Latest / Becker’s Healthcare Podcast / Scaling Laboratory Services for Growth at Brown University Health with Christopher Burks

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Scaling Laboratory Services for Growth at Brown University Health with Christopher Burks · Becker’s Healthcare Podcast

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This is where health care leadership comes together.
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Becker's sixteenth annual meeting brings more than 3,500
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hospital and health system executives and nearly 800
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speakers to Chicago
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April.
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This year's event includes keynote conversations with Dallas
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Cowboys legend Troy Aikman and former president George
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w Bush. For the agenda and event details,
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visit beckershospitalreview.com
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and click on the events tab in the
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upper right. We're looking forward to hosting you
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in Chicago.
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This is Laura Dierdahl with the Becker's Healthcare
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podcast. I'm thrilled today to be joined by
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Christopher Birx, vice president of laboratory and support
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services
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at Brown University Health. Christopher, it's a pleasure
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to have you on the podcast today. Thank
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you for having me. Absolutely. Now I'm excited
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for our conversation because I know there's, you
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know, a a lot going on in health
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care and particularly looking at,
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laboratory
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space and and how it's growing and evolving
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as a critical aspect to the health system.
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So I'm looking forward to learning more from
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you. But before we dive in, can you
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tell me just a little bit more about
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yourself and Brown University Health?
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Sure. Sure. So my name is Christopher Burkes,
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and I serve as the vice president of
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laboratory and support services here at Brown University
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Health.
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Brown Health is a, academic health sys system
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at AMC headquarters in Providence, Rhode Island.
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The group was originally founded as Lifespan in
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1994,
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through an affiliation between Rhode Island Hospital, which
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is our
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flagship, and, the Merriam Hospital, which is a
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sister hospital,
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in the Providence area.
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The system later grew and expanded and acquired
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Newport Hospital,
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Bradley,
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the April,
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and we also have Gateway in terms of
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our outreach,
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behavioral health setting.
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And very recently in
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2024,
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we acquired the previous Stewart Haas hospitals,
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St. Anne's Hospital in Morton.
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And we reorganized in October of the same
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year in 2024 and became Brown University Health.
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So Brown Health is a principal teaching
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affiliate of Warren Alpert,
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Medical School of Brown University.
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And
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we have about 20,000 employed
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across Rhode Island and Southern Massachusetts.
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And, that basically speaks to,
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Brown University Health. My background is specifically,
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I'm a trained microbiologist
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that over the years, you know, with progressive,
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promotions
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and movement,
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managed,
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you know, large labs in New York City,
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moved to Temple in Philadelphia, and now I've
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arrived, in 2023
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at Brown University Health.
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That's amazing to hear. And what a great
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background bringing you all a full circle into
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the space where you're in today. Now when
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you think about the last year or so,
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what was the most important initiative that you
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led? What did you do, and what were
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the results?
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The most, important initiative
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was really in integrating the Massachusetts campus and
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the Massachusetts group.
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When Brown Health acquired,
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the former Steward facilities, we also got some
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ambulatory sites.
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So we have a large,
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Hawthorne Medical Group,
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Medical Associates Group in,
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Dartmouth,
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Massachusetts, and we also have another group up
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in Foxborough.
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So it's integrating those group. They were in
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a different LIS system, a different financial system.
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They used third party,
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professional billing.
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So the real strategic
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initiative that we led was integrating them.
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From a lab perspective,
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it was really
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understanding
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where the investments needed to be made, and
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also that revenue cycle piece, making sure that
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the bills are going out, that they're being
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done appropriately,
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that the CPT codes are matching,
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that revenue cycle is is is in true
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alignment, and and what lab is doing in
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terms of output,
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and being able to ensure that those payments
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are being made.
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Got it. That makes a lot of sense.
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And, you know, I know it's,
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a
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huge challenge to to be able to,
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you know, get all those processes in place
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and make sure that, you know, you've got
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everything done correctly, but so so important for
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the health system overall.
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I'm curious, you know, when you look at
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that strategic initiative in trying to,
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you know,
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figure out where to best put your resources,
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was there anything that surprised you throughout the
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process, or or what did you learn? How
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did you really, incorporate it to, make sure
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that everything was aligned and, continues to be
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productive?
