James D. Ralston, MD, MPH

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

Health Informatics

eHealth; hypertension; diabetes
Chronic Illness Management

Health informatics; hypertension; diabetes; health behaviors; multiple chronic conditions
Behavior Change

Self-management support
Health Services & Economics

Health care disparities

Recent publications

Schuttner L, Hockett Sherlock S, Simons CE, Johnson NL, Wirtz E, Ralston JD, Rosland AM, Nelson K, Sayre G My Goals Are Not Their Goals: Barriers and Facilitators to Delivery of Patient-Centered Care for Patients with Multimorbidity 2022 Dec;37(16):4189-4196. doi: 10.1007/s11606-022-07533-1. Epub 2022-05-23. PubMed

Schuttner L, Lee JR, Hockett Sherlock S, Ralston JD, Rosland AM, Nelson K, Simons C, Sayre GG Primary Care Physician Perspectives on the Influence of Patient Values, Health Priorities, and Preferences on Clinical Decision-Making for Complex Patients with Multimorbidity: A Qualitative Study 2022 Nov 16;15:2135-2146. doi: 10.2147/RMHP.S380021. Epub 2022-11-16. PubMed

Lozano PM, Lane-Fall M, Franklin PD, Rothman RL, Gonzales R, Ong MK, Gould MK, Beebe TJ, Roumie CL, Guise JM, Enders FT, Forrest CB, Mendonca EA, Starrels JL, Sarkar U, Savitz LA, Moon J, Linzer M, Ralston JD, Chesley FD Training the next generation of learning health system scientists 2022 Oct;6(4):e10342. doi: 10.1002/lrh2.10342. Epub 2022-09-10. PubMed

Haas CB, Ralston J, Fullerton SM, Scrol A, Henrikson NB Environmental scan of family chart linking for genetic cascade screening in a U.S. integrated health system 2022 Aug 11;13:886650. doi: 10.3389/fgene.2022.886650. Epub 2022-08-11. PubMed

Blasi PR, Scrol A, Anderson ML, Gray MF, Tiffany B, Fullerton SM, Ralston JD, Leppig KA, Henrikson NB Feasibility, acceptability, and limited efficacy of health system-led familial risk notification: protocol for a mixed-methods evaluation 2022 Aug 9;8(1):174. doi: 10.1186/s40814-022-01142-9. Epub 2022-08-09. PubMed

Miller-Rosales C, McCloskey J, Uratsu CS, Ralston JD, Bayliss EA, Grant RW Associations Between Different Self-reported Social Risks and Neighborhood-level Resources in Medicaid Patients 2022 Aug;60(8):563-569. doi: 10.1097/MLR.0000000000001735. Epub 2022-05-30. 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 2021-10-16. PubMed

Leppig KA, Kulchak Rahm A, Appelbaum P, Aufox S, Bland ST, Buchanan A, Christensen KD, Chung WK, Clayton EW, Crosslin D, Denny J, DeVange S, Gordon A, Green RC, Hakonarson H, Harr MH, Henrikson N, Hoell C, Holm IA, Kullo IJ, Jarvik GP, Lammers PE, Larson EB, Lindor NM, Marasa M, Myers MF, Perez E, Peterson JF, Pratap S, Prows CA, Ralston JD, Rasouly HM, Roden DM, Sharp RR, Singh R, Shaibi G, Smith ME, Sturm A, Thiese HA, Van Driest SL, Williams J, Williams MS, Wynn J, Blout Zawatsky CL, Wiesner GL The reckoning: The return of genomic results to 1444 participants across the eMERGE3 Network 2022 May;24(5):1130-1138. doi: 10.1016/j.gim.2022.01.015. Epub 2022-02-22. PubMed

McCloskey JK, Ellis JL, Uratsu CS, Drace ML, Ralston JD, Bayliss EA, Grant RW Accounting for Social Risk Does not Eliminate Race/Ethnic Disparities in COVID-19 Infection Among Insured Adults: a Cohort Study 2022 Apr;37(5):1183-1190. doi: 10.1007/s11606-021-07261-y. Epub 2022-02-02. PubMed

Patel HV, Henrikson NB, Ralston JD, Leppig K, Scrol A, Jarvik GP, DeVange S, Larson EB, Hartzler AL Implementation matters: How patient experiences differ when genetic counseling accompanies the return of genetic variants of uncertain significance 2022 Feb 21;2021:950-958. Epub 2022-02-21. PubMed