Mark Kestner shares a chief innovation officer’s perspective on healthcare in this episode of the Perspectives on Healthcare Podcast with Rob Oliver. Among his many accomplishments, Mark served in the Army and we appreciate his service to our country. Located in Washington DC, Mark Kestner is a member of the baby Boomer generation. He has worked in healthcare as a surgeon and now is the chief innovation officer at MediGuru.
Here are 3 things that stood out as Mark Kestner gave us a chief innovation officer’s perspective on healthcare:
· Quality healthcare must be patient centric, it must be focused on outcome and decreasing overall cost
· Mark has a unique view in which he makes an important distinction between people who are “patients” and those who are “customers” of healthcare
· In the past, systems were built around what was convenient for the healthcare system and the providers. Systems now should be built around what is most convenient for the patient/customer.
You can learn more about Mark Kestner and MediGuru through the website and social media links below:
Website http://mediGuru.com
Linkedin https://www.linkedin.com/in/markkestnermd/
Here is the text from my conversation with Mark Kestner as he presented a chief innovation officer’s perspective on healthcare:
Introduction to Mark Kestner
Rob Oliver: Thank you. And welcome to another edition of Perspectives on Health Care. Today, my perspective comes from Mark Kestner. He is the chief innovation officer at MediGuru. He is a member of the baby Boomer generation. He is in Washington, D. C. Mark, welcome to the podcast.
Mark Kestner: Yes. Thank you so much.
Tell me about yourself and your role in healthcare
Rob Oliver: You bet. So tell me a little bit about yourself and your role in health care, please.
Mark Kestner: Yeah. So I started out as an engineer. I went to a small engineering school. So that sort of flavors the way I looked at healthcare was went to University of Michigan and ultimately became a general surgeon. During that residency, I joined the army for fun so that we could travel. I have two small children and worked as a general surgeon in the army for seven years. During that time period, I did a trauma critical care fellowship and then pretty much moved all around the United States. Was in El Paso, Texas, Albuquerque, New Mexico, Portland, Oregon, Omaha, Nebraska, Phoenix, California, Fresno, California, and ultimately here in DC. In 2007, I sort of got up with healthcare being broken. All the processes around health care were broken, and I left clinical practice and got my MBA, spent a year at Gallup University trying to figure out how we could engage physicians in changing healthcare. And from that period on, I worked as a chief medical officer, chief quality officer, associate chief medical officer. Had done a lot of those things while I was still clinically active, but now I was doing it more full time, ultimately started a consulting company to look at throughput through facilities, and then ultimately went into some venture capital companies, then ultimately joined MediGuru. So I’ve pretty much had a very diverse background in healthcare and have looked at it from multiple angles, from the business of medicine to the management of physicians. And now we’re looking at it from the perspective of telehealth.
Rob Oliver: Excellent. Well, you bring a truly unique perspective, and it is that perspective that is valuable for both me and my listeners. I will also add thank you very much for your service to our country. I appreciate that and definitely want to recognize that service. So you have worn a number of different hats. You’ve been in a number of different areas.
Your definition of quality healthcare
Rob Oliver: So I’m curious to hear your answer to this question. What does quality health care mean to you?
Mark Kestner: Well, I think it becomes very patient centric. It has to be patient centric. It has to be focused on outcomes and decreasing overall cost. And I think I’m a little concerned about the fact that we focus on the profit of health care, the profitability of health care and somehow get lost in the outcomes of health care. And so I think if anything, the pandemic has forced the issue of putting the customer first, doing what the customer wants and healthcare being a delivery model around the customer. So I think and with that will come quality outcomes and overall lower cost.
Rob Oliver: Okay. I’m very interested in hearing your thoughts on this because you use the word customer where I’m used to hearing the word patient. Can you talk to me about the difference in viewpoint between patients and customers and why it’s important to have that understanding?
