Andrew Morris of SQI Diagnostics: In Light of The Pandemic, Here Are The 5 Things We Need to Do to Improve the US Healthcare System

An Interview with Luke Kervin

Be an example as a leader. Whether you’re a health care provider or a head of a corporation, it’s important for all leaders in a community to follow and champion the science, follow the data.

The COVID-19 Pandemic taught all of us many things. One of the sectors that the pandemic put a spotlight on was the healthcare industry. The pandemic showed the resilience of the US healthcare system, but it also pointed out some important areas in need of improvement.

In our interview series called “In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System”, we are interviewing doctors, hospital administrators, nursing home administrators, and healthcare leaders who can share lessons they learned from the pandemic about how we need to improve the US Healthcare System.

As a part of this series, I had the pleasure to interview Andrew Morris, Chief Executive Officer of SQI Diagnostics.

Andrew Morris has more than 30 years of experience across diagnostics, life sciences, and medical device sectors as CFO, CEO, and co-founder of numerous public and private companies. An accomplished executive, Morris is known for his compelling leadership skills and proven track record in financing, regulatory approvals, scaling, and commercializing healthcare products to improve health outcomes. As CEO of SQI Diagnostics, Morris leads the publicly traded company in developing innovative diagnostic testing solutions that address unmet medical needs and improve lung health.

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?

Like a lot of things in life, it was a combination of plans and serendipity. As early as I could remember, I’d always had a passion for science — at school and at home. I attended Western University under the ROTP scholarship program here in Canada, graduated with an HBSc, and joined the Canadian Air Force as a pilot. I spent 13 years in the Canadian Armed Forces as an officer Air Force where, for 9 of those years, I led applied research and development projects focused on soldier survivability in a variety of harsh environments.

While in the military, I completed two post-grad degrees at the University of Toronto, including an MBA and an MSc in Exercise Physiology. From my studies of back pain medicine, I jumped into the finance world during the first Internet boom and gained a lot of experience there in financing, investment banking, equity research, and M&A.

I ultimately learned that I enjoyed working for smaller companies, starting things, and shaping chaos into companies. So, I was a co-founder of a number of startups that were successful, including FORGE Hydrocarbons Corp, Planet People (Concrobium branded products) that was sold to Rustoleum, Norigen Communications.

I’d suppose that the throughline is an interest in science, finance, and building organizations and bringing together teams of really good people. These parts of my personality brought me to healthcare.

I was drawn to diagnostics in particular because, frankly, pharmaceuticals seemed like a gamble. As an equity research analyst, I was struck by how even the most respected researchers and companies were unable to predict which drugs were going to be successful and which weren’t.

Can you share the most interesting story that happened to you since you began your career?

The most interesting thing I’ve seen during my career has been the ebb and flow of companies, trends, industries, and markets. And I’ve seen a lot of it.

I spent some of my career in the tech industry and was a very early employee at one company. In a 2-year timeframe we grew to more than 1,000 employees. These were the heady days of the NASDAQ technology bubble, and at this business we’d raised about $400 million and were preparing for an IPO to be led by Bear Stearns and JP Morgan. One day I bumped into an old fraternity friend as I walked into the office and, as we caught up, I learned that he was working at the same company — our company was growing so fast that I didn’t even notice the name of this long-time friend of mine on our list of new hires!

And then the NASDAQ Tech bubble burst. My company did not escape the fallout and after seeing the company expand from the beginning, I was the second to last to leave. It was a boom-and-bust scenario wasn’t unheard of at the time but was still interesting to witness firsthand because of its speed and as an illustration of how things outside of your control — in this case, NASDAQ — can take you down. We were on a great run, but it was an interesting experience in a time that we probably won’t see again.

I think one of the things that I learned from that is not to rely on the “build it and they will come” philosophy. I think I’ve learned to avoid that by making sure increased capacity is not made for its own sake but to meet an observed market need. We see a bit of that “boom and bust” rhythm in the healthcare space from time, though less so in the diagnostic sector. There was an increased demand during the pandemic that we are able to react to with increased or decreased supply of product as needed, but in general, the need for diagnostics never goes away.

During the pandemic, we certainly have products that address the current needs, but we’ve also built products that we believe have longer lives to them than just having pertinence to COVID. There has been so much demand for diagnostic tests for COVID; we’ve tried to keep an eye on going beyond tests that confirm infection. Our RALI-Dx IL-6 Severity Triage Test for COVID-19 patients has broader applicability in helping to identify patients with severe respiratory-based inflammatory response arising from COVID-19 who are likely to need hospitalization. Our EXACT COVID-19 HOME Antibody Test can distinguish between past infection and vaccination and monitor for immunity over the long run as we look at the post-emergency phase of the pandemic. So, we’ve built products that we believe address the long end of the tail of the pandemic, or endemic transition, as opposed to the top of the spike or the peak of the pandemic.

