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

Li KH, Krakauer C, Nelson JC, Crane PK, Andre JB, Curl PK, Yuh E, Mossa-Basha M, Ralston JD, Mac Donald CL, Gray SL. Cumulative anticholinergic exposure and white matter hyperintensity burden in community-dwelling older adults. J Am Geriatr Soc. 2024 Dec 19. doi: 10.1111/jgs.19325. [Epub ahead of print]. PubMed

Hoopes AJ, Cushing-Haugen K, Coley RY, Fuller S, Sucato GS, Mangione-Smith R, Ralston JD. Teen secure messaging is associated with use of sexual and reproductive health services in One Health system. J Adolesc Health. 2024 Nov 22:S1054-139X(24)00512-3. doi: 10.1016/j.jadohealth.2024.10.016. [Epub ahead of print]. 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. bioRxiv [Preprint]. 2024:2024.11.10.622861. doi: 10.1101/2024.11.10.622861. PubMed

Penfold RB, Idu AE, Coley RY, Cushing-Haugen KL, King D, Glass A, Phillips RC, Renz AD, Pabiniak CJ, Graham VF, Thompson EE, Ralston JD, Simon GE, Gonzalez ES, Myers KM, Beck A, Quintana LM, Runkle AJ, Rogers M, Foster DM, Clarke GN, Massimino S, Crawford PM, Cavese JA, Cordaro AR, Chavez LI, Kelleher KJ, Schwartz N, Jiner KR, Liu SB, Condrac S, Hilt RJ. Safer and targeted use of antipsychotics in youth: an embedded, pragmatic randomized trial. J Child Psychol Psychiatry. 2025 Mar;66(3):301-310. doi: 10.1111/jcpp.14059. Epub 2024 Oct 29. 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. Public Health Genomics. 2024;27(1):150-160. doi: 10.1159/000541532. Epub 2024 Sep 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. Med Care. 2024 Jun 4. doi:10.1097/MLR.0000000000002021. [Epub ahead of print]. 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. J Gen Intern Med. 2024 May 20. doi: 10.1007/s11606-024-08801-y. [Epub ahead of print]. 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. medRxiv [Preprint]. 2024:2024.04.05.24305377. doi: 10.1101/2024.04.05.24305377. 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. Contemp Clin Trials. 2024 Mar 11;140:107495. doi: 10.1016/j.cct.2024.107495 [Epub ahead of print] 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. Br J Radiol. 2024;97(1155):614-621. doi: 10.1093/bjr/tqae004. PubMed