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Making health IT work for, not against, family docs

As a young doctor, Steven Waldren, M.D., envisioned himself devoting about 70 percent of his time to practicing family medicine and the rest to his awakening interest in medical information technology. Instead, the latter field turned into his full-time career as it exploded in importance for the medical community in general.

As a young doctor, Steven Waldren, M.D., envisioned himself devoting about 70 percent of his time to practicing family medicine and the rest to his awakening interest in medical information technology.

Instead, the latter field turned into his full-time career as it exploded in importance for the medical community in general.

Waldren, a graduate of KU School of Medicine (1999) and the KU School of Medicine-Wichita Family Medicine residency program at Wesley Medical Center (2003), is director of the Alliance for eHealth Innovation, a part of the Overland Park-based American Academy of Family Physicians (AAFP).

Waldren misses seeing patients but doesn't regret focusing his career on the improvement of health care through IT. 

"I found this to be fascinating," he said.

A native of southeast Kansas, Waldren said he wanted to be a doctor for as long as he can remember. Losing his spleen in a freak golfing accident when he was nine years old - a club slipped out of his brother's hand - played a role. He still remembers the name of the physician, Dr. F. Ronald Seglie (a former AAFP Kansas physician of the year), who treated him.

Waldren majored in biology and chemistry at Pittsburg State University. He went on to earn his medical degree from KU School of Medicine-Kansas City before completing his residency in Wichita.

At Wesley, as part of an elective in medical informatics, he created a computerized rounds report that physicians could access for patients. It included lab test results, vital signs and other information. Prior to that, he said, the information "was all there. It was just in different places."

He also concluded that the KU faculty member who "seemed to be the happiest" - Dr. Mary Boyce - had a significant pursuit away from medicine, interviewing and testifying in child abuse cases.

"I needed to find a professional hobby," Waldren concluded.

At KU, Waldren had learned about a fellowship and master's program in information technology at the University of Missouri in Columbia. Waldren completed the two-year program and went to work at AAFP in 2004. At the nonprofit, which represents and serves more than 124,000 family physicians, Waldren started as assistant director of the Center for Health IT, which had been created the year earlier.

Waldren's chief goal initially was to help family physicians adopt electronic health records, to the benefit of patients and their doctors alike. But he's also been the AAFP's representative on several outside bodies and organizations involved in medical IT. These include the Center for Improving Medication Management, a national group that educates clinicians and staff about prescribing technology; the Ambulatory Care Quality Alliance's Data Aggregation and HIT Subcommittee; the Medicaid and Children's Health Insurance Access and Payment Commission; and American Society for Testing and Materials' E31 Health Information Standards Committee.

That's a lot of meetings and agendas. Waldren says his efforts basically boil down to three things: advocacy, education and the setting of standards to benefit family physicians in the area of health IT.

Because 80 percent of family physicians now use electronic health records (EHR), Waldren's work at AAFP has shifted somewhat. Waldren says current IT products are not as functional as they should be, especially when it comes to "interoperability" - that is, the ability of one physician's EHR system to share information with another physician, patient or other authorized person. Also, too many of the EHR systems are not user friendly. Waldren says they need improvement before physicians view them as a help rather than a hindrance.

"Instead of the doctor working for the EHR, the EHR should be working for the doctor."

Waldren, on behalf of the AAFP, advocates to both the federal government and the makers of EHR systems that these changes must be made, and argues against other proposed IT regulations that the organization believes would be counterproductive.

Looking ahead, Waldren sees a time when family physicians will use voice-activated machines with artificial intelligence to help them in their practice. The physician would simply have a conversation with the machine about the patient's medical history and be able to take into consideration a vast realm of data, succinctly correlated, when prescribing treatment.

Family physicians shouldn't fear this brave new world, Waldren said. It will make them more effective than ever.

"I think it's just going to augment the capabilities of the family doctor," Waldren said. "The family doc's not going to get replaced."


KU School of Medicine-Wichita