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Looking at the structure and how it was
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originally built,
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what we really
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gained were the people capital.
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And when I say that is that they
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were very excited for change.
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Obviously, you know, they were in a filling
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private sec sector, but what what we found
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was that not only the infrastructure needed to
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be to be addressed,
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the asset management needed to be addressed,
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in terms of investment.
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Staffing was appropriate, but we needed to look
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at the declining volume and be able to
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address that.
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Also be able to align
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more closely with Rhode Island in terms
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of testing, understanding,
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do we need to be duplicative
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in our resources?
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And where do we align? Where do we
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standardize?
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Great partners on the Massachusetts side with the
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campus presidents and the leadership in the ambulatory
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setting,
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understanding what do we need to what do
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we need to do to to in the
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immediacy
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to be able to to support them in,
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their strategic goals.
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And what we were able to do was
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bring all the outsourcing
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in house.
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And where was where it made sense to
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continue to outsource, we continue to do so.
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But with a strategic plan to bring everything
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in in house,
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With units of measure,
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being able to get vendors,
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contracts,
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leadership aligned,
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then we could be able to financially
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support more.
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And then with that, being able to reinvest
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in those inf infrastructure
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and to be able to to to build
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up and spiral up in terms of how
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we are addressing our volume.
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That makes a lot of sense. And, you
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know, it is really helpful to understand that
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process there. Thank you for going a bit
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deeper. Now looking ahead into 2026,
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what are some of the big priorities and
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headwinds that you're most focused on?
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Growth. Growth opportunities.
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We're starting to look at other areas. I
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can't go into detail about it, but looking
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into
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other areas within that market,
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building out more so around the hospital setting.
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Unfortunately, Stewart was selling off pieces of their
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outreach
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and pieces of the ambulatory, so we're looking
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to bring that back in under the umbrella
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of Brown Health. But as we do that,
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we have to be more strategic with our
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service lines and with our leaders
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and dealing in detail with strategic initiatives.
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So, again, by looking at the volume, the
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staffing, our assets, we determine, you know, what
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our course is and planning forward,
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with noted whatever needed capital or infrastructural
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basis that we need to invest in.
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And, you know, also,
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from my perspective, what's what was important was
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to know the contractual constraints
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and what does that look like as we
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build out. Right?
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So so that's what we are looking to
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do,
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in 2026,
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look at the growth opportunities to make sure
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we're aligned,
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strategize it for lean functionality
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investment,
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you know, and appropriately support the business on
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the front end and on the back end.
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So as you build up in the front,
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you know, building up the business, I have
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to make sure I have capacity and bandwidth
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on the back end and actual laboratories
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that can actually funnel that work through.
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So as ambulatory grows, so does the patient
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capture in the patient service center settings.
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And then on top of that, being able
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to, on the back end, to be able
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to fulfill those
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tests more timely,
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efficiently,
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get them out, and get have that relationship
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from a supportive customer service standpoint
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with the different faculty groups that we're working
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with in ambulatory settings,
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and be very mindful of the downstream effects.
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So, you know, laboratory support,
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consumables, operational needs.
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So
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the big priority,
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that I'm focused on in 2026 is growth
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and being making sure the growth opportunities are
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aligned with what we are wanting to do
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on the long term on the strategy again.
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That makes sense, and it's helpful to understand.
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I think, you know, always,
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figure out how you can funnel up those
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efforts, to create value and think about growth.
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And it's great that you're in a position
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to be thinking about growth because I know
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so many organizations and leaders are trying to,
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you know, just minimize any any shrinkage or
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challenges that they have, and so that's incredible
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to hear.
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What do you think the hardest thing that
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you'll have to do in the next year
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will be?
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Bandwidth.
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Bandwidth.
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I'll just stop there.
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From my standpoint,
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we have always
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built ourselves
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to support Rhode Island,
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with the new acquisition of the former Stewart
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hospitals and ambulatory settings, and as we continue
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to grow and open up new ambulatory sites
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and and primary service primary care,
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service areas and and practices,
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it's all about the bandwidth. Do we have
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the capacity to keep up?
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From my standpoint, what I'm charging
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my folks to do is,
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you know, instead of
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always building business plans, look at your current
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capacity.
