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

Gordon AS, Rosenthal EA, Carrell DS, Amendola LM, Dorschner MO, Scrol A, Stanaway IB, DeVange S, Ralston JD, Zouk H, Rehm HL, Larson E, Crosslin DR, Leppig KA, Jarvik GP. Rates of actionable genetic findings in individuals with colorectal cancer or polyps ascertained from a community medical setting. Am J Hum Genet. 2019 Aug 8. pii: S0002-9297(19)30275-7. doi: 10.1016/j.ajhg.2019.07.012. [Epub ahead of print]. PubMed

Hartzler AL, Ralston JD, Hannan TA, Kelleher KJ, Penfold RB. Designing safer use of antipsychotics among youths: a human-centered approach to an algorithm-based solution. Psychiatr Serv. 2019 Jul 16:appips201800390. doi: 10.1176/appi.ps.201800390. [Epub ahead of print]. PubMed

Tchesnokova VL, Rechkina E, Chan D, Haile HG, Larson L, Ferrier K, Schroeder DW, Solyanik T, Shibuya S, Hansen K, Ralston JD, Riddell K, Scholes D, Sokurenko EV. Pandemic uropathogenic fluoroquinolone-resistant Escherichia coli have enhanced ability to persist in the gut and cause bacteriuria in healthy women. Clin Infect Dis. 2019 Jul 4. pii: ciz547. doi: 10.1093/cid/ciz547. [Epub ahead of print]. PubMed

Henrikson NB, Blasi PR, Corsmo JJ, Sheffer Serdoz E, Scrol A, Greene SM, Matthews TL, Ralston JD. "You really do have to know the local context": IRB administrators and researchers on the implications of the NIH Single IRB mandate for multisite genomic studies. J Empir Res Hum Res Ethics. 2019 Jul;14(3):286-295. doi: 10.1177/1556264619850440. Epub 2019 May 22. PubMed

Vizer LM, Eschler J, Koo BM, Ralston J, Pratt W, Munson S. "It's not just technology, it's people": constructing a conceptual model of shared health informatics for tracking in chronic illness management. J Med Internet Res. 2019 Apr 29;21(4):e10830. doi: 10.2196/10830. PubMed

Karter AJ, Warton EM, Moffet HH, Ralston JD, Huang ES, Miller DR, Lipska KJ. Revalidation of the hypoglycemia risk stratification tool using ICD-10 codes. Diabetes Care. 2019 Feb 14. pii: dc18-2154. doi: 10.2337/dc18-2154. [Epub ahead of print]. PubMed

O'Leary K, Tanghe D, Pratt W, Ralston J. Collaborative health reminders and notifications: insights from prototypes. AMIA Annu Symp Proc. 2018 Dec 5;2018:837-846. eCollection 2018. PubMed

Tchesnokova VL, Rechkina E, Larson L, Ferrier K, Weaver JL, Schroeder DW, She R, Butler-Wu SM, Aguero-Rosenfeld ME, Zerr D, Fang FC, Ralston J, Riddell K, Scholes D, Weissman S, Parker K, Spellberg B, Johnson JR, Sokurenko EV. Rapid and extensive expansion in the U.S. of a new multidrug-resistant Escherichia coli clonal group, sequence type ST1193. Clin Infect Dis. 2019 Jan 7;68(2):334-337. doi: 10.1093/cid/ciy525. PubMed

Aronson S, Babb L, Ames D, Gibbs RA, Venner E, Connelly JJ, Marsolo K, Weng C, Williams MS, Hartzler AL, Liang WH, Ralston JD, Devine EB, Murphy S, Aronson S, Babb L, Ames D, Gibbs RA, Venner E, Connelly JJ, Marsolo K, Weng C, Williams MS, Hartzler AL, Liang WH, Ralston JD, Devine EB, Murphy S, Chute CG, Caraballo PJ, Kullo IJ, Freimuth RR, Rasmussen LV, Wehbe FH, Peterson JF, Robinson JR, Wiley K, Overby Taylor C, eMERGE Network EHRI Working Group. Empowering genomic medicine by establishing critical sequencing result data flows: the eMERGE example. J Am Med Inform Assoc. 2018 May 31. pii: 5026196. doi: 10.1093/jamia/ocy051. [Epub ahead of print]. 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 patient's perspectives. J Gen Intern Med. 2017 Aug 28. doi: 10.1007/s11606-017-4154-3. [Epub ahead of print]. PubMed

 

research

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Kaiser Permanente Research Bank: Why you should join

All Washington members are invited to be part of research that could improve health for millions.

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.

research into communication

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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.

clare project study

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Young adults with cancer speak about balancing hope and risk

The first Clare Project study asked about values and care preferences. Project leaders are now building on that foundation.

Chronic Illness

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New tool pinpoints diabetes patients at highest risk for hypoglycemia

Dr. James Ralston worked with Kaiser Permanente Northern California’s Dr. Andrew Karter and colleagues.

Read it in Healthy Findings.