Greg Kefer of Lifelink Systems: In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System

An Interview With Luke Kervin

Payment models must be reimagined. Insurance claims are an expensive nightmare for patients and providers. One wrong digit on a code triggers a two-month reconciliation odyssey that is incredibly expensive for everyone. Today, insurance providers have incentives to reject claims, which often happen because of the dense layers of data, incompatible systems and low-paid, untrained call center agents that are scattered around the world. Ironically, Medicare is one of the best in terms of dealing with claims when compared to the commercial providers.

The COVID-19 Pandemic taught all of us many things. One of the sectors that the pandemic put a spotlight on was the healthcare industry. The pandemic showed the resilience of the US healthcare system, but it also pointed out some important areas in need of improvement.

In our interview series called “In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System”, we are interviewing doctors, hospital administrators, nursing home administrators, and healthcare leaders who can share lessons they learned from the pandemic about how we need to improve the US Healthcare System.

As a part of this series, I had the pleasure to interview Greg Kefer.

Greg Kefer is the Chief Marketing Officer at Lifelink Systems, responsible for all marketing, strategy and the healthcare chatbot technology company. Previously he served as VP of Marketing at Infor Corporation, supporting a business unit focused on global supply chains and commerce automation for large enterprises. Greg was also VP of corporate marketing at GT Nexus, a cloud supply chain platform provider where he led all marketing and communications functions as the company grew from startup stage through a successful $700 million acquisition in 2015. Greg started his career in the advertising agency business in a strategic account management role and has a BS from the University of Oregon.

Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a bit about your backstory and a bit about what brought you to this specific career path?

I have had a long career in advertising and marketing. At the peak of the dot com bubble, I took a gamble and joined a startup that was attempting to disrupt the global container shipping industry with a cloud-based network that allowed companies to track inventory as it was produced and moved around the world. We had the right solution at the right time, but it still took a lot of work to re-orient a huge, entrenched industry and get it to think differently about what technology they needed. Marketing played a huge role in the success of that company, GT Nexus, which gained traction through the success of very large, influential customers sharing their success through various marketing channels. Ultimately Infor purchased GT Nexus for $675 million. What I’m doing now at Lifelink Systems feels like a repeat — a big, complex, broken industry in need of different thinking around technology and we’re tapping industry leaders to showcase how they’re using conversational AI to reimagine the patient experience in healthcare.

Can you share the most interesting story that happened to you since you began your career?

A 30-year career produces many interesting moments. Early on, I was an advertising agency client manager for the Oakland Raiders account. The Raiders had just moved back to Oakland for the 2nd time and there was a challenging ticket sales and marketing partnership between the team, the city, and county. I had called a meeting with my client to review a marketing plan for an upcoming home game but when I arrived, there were 15 people in attendance at the meeting, including several team executives and local politicians. I got through the first page of my proposal before the conversation degenerated into a blame game regarding who was at fault for slow ticket sales. The next day, the meeting was covered in a story about why the deal with the Raiders was doomed for failure. We never knew who leaked the minutes of the meeting to the press, but it was eye opening to see the culture clash between an NFL team and the government.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

In my advertising days, we had a video game client that was a Japan based company. The client and I decided to pull a joke on my boss and came up with this concept that they wanted to start paying the agency fees in yen currency. The ruse got out of control and led to our CFO spending hours creating a currency valuation model to ensure we were properly paid. Upon discovering it was all a joke, certain people were not too pleased with the distraction, and it was not funny. So, lesson learned was to have fun with your job, but avoid things that might impact other people. I still think it was pretty funny but wouldn’t do it again.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“Innovation distinguishes between a leader and a follower” is one of many great Steve Jobs quotes. I find it professionally relevant because I spend my working hours looking for ways to make believers of the innovation my company sells. The followers outnumber the innovators by 50x. I build marketing campaigns around the innovators. And I tend to live my life the way an innovator would, not because everyone else is doing something.

Are you working on any exciting new projects now? How do you think that will help people?

At Lifelink Systems, we have a lot of great technology that’s predicated on the notion of language at the user interface — called conversational AI. It works because it’s simple for anyone to use, which is very important in healthcare. One of our products is called the Virtual Waiting Room, and it’s deployed at major health systems and allows millions of patients to skip going to waiting rooms before appointments. We’re improving on an experience that most people don’t like and is expensive for healthcare providers. It’s live at some of the biggest healthcare providers in the nation, giving millions of people the option to skip going to the waiting room ever again. I think that’s a pretty cool thing to be part of.

