.2022-060271. PubMed

McCloskey JK, Ellis JL, Uratsu CS, Drace ML, Ralston JD, Bayliss EA, Grant RW. Telehealth during COVID-19 for adults with multiple chronic conditions: Associations with self-reported food insecurity and with physical limitations. Telemed J E Health. 2023 Oct;29(10):1446-1454. doi: 10.1089/tmj.2022.0206. Epub 2023 Mar 6. PubMed

Karter AJ, Parker MM, Moffet HH, Lipska KJ, Ralston JD, Huang ES, Gilliam LK. Validation of a hypoglycemia risk stratification tool using data from continuous glucose monitors.  JAMA Netw Open. 2023 Mar 1;6(3):e236315. doi: 10.1001/jamanetworkopen.2023.6315. PubMed

Tchesnokova V, Larson L, Basova I, Sledneva Y, Choudhury D, Heng J, Solyanik T, Bonilla T, Pham S, Schartz E, Madziwa L, Holden E, Weissman S, Ralston J, Sokurenko E. Increase in the rate of gut carriage of fluoroquinolone-resistant Escherichia coli despite a reduction in antibiotic prescriptions. Res Sq. 2023 Jan 12;rs.3.rs-2426668. doi: 10.21203/rs.3.rs-2426668/v1. Preprint. PubMed

Schuttner L, Lee JR, Hockett Sherlock S, Ralston JD, Rosland AM, Nelson K, Simons C, Sayre GG. Primary care physician perspectives on the influence of patient values, health priorities, and preferences on clinical decision-making for complex patients with multimorbidity: A qualitative study. Risk Manag Healthc Policy. 2022 Nov 16;15:2135-2146. doi: 10.2147/RMHP.S380021. eCollection 2022. PubMed

Lozano PM, Lane-Fall M, Franklin PD, Rothman RL, Gonzales R, Ong MK, Gould MK, Beebe TJ, Roumie CL, Guise JM, Enders FT, Forrest CB, Mendonca EA, Starrels JL, Sarkar U, Savitz LA, Moon J, Linzer M, Ralston JD, Chesley FD Jr. Training the next generation of learning health system scientists. Learn Health Syst. 2022 Sep 10;6(4):e10342. doi: 10.1002/lrh2.10342. eCollection 2022 Oct. PubMed

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

 

News

E-STAR_Center_story_1col.jpg

Training scientists as partners in transforming primary care

Newly funded center will elevate equity and community in learning health system research.

Research

Resistent-E.-coli-rises_photo-Sokurenko-Lab_1col.jpg

Resistant E. coli rises despite drop in ciprofloxacin use

Community circulation of ciprofloxacin-resistant E. coli increased after 6-year reduction in antibiotic prescriptions

New findings

Adolescents-use-of-health-portal_1col.jpg

Some adolescents are more likely to use patient portal than others

A new study aims to understand trends in digital care communication among teens.

Open notes

African-American Doctor Working On Laptop

Concerns about note-sharing fade with practice

A new federal rule requiring physicians to give patients access to their notes may be easier to follow than physicians expected.

Research

CV-risk-calution-in-primary-care_screen_1col.jpg

CVD risk calculation: Can smaller clinics break through?

KPWHRI researchers uncover obstacles faced by smaller practices when adding CVD risk calculators into primary care.