The pandemic is showing the resilience of the US healthcare system, but it also points out some important areas in need of improvement.
In Authority Magazine’s interview series, “In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System,” they are interviewing healthcare leaders, like Coriell Life Sciences’ President and CEO, Scott Megill, who can share lessons they learned from the pandemic about how we need to improve the US Healthcare System.
Unlocking the power of technology to fuel smarter healthcare, Scott is a driving force in setting the industry standard for pharmacogenomics (PGx) and advancing a healthier world.
Read the full interview with Authority Magazine’s Luke Kervin here:
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 been fascinated by technology for as long as I can remember. I went to college thinking I wanted to be a computer science major but found out pretty quickly that programming wasn’t for me. I was much more interested in how technology can be applied to drive business. This led me down a path of IT and software development leadership roles at an HR benefits firm, Rohm & Haas, and Dow Chemical Company. After leading the IT integration following Dow’s acquisition of Rohm & Haas, I knew I wanted to shift my focus to an opportunity that would allow me to make a really meaningful impact on people’s lives.
After one (10 hour-long) conversation with Dr. Michael Christman, then President and CEO of the renowned Coriell Institute for Medical Research, and a literal back of the napkin sketch of a spinout organization that could combine the Institute’s proprietary scientific research on genetics with cutting-edge technology to help millions, if not billions, of people around the world, it was clear I found that opportunity. I signed on as CIO of the Coriell Institute for Medical Research in 2009. Then, in 2013, I officially launched Coriell Life Sciences out of the Institute with a mission to use genetic science, research, and technology to empower the most precise medical care.
Can you share the most interesting story that happened to you since you began your career?
In the early days of Coriell Life Sciences, we were struggling to find doctors who would be willing to spend the time to learn about the new use of genetic science we were promoting. We met with a group of physicians at our local community hospital who, I am convinced, only came to our meeting because we provided dinner. After hearing about pharmacogenomics for an hour, the group thanked us with less enthusiasm than we were hoping for and left. However, one cardiologist hung back. Without telling us any specifics, he asked if we would be willing to test his mother’s DNA for medication response. We did, and it turned out that she had a genetic variation that caused her cholesterol medication to be unsafe for her. He quickly switched her to a different statin and a few days later, she got out of bed for the first time in six months. He said he never even considered the statin as a possible cause of her joint pain.
A few months later, we held another information session at the same hospital and, due to the increased interest level, we had to book a much larger room. I’ve never experienced a more direct example of the power of having champions willing to speak about their own positive experiences.
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?
My career has largely been focused on applying technology to solve business and healthcare problems. Most technologists live a bit insulated from their actual users and can sometimes get disconnected from how their tools will be used in the real world. I recall being guilty of this myself when early in my career I was leading a software development team building a new wellness application for Campbell’s Soup Company. The goal of the project was to promote new health benefits being offered by the company that were being underutilized. Our vision was to build an online application that would walk the employees through an interview process and ultimately recommend plan benefits they weren’t currently using. We spent several weeks designing and creating wireframe mockups for an elaborate internet user experience that was quite advanced for its time. Proud of what we’d done, we met with our clients to demonstrate the vision.
Midway through the presentation, the head of Human Resources paused our presenter and said, “This is all very pretty son, but I have 5,000 people picking mushrooms in a field. We can barely reach them by postal mail, let alone expect they have internet-capable machines in their homes.” The air in the room rushed out as the realization hit the team. We neglected to really understand our target audience before running off to build something we thought would be exciting. Decades later, my former colleagues and I still laugh at that moment when we see one another.
To this day, I make sure the “5,000 people picking mushrooms” test is accounted for in any product or service design. Nowhere is this more important than in the world of precision medicine where access to healthcare and technology is not universal.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
My grandfather was an engineer in the Army during both WWI and WWII. He lived a long, but difficult, life. My one strong memory of him before he passed was him telling me, “Learn everything you can. If it’s in your brain, no one can take it away from you.”
As I progressed through my education, my career, and building my family, I’ve come to really appreciate the sentiment of that statement. One of my undergraduate degrees was in philosophy where I wrote my thesis on knowledge and self-identity. I’ve been a voracious consumer of information and a life-long learner. I’ve gravitated toward career opportunities and projects that seek to use data and information to derive insights that drive change. Leading the charge at Coriell Life Sciences, I have had the great pleasure of being able to build a team of like-minded individuals who value the power of science and information. Even more satisfying has been seeing the use of that data positively impact patients. I can’t think of a better application of learning than easing the suffering of others.
