Laboratory Stewardship: Taking the First Steps to Downstream Savings


This presentation will delve into the concept of lab stewardship and its critical role for the future of laboratory medicine. Dr. Fletcher will also outline several strategies for implementing successful interventions to drive downstream savings in healthcare systems.

Originally presented on June 27, 2018, in Salt Lake City, Utah.

Lecture Presenter

Andrew Fletcher, MD, CPE

Andrew Fletcher, MD, CPE

Medical Director, Consultative Services
ARUP Laboratories

Dr. Fletcher is a board-certified anatomic/clinical pathologist and certified physician executive with significant experience in leading quality across an organization and reducing clinical variation to effectively drive safety and value. Most recently, he was instrumental in developing a utilization management program that captured over $1 million in cost savings within the first year and significantly improved downstream metrics driving utilization in various areas, including pharmacy, radiology, length of stay, and sepsis mortality. Dr. Fletcher has a doctor of medicine degree from the Mercer University School of Medicine in Georgia and is currently pursuing his MBA from the University of Massachusetts at Amherst. He completed a surgery internship at the Geisinger Medical System in Pennsylvania, as well as a residency in anatomic and clinical pathology and a cytopathology fellowship at the University of Florida in Gainesville. Dr. Fletcher has received numerous awards for quality and utilization, including research grants for blood utilization.


After this presentation, participants will be able to:

  • Analyze ordering patterns to identify over, under, and misuse of tests.
  • Estimate the clinical and economic impact of suboptimal test ordering.
  • Identify opportunities to improve patient care with shorter times to diagnosis.
  • Develop and implement a laboratory test formulary.
  • Describe ways to establish client UM program governance and engage ordering physicians.
  • Formulate strategies to minimize downstream costs through appropriate testing.

Sponsored by:

University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories