James D. Ralston, MD, MPH

“My work focuses on helping health care providers use information technologies to engage patients and their family members outside of traditional in-person visits.”

James D. Ralston, MD, MPH

Senior Investigator, Kaiser Permanente Washington Health Research Institute
Physician, Washington Permanente Medical Group, Internal Medicine


How can health care be redesigned to better meet the needs and preferences of the millions of Americans living with chronic conditions? This question is at the heart of James Ralston’s research, compelling him to explore innovative designs of care that take advantage of new information technologies.

A general internist, Dr. Ralston joined Kaiser Permanente Washington Health Research Institute (KPWHRI) in 2003 to lead the Institute’s health informatics research program. But his expertise and interests go far beyond informatics. While much of Dr. Ralston’s work emphasizes information technologies as helpful components of care, they serve his true passion: that is, improving the health and health care of people who have common chronic conditions. This mission requires effectively evaluating new communication technologies that foster continuous care and a closer connection between patients and health care teams. In the past several years, Dr. Ralston has led and contributed to research showing that using new information and communication technologies to move care from the provider’s office to the patient’s home leads to promising outcomes.

Dr. Ralston’s commitment to finding effective redesigns of care spans all stages, from development to complete translation. With a team of KPWHRI and UW colleagues, he is helping evaluate Kaiser Permanente Washington's “access initiative”—a suite of innovations designed to make health care easier to get, in part by leveraging advances in information technology, such as secure member websites and electronic medical records (EMRs). Dr. Ralston also collaborates with the informatics department at Kaiser Permanente Washington, and he sits on the oversight committee that explores how doctors can best use it to help patients.

Dr. Ralston provides outpatient consultation through Washington Permanente Medical Group’s Consultative Internal Medicine Group and is a volunteer medical advisor on the Steven’s Pass ski patrol. He is also an affiliate associate professor in health services at the UW, where he serves on student PhD and MPH committees. 

Research interests and experience

Recent publications

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

Karter AJ, Warton EM, Lipska KJ, Ralston JD, Moffet HH, Jackson GG, Huang ES, Miller DR. Development and validation of a tool to identify patients with type 2 diabetes at high risk of hypoglycemia-related emergency department or hospital use. JAMA Intern Med. 2017 Oct 1;177(10):1461-1470. doi: 10.1001/jamainternmed.2017.3844. PubMed

Berry A, Lim C, Hartzler AL, Hirsch T, Ludman E, Wagner EH, Ralston J. Creating conditions for patients’ values to emerge in clinical conversations: perspectives of health care team members. DIS (Des Interact Syst Conf). 2017 Jun;2017:1165-1174. doi: 10.1145/3064663.3064669. PubMed

Crane HM, Crane PK, Tufano JT, Ralston JD, Wilson IB, Brown TD, Davis TE, Smith LF, Lober WB, McReynolds J, Dhanireddy S, Harrington RD, Rodriguez CV, Nance RM, Delaney JA, Safren SA, Kitahata MM, Fredericksen RJ. HIV provider documentation and actions following patient reports of at-risk behaviors and conditions when identified by a web-based point-of-care assessment. AIDS Behav. 2017 Feb 15. doi: 10.1007/s10461-017-1718-5. [Epub ahead of print]. PubMed

Leppig K, Thiese H , Carrell D, Crosslin D , Dorschner M, Gordon A, Hartzler A, Ralston J, Larson E, Jarvik G. Building a family network from genetic testing. Mol Genet Genomic Med. 2016 Dec 29;5(2):122-129. doi: 10.1002/mgg3.259. eCollection 2017.

Peikes D, O'Malley AS, Wilson C, Crosson J, Gaddes R, Natzke B, Day TJ, Cromp D, Keith R, Little J, Ralston J. Early experiences engaging patients through patient and family advisory councils. J Ambul Care Manage. 2016 Oct-Dec;39(4):316-24. doi: 10.1097/JAC.0000000000000150. PubMed



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.

Recent News

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.

Chronic Illness

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.

Studying patient reminders

REMIND study

The REMIND study is a three-year project to redesign reminders and notifications for patients with chronic and preventive health care needs.

KPWHRI In the Media

Health information technology

The delicate question of sharing medical information with adult children

The Wall Street Journal, Apr. 23, 2017