I think the fascinating quality to these types of cycles is how they require you to ride the boom while planning for longevity, like a surfer on a very big wave.

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?

When I was young logistics officer in the in the military, I told my commanding officer at my first posting that I was not really interested in a military career. I was young and ambitious, and I thought my ultimate destiny was to solve the world’s problems. Luckily, my boss saw potential in me and gave me some very valuable advice and redirected my energies. (But I did have some “make good” to do with that commanding officer!) Ultimately, I switched careers and became a bioscience officer and that led me into the career I have now.

But I learned an important lesson that was bigger than “don’t tell the most senior person in the room that the thing he’s doing is uninteresting.” What I learned is that to some degree, we all have to learn to become salespeople. You have to sell yourself in your career. At a company, everyone — from the literal salespeople to the scientists — has a role in selling the product, the company, and/or the investment.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

Terry Pratchett — ‘Even if it’s not your fault, it’s your responsibility.’

As a leader, you’re not always directly doing the things that might lead to a mistake, but you’re ultimately responsible for it. This is a great thing in good times. But when things go sideways, you need to be there to support those in the trenches. As a leader, you have to stand with your people and take the heat.

Are you working on any exciting new projects now? How do you think that will help people?

We’re ramping up to launch our EXACT COVID-19 Antibody Test into the US market. We recently received approval from the New York State Department of Health for that product, which clears us to test specimens from anywhere in the United States. By providing semi-quantitative measurements of six distinct antibodies produced in response to exposure to the SARS CoV-2 virus or to COVID-19 vaccination in an at home test, it fills an unmet need to address the new phase we see in this COVID pandemic.

We’re all seeing and experiencing pandemic fatigue as we enter the 6th wave of the pandemic. People are taking off masks in airports and airplanes, social measures to mask and distance are loosening. At the same time, immunity is waning in the general population amidst a lack of uptake on additional boosters so this test launch is coming at a very important time when people will want access to objective, personalized information about their immunity.

We are positioning ourselves to meet demand from employers and individuals alike to measure and track COVID-19 antibodies — as a complement to consultation with individuals’ health care providers. We think the EXACT test will provide a means to observe changes in immunity and general changes to antibody levels across populations. These are the key signals of defense against infection or reinfection from COVID in the long run. Despite of all the changes that are being made socially and politically, testing continues to play an important role in protecting the general population and head off big surges in the emergency departments and hospital ICUs.

How would you define an “excellent healthcare provider”?

I think an excellent healthcare provider — and this applies to “provider” in the sense of individual practitioners as well as institutions of healing — is one who pursues science, quality, and innovation with a high degree of focus on exceeding customer/patient expectations. They follow science, provide quality care, and always innovate.

SQI builds for these practitioners by anticipating and meeting the needs of those who bear these excellent qualities. That’s what we’re doing with our EXACT Antibody Test and with our RALI-Dx or rapid acute lung injury diagnostic test. We’re creating data that helps doctors make better decisions for their patients and families.

The same can be said with our TORdx test, which converts transplant doctors from solely relying on the qualitative decision-making tools that they’ve developed over their careers and provides them with a quantitative measurement of the health of a donor lung. We want to apply this same technology across multiple organs. The TORdx test is disruptive and meets an unmet need by providing information based on broader datasets as opposed to individual spot tests used before individual lung transplants. We found, after looking at the big data, that a lot of lungs were being discarded using mostly qualitative assessments by transplant surgeons and we found that about half of those discarded lungs were actually quantitatively similar to viable lungs.

Providers looking to improve care have a tool to help them rebalance the supply-demand curve and get lungs into patients earlier in their disease stages. They’re healthier when they get their transplanted lung, their time in the ICU is shortened, and the recovery time is shortened and the cost to the health care system is, in theory, reduced.

Disruptive technologies require health care providers to adopt new ways of doing things, and that’s not always the easiest. However, in order to deliver the highest quality care, an excellent provider will follow science and data and is open to innovation when the data shows that a potential therapy or diagnostic product is really addressing an unmet need.

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?