How would you define an “excellent healthcare provider”?

Providers are not differentiated based on the clinical care they provide. It’s all excellent. Where they do diverge is in the patient experience. Some are still using paper forms, robo calls, and e-mail to communicate with patients. The “excellent providers” are rapidly pivoting and providing a more consumer-like experience, like the way we interact with businesses in banking, travel, or retail. If existing healthcare providers don’t figure it out, companies like Apple, Amazon, Walgreens or Walmart will. When the great clinical care is “wrapped” with a great consumer experience, that defines an excellent healthcare provider.

Ok, thank you for that. Let’s now jump to the main focus of our interview. The COVID-19 pandemic has put intense pressure on the American healthcare system. Some healthcare systems were at a complete loss as to how to handle this crisis. Can you share with our readers a few examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these specific issues moving forward?

There have been many moments over the past 18 months where the healthcare system came close to hitting its breaking point. One common theme throughout the course of the pandemic has been dealing with the supply-demand capacity mismatch that were caused by the unpredictable nature of the infection surges. While it’s not realistic to build expensive infrastructure like a back-up wing to the ER to handle a once in a generation flood of patients, COVID-19 did expose the shortcomings of the administrative side of our healthcare system. There is still too much reliance on “analog” processes — paper, phone calls, 1:1 interaction, etc. For example, in the early days of pandemic, hospitals were overwhelmed with worried patients calling in or showing up at urgent care centers for treatment. The reality was that most didn’t have COVID, but the established urgent care screening process was typically an exam, performed in real time by a trained clinician and that could not scale. To its credit, the industry pivoted rapidly to virtual triage technology to help pre-screen patients and help prioritize those who had legitimate risk for COVID. The new virtual solutions handled millions of inbound calls. Nobody was on hold for an hour. Worried people got some answers. And, importantly, the overstretched care teams got some workload relief so they could focus on those who needed care most. For example, we saw a virtual army of chatbots arrive on the front lines of the early days of the COVID battle to digitize screening and millions of patients used and liked the technology. That opened a lot of eyes, and we are already seeing a huge push for more technology across the full spectrum of care. I expect we will see a lot of changes to the administrative side of healthcare in the coming years because of this.

Of course the story was not entirely negative. Healthcare professionals were true heroes on the front lines of the crisis. The COVID vaccines are saving millions of lives. Can you share a few ways that our healthcare system really did well? If you can, please share a story or example.

Yes, the front-line heroes are working miracles everywhere and the rapid development of highly effective vaccines illustrate just how far the science of healthcare has advanced. One example that shows how innovation can make a difference is from Banner Health, a 30-hospital system across six southwestern states. In late Spring of 2020, they needed to get their clinics opened so patients could see their physicians for the routine care that had been placed on hold while hospitals figured out how to operate safely. But the waiting room was something that had to change because of the social distancing guidelines. So Banner launched a mobile chatbot across thousands of clinics to handle the check in process that had previously been handled in person, with paper forms in waiting rooms. Reminders, instructions, and forms were all handled using conversational bots a few days before the appointment and when patients arrived to see their doctor, they bypassed the waiting area and headed directly to the exam room. Waiting rooms were never a good patient experience and they take up expensive real estate. Banner is on the path to proving there’s a better way, and it’s virtual.

Here is the primary question of our discussion. As a healthcare leader can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

