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

Ralston JD, Coleman K, Reid RJ, Handley MR, Larson EB. Patient experience should be part of meaningful-use criteria. Health Aff (Millwood). 2010;29(4):607-13. PubMed

Ralston JD, Martin DP, Anderson ML, Fishman PA, Conrad DA, Larson EB, Grembowski D. Group Health Cooperative's transformation toward patient-centered access. Med Care Res Rev. 2009;66(6):703-24. Epub 2009 Jun 23. PubMed

Harris LT, Haneuse SJ, Martin DP, Ralston JD. Diabetes quality of care and outpatient utilization associated with electronic patient-provider messaging: a cross-sectional analysis. Diabetes Care. 2009;32(7):1182-7. Epub 2009 Apr 14. PubMed

McCarrier KP, Ralston JD, Hirsch IB, Lewis G, Martin DP, Zimmerman FJ, Goldberg HI. Web-based collaborative care for type 1 diabetes: a pilot randomized trial. Diabetes Technol Ther. 2009;11(4):211-7. PubMed

Moreno MA, Ralston JD, Grossman DC. Adolescent access to online health services: perils and promise. J Adolesc Health. 2009;44(3):244-51. Epub 2008 Nov 11. PubMed

Ralston JD, Rutter CM, Carrell D, Hecht J, Rubanowice D, Simon GE. Patient use of secure electronic messaging within a shared medical record: a cross-sectional study. J Gen Intern Med. 2009;24(3):349-55. Epub 2009 Jan 10. PubMed

Ralston JD, Hirsch IB, Hoath J, Mullen M, Allen C, Goldberg HI. Web-based collaborative care for type 2 diabetes: a pilot randomized trial. Diabetes Care. 2009 Feb;32(2):234-9. Epub 2008 Nov 18. PubMed

Grembowski D, Anderson ML, Conrad DA, Fishman PA, Larson EB, Martin DP, Ralston JD, Carrell D, Hecht J. Evaluation of the Group Health Cooperative Access Initiative: study design challenges in estimating the impact of a large-scale organizational transformation. Qual Manag Health Care. 2008;17(4):292-303. PubMed

Tufano JT, Ralston JD, Martin DP. Providers' experience with an organizational redesign initiative to promote patient-centered access: a qualitative study. J Gen Intern Med. 2008;23(11):1778-83. Epub 2008 Sep 4. PubMed

Conrad D, Fishman P, Grembowski D, Ralston J, Reid R, Martin D, Larson E, Anderson M. Access intervention in an integrated, prepaid group practice: effects on primary care physician productivity. Health Serv Res. 2008;43(5 Pt 2):1888-905. Epub 2008 Jul 25. PubMed

 

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.

healthy findings blog

LHS_Buprenorphine-TEAM-mtg-Amy-Lee__1col.jpg

Partnering to advance lifesaving care

Amy Lee describes how the LHS Program is helping KP Washington track and improve treatment for opioid use disorder.

research

biobank-Kp-video_-_1_col.jpg

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

VITAL-storyboard-2col.jpg

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.

KPWHRI In the Media

James Ralston on physicians sharing visit notes online with patients

Physician support for open notes grows over time, with caveats

Medscape, April 29, 2021