Growing up in Kenosha, Wisconsin, Kim Shoenbill enjoyed learning about science, biology, and how the human body worked. She was always a great listener and wanted to be in a helping profession.
Kim was the sixth of seven children, but was the first child in her family to go to college and undertook the process largely alone. She put herself through Marquette University, where she majored in psychology and took the pre-med prerequisites. During college she was a resident advisor and worked at a hospital on the med-surg floor.
As she completed college, Kim was wavering between pursuing psychology and medicine. She took a year off to earn some money. During that year, she decided that while counseling was appealing, medicine provided the ability to treat the whole person.
Kim proceeded to medical school at the University of Wisconsin (UW), which has a strong primary care focus. As a med student, she had a foray into research, assisting a professor studying amyotrophic lateral sclerosis (ALS) by analyzing data. Kim said, “We were using data to do informatics before it was called informatics.” She learned that both clinical care and research are team sports.
After graduating from medical school, Kim practiced family medicine for several years. She enjoyed developing relationships with patients and had a philosophy of always seeing the potential in every person and situation.
In working at a clinic and treating patients over time, Kim would start to see patterns and observe correlations. But she was so busy seeing patients, there was never time to analyze these patterns, nor did she have the tools to do so. Yet her interest lingered, and Kim wanted to learn more about data and informatics in improving care.
At the same time, Kim became interested in electronic health records (EHRs). She saw the potential of EHRs as well as shortcomings. She also saw the potential for the massive amounts of data collected in EHRs, most of which wasn’t used.
For a birthday present, Kim asked her husband for an expensive informatics textbook, which he bought for her. She read it cover to cover, which further fueled her interest in data and informatics. She realized the importance of aggregating data, understanding the data, and getting useful information from data. She saw the potential of using knowledge to improve patient care by developing guidelines and metrics.
“Data can lead to knowledge. From knowledge, you can start changing how you treat patients.”
This led Kim to initially seek additional training and eventually led her to a master’s degree, an NLM (National Library of Medicine) Fellowship, certification in clinical informatics, and a PhD. But her path wasn’t straightforward.
At the time, UW didn’t offer a master’s degree in biomedical informatics. Kim identified pockets of the training she wanted in various departments. Eventually, the administration asked her to help build the program. She began in the clinical investigation program and learned about data, statistics, research skills, clinical trials, and more. What Kim did for her master’s is now UW’s master’s program, and what she did for her PhD became the template for the PhD program.
During her PhD, Kim looked at lifestyle modification in treating hypertension. She used AI, specifically natural language processing, to review text in patients’ records to see if a doctor had discussed lifestyle modification. She could see if a physician had written a note in the EHR about counseling a patient on lifestyle modification, such as exercise.
Using AI, she reviewed over 800,000 charts for 15,000 patients. She found documentation about lifestyle modification for 78% of patients, but also found that physicians had followed up with only about 5% of patients. Kim is now working to create systemic solutions to make it easier for physicians to document and follow up with patients about lifestyle modification. She is also looking at benchmarks and metrics.
Kim has now moved to the University of North Carolina School of Medicine where she is an assistant professor in family medicine and a faculty member of the Program of Health and Clinical Informatics. She still sees patients, but is now doing more research and teaching. UNC recently established a clinical informatics fellowship, which will further increase her focus on teaching and training.
In reflecting on her journey, Kim recounts, “I went into medicine to help people. This [biomedical informatics] is a wonderful way to help people out at a higher level, that is more far reaching.” She enjoys using information to inform how she treats patients at the point of care, while also using data to inform doctors and patients more broadly.
“If you went into medicine to help patients, this is a way you can have a broader, more far-reaching scope to reach patients and help them.”