Changemakers: David Inns, CEO of GreatCall

Perhaps nothing is transforming senior living more than technology, and few tech companies in the space have matched the success and impact of GreatCall, which has been led by changemaking CEO David Inns since 2006.

After being acquired by Best Buy for $800 million last year, San Diego-based GreatCall is in a new league. Its products that are custom-designed for seniors — including the Jitterburg smartphone and Lively emergency response tech — are being sold in Best Buy stores nationwide, and Best Buy’s Geek Squad tech support teams are available for installation and troubleshooting. Approximately 1 million people subscribe to GreatCall services, and the company has annual revenue of more than $300 million.

The Best Buy deal also has given GreatCall more runway for its commercial business, where its clients include senior living companies and other health care providers and payers.

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Inns envisions a future in which GreatCall is an integral part of senior living efforts to manage population health by reducing spending and improving outcomes — and earning financial rewards for doing so.

Inns also spoke about what it takes to time the senior market, GreatCall’s adoption of Lean principles, and the potential power of predictive analytics in senior living.

What are some changemaking efforts you’re most proud of?

When the company started, it was really focused on simple technology, particularly a simple phone for seniors. But we always had a larger vision, that once we established that connection and helped seniors with technology, what we really wanted to do was get more involved with providing services to them.

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So in 2009, we launched our first service, an enhanced wellness service offering, what we call Urgent Care Now. This is unlimited access to nurses and doctors through the phone.

Very quickly after that — and probably what really changed the company — was launching one of the first mobile personal emergency response products and services in the industry. That was huge, because it changed the trajectory of the company, moving us even further into being a health and wellness and safety company, as opposed to a technology-based company.

Our growth really took off, because it differentiated us in the marketplace, and people started to understand what we were trying to do.

How has tech evolved since the days of “I’ve fallen and I can’t get up” emergency pendants?

When you look at our products now, right, we have everything from a smartphone to wearables to smart home sensors that are able to detect changes in peoples’ wellbeing. So, we do see ourselves on the forefront of pushing the boundaries of where technology can go for senior care.

But I think the thing that has made us the most successful, and maybe what has helped us to be a leader in this space, is balance.

I had people five years ago saying, “Five years from now, all seniors are going to be using smartphones.” How can you make a broad statement like that? Even today, in the 75-plus age group, only 30% of seniors have smartphones.

We do see ourselves on the forefront of pushing the boundaries of where technology can go for senior care.

Making the assumption that you can solve the senior care conundrum using technology that is all smartphone- based and do it with apps, obviously people that were trying to do that five years ago completely failed because the adoption just wasn’t there.

You can go too far the other way, and say, “Seniors are never going to adopt new technologies and we should just be focused on red buttons that you wear on your chest.”

I think there’s a happy medium that we’ve ridden, of saying, “Let’s understand our customers, let’s understand their limitations, let’s understand their fears, let’s work with them and provide a level of service where we can help them adopt new technologies, we can get them more comfortable with engaging with it, without pushing the envelope so far that we block them.”

How do you strike that balance?

I’m not big on gut feels.

We use a lot of what’s called Lean development methodology, and that is research, focus groups … So what we do a lot of is interviewing. Running concepts by people, really getting their true emotional reactions to concepts, new products, new technologies, and trying to draw out those emotions, their fears about it, their willingness to adopt, and having discussions about it.

Not yes/no surveys, which are very famous for providing direction that ends up being wrong. It’s very easy to say yes. Would you buy this? Yes, of course I would buy this. Instead, really getting [at], why would you buy it? Or why wouldn’t you buy it? And what are some of the things that you fear about it? And what are some of the challenges you’re going to have?

Let’s put some minimum viable product in front of you and watch you interact with it. That’s where we really get the concepts that we can move forward with. I’d say we’ve made lots of mistakes over the years, especially before we started using Lean, where we were sure we had some ideas that were going to be amazing, only to have them really not end up with as many customers as we had hoped.

Can you describe a time when you tried to make a change and it didn’t go so well?

One great example was our first medication adherence product, which required the caregiver or the senior to enter in the list of medications that the senior was taking, and then it would basically do reminders, and you would confirm that you’d taken this medication or that medication.

What we realized is to have the senior, or even the caregiver, manually keep a list up to date on a phone or through the web is asking too much. Medication lists for the senior — and especially somebody that would be interested in a service like this — are so long and complex that just managing that list takes too much time and effort.

That was a big “a-ha” for us. We went and developed this, and making the realization that for medication adherence to really work, you’re going to have to be integrated into a system that is automatically taking their medications and loading them into the system.

You mentioned the Lean approach. Was there a moment in the company that drove you to find that framework?

I think it was around 2014 we adopted it.

At this time, our CIO was tired of having his team work on projects where there wasn’t as high confidence they would be successful in the marketplace as they wanted. They identified the methodology to say, “Before we start doing this expensive, heavy development, when you don’t have much bandwidth as it is for all the priorities you want to execute on, you don’t want to waste any time.” Let’s validate our ideas, and make sure we’ve done everything we can before an engineer ever even picks up their finger and starts writing code.

GreatCall has gone all the way to being acquired for $800 million. How did GreatCall succeed, when other senior living tech startups have failed?

First is a very deep focus and understanding of our customers, who our target customers are, and understanding to the point where we know how to develop what they want, when they want it.

The second thing is delivering an amazing customer experience that is customized for our target group. We are always thinking about how to make sure that the people that are servicing our customers — and they go through senior sensitivity training — they’re compassionate, they’re empathetic, they know what the senior is going through, they know how to talk to them, and at the end of the day, our customers feel respected and loved by our agent.

How are the efforts to integrate with Best Buy, and what are some of the synergies you’re seeing?