I’ve got a different perspective, to be honest. The pandemic is a once in a hundred years event. The US healthcare system really scaled up for the crisis that emerged from the pandemic. I think the US healthcare system struggled somewhat, of course, but it was designed for a vastly smaller total number of patients. I think it actually performed quite well in spite of the crushing numbers of incredibly sick people.

We were in a war against COVID, and you have to look at it from a triage or a battle perspective. The system was initially overwhelmed because it didn’t have the tools to reduce the numbers of patients coming into the hospital system, but it did react very quickly.

You can’t create vaccines overnight and get them approved. You can’t create diagnostic tests overnight and get them approved. But these things happened faster than anything has really ever happened before, so I think everyone did work together. A huge amount of money poured in to support it. Governments reacted in a way that they’re not really designed to react.

It can’t really be compared to the many smaller pandemics that we’ve seen in our lifetimes. This was an overwhelming crisis and no health care system with the populations of people that the U.S. had reacted to as quickly.

Now, while I think the healthcare system in general reacted well to a potentially overwhelming pandemic, there were fringe elements out there that weren’t following the data. Perhaps it’s my background in diagnostics and business, but I believe that decisions must follow from relevant, obtainable, objective information and data. People making decisions based on inadequate or inaccurate data not only had tragic effects but placed enormous strain on front-line providers.

When we look at the core of the pandemic crisis, the emergency departments were at the forefront, taking onslaught. You also had the ICUs that were at the top of the pyramid in terms of crisis management for morbidity and mortality.

At the start, those facilities weren’t scaled up for the numbers that they had to deal with, but they followed the data and were able to adapt to the surge. I think the pandemic exposed the degree to which there are fringe elements among healthcare providers who, for whatever motivation, aren’t following the data and introduce confusion that leads to worse outcomes. We need to find a way to communicate with the general public. Most of the work and time spent maintaining a person’s health comes outside of a doctors’ office and we have to find a way to maintain that partnership to keep people well.

We’re not going to triple the size of our hospitals or emergency departments for the next pandemic that might not come for 100 years. Those people that were on the front lines made the best of a really, really horrendous and unforeseen situation. But as we look to how to deal with the next pandemic, we can see that the most effective improvements will be to education and finding a way to vaccinate more people — or rather to get more people to understand and want to be vaccinated.

And again, that’s following the data.

Another takeaway from this pandemic is testing’s contribution to better outcomes. Data comes from testing which can go on to give clear insight and foresight into what’s going to happen. You can see the rate of increase in infections through testing and take measures in advance.

By the time the patient is in the ICU, it’s too late for that patient data to provide much useful, proactive information to the system. But if testing had been able to be rolled out a little faster at the beginning phases, we probably could have triaged the entire system more efficiently, and then you wouldn’t have had as many people in the emergency rooms and in the ICUs. Data can help the system focus its efforts on those who are truly going to become sick.

This was part of the drive to develop our RALI-Dx test for COVID, which is meant to triage patients in the emergency department who are positive for COVID-19. The test’s endpoint is the probability of intubation, and it uses IL-6 as a biomarker — rather than relying on blunter tools like known comorbidities or age and weight — to decide whether to send a patient home or focus aggressive treatment on them. As the shortage of hospital beds has become less of an acute crisis, the FDA has shifted its priorities on this particular test (though Health Canada is looking at the test under expedited review), but the response from the provider community shows that they value this kind of data being made available to them. After all, the RALI-Dx test is a derivative of our TORdx lung transplant product, with RALI-Dx’s broader application being to triage any patient in respiratory distress coming into the hospital, not just COVID positive patients.

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.

Tragically, a lot of lives were lost at the beginning of the pandemic, but I don’t think that takes away from the level of coordination and the speed of the response we saw. I think the system did a pretty good job of reacting well to the development of lifesaving technologies.

A lot of capital flowed into pharmaceuticals, diagnostics, and even into devices and supplies. It typically takes years to develop new vaccines and diagnostics and usher them through the approval process. During the pandemic, we saw researchers and regulatory bodies come together to really fast-track the process while still adhering to science.

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.

I think the US performed well in the crisis in general. It developed and executed a plan to deliver world leading healthcare to 330 million people. For a healthcare system that is very bureaucratic, the US led in new drug and diagnostic test approvals and in multiple key measures to protect its body.

I think COVID exposed a disconnect between the medical community and many people which is evident in the still large segments of the population that are opposed to well-established measures like vaccinations, social distancing, and diagnostic tests. This is how we keep people well and out of hospitals in the first place.

