Episode Overview
Podcast: Becker’s Healthcare Podcast
Episode: Lab Stewardship as a Strategic Lever for Health Systems
Date: December 23, 2025
Host: Lucas Voss
Guests:
- Dr. Sanjay Nagendra, Medical Director, Center for Esoteric Testing & Atlantic Regional Laboratories, LabCorp
- Cameron Thomason, National VP, Acute Care Services & Vision Hospitals and Health Systems, LabCorp
This episode explores laboratory stewardship as a transformative tool for improving quality, reducing waste, optimizing costs, and aligning laboratory operations with broader healthcare strategy. Dr. Nagendra and Cameron Thomason share current best practices, innovations in data and analytics, AI’s emerging role, and how health system leaders can embed stewardship programs for lasting, system-wide impact.
Key Discussion Points & Insights
1. Defining Lab Stewardship: Evolution and Importance
[04:21–09:02]
- Broad Definition: Lab stewardship is the “coordinated, responsible management of laboratory resources, processes and data,” aiming to optimize patient care, ensure quality, and control costs.
“Key elements…are appropriate laboratory test utilization, compliance with regulatory standards…and data-driven decision making.”
— Dr. Nagendra [04:21] - Commercial Lab Perspective: Focus is on updating test menus, discontinuing low-value tests, educating providers about offerings, and balancing evidence-based medicine with profitability.
- Hospital Perspective: Emphasizes integration of the lab into patient care pathways, collaboration with clinicians, standardization, and both over- and under-utilization avoidance.
- Evolution Over Time: Moved from basic utilization review toward comprehensive, multidisciplinary stewardship with real-time analytics and clinical collaboration — especially accelerated by the COVID-19 pandemic and rapid advances in informatics and AI.
“As we approach 2026…lab stewardship is a proactive, system-wide approach to improving care quality, reducing waste, and supporting population health.”
— Dr. Nagendra [08:44]
2. Lab Stewardship as a Lever for Cost Control
[09:40–12:29]
- Context of Rising Costs: Non-labor expenses for hospitals have risen nearly 6% year-over-year, putting enormous pressure on financial sustainability.
- Strategic Value: Stewardship is unique in delivering both cost savings and improved quality, safety, and outcomes.
- Misconceptions: Lab stewardship is not “just a lab function” — best programs are cross-functional and enterprise-wide.
- Leadership Buy-in: When data is accessible and communicated, and when wins are highlighted, trust and engagement grow across the organization.
“Lab stewardship committees create value far beyond the incremental cost savings from reducing overuse…there’s a direct impact on quality, safety and clinical outcomes.”
— Cameron Thomason [10:44]
3. Technology, Data, and AI: Tools for Advanced Stewardship
[13:08–17:50]
Dr. Nagendra outlines four critical tools:
- Advanced Analytics & Decision Support:
- Real-time dashboards track test utilization, turnaround, cost, and monitor individual provider patterns.
- Clinical Decision Support Systems (CDS):
- Integrated tools (e.g., LabCorp’s Diagnostic Assistant) suggest tests, flag redundancies, and guide ordering at the point of care without disrupting workflow.
- Predictive Analytics:
- Use lab findings to flag patient risks (e.g., sepsis risk, chronic disease), supporting both stewardship and patient safety.
- Integrated Data Platforms:
- Unifying lab, imaging, pharmacy, and socio-demographic data to drive holistic, rapid clinical decisions.
- Population Health Analytics:
- Tools like LabCorp's Insight aggregate data across communities, identify testing gaps (like low diabetes screening in certain zip codes), and guide outreach.
- Patient Engagement:
- Educating patients via portals to support appropriate test demand, helping reduce pressure for unnecessary testing.
- AI-driven Pathways:
- Algorithmic ordering based on evidence, improving efficiency and minimizing waste.
“Algorithm-driven test selection is really important…that can be much more cost effective than ordering 100 different tests at one time.”
— Dr. Nagendra [17:26]
4. Embedding Stewardship: Leadership and Organizational Strategies
[17:50–21:46]
Cameron outlines five key components for building stewardship into system strategy:
- Executive Sponsorship: Visible support and clear enterprise alignment.
- Formal Governance: Structured committees with defined charters, metrics, and ongoing cadence.
- Multidisciplinary Participation: Champions from medicine, nursing, pharmacy, IT, and more.
- Data Access: Trusted, real-time analytics to prioritize, engage, and track outcomes.
- Communication: Publicizing wins to build momentum and reinforce engagement.
“When it’s aligned with the strategy, governed well, data enabled and clinically led, [stewardship] can become a part of the operating rhythm and the culture of the health system.”
— Cameron Thomason [21:33]
5. Final Takeaways: Sustaining Stewardship & Partnerships
[22:05–25:26]
- LabCorp Initiatives:
- Ongoing directory optimization (phasing out obsolete/redundant tests based on guidelines).
- Developing algorithmic panels and cascades for complex diagnoses (e.g., anemia, B12)—ensuring efficiency and accuracy.
- Continuous clinician education through various platforms (webinars, white papers, direct outreach).
- Strategic Partnerships:
- Effective partners bring credibility, tailored analytics, demonstrated long-term results, and a philosophy of continuous shared learning.
- Scale enables knowledge transfer, accelerates best practices, and strengthens stewardship outcomes.
“We think of that as like this ecosystem of shared learning where collaboration accelerates best practices and helps all of us be better together.”
— Cameron Thomason [24:53]
Notable Quotes & Memorable Moments
- On the evolution of lab stewardship:
“Prior to the pandemic, we were doing basic utilization review and now we’ve more shifted to comprehensive multidisciplinary programs…real time analytics and clinical collaboration.”
— Dr. Nagendra [07:29] - On misconceptions about stewardship:
“A common misconception is that lab stewardship lives inside the lab. It doesn’t really live inside the lab. The reality is it’s a cross functional enterprise approach.”
— Cameron Thomason [10:58] - On the dual value proposition:
“A fully integrated stewardship program becomes a lever for safer, higher quality care, and it also lowers cost…”
— Cameron Thomason [12:16] - On AI and decision support:
“Algorithm-driven test selection…can be much more cost effective than ordering 100 different tests at one time.”
— Dr. Nagendra [17:26] - On embedding stewardship into strategy:
“When it’s aligned with the strategy, governed well, data enabled and clinically led, it can become a part of the operating rhythm and the culture...”
— Cameron Thomason [21:33] - On lessons from LabCorp’s stewardship journey:
“We have…created a multidisciplinary team...to discuss LabCorp’s test menu…discontinuing obsolete tests…working on cascades to ensure clinicians order the right test.”
— Dr. Nagendra [22:07] - On choosing a stewardship partner:
“You want a trusted advisor who brings a purpose built approach…embedded analytics…demonstrated sustainable performance across a long-term relationship…”
— Cameron Thomason [24:17]
Timestamps for Key Segments
- Introductions & Backgrounds – [00:36–03:48]
- What is Lab Stewardship? – [04:21–09:02]
- Cost Control & Value Proposition – [09:40–12:29]
- Analytics, AI & Decision Support – [13:08–17:50]
- Building Organizational Stewardship – [17:50–21:46]
- Final Thoughts & Takeaways – [22:05–25:26]
This episode provides a compelling look into how laboratory stewardship can serve as both a strategic and operational lever for hospitals and health systems—offering concrete insights and practical recommendations for leaders, clinicians, and health system partners seeking to optimize care, cost, and outcomes.