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Background: Clinical laboratories are vital in healthcare, influencing medical decisions. As the field moves toward precision medicine and digital tools, laboratories must innovate