Once the patients are there, providers need tools in their hands that can help them assess and triage patients out of the hospital more efficiently, such as tests that measure the probability that a patient is going to progress in their disease, and then you can again more aggressively treat them well while sending the other people home. We need to leverage the amazing biomarker research to observe and retest patients in the hospital, so that you can and hopefully treat them more aggressively ahead of downturns instead of mitigating symptoms and complications.

For that, I think we need a little bit more political motivation behind investing in keeping people well over letting people become really sick before intervening. The best care and the best patient experience is one that helps keep people out of hospitals.

The pandemic demonstrated the value of population surveillance. The signals that we see ahead of a pandemic, like rise in infections, could be more useful to track so that we kind of head it off more quickly through responsiveness to those signals.

What we saw at the front lines with healthcare providers at the front lines was a heroic effort to save and protect the lives of those around them and we saw and are seeing how this leads to burn out. We need the system to not just think about how it can be more responsive to patients, but how it can better conserve the precious resource that is healthcare providers. Even today, at the front end of the system the emergency departments are still overwhelmed with the number of COVID patients seeking treatment — as well as with patients who delayed care because of fear of COVID or for financial reasons.

At the political level, it’s interesting to us to see that the FDA the CDC resist certain interventions that seem to be suggested by the research. While there is a tide turning in favor of antibody testing, the CDC and FDA appear to have been resistant to it.

The science would tell us that a person’s level of antibodies is linked to their protection against infection. But there seems to be a lack of desire or will at the FDA and the CDC to roll out broad population-based antibody testing and monitoring. Their adoption of another sensible strategy, boosters, demonstrate that they understand waning protection. At the same time, antibody levels can act as the proverbial “canary in the coal mine” for the general waning in protection against infection. Right now, a person has to get infected for us to know that obviously they were no longer protected either through their vaccination or previous COVID infection. This is a big lag, and the opportunity remains to get in front of that lag with big data. There needs to be a will and there needs to be a regulatory pathway to collect the data. I think that is changing, but it’s taken quite a while for those pathways to start to become available.

One change I would import from my native Canada would be the approach to delivering care to marginalized segments of the population. There’s never a financial limitation to somebody getting treatment; if you show up at a hospital, you will receive care. If you’ve got money, there’s no place I’d rather get sick than the states. But economically marginalized members of a population and even the lower middle class often stay away from the healthcare system because no one wants to go into debt to get treated.

I think that is kind of one of the aspects that we’ve nailed here in Canada, though it’s not a perfect system either. Because everyone is treated more or less equally, you have longer wait times for things that are classified as “elective.” If you’re really sick you get treated immediately, but other, less acute care things, for example, if you need a knee replacement you will likely have to wait compared to a similar situation in the US.

Bringing it back around to COVID and the strain it put on the system, a patient who avoids care until their condition is acute is likely to end up in the emergency department or ICU instead of a rheumatologist’s, nephrologist’s, or cardiologist’s office. As we saw, their capacity is not endless.

Let’s zoom in on this a bit deeper. How do you think we can address the problem of physician shortages?

I’ve seen the predictions that the United States could see an estimated shortage of between 37,800 and 124,000 physicians by 2034, including shortfalls in both primary and specialty care.

My contrarian view, or rather, question, is whether there is a physician shortage or are there too many patients? If you can solve the problem at the front end of the system — and you know you can do this through education, raising the standard of living for all people, putting some muscle behind testing and population-level surveillance, that will obviously reduce the burden on the health care system. And if you can triage out people from the front end of the hospital system, then you can reduce the burden further up the value chain in the healthcare system. A specific example from the real world is the RALI-Dx test which is intended as a tool to give providers the confidence to send the less sick patients to back home or to a medicine ward for observation instead of them ending up in the ICU, which is one of the most expensive places to be when they have a more or less a simple infection that has developed into a more serious morbidity.

I also think one of the biggest burdens on the healthcare system in delivery of healthcare is the shortage of the support people around the physicians. The shortage of nurses may be a bigger problem than that of physicians.

As with diagnostic testing, we need to opportunities to lighten the load in a science-based manner. Can we help physicians make the best possible use of their time with each patient and allow them to spend time where they’re needed most?

We’re now looking at a logjam in the system that is the after effect of COVID. Thankfully, hospitals have regained the capacity that they lost to COVID beds at the height of the pandemic and now we’re seeing a wave of elective procedures. McKinsey & Co estimate that COVID-19 has caused the deferral of millions of elective procedures. To clarify, elective surgery does not always mean it is optional. It simply means that the surgery can be scheduled in advance.

