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Becker’s Healthcare Podcast
Scaling Laboratory Services for Growth at Brown University Health with Christopher Burks
00:14:49
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- [00:02]
A
This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you in Chicago.
- [00:32]
B
This is Laura Darda with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Christopher Birx, vice president of laboratory and support services at Brown University Health. Christopher, it's a pleasure to have you on the podcast today.
- [00:44]
C
Thank you for having me.
- [00:45]
B
Absolutely. Now, I'm excited for our conversation because I know there's, you know, a lot going on in healthcare and particularly looking at laboratory space and how it's growing and evolving as a critical aspect of the health system. So I'm looking forward to learning, learning more from you. But before we dive in, can you tell me just a little bit more about yourself and Brown University Health?
- [01:06]
C
Sure, sure. So my name is Christopher Birx, and I serve as the vice president of laboratory and support services here at Brown University Health. Brown Health is a academic health system, AMC headquarters in Providence, Rhode Island. The group was originally founded as Lifespan in 1994 through an affiliation between Rhode Island Hospital, which is our flagship, and the Miriam Hospital, which is a sister hospital in the Providence area. The system later grew and expanded and acquired Newport Hospital, Bradley Behavioral Hospital, and we also have a gateway in terms of our outreach behavioral health setting. And very recently, in 2024, we acquired the previous Steward Hospitals, St. Anne's Hospital in Morton, and we reorganized in October of the same year in 2024 and became Brown University Health. So Brown Health is a principal teaching affiliate of Warren Allpert Medical School at Brown University. And we have about 20,000 employees across Rhode island and southern Massachusetts. And that basically speaks to Brown University Health. My background is specifically I'm a trained microbiologist that over the years, you know, with progressive promotions and movement, managed, you know, large labs in New York City, moved to Temple in Philadelphia. Now I've arrived in 2023 at Brown University Health.
- [02:41]
B
That's amazing to hear and what a great background. Bring you all full circle into the space where you're in today. Now, when you think about the last year or so, what was the most important initiative that you led? What did you do and what were the results?
- [02:55]
C
The most important initiative Was really integrating the Massachusetts campus and the Massachusetts group. When Brown Health acquired the former steward facilities, we also got some ambulatory sites. So we have a large Hawthorne Medical Group, Medical Associates group in Dartmouth, Massachusetts, and we also have another group up in Foxborough. So it's integrating those groups. They were on a different LIS system, a different financial system. They used third party professional billing. So the real strategic initiative that we led was integrating them from a lab perspective. It was really understanding where the pitfalls were, understanding where the investments needed to be made, and also that revenue cycle piece, making sure that the bills are going out, that they're being done appropriately, that the CPT codes are matching, that revenue cycle is in true alignment and what lab is doing in terms of output and being able to ensure that those payments are being made.
- [04:04]
B
Got it. That makes a lot of sense. And I know it's a huge challenge to be able to get all those processes in place and make sure that you've got everything done correctly. But so, so important, the health system overall. I'm curious, you know, when you look at that strategic initiative in trying to, you know, figure out where to best put your resources, was there anything that surprised you throughout the process or what did you learn? How did you really incorporate it to make sure that everything was aligned and continues to be productive?
- [04:39]
C
Looking at the structure and how it was originally built, what we really gained were the people capital. And when I say that is that they were very excited for change. Obviously, you know, they were in the Philly private sector. But what, what we found was that not only the infrastructure needed to be to be addressed, the asset management needed to be addressed in terms of investment, staffing was appropriate, but we needed to look at the declining volume and be able to address that. Also be able to align more closely with Rhode island in terms of testing understanding. Do we need to be duplicative in our resources and where do we align? Where do we standardize great partners on the Massachusetts side with the campus presidents and the leadership in the ambulatory setting, understanding what do we need to do in the immediacy to be able to support them in their strategic goals? And what we were able to do was bring all the outsourcing in house and where it made sense to continue to outsource, we continued to do so, but with a strategic plan to bring everything in house with units of measure, being able to get vendors, contracts, leadership aligned, then we could be able to financially support more. And then with that, being able to reinvest in those infrastructures and to be able to build up and spiral up in terms of how we are addressing
- [06:19]
B
our volume, that makes a lot of sense and it is really helpful to understand that process there. Thank you for going a bit deeper. Now looking ahead into 2026, what are some of the big priorities and headwinds that you're most focused on?