Mark Kestner: Well, I think this is just my opinion that a patient is really somebody who’s sick, whereas a customer, it’s similar to using my cell phone. It’s similar to tracking the number of steps I take on a daily basis. We become a consumer of health care. Right. And if we’re talking about health care, we’re supposed to be talking about not only when we’re sick, but when we’re healthy. And so that’s where I sort of take exception. I think of patience as being somebody who’s sick. I think customers are trying to stay well.
Rob Oliver: Okay. Which is, again, a unique perspective, because when I’m hearing that the underlying subtext of what you’re saying is that health care is not specifically for only people who are sick, but health care should be something that is a part of everyone’s lives, not just at the moment when they are experiencing acute symptoms. Is that properly summarizing?
Mark Kestner: Yeah, no, that’s exactly right. I mean, we all make our New Year’s resolution and we’re all focusing on health at the beginning of the year. But I don’t think of us as being patients. I think of us as putting together a map or a plan to remain healthy so that to me, feels like a customer.
Rob Oliver: Yeah. Okay. So you mentioned New Year’s resolutions. And here’s a random fact for you. I got an email the other day. It was like January 17 is Break Your Resolution Day. And I’m like, you can’t even wait until February to give us Break your Resolution Day. It’s coming in January. All right.
An example of quality healthcare
Rob Oliver: Can you give me an example of quality health care?
Mark Kestner: Well, hospital avoidance, telehealth, having access to your needs, whether that be therapy, whether that be physician. So I think all of those are sort of defining the mode at which health care is being delivered, as well as the outcome. By providing those services, you’re improving outcome. So I consider that to be quality of health care because I was a chief quality officer, was data mining from the electronic health record. And did you give the aspirin on arrival, what’s your readmission rate, all that kind of stuff? I think that is patient data, but I really think that quality healthcare is what you’re delivering to customers. And so I think whatever improves the life, the life expectancy, the quality of life for somebody is really what we should be focused on.
Rob Oliver: Okay. And it’s very interesting to hear you say that because as you and I are both likely aware, when you’re practicing patient centered care and you’ll find the statistics will show you that things such as the duration of the common cold are shortened, blood pressure rates are lowered, and all of those things are happening. And those are quantifiable things that come from what can be viewed as a qualitative measure when it comes to patient centered care.
What do you wish people understood about your role in healthcare?
Rob Oliver: Can you tell me a little bit what do you wish people understood about your role in health care?
Mark Kestner: Well, I think through the pandemic, physicians have become employees. And I think that that unique employed group hasn’t been managed appropriately in the past. Positions wrote orders and people followed them. Mouth positions are part of a team. And so my hope is to be able to give the manager of that physician workforce the tools they need to manage that workforce effectively. We know from engagement studies that the thing that engages an employee is their manager. And yet through this transition, physicians have become employees, but nobody has given their manager the tools to manage that workforce. So one of my goals is to make sure that we’re grooming the next generation of physician leaders to manage a complex and expensive workforce.
Rob Oliver: Okay. Again, you bring up something, and it’s not directly related to what you said, but you were talking about what’s going on with the pandemic and the relationship between I’m thinking about the relationship between customers and physicians and the medical community at large in which people are doing a lot more research on their own. And the concept of the doctor as the all knowing source of information has really changed. Where you have people who are self treating with Ivermectin or whatever that is, you have people who are choosing to listen to one doctor over another when it comes to whether or not they are going to have a vaccine or wear a mask. And in that way, I think it really contributes to that concept that you have of people as customers in which they are really choosing the direction that their health care goes based on their own information. How does that resonate with you?
Mark Kestner: Yeah, I think that’s the case. I think what has to happen over time is that the importance of the relationship a patient has to their healthcare team is going to become increasingly important. So in other words, I guess I’m having a hard time understanding why somebody would go to Google to find out a health care treatment plan as compared to going to their physicians or their primary care or calling the office. Right. And why there is such distrust in some segments of the population with the medical community. I’m hopeful that increasingly people will turn to physicians or their healthcare provider as being that expert. And I think that gets back to the idea that their customers, they’re not patients. They’re not sick right now. Right. And so we should arm that customer with the appropriate tools and recognize the expertise of the healthcare delivery system as compared to questioning it all the time.