While neither the COVID nor post-COVID situation could really be helped, we need to look at ways to alleviate some of this strain. This is where tests like the TORdx test can help, by potentially making more lungs available for transplants and treating people sooner to help potentially prevent them from getting sicker.

I think that a big impact can be made at the front end of the system to help clear out the emergency departments, transplant queues, and medical wards. And this lightening of the load comes from testing.

How do you think we can address the issue of physician diversity?

It’s a big issue that affects a lot of fields, not just medicine — it’s a question of getting more people into post-graduate programs. I think there’s a lot the field of medicine can do to attract those potential candidates out there.

I think that COVID did not likely reduce the number of people who want to become a doctor, but perhaps affected the type of doctor they wanted to become. The in-demand specialties might have changed from a frontline worker to something else.

You probably have fewer people that want to go into emergency medicine or intensivists because of the stories of the burden on the system and the emotional drain on those professionals.

Lighten the load on the whole system and you can reduce the perception that these aren’t the best careers to go into.

How do you think we can address the issue of physician burnout?

I think this second phase of physician burnout is upon us right now. My wife is an emergency doctor at one of the busiest COVID hospitals in Canada. She’d go in every day during the peak of the pandemic and the halls were filled with people. The crisis drew focus from people with other critical illnesses. What we’re seeing right now is a wave of people who ought to, in a perfect world, have been at the hospital sooner but weren’t.

I think that created and is still creating a lot of physician burnout because now providers are facing the secondary wave of non-COVID patients who are coming in with very high acuity because they avoided hospital settings. Physicians are seeing patients coming into the emergency department with a very high acuity compared to the average day. Those higher acuity patients are then triaged up into the other areas of specialty, so those doctors are also seeing much higher acuity and many more patients being referred to their care -there are only so many hours in a day.

It’s a burden on the nurses and physicians who are treating those patients, because everything is at higher acuity than before. COVID subsiding somewhat has not reduced the pressure on providers.

Again, one way we can support these providers is surveillance and testing and identifying which patients need to be in the hospital and who can safely go home.

What concrete steps would have to be done to actually manifest all of the changes you mentioned? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

Be an example as a leader. Whether you’re a health care provider or a head of a corporation, it’s important for all leaders in a community to follow and champion the science, follow the data.

As individuals, we all have to band together to protect each other. In America, we have people with very diverse backgrounds — from education levels to culture. But wherever you can, drive the message home to others and follow the signs and the data. Because we need consistency and unity in order to generate the will for change and repair the fabric of trust in science and data. Which runs counter to the politically motivated position that the pandemic is over, because I don’t think many people who are following the science and data would tell you that it is.

The next variant is going to come probably from unvaccinated parts of the population. That’s where the next threat is, and I think the only way to protect us from that next threat is to educate people, get everyone vaccinated, and stop the next variant in its tracks before it can even get started.

And if it’s going to come, then there needs to be a will to continue to test within our communities. As business leaders, we can step up as people head back into workplaces. Business has a role to play in providing their employees with safe work environments and testing for early warning signs of employees that may be infected or in close contact with people that are infected.

They need to step up as leaders and, particularly when an infectious disease is concerned, give employees the ability to not come to work when they are sick. If their employees do test positive for COVID, for example, follow the science and don’t make them come into work two days later because a politically motivated directive allows them to.

Responsibility extends to communities, also. I think it’s hard for people in the general population to know who to trust and what message to trust. The biggest contribution we can make is to provide trustworthy information.

Be trustworthy and responsible; I think that’s the biggest kind of influence we can have.

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 like to see all people of influence talk about the data and the science, and to be trustworthy so that people in their communities can make better decisions. There’s a lack of trust in science in some segments of the population, but we have to find a way to regain it. I think that to do that, we need to depoliticize healthcare and follow the data. The outcomes of behaviors and courses of disease do not change based on personally held beliefs, but the way some of us perceive these things do.

So, if I can inspire a movement, it would about education and scientific literacy.

How can our readers further follow your work online?

SQI Diagnostics’ news can be found on our LinkedIn.

Thank you so much for these insights! This was very inspirational, and we wish you continued success in your great work.

About the Interviewer: Luke Kervin is the Co-Founder and Co-CEO of PatientPop, an award-winning practice growth technology platform. PatientPop is Kervin’s third successful business venture. Prior to co-founding PatientPop, Kervin co-founded and was President of ShopNation (acquired by Meredith Corporation) and was the first executive hire at StarBrand Media (acquired by POPSUGAR).