James D. Ralston, MD, MPH

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“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.

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Research interests and experience

Recent publications

Grembowski D, Ralston JD, Anderson ML. Hemoglobin A1c, comorbid conditions and all-cause mortality in older patients with diabetes: a retrospective 9-year cohort study. Diabetes Res Clin Pract. 2014 Nov;106(2):373-82. doi: 10.1016/j.diabres.2014.07.017. Epub 2014 Jul 29. PubMed

Rasmussen-Torvik LJ, Stallings SC, Gordon AS, Almoguera B, Basford MA, Bielinski SJ, Brautbar A, Brilliant M, Carrell DS, Connolly J, Crosslin DR, Doheny KF, Gallego CJ, Gottesman O, Kim DS, Leppig KA, Li R, Lin S, Manzi S, Mejia AR, Pacheco JA, Pan V, Pathak J, Perry CL, Peterson JF, Prows CA, Ralston J, Rasmussen LV, Ritchie MD, Sadhasivam S, Scott SA, Smith M, Vega A, Vinks AA, Volpi S, Wolf WA, Bottinger E, Chisholm RL, Chute CG, Haines JL, Harley JB, Keating B, Holm IA, Kullo IJ, Jarvik GP, Larson EB, Manolio T, McCarty CA, Nickerson DA, Scherer SE, Williams MS, Roden DM, Denny JC. Design and anticipated outcomes of the eMGERG-PGx project: a multi-center pilot for pre-emptive pharmacogenomics in electronic health record systems. Clin Pharmacol Ther. 2014 Oct;96(4):482-9. doi: 10.1038/clpt.2014.137. Epub 2014 Jun 24. PubMed

Oster NV, Jackson SL, Dhanireddy S, Mejilla R, Ralston JD, Leveille S, Delbanco T, Walker JD, Bell SK, Elmore JG. Patient access to online visit notes: perceptions of doctors and patients at an urban HIV/AIDS clinic. J Int Assoc Provid AIDS Care. 2015 Jul-Aug;14(4):306-12. doi: 10.1177/2325957414526783. Epub 2014 Apr 11. PubMed

Ralston JD, Cook AJ, Anderson ML, Catz SL, Fishman PA, Carlson J, Johnson R, Green BB. Home blood pressure monitoring, secure electronic messaging and medication intensification for improving hypertension control: a mediation analysis. Appl Clin Inform. 2014 Mar 12;5(1):232-48. doi: 10.4338/ACI-2013-10-RA-0079. eCollection 2014. PubMed

Jackson SL, Mejilla R, Darer JD, Oster NV, Ralston JD, Leveille SG, Walker J, Delbanco T, Elmore JG. Patients who share transparent visit notes with others: characteristics, risks, and benefits. J Med Internet Res. 2014 Nov 12;16(11):e247. doi: 10.2196/jmir.3363. PubMed

Lyles CR, Sarkar U, Ralston JD, Adler N, Schillinger D, Moffet HH, Huang ES, Karter AJ. Patient-provider communication and trust in relation to use of an online patient portal among diabetes patients: The Diabetes and Aging Study. J Am Med Inform Assoc. 2013 Nov-Dec;20(6):1128-31. doi: 10.1136/amiajnl-2012-001567. Epub 2013 May 15. PubMed

Hartzler A, McCarty CA, Rasmussen LV, Williams MS, Brilliant M, Bowton EA, Clayton EW, Faucett WA, Ferryman K, Field JR, Fullerton SM, Horowitz CR, Koenig BA, McCormick JB, Ralston JD, Sanderson SC, Smith ME, Trinidad SB. Stakeholder engagement: a key component of integrating genomic information into electronic health records. Genet Med. 2013 Oct;15(10):792-801. doi: 10.1038/gim.2013.127. Epub 2013 Sep 12. doi: 10.1038/gim.2013.127. PubMed

Vodicka E, Mejilla R, Leveille SG, Ralston JD, Darer JD, Delbanco T, Walker J, Elmore JG. Online access to doctors' notes: patient concerns about privacy. J Med Internet Res. 2013 Sep 26;15(9):e208. doi: 10.2196/jmir.2670. PubMed

Fishman PA, Cook AJ, Ralston JD, Anderson M, Catz SL, Carrell D, Carlson J, Larson EB, Green BB. Improving BP control through electronic communications: an economic evaluation. Am J Manag Care. 2013;19(9):709-16. PubMed

Green BB, Anderson ML, Ralston JD, Catz SL, Cook AJ. Blood pressure 1 year after completion of web-based pharmacist care. JAMA Intern Med. 2013 Jul 8;173(13):1250-2. doi: 10.1001/jamainternmed.2013.1037. Epub 2013 May 20. PubMed

 

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