We’re just really ecstatic with the relationship and where we are from an integration perspective.

We’re part of a division within Best Buy called Best Buy Health, which is focused on a similar mission of enabling seniors to live in their homes longer, on their own terms. We now have Geek Squad doing all of our installations of our products and technology in the homes of seniors, or in senior living, if necessary. So that’s been a huge capability that we never had before.

We are working together to develop an even more robust road map where we can accelerate product development, we can accelerate growth by getting into all of their stores on a larger scale. We have end caps in every Best Buy now with all of our technology available and on display. It’s only been six months, but it feels like we’ve just made some incredible progress so far.

Companies like Apple and Amazon are creating products like Echo or the Apple Watch, that aren’t designed and marketed specifically for seniors. Do you view these companies as your competitors?

I think over time, there is going to be more and more opportunity to just leverage the mass technology platforms to even serve seniors. I believe that the real differentiation in what we do isn’t the technology, it’s the services, and how to actually service older Americans, thinking about what they really need and being able to deliver those services through the technology.

We’re looking at opportunities all the time to say, “How can we provide our services through the mass technology platforms?”

Are there other changes in senior-focused technology that you anticipate?

I’d say the first thing in terms of road-mapping the future is predictive analytics, and particularly for seniors, which is a very unique skillset. It’s something that we are absolutely focused on.

We want to be able to leverage data that we can collect from seniors, whether it’s body sensors or room sensors, from their devices, taking that data and being able to understand what is happening with them and catching issues before they become expensive health care episodes … To me, that’s the future.

GreatCall is already providing these type of analytics to some extent, correct?

Lively Home is activities of daily living monitoring. So it’s a package that is installed in the home of the senior, and the data’s collected. We have a team of top data scientists that has developed algorithms that can look at the data, not only comparing it to that individual member’s history, but also comparing it to population history, so that we can get very accurate in predicting when things are not going as planned for that senior.

I think change in the senior living industry has been slow.

So, whether it’s declining appetite, changing bathroom behaviors, changing bed and waking times, sitting times, movement around the house, leaving the house, things like that … we actually have our agents who are doing the first following up with the senior on that information, so that we can verify the validity of the alarm by pulling information out from that senior, and then working with the case managers in the managed care setting to say, “Hey, this is something that needs following up on.”

We have three studies completed, [showing] that we have on average about a 20% reduction in the health care cost of those seniors by basically avoiding expensive health episodes and replacing them with less expensive interventions.

Do you think the senior living industry is embracing changes in technology?

It’s probably not a surprise to you, but I think change in the senior living industry has been slow.

The discussion around technology and connected health has generated excitement around improving remote care and health outcomes. An overlooked area where there is significant opportunity for growth and change is connected health for seniors, especially in senior living communities. Whether it’s peace of mind for family members or 24/7 support for a resident, senior living communities are beginning to see the significant benefits of a service such as GreatCall. We see varying visions for connected health, ranging from Holiday Retirement, a client of ours who understands the merits of advanced technology, to others who are gaining understanding as the discussions around technology educate on impactful change.

I’m a big believer in that the senior living industry has an opportunity to increase its role in managing the risk of seniors and capturing a portion of that health care value chain by … managing that risk.

I think that’s where we can help. By using technology, we can help the senior living facilities reduce the health care costs of the people that are in their care. That earns the senior living group the right to some of the health care risk value chain, which is a very significant monetary opportunity, in my opinion.

Are more senior living providers recognizing this opportunity? We’re seeing more play in the Medicare Advantage space.

It feels like it’s still very early stages of this opportunity being identified.

GreatCall itself is working directly with insurance companies, right?

Yes. We work with managed care companies in taking care of their members that are in their homes, and helping them stay in their homes and stay out of the hospital and that long-term care.

Care coordination is a big part of driving population health. Is technology like GreatCall supporting coordination among different types of providers?

Care coordination is going to be a really important component of senior care going forward, and I think right now, it’s behind.

I don’t really have an answer for you, because right now, we’re not integrated into EMRs or EHRs. At some point, if we can have interconnectivity between all of the different systems, and we can be present in and providing our predictive insights into some of those systems, it will increase the overall value that the ecosystem can deliver for the senior.

Do you thrive on change?

I don’t know that I’d say I thrive on change, but I’d say to be successful today, you have to be accepting of change and know how to handle it. And to adapt, to be able to make change work for you, not have it done to you.

What skills and traits help you be a changemaker?

The first one that would come to mind is the culture that we established here at GreatCall. That culture has been a huge part of our success. It starts with the fact that we do meaningful work, so that helps. But then it’s also about creating an environment of respect.

I am very empathetic toward people, and we have always tried to make this a great place to work. We want people to enjoy coming to work every day as much as possible. To me, if you can achieve that, then you have a group of people that want to help customers and are going to do what they can to make the company successful by first making our customers happy, and by themselves being happy.

Do you have mentors or other changemakers who you admire?

It’s funny, I was a consultant at a company called Diamond Technology Partners in the late ’90s and early 2000s. The CEO was a gentleman by the name of Mel Bergstein, and he, I think, was the first leader that I saw who had a style of, to be honest with you, just being kind. Being thoughtful of employees and communicating very well. He is probably the first mentor that I always think of in terms of leadership style.

Then, for me, when things are going hard, I don’t necessarily turn to people, but I do turn to family and I’m just huge into exercising. When you’re stressed out, it’s the easiest time to say, “I don’t have time to take care of myself.” That’s the time to actually do it, because that’s how you’re going to keep yourself fresh, and you’re going to think of the solutions that you can’t think of if you’re overworked and stressed out and sitting in your office.

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