What excites you about the future of healthcare?
Rob Oliver: Yeah, very well stated. This one, I believe, is right in your wheelhouse. So what excites you about the future of health care?
Mark Kestner: I look at my grandchildren and they can’t live. I mean, the first thing they want to do is hold my phone. So the future of health care needs to move to that modality to virtual care. Right. It needs to be quick, easy, accessible. It needs to be available all the time wherever you need. It not necessarily just waiting in the office waiting room. All of those modalities in which we delivered care five years ago, I think, are going to change significantly. And so I’m excited about that. I love change. I love doing new models of care delivery. I think that’s the future and the expectation of the customer is going to be that I have my care available when I want it.
Rob Oliver: That’s a really interesting concept because typically, as you said five years ago, which in technology terms is decades, five years ago, you would call the doctor and see when the first available appointment was. Yeah. And for the record, when you said this, you were holding up your cell phone, you have that in your hand, and you can get a telemedicine or a telehealth appointment almost any time that you want. Your career has become that accessible. Do you see that more as a function of advances in technology? Is that something that the pandemic has kind of accelerated or caused? What’s your viewpoint on that?
Mark Kestner: I think the pandemic has changed patients to customers. Right. And so in the past, we built processes around what was convenient for either the health system or the physician. In the future, we’re going to build processes that make us more desirable to the customer. Right. And so I’ll give an example, one that just drives me crazy. Why do I have to sit and wait and fill out paperwork? I got my COVID vaccine at the grocery store here, and I had to fill up the same paperwork three separate times with a pencil. I don’t even know how to write anymore on a clipboard. Right. That’s inexcusable. And so to have a patient come to a waiting room and wait, I think, is a waste of time and was a relic of the past. What I envision is whether it’s a virtual visit or whether it’s an in person visit that I’ve been given all of the paperwork beforehand that needs to be validated. The prior authorization has occurred, and all I do is either click a link to get a virtual visit, or I walk from my car to the exam room to see the doctor and everything’s been done that becomes more customer centric as compared to healthcare centric.
Rob Oliver: Yeah. And it’s so interesting to hear you say that as well Because I’m pretty sure that when you fill out that paperwork with a pen or a pencil and you hand it in, Someone takes that and they hold it up next to a computer screen to double check that the information that’s on the piece of paper Matches what’s in the computer. So it’s all going to something that’s already computerized, right. So very interesting.
Healthcare quality improvement strategies
Rob Oliver: What is one thing Medical professionals can start doing today to improve the quality of healthcare?
Mark Kestner: I recognize that they’re part of a team and that we want to maximize every member on that team. Physicians. The biggest dissatisfier among physicians is the administrative burden. And when so many of the virtual care televisit solutions Were nothing more than a Zoom on top of I shouldn’t use the word, but they just bolted this on top of the electronic health record and then gave it to the positions to facilitate a visit. I think what we’re going to have to do Is recognize every member of the team Needs to contribute to the care delivery model, and if that means the prior authorization Is done proactively by somebody else on the team as compared to just being a denial after the fact, we need to do that. We need to have the medical assistant do as much as they can. We need to have the nurses do as much as they can and we need to empower them to be able to do that. So I think if we’re going to engage the workforce, if we’re going to retain the workforce Because it’s anticipated that 130,000 physicians Will be behind 130,000 physicians by the year 2030, we’re going to have to maximize the use of every team member in order to deliver the care into the future.
Rob Oliver: Yeah. And from my viewpoint, I would just add that it’s important to include the patient as part of the team.
Mark Kestner: Correct.
Rob Oliver: Because they’re Ultimately, the medical profession only exists Because of the customers, Because of the patients. As pesky as they may be and as annoying as they may seem without them, It seems kind of pointless for healthcare to exist at all. Listen, Mark, I really appreciate you being here. You bring a lot of experience. You bring a unique viewpoint, and I have to say thank you for being with us and for sharing your perspective on healthcare.
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