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

Harris LT, Koepsell TD, Haneuse SJ, Martin DP, Ralston JD. Glycemic control associated with secure patient-provider messaging within a shared electronic medical record: a longitudinal analysis. Diabetes Care. 2013 Sep;36(9):2726-33.doi: 10.2337/dc12-2003. Epub 2013 Apr 29. PubMed

Ralston JD, Silverberg MJ, Grothaus L, Leyden WA, Ross T, Stewart C, Carzasty S, Horberg M, Catz SL. Use of web-based shared medical records among patients with HIV. Am J Manag Care. 2013 Apr 1;19(4):e114-24. PubMed

Lyles CR, Grothaus L, Reid RJ, Sarkar U, Ralston JD. Communication about diabetes risk factors during between-visit encounters.  Am J Manag Care. 2012;18(12):807-15. PubMed

McInnes DK, Brown JA, Hays RD, Gallagher P, Ralston JD, Hugh M, Kanter M, Serrato CA, Cosenza C, Halamka J, Ding L, Cleary PD. Development and evaluation of CAHPS questions to assess the impact of health information technology on patient experiences with ambulatory care.  Med Care. 2012;50 Suppl:S11-9. doi: 10.1097/MLR.0b013e3182610a50. PubMed

Delbanco T, Walker J, Bell SK, Darer JD, Elmore JG, Farag N, Feldman HJ, Mejilla R, Ngo L, Ralston JD, Ross SE, Trivedi N, Vodicka E, Leveille SG. Inviting patients to read their doctors' notes: a quasi-experimental study and a look ahead.  Ann Intern Med. 2012;157(7):461-70. doi: 10.7326/0003-4819-157-7-201210020-00002. PubMed

Grembowski D, Anderson ML, Ralston JD, Martin DP, Reid R. Does a large-scale organizational transformation toward patient-centered access change the utilization and costs of care for patients with diabetes?  Med Care Res Rev. 2012 Oct;69(5):519-39. Epub 2012 May 31. PubMed

Silverberg M, Leyden W, Stewart C, Ralston J, Horberg M, Carzasty S, Grothaus L, Catz S. Change in adherence to antiretrovirals after initial use of an electronic shared medical record among HIV-infected individuals. Clin Med Res. 2012;10(3):144-5. PubMed

Lyles CR, Harris LT, Jordan L, Grothaus L, Wehnes L, Reid RJ, Ralston JD. Patient race/ethnicity and shared medical record use among diabetes patients.  Med Care. 2012 May;50(5):434-40. PubMed

Leveille SG, Walker J, Ralston JD, Ross SE, Elmore JG, Delbanco T. Evaluating the impact of patients' online access to doctors' visit notes: designing and executing the OpenNotes project.  BMC Med Inform Decis Mak. 2012 Apr 13;12:32. PubMed

Frederickson R, Crane PK, Tufano J, Ralston J, Schmidt S, Brown T, Layman D, Harrington RD, Dhanireddy S, Stone T, Lober W, Kitahata MM, Crane HM. Integrating a web-based, patient-administered assessment into primary care for HIV-infected adults. J AIDS HIV Res. 2012;4(2):47-55.




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