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.D.Ralston@kp.org
206-287-2076
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
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Health Informatics
eHealth; hypertension; diabetes
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Chronic Illness Management
Health informatics; hypertension; diabetes; health behaviors; multiple chronic conditions
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Behavior Change
Self-management support
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Health Services & Economics
Health care disparities
Recent publications
Tuzzio L, O'Meara ES, Holden E, Parchman ML, Ralston JD, Powell JA, Baldwin LM. Barriers to implementing cardiovascular risk calculation in primary care: alignment with the Consolidated Framework for Implementation Research. Am J Prev Med. 2021 Feb;60(2):250-257. doi: 10.1016/j.amepre.2020.07.027. Epub 2020 Dec 3. PubMed
Berry AB, Lim CY, Liang CA, Hartzler AL, Hirsch T, Ferguson DM, Bermet ZA, Ralston JD. Supporting collaborative reflection on personal values and health. Proc ACM Hum Comput Interact. 2021 Oct;5(CSCW2):1-39. doi: 10.1145/3476040. Epub 2021 Oct 18. PubMed
Bell SK, Bourgeois F, DesRoches CM, Dong J, Harcourt K, Liu SK, Lowe E, McGaffigan P, Ngo LH, Novack SA, Ralston JD, Salmi L, Schrandt S, Sheridan S, Sokol-Hessner L, Thomas G, Thomas EJ. Filling a gap in safety metrics: development of a patient-centred framework to identify and categorise patient-reported breakdowns related to the diagnostic process in ambulatory care. 2022 Jul;31(7):526-540. doi: 10.1136/bmjqs-2021-013672. Epub 2021 Oct 16. PubMed
Tchesnokova V, Kulasekara H, Larson L, Bowers V, Rechkina E, Kisiela D, Sledneva Y, Choudhury D, Maslova I, Deng K, Kutumbaka K, Geng H, Fowler C, Greene D, Ralston J, Samadpour M, Sokurenko E. Acquisition of the L452R mutation in the ACE2-binding interface of Spike protein triggers recent massive expansion of SARS-CoV-2 variants. J Clin Microbiol. 2021 Aug 11:JCM0092121. doi: 10.1128/JCM.00921-2. Online ahead of print. PubMed
Tuzzio L, Berry AL, Gleason K, Barrow J, Bayliss EA, Gray MF, Delate T, Bermet Z, Uratsu C, Grant RW, Ralston JD. Aligning care with the personal values of patients with complex care needs. Health Serv Res. 2021 Aug 6. doi: 10.1111/1475-6773.13862. [Epub ahead of print]. PubMed
Henrikson NB, Blasi P, Figueroa Gray M, Tiffany BT, Scrol A, Ralston JD, Fullerton SM, Lim CY, Ewing J, Leppig KA. Patient and family preferences on health system-led direct contact for cascade screening. J Pers Med. 2021;11(6):538. doi: 10.3390/jpm11060538. PubMed
Khan SS, Hoell C, Castillo LM, Connolly JJ, Crosslin DR, Chung WK, Gordon AS, Harr M, Jarvik GP, Kullo I, Larson EB, Leppig KA, Manolio T, Pacheco JA, Ralston JD, Puckelwartz MJ, Smith ME, Wells Q, McNally EM, Rasmussen-Torvik LJ. Practice patterns after return of rare variants associated with cardiomyopathy in the Electronic Medical Records and Genomics Network. Circ Heart Fail. 2021 May;14(5):e008155. doi: 10.1161/CIRCHEARTFAILURE.120.008155. Epub 2021 May 6. PubMed
Ralston JD, Yu O, Penfold RB, Gundersen G, Ramaprasan A, Schartz EM. Changes in clinician attitudes toward sharing visit notes: surveys pre- and post-implementation. J Gen Intern Med. 2021 Apr 22;1-7. doi: 10.1007/s11606-021-06729-1. Online ahead of print. PubMed
Henrikson NB, Scrol A, Leppig KA, Ralston JD, Larson EB, Jarvik GP. Preferences of biobank participants for receiving actionable genomic test results: results of a recontacting study. Genet Med. 2021 Jun;23(6):1163-1166. doi: 10.1038/s41436-021-01111-2. Epub 2021 Feb 18. PubMed
Makhnoon S, Bowen DJ, Shirts BH, Fullerton SM, Larson EB, Ralston JD, Leppig KA, Crosslin DR, Veenstra D, Jarvik GP. The FamilyTalk randomized controlled trial: patient-reported outcomes in clinical genetic sequencing for colorectal cancer. Cancer Causes Control. 2021 Feb 16. doi: 10.1007/s10552-021-01398-1. [Epub ahead of print]. PubMed
Open notes
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
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
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
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
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
Land Acknowledgment
Our Seattle offices sit on the occupied land of the Duwamish and by the shared waters of the Coast Salish people, who have been here thousands of years and remain. Learn about practicing land acknowledgment.