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

Chang K, Burke L, LaPiana N, Howlett B, Hunt D, Dezelar M, Andre JB, Curl P, Ralston JD, Rokem A, Mac Donald CL Free water elimination tractometry for aging brains 2025 Jan;3. doi: 10.1162/IMAG.a.991. Epub 2025-11-07. PubMed

Chang K, Burke L, LaPiana N, Howlett B, Hunt D, Dezelar M, Andre JB, Curl P, Ralston JD, Rokem A, Mac Donald CL Free water elimination tractometry for aging brains 2024 Nov 11 doi: 10.1101/2024.11.10.622861. Epub 2024-11-11. PubMed

Karter AJ, Parker MM, Huang ES, Seligman HK, Moffet HH, Ralston JD, Liu JY, Gilliam LK, Laiteerapong N, Grant RW, Lipska KJ Food Insecurity and Hypoglycemia among Older Patients with Type 2 Diabetes Treated with Insulin or Sulfonylureas: The Diabetes & Aging Study 2024 Oct;39(13):2400-2406. doi: 10.1007/s11606-024-08801-y. Epub 2024-05-20. PubMed

Blasi PR, Zepp JM, Scrol A, Ewing J, Anderson ML, Ralston JD, Fullerton SM, Leppig K, Henrikson NB "I didn't have to worry about it": Patient and family experiences with health system involvement in notifying relatives of genetic test results 2024 Sep 30;27(1):150-160. doi: 10.1159/000541532. Epub 2024-09-30. PubMed

Grant RW, McCloskey JK, Uratsu CS, Ranatunga D, Ralston JD, Bayliss EA, Sofrygin O Predicting Self-Reported Social Risk in Medically Complex Adults Using Electronic Health Data 2024 Sep;62(9):590-598. doi: 10.1097/MLR.0000000000002021. Epub 2024-06-04. PubMed

Luce C, Palazzo L, Anderson ML, Carter-Bawa L, Gao H, Green BB, Ralston JD, Rogers K, Su YR, Tuzzio L, Triplette M, Wernli KJ A pragmatic randomized clinical trial of multilevel interventions to improve adherence to lung cancer screening (The Larch Study): Study protocol 2024 May;140:107495. doi: 10.1016/j.cct.2024.107495. Epub 2024-03-11. PubMed

Tchesnokova V, Larson L, Basova I, Sledneva Y, Choudhury D, Solyanik T, Heng J, Bonilla TC, Pasumansky I, Bowers V, Pham S, Madziwa LT, Holden E, Tartof SY, Ralston JD, Sokurenko EV Gut resident Escherichia coli profile predicts the eighteen-month probability and antimicrobial susceptibility of urinary tract infections 2024 Apr 9 doi: 10.1101/2024.04.05.24305377. Epub 2024-04-09. PubMed

Ralston JD, Anderson M, Ng J, Bashir A, Ehrlich K, Burns-Hunt D, Cotton M, Hansell L, Hsu C, Hunt H, Karter AJ, Levy SM, Ludman E, Madziwa L, Omura EM, Rogers K, Sevey B, Shaw JAM, Shortreed SM, Singh U, Speight J, Sweeny A, Tschernisch K, Sergei Tschernisch S, Yarborough L Preventing severe hypoglycemia in adults with type 2 diabetes (PHT2): Design, delivery and evaluation framework for a randomized controlled trial 2024 Apr;139:107456. doi: 10.1016/j.cct.2024.107456. Epub 2024-01-20. PubMed

Tuzzio L, Gleason KS, Ralston JD, Drace M, Gray MF, Bedoy R, Ellis JL, Grant RW, Bayliss EA, Jauregui L, Bermet ZA Managing Multiple Chronic Conditions during COVID-19 Among Patients with Social Health Risks 2024 Mar;37(2):172-179. doi: 10.3122/jabfm.2023.230053R2. PubMed

Mossa-Basha M, Andre JB, Yuh E, Hunt D, LaPiana N, Howlett B, Krakauer C, Crane P, Nelson J, DeZelar M, Meyers K, Larson E, Ralston J, Mac Donald CL Comparison of brain imaging and physical health between research and clinical neuroimaging cohorts of ageing 2024 Feb 28;97(1155):614-621. doi: 10.1093/bjr/tqae004. PubMed

 

Research

Lung_cancer_screening_1col.png

Helping first-time screeners know when to return

Well-timed outreach in print and video can boost awareness of repeat screening for lung cancer, study finds.

News

E-STAR-Scholars_Gondwe-Shapiro-Rau_1col.png

LHS E-STAR training program selects 3 new scholars

Trainees will lead learning health system research at Kaiser Permanente Washington and VA Puget Sound.

Research

social-support-EHR-494323047_Getty_RF_HiRes_1col.jpg

Identifying patients in need of social support services

Kaiser Permanente researchers develop predictive model to help adults with multiple health conditions.

News

E-STAR_Center_story_1col.jpg

Training scientists as partners in transforming primary care

Newly funded center will elevate equity and community in learning health system research.

Research

Resistent-E.-coli-rises_photo-Sokurenko-Lab_1col.jpg

Resistant E. coli rises despite drop in ciprofloxacin use

Community circulation of ciprofloxacin-resistant E. coli increased after 6-year reduction in antibiotic prescriptions