Are you working on any exciting new projects now? How do you think that will help people?
Using genetic science, research, and cutting-edge technology to improve lives, reduce healthcare costs, and simplify decision-making for payers and providers around the world is core to everything we do at Coriell Life Sciences.
Right now, we are primarily partnering with large employers and benefits providers to roll out our Corigen® medication safety program worldwide. Corigen essentially matches individuals with the right prescription medications for them based on their DNA and many other factors — given that for hundreds of medications, successful treatment is directly related to an individual’s unique genes. In addition to the individual health benefits, Corigen lowers healthcare costs for both individuals and sponsoring organizations by enabling more streamlined and effective care.
Using a data set we’ve built up from pharmacists using our proprietary technology with patients, we are also using machine learning and artificial intelligence to essentially train machines to behave like a pharmacist. This is going to be incredibly impactful for getting medication safety insights to huge numbers of people.
How would you define an “excellent healthcare provider”?
Patients are unique right down to their DNA. Excellent healthcare providers always keep that top of mind. They tailor patient care not only according to things like overall health, age, lifestyle, and medical conditions, but also according to their genetic makeup, which plays a very significant role in how individuals’ bodies function. The best healthcare providers embrace new advancements in science and technology to provide the very best personalized care for each patient — and elevate the overall standard of care.
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?
The confounding nature of COVID-19’s different effects on individuals has certainly been a struggle for our healthcare system. On the one hand, we had huge swaths of the population with the disease that were completely asymptomatic and never felt any impact. At the same time, COVID has killed more than 610,000 people in the US alone. This points to the need for better insight into the various factors that determine an individual’s response to diseases and treatments alike.
When it comes to the latter, pharmacogenomics (PGx) testing, which reveals how an individual’s DNA impacts his or her response to medication, is key to gaining insight on which prescription drugs a patient will respond well to — and which medications may be ineffective or even harmful to their health — so treatment plans can be tailored with the highest likelihood of success.
PGx also applies to the mental health crisis, another area exacerbated by the pandemic and where our healthcare system is struggling. While there is no silver bullet for solving a challenge this complex and widespread, PGx is emerging as a formidable tool as prescription drug use for treating mental health continues to rise. By providing a clear view of which medications will be safest and most effective for an individual, PGx can help physicians in speeding their patients’ return to good health.
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.
Thankfully there are a number of bright spots related to the pandemic and our healthcare system. Most people are likely to think about things like the heroic acts on the front lines, the collaboration between the US Food & Drug Administration (FDA) and the pharmaceutical industry to serve an emergency need, or the speed at which the COVID-19 vaccine was made available to the public. However, another positive advancement in the healthcare system was how leaders in the industry mobilized and invested to exponentially grow our collective capacity for laboratory testing. While this was initially needed for COVID testing, to the tune of more than 1 million tests per day, the US now effectively has a national asset for testing that can be leveraged to drive new healthcare technology, such as personalized medicine testing, out into the world at scale.
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.
Among the most impactful ways to improve the overall US healthcare system, we must:
- Invest in precision medicine. From no symptoms to fatal conditions, COVID-19’s wide range of effects on those who contracted the disease underscore how just differently everyone’s bodies function. That’s the fundamental premise of precision medicine, which aims to provide highly personalized care based on all of the factors that make a patient unique, right down to their DNA. By investing in proven precision medicine tools and technologies, healthcare leaders — including payers and providers — are well-positioned to improve outcomes, reduce unnecessary costs, and raise the bar on the standard of care.
- Prioritize the issue of medication safety. When patients were hit hard by COVID, physicians were put in the position to choose from among approximately 45 FDA-approved medications for treatment using their best judgment. However, this type of traditional trial-and-error prescribing can be both dangerous and costly, as natural variation in our DNA can cause the same drug to produce different effects for different people. That means even when people take medications as prescribed by their doctor — for COVID or any other condition — drug-gene interactions may cause those drugs to be ineffective (hardly ideal when the time to treatment is critical) or actually harmful to a person’s health. In fact, medication errors are one of the leading causes of death in the US, and the cost of medication-associated errors exceeds $40 billion. In a nutshell, the cost of getting medications wrong reverberates throughout the healthcare service model and echoes back as wasted resources, time, and poor health.
