When discussing the current state of the healthcare system, Steve Monaghan isn’t one to mince words.

“It’s stupid,” says the former commercial pilot turned serial entrepreneur who now serves as Chairman and CEO of GenLife, a Hong Kong-based insurance technology company.

Monaghan sees healthcare as painfully outdated and ineffective, but also believes we are at a moment when real change can take flight.

With deep experience in the finance, insurance and technology sectors, Monaghan has a keen perspective on the many challenges in healthcare today, and what this means for the laboratory diagnostics sector.  

Improve insurance to encourage testing

One challenge in the healthcare system is the lack of willingness for many patients to go for routine screenings and proactively test for potential health issues. Monaghan believes the insurance industry bears a part of the blame. 

“People don’t go and do medical tests for fear of ruining their insurance,” he observes. “Health insurance is so complex that people don’t understand it as a product to begin with. Very few people can articulate what they’re actually insured for and what’s excluded. I think this is wrong.”

Insurance companies have an opportunity to help address the situation, but many are focused on predicting and measuring loss when they should be tackling risk management. This might involve making proactive efforts to encourage preventative medicine and address chronic diseases, a major driver of losses.

Improving insurance could help bring more people into the healthcare system, which will create economies of scale that reduce costs for everyone. Monaghan points to the consumer technology industry as an illustration of how this virtuous cycle works.  

“Almost everyone has a mobile phone and there’s little economic barrier to technology,” he notes. “Once you move medicine, diagnostics and treatment onto those technology curves, you have superior margins at a lower cost.”

Leverage new technologies

Monaghan also believes we are at a technological inflection point that will impact all corners of the healthcare system, including the lab. One area that excites him is genomics, where sequencing costs have plummeted in recent decades.  

“Once you have a genomics test, you can work out what you’re at risk of,” explains Monaghan. This means going beyond generic risk to understand specific risks at a personal level, and to develop interventions to prevent those risks from becoming a reality.

He is also excited by recent advances in artificial intelligence. “It’s the enabler,” says Monaghan, who adds that it will help labs to increase performance levels, decrease errors, and make tests that were once incredibly expensive become affordable.

Other technologies can facilitate patient empowerment by putting individuals be in control of their medical information. He thinks that blockchain—a decentralised data structure that functions as a digital record book and allows for easy collaboration between multiple entities—will help to make this happen.

“Being able to put individuals in control of their own data to take it wherever they want, and also withdraw that information if you don’t prove trustworthy with it—it’s the right way to go,” says Monaghan. This forward-looking ideology is a key pillar of Monaghan’s GenLife, which leverages AI and blockchain technology to improve insurance.

Individual control of one’s own medical data can potentially facilitate new business models, such as allowing patients to sell their personal disease risk to a device or diagnostic company, which would then be incentivised to manage that risk down. Non-traditional arrangements like this may incur resistance from some incumbents but are increasingly essential for addressing the dual issues of rising medical costs and ageing populations, which are putting pressure on healthcare systems around the world.

Monaghan notes that dialogue with regulators will be critical for overcoming resistance. “You really need to engage and point out those deficiencies in a much more open dialogue with regulators. This is also why many regulators are building sandboxes – essentially closed testing environments to safely test new technology and business models.”

This content is based on interviews with Steve Monaghan, Dia:gram Edition 2018 Vol. 3. For more on Steve Monaghan’s vision for healthcare reform, see this article from Dia:gram (Moving diagnostics and medicine onto the technology curve).