It's the rare health system C-suite that has a large enough table for everyone who wants a seat. Laboratories are often stretched thin and perceived to be a cost center—or at best a commodity service—rather than a strategic asset that must have its point of view incorporated into an organization's overall vision.
“Anytime we talk about lab, it's more of an afterthought," says David Chou, Chief Information and Digital Officer at Children's Mercy Hospital, Kansas City. “We think about it, but it's not as relevant as pharmacy or other specialty departments."
But why? One reason is that lab leaders often don't know how to make a clear and irrefutable case for the value of their services—and in particular the value of their data— in the era of data-driven healthcare. Chou says that even though his CIO/CDO role makes him the organization's point person on the value of data, he doesn't understand all the ways that he could potentially use lab data. He's willing to advocate for it as a CIO who can make his case to the rest of the C-suite, as long as he understands it himself.
“Have you created the story theme of why the lab is critical?" he asks.
Patterns in lab results, for example, could give an organization an early heads-up on all kinds of valuable epidemiological information, from an outbreak of food poisoning to a prediction of how bad a flu season is going to be. The lab's data could help tell Chou how the flu, its symptoms, and its complications will tax the resources of the organization, and perhaps help identify which patients might be at highest risk. “We need to put together the story of the relevancy of this lab data, and make sure we get the story up to myself, as the CIO. If I don't know the story, I can guarantee you that the rest of the C-suite and the board members are not aligned."
The stakes are high when the lab doesn't make itself heard, notes Peter Gershkovich, Director of Pathology Informatics at Yale University Medical School. “It's very rare that you have a powerful lab with a presence in the C-suite," he says, which means the lab may not get the resources it needs to fully meet the strategic needs of the organization or input into IT planning. For instance, Yale's pathology lab has a core lab information system and uses nimble technologies to add functionality quickly and at minimal expense.
“If our system became part of the big over-arching [IT] structure, it would increase the cost of an upgrade and the cost of an error," Gershkovich says. If his lab lost its relative IT autonomy, it would lose control not just of the technology, but of the ability to change its workflow as needed, and potentially its ability to address patient safety issues and care needs.
Chou advises labs to elevate their story so it's impossible to ignore. “Market yourself, put together the [return on investment], put together the justification, and you will get a seat at the table."