- Make precision prescribing the standard of care. The pitfalls of trial-and-error prescribing are remedied with precision prescribing. Precision prescribing is the practice of matching patients with the safest, most effective medications for them individually based on their DNA and dozens of other factors. This takes into consideration how medications behave together at a chemical level; how they are impacted by an individual’s genes; how they behave with the food an individual eats, what they drink and if they smoke; how they are influenced by lifestyle factors; how they are impacted by medical conditions, age, whether they’re pregnant; and the list goes on.
While this idea and various takes on execution have been circulating around the healthcare community for years, new advancements in the rapidly evolving field of pharmacogenomics (PGx) have finally pushed precision prescribing to the point of being comprehensive, nondisruptive, and widely scalable.
For patients, this is as simple as providing a saliva sample at home and mailing it in for secure PGx testing. The analysis and a pharmacist consult reveal any recommended changes to medication regimens. For providers, this information is analyzed and interpreted in a clinical decision support tool that provides actionable insight on which medications are best suited for an individual. And for payers, it means improving the health of employee or member populations while enabling more efficient and cost-effective healthcare.
- Elevate the role of pharmacists. Unprecedented collaboration throughout the healthcare ecosystem in the face of COVID highlights just how powerful increased collaboration between physicians and pharmacists could be. Pharmacists are critical players in the world of healthcare, though in many states pharmacists cannot order lab tests or be reimbursed for testing that may significantly improve a patient’s care. Along with physicians, they are the experts when it comes to the pills and medications patients are being advised to put into their bodies, and they can play an even bigger role in enhancing patient care with the right partnerships and authority to do so.
- Allow healthcare data to move with patients. One of the major deficiencies in the US healthcare system compared to virtually every other developed country is that we don’t have a unified technology platform for storing and transmitting patients’ healthcare data. Confining personal healthcare information to a silo that can’t be easily accessed by providers outside of a healthcare system that generated it severely limits the value of that data — for both patients and providers — and creates unnecessary administrative burden. When a patient’s healthcare information moves around with them seamlessly, a complete picture of their health helps enable physicians and pharmacists in providing comprehensive, personalized care.
Let’s zoom in on this a bit deeper. How do you think we can address the problem of physician shortages?
I don’t think there’s just one answer to this question, but I do think we can spark new interest in physician careers by creating new disciplines centered on genetics and personalized medicine that focus on the new ways science and technology are driving the future of healthcare. There is so much innovation happening in the world of healthcare, and if we share that with the next generation of professionals, we’ll begin to spark interest from a new pool of candidates who may have not envisioned themselves as ‘old school’ physicians.
How do you think we can address the issue of physician diversity?
When it comes to physician diversity, we need to remember that socioeconomic barriers may be at play. You can spark interest in the profession from as many young students as you want, but if it’s not feasible for them to pursue that career path, that’s where the road ends. Merit-based tuition can help address this barrier and encourage people of all backgrounds to pursue careers in medicine.
How do you think we can address the issue of physician burnout?
We can reduce physician burnout by putting more information in their hands that makes their job easier. Technology can speed an awful lot of clinical decision support for physicians and allow them to focus on the actual practice of medicine rather than carrying the extra burden of also being the researcher or the data scientist, for example.
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?
To manifest the growth and adoption of precision medicine in the US healthcare system, each stakeholder plays a key role. Individuals need to be educated about what’s possible in terms of personalized care so they can advocate for their health and make their voices heard with how they spend their healthcare dollars. Corporations, specifically self-insured employers, need to take a more active role with their third-party administrators (TPAs) in implementing programs that provide personalized care to benefit their employees. Healthcare providers will need to be open to new ways of working as new technologies roll out and voice their support for those that will truly improve patient care. Lastly, leaders must set the tone for collaboration throughout the healthcare landscape to foster innovation and continue pushing the boundaries of what’s possible.
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 would institute a standard of care that entails full genome sequencing at birth. That means analyzing 3 billion points of DNA for every single person, which contain not only pharmacogenomic markers but also key information related to complex disease predilection, treatment, and more for that specific individual. Because a person’s DNA doesn’t change over time, having a complete picture of their genomic information from day one could steer a hyper-personalized course of care that will serve them throughout their entire life.
There are a number of reasons this isn’t feasible today — among them, where does all of that data live and how is it all interpreted in a way that makes sense — but it’s an audacious vision that, in an ideal world, would improve healthcare for every person on the planet.
How can our readers further follow your work online?
Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.