James D. Ralston, MD, MPH


“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


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

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

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




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