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

Fishman PA, Anderson ML, Cook AJ, Ralston JD, Catz SL, Carlson J, Larson EB, Green BB. Accuracy of blood pressure measurements reported in an electronic medical record during routine primary care visits. J Clin Hypertens. 2011;13(11):821-8. PubMed

Green B, Anderson M, Catz S, Ralston J. Self-reported use of home blood pressure monitoring does not predict improved hypertension control. Clin Med Res. 2011;9(3-4):152-3. PubMed

Simon GE, Ralston JD, Savarino J, Pabiniak C, Wentzel C, Operskalski BH. Randomized trial of depression follow-up care by online messaging. J Gen Intern Med. 2011 Jul;26(7):698-704. Epub 2011 Mar 8. PubMed

Lyles CR, Harris LT, Le T, Flowers J, Tufano J, Britt D, Hoath J, Hirsch IB, Goldberg HI, Ralston JD. Qualitative evaluation of a mobile phone and web-based collaborative care intervention for patients with type 2 diabetes. Diabetes Technol Ther. 2011 May;13(5):563-9. Epub 2011 Mar 15. PubMed

Green BB, Anderson ML, Ralston JD, Catz S, Fishman PA, Cook AJ. Patient ability and willingness to participate in a web-based intervention to improve hypertension control. J Med Internet Res. 2011 Jan 20;13(1):e1. PubMed

McCarrier KP, Zimmerman FJ, Ralston JD, Martin DP. Associations between minimum wage policy and access to health care: evidence from the behavioral risk factor surveillance system, 1996-2007. Am J Public Health. 2011 Feb;101(2):359-67. Epub 2010 Dec 16. PubMed

Harris LT, Tufano J, Le T, Rees C, Lewis GA, Evert AB, Flowers J, Collins C, Hoath J, Hirsch IB, Goldberg HI, Ralston JD. Designing mobile support for glycemic control in patients with diabetes. J Biomed Inform. 2010;43(5 Suppl):S37-40. PubMed

Tufano JT, Ralston JD, Tarczy-Hornoch P, Reid RJ. Participatory (re)design of a sociotechnical healthcare delivery system: the Group Health patient-centered Medical Home. Stud Health Technol Inform. 2010;157:59-65. PubMed

Weppner WG, Ralston JD, Koepsell TD, Grothaus LC, Reid RJ, Jordan L, Larson EB. Use of a shared medical record with secure messaging by older patients with diabetes. Diabetes Care. 2010 Nov;33(11):2314-9. Epub 2010 Aug 25. PubMed

Delbanco T, Walker J, Darer JD, Elmore JG, Feldman HJ, Leveille SG, Ralston JD, Ross SE, Vodicka E, Weber VD. Open notes: doctors and patients signing on. Ann Intern Med. 2010;153(2):121-5. PubMed

 

Open notes

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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.

KPWHRI In the Media

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Physician support for open notes grows over time, with caveats

Medscape, April 29, 2021