1. The industry must virtualize the way it communicates with patients. The administrative overhead is too complex and expensive. It needs 21st century innovation, which is not solved with more broadcast e-mail campaigns and robocalls. The virtual waiting room example described above is one example of the massive opportunity at hand. If you can engage millions of patients and help them navigate the bidirectional, long arc workflows that come with healthcare, the positive impact is significant.
2. The system needs to become less reactive in the way it treats patients. Today, you get sick, you get treated and you (or insurance) pay for that treatment. It needs to become more outcome focused. The shift from an episodic model to a value-based model is not a new idea, but more must be done. Every person in this country should be in regular contact with their healthcare providers, regardless of if they are sick or not. Simple regular check ins to make sure things such as mammograms are scheduled, that there are no lingering side effects from a previous injury, that annual physicals are scheduled, and allergies are under control is part of a strategy that builds long term relationships and positive outcomes with all patients. The only way to pull this off is through advanced technology as there will never be enough human teams. The good news is that technology has matured to the point where digital assistants can augment care teams with unlimited conversational scale.
3. Equity and access must continue to be a priority. Again, I think technology can play a huge role helping underserved communities get care and stay healthy. Dealing with healthcare is complex and time consuming for everyone, but if you have two jobs, no reliable transportation, or no insurance it becomes nearly impossible. We know that 82% of US adults own a smartphone, which covers all demographic groups. We can now do so much virtually, through a smartphone, to engage people across all communities regardless of income, race, age or education. For example, Genentech is using mobile chatbots to help people in disadvantaged communities participate in clinical trials for new drugs.
4. Healthcare has a massive, looming staffing crises. The overall workforce shortages are impacting all industries but healthcare has the added burden of massive burnout after a nearly two-year battle with COVID-19. Technology will be part of the solution by taking on a lot of the robot, repetitive time-consuming tasks that tend to eat up a lot of time and create frustration. The back-office automation initiatives are significant undertakings, but also vital. When those are then connected to the “front office” patient experience solutions, the upside is significant. When a patient checks in to their appointment with a virtual waiting room chatbot, five forms are completed and transmitted directly to their records in the EHR system. That means a human clerk didn’t need to re-key that information, data was accurate, and the information digitally triggers other related processes. That will save millions of hours of costly, frustrating time and allow care teams to focus on providing great care.
5. Payment models must be reimagined. Insurance claims are an expensive nightmare for patients and providers. One wrong digit on a code triggers a two-month reconciliation odyssey that is incredibly expensive for everyone. Today, insurance providers have incentives to reject claims, which often happen because of the dense layers of data, incompatible systems and low-paid, untrained call center agents that are scattered around the world. Ironically, Medicare is one of the best in terms of dealing with claims when compared to the commercial providers.

Let’s zoom in on this a bit deeper. How do you think we can address the problem of physician shortages?

Part of the problem is that physicians are being asked to do too much beyond just treating patients. Whether it’s spending late nights updating digital patient records or responding to hundreds of patient e-mails, the administrative overhead is driving physicians into different careers. There is potential to augment physician workloads with digital assistants. Imagine having a conversational chatbot that can answer 80% of the questions patients ask their doctor each day. Digitizing that would not solve the burnout problem, but it would help. Also, something must be done about medical education as it is too expensive. Medical school costs, plus the 8+ years of training is a huge financial commitment. It’s a borderline national security issue and I think most taxpayers would not be opposed to subsidizing the price of training new generations of care givers.

How do you think we can address the issue of physician diversity?

I think the cost aspect described above is huge here. If somebody has the smarts and desire to pursue a career in medicine, concerns about being able to pay for it should not be a factor. There’s no reason that one’s zip code should play a role in whether someone can become a physician. If this cost is addressed, we will see diversity improve.

How do you think we can address the issue of physician burnout?

We have got to find a way to relieve them of all the administrative headaches and allow them to practice their craft, which is treating patients. I’m a firm believer that technology is the only path here, but somehow today’s technology has managed to create even more administrative overhead. IT is evolving quickly, and we are beginning to see solutions that use language as the user interface, which could make an impact. The tech needs to augment physicians, not replace them, and pick up all the low-end tasks that take up so much time.

What concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

First, you half to recognize there’s a huge problem and I think that is happening — especially as we come out of the COVID-19 pandemic. Everyone is trying to do the right thing, and nobody is sitting around thinking that all is well in American healthcare. Leaders need to take a disruptive mindset towards solving the problems. That means moving fast, taking some risks, and innovating rapidly. Every time I see an IT steering committee with a 5-year plan, I think to myself that Amazon are Apple are going to come in and eat these guys alive. The big consumer companies are moving into healthcare and if the incumbents don’t act quickly, someone else will. Maybe that’s a good thing!

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

I’d love to start a crowdfunding movement to raise billions of dollars to buy Twitter. Once I owned it, I’d turn it off.

How can our readers further follow your work online?

You can follow me on LinkedIn here: https://www.linkedin.com/in/greg-kefer/

I’m on Twitter here: https://twitter.com/Gregkefer

My blogs and podcasts are here: https://resources.lifelinksystems.com/

Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.