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Look at your current ability to scale up.
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So if I were
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to take on a new practice,
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looking at our current capacity, are we able
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to scale up, you know, 30,000 in volume
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or 10,000 in volume?
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You know, what does it look like if
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we were to expand
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southwards into,
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into the Connecticut market? You know? What does
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that look look like? So for me, it's
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all about the bandwidth and being able to
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supply and some and and support,
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our our different groups that would bring it
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into
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Brown Brown Health.
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And by supporting them, you know, we do
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it inefficiently,
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and is our bandwidth able to to support
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further growth? So those are the things that
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it it's it's very hard for us right
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now,
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is that we are constrained by
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out four walls. You know? Do we need
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to look at being a freestanding laboratory?
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Do we need to move off campus?
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You know? So it's all about bandwidth.
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The people capital, we have that in in
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place. It's about the bandwidth and the and
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the ability to scale up.
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Got it. And that's helpful to understand. You
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know? And truly,
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trying to create that right balance and figure
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out what's right strategy
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is,
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is no easy task.
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And,
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but it seems like, you know, you've got
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a a team in place there. And, when
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you you're looking at that and thinking through
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all of those things, what type of data
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do you look like look at? How do
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you I guess, what factors do you think
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about as you're trying to decide where the
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next growth opportunities are gonna be?
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So we work with consultancy groups,
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one one in particular.
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But we also have internal,
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bench benchmarking that we use. So we use
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Premier.
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Very similar to Visiate if you used to
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Visiate DBA or database.
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So we look at the market. We look
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at where we're at. We also look at
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the ability,
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by just looking at and and being aware
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of the environment and and and who's around
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us and who our competitors are,
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in the ever changing health care market and
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also with,
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reimbursement
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issues in in terms of how congress is
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moving and whatnot, what we're finding as
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as the different ambulatory groups are are looking
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to expand
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or looking to find savings. You know? Are
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we
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able to
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pivot
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and be able to take on that extra
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business? And if we do take on that
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business, what does that mean for us in
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terms of our market? What does it mean
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for us in terms of our contribution margins
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and our margins in general?
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We have goals on a financial side,
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with Brown Health that we try to meet
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every year.
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In Rhode Island, we're doing very well, but,
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unfortunately, you know, with purchasing
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the formerly,
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bankrupt Stewart, you know, we're having to invest
12:47
there. But we always are looking for our
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return on that.
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Got it. That, you know, is so helpful
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to think through. I think, you know, having
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that,
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kind of, that kind of me be between
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the legacy organization and then the hospitals coming
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in from Stewart and the those types of
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facilities to understand, you know, the different approach
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there makes a lot of sense.
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Before we wrap up, is there anything else,
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you know, love to kinda get your sense
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on,
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in terms of growth coming forward, anything else
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you're thinking about or looking at or just,
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you know, really excited about for the future?
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Yeah. Ambulatory.
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For us, ambulatory is is where we wanna
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move into. When I first got to Brown
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in 2023,
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we did not market ourselves in the ambulatory
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space that well. We we
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started doing so in 2023
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before I arrived earlier that year,
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in acquiring Coastal, which is a large primary
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group,
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primary care
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with,
13:45
the purchase of Steward Kim. You know, again,
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I mentioned earlier, the large ambulatory setting,
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where there is a myriad
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of, services, you know,
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OBGYN,
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you know, urology,
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GI practices,
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oncology infusion.
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For us, you know, the ambulatory setting is
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is is really the hotbed
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and where we really wanna invest in.
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And by investing in that, then then we
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can, you know, support our hospitals,
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the the continuousness
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of care or or the continuity of care,
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where we can support them, you know, on
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an inpatient setting, but be able to really
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support them on the ambulatory side in a
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private faculty setting.
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That makes a lot of sense. Christopher, thank
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you so much for joining us on the
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podcast today. This has been such a fun
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and informative conversation, and I look forward to
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seeing you as well at our annual meeting.
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I know you'll be speaking on a panel
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there and, you know, really kind of continuing
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on. Many of these seem to be talked
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about digging a little bit deeper, and so
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it'll be great to connect and looking forward
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to seeing you. Thank you, Lauren.