- [06:34]
C
Growth. Growth opportunities. We're starting to look at other areas. I can't go into detail about it, but looking into other areas within that market, building out more so around the hospital setting. Unfortunately, Stuart was selling off pieces of their outreach and pieces of the ambulatory. So we're looking to bring that back in under the umbrella of Brown Health. But as we do that, we have to be more strategic with our service lines and with our leaders and daily and detailing strategic initiatives. So again, by looking at the volume, the staffing, our assets, we determine, you know, what our course is and planning forward with noted whatever needed capital or infrastructural basis that we need to invest in. And you know, also from my perspective, what was important was to know the contractual constraints and what does that look like as we build out. Right. So that's what we are looking to do in 2026, looking at the growth opportunities, make sure we're aligned, strategizing for lean functionality and investment and appropriately support the business on the front end and on the back end. So as you build up in the front building up the business, I have to make sure I have capacity and bandwidth on the back end in actual laboratories that can actually funnel that work through. So as ambulatory grows, so does the patient capture in the patient service center settings. And then on top of that, being able to on the back end to be able to fulfill those tests more timely, efficiently get them out and have that relationship from a supportive customer service standpoint with the different faculty groups that we're working with in ambulatory settings and be very mindful of the downstream effects. So you know, laboratory support, consumables, operational needs. So the big priority that I'm focused on in 2026 is growth and being, making sure the growth opportunities are aligned with what we are wanting to do on the long term public strategy.
- [08:47]
B
That makes sense and it's helpful to understand, I think, always figuring out how you can funnel up those efforts to create value and think about growth. And it's great that you're in a position to be thinking about growth because I know so many organizations and leaders are trying to just minimize any shrinkage or challenges that they have. And so that's incredible to hear. What do you think the hardest thing that you'll have to do in the next year will be?
- [09:12]
C
Bandwidth. Bandwidth. I'll just stop there. From my standpoint, we have always built ourselves to support Rhode island with the new acquisition of the former Stewart hospitals and ambulatory settings. And as we continue to grow and open up new ambulatory sites and primary service, primary care service areas and practices, it's all about the bandwidth. Do we have the capacity to keep up? From my standpoint, what I'm charging my folks to do is, you know, instead of always building business plans, look at your current capacity, look at your current ability to scale up. So if I were to take on a new practice, looking at our current capacity, are we able to scale up, you know, 30,000 in volume or 10,000 in volume, you know, what does it look like if we were to expand southwards into, into the Connecticut market, You know, what does that look, look like? So for me it's all about the bandwidth and being able to supply and, and, and support our, our different groups that we're bringing into Brown, Brown Hill. And by supporting them, you know, are we doing it efficiently and is our bandwidth able to, to support further growth? So those are the things that is very hard for us right now, is that we are constrained by our four walls. You know, do we need to look at being a freestanding laboratory? Do we need to move off campus? You know, so it's all about bandwidth. The people, capital we have that in place is about the bandwidth and the ability to scale up.
- [11:03]
B
Got it. And that's helpful to understand, you know, and truly trying to create that right balance and figure out what the right strategy is is no easy task. But it seems like, you know, you've got a team in place there. And when you're looking at that and thinking through all of those things, what type of data do you look like? Look at, how do you, I guess, what factors do you think about? You're trying to decide where the next growth opportunities are going to be.
- [11:32]
C
So we work with consultancy groups, one in particular, but we also have internal benchmarking that we use. So we use Premier, very similar to vision, if you used to visio, DBA or database. So we look at the market, we look at where we're at. We also look at the ability by just looking at and being aware of the environment and who's around us and who our competitors are in the ever changing healthcare market. And also with reimbursement issues, in terms of how Congress is Moving and whatnot. What we're finding as the different ambulatory groups are looking to expand or looking to find savings, are we able to pivot and be able to take on that extra business? And if we do take on that business, what does that mean for us in terms of our market? What does it mean for us in terms of our contribution margins and our margins in general? We have goals on the financial side with Brown Health that we try to meet every year in Rhode Island. We're doing very well, but unfortunately, you know, we're purchasing the formerly bankrupt Steward. You know, we have to invest there, but we always are looking for our return on that.
- [12:51]
B
Got it. That, you know, is so helpful to think through. I think, you know, having that kind of dichotomy between the legacy organization and then the hospitals coming in from Steward and those types of facilities to understand, you know, the different approach there makes a lot of sense. Before we wrap up, is there anything else, you know, love to kind of get your sense on in terms of growth coming forward? Anything else you're thinking about or looking at or just, you know, really excited about for the future?
- [13:19]
C
Ambulatory. For us, ambulatory is. Is where we want to move into. When I first got to Brown In 2023, we did not market ourselves in the ambulatory space that well. We. We started doing so in 2023, before I arrived earlier that year in acquiring Coastal, which is a large primary group primary care with the purchase of Stuart Kim. You know, again, I mentioned earlier, the large ambulatory setting where there is a myriad of services, you know, obgyn, urology, GI practices, oncology infusion. For us, you know, the ambulatory setting is really the hotbed and where we really want to invest in. And by investing in that, then we can support our hospitals with the continuousness of care, the continuity of care, where we can support them on an inpatient setting, but be able to really support them on the ambulatory side in the private faculty settings.
- [14:27]
B
That makes a lot of sense. Christopher, thank you so much for joining us on the podcast today. This has been such a fun and informative conversation and I look forward to forward to seeing you as well at our annual meeting. I know you'll be speaking on a panel there and, you know, really kind of continuing on many of these themes. We talked about digging a little bit deeper and so it'll be great to connect and looking forward to seeing you.
- [14:46]
C
Thank you, Lord.