Empathy by design: Creating hospital billing that understands

By Marg Stark


For Eric Krepfle, the software he designs is not merely about creating an efficient system — it’s about developing an empathetic one as well.

That’s because the work Krepfle does developing hospital billing systems touches people at their most vulnerable when the stresses of health and finances intersect. “There are two things a patient is concerned about. Am I going to be okay, and can I afford my care?” he explains.

Working for Nashville-based Emdeon, Krepfle says one of his company’s goals is “to assuage patients’ fears, namely, how they are going to cover their financial responsibility for their treatment.” He puts that goal into action by designing software and services that hospitals use for revenue and payment management to deliver a streamlined experience for the patient and the health care provider.

The North Park resident’s own experiences inform his approach to life and his work. Five years ago, Krepfle experienced uncertainty when, in a single year, he says, “I lost my Dad, I lost my dog, and I lost my job.”

The layoff from a data management company was a stinging and unexpected blow.

“Never in my life did I think this could happen to me,” Krepfle says. “So I decided I had to find an industry with more longevity, more stability.”

The career he chose was one in the booming field of health care information technology. Krepfle completed his certificate in Healthcare Information Technology (HIT) at UC San Diego Extension in 2013, and now Krepfle is a product manager, overseeing the design of patient access products for client hospitals.

“We enhance and complement our clients. Because of the scale of our products and services, we help coordinate relationships between all parties. In this way, we promote the health and viability of hospitals.” He and his team develop software products that capture patient information, determine insurance eligibility, estimate patient liability, collect funds, provide financial counseling, and promote a healthy relationship between the patient, the provider and the payer.

But for Krepfle, it’s not enough to “talk the talk” of using technology to enrich a patient’s relationship with a health care provider. For more than two years, he served as a volunteer at Scripps Mercy Hospital where he experienced firsthand the difficulties of obtaining information from patients and families in the throes of both urgent and routine health care visits.

Without this firsthand experience, Krepfle continues, “It’s impossible to appreciate the speed with which patient access has to work because you’re explaining financial liability to people who are in distress.” Serving in one of the city’s busiest hospitals, Krepfle saw how “natural the encounter must be – how clear, concise and description-free hospitals need the software to be – because the engagement time with the patient is so limited.”

Krepfle is passionate about helping hospitals move past the long-held discomfort of asking patients for money and embracing sensitive and transparent ways of discussing financial assistance and explaining payment options from the outset. Indeed, he talks animatedly about the health care environment of the future, in which patients choose and sustain relationships with providers who make financial transactions as healthy and smooth as medical outcomes.

Most hospitals have a standard practice of using a sticker on the door of some patient rooms, or in medical records, to alert clinicians that the occupants are at risk for falling, Krepfle shares. “We need to be able to identify patients who are at risk, too, of not being able to pay their bills. When that happens, a patient’s credit could possibly be hurt and, with it, the hospital’s relationship with a patient. You can’t build loyalty to your hospital by turning folks over to collections.” Krepfle knows there are better ways to ensure both patient care and hospital payment are fulfilled.

Krepfle started on his journey in 2011 when he joined Avadyne Health, a San Diego-based revenue cycle management company. Shortly thereafter, on the recommendation of a friend, he started the HIT certificate program at UC San Diego Extension. Serving as project lead for the HIT capstone project, Krepfle directed a team of twenty-two students through a complex project to a four-hour presentation. He likens that experience to the work he did at Avadyne, bringing together disparate systems and teams during a company merger. “The challenge is encountering teams with different terminologies, with a wide variety of legacy systems, different procedures and processes, and sometimes fragmented visions, and bringing them into harmony, creating new paradigms for patient communication.”

Krepfle’s completion of the HIT program was key to his 2013 acceptance for volunteer work at Scripps Mercy, which prefers pre-med students. Listed on his LinkedIn profile, the HIT certification and the volunteer experience recently caught the eye of an executive recruiter for Emdeon, the nation’s largest health care revenue cycle management company. Krepfle was offered an incredible opportunity: a significant promotion and the flexibility to stay in San Diego but commute part-time to the company’s headquarters in Nashville.

Dealing with change is something Krepfle has become quite adept at, personally and professionally. What are the tools he calls upon most in his work? Tenacity and patience. “Consistent and gentle pressure makes most anything want to change, including me,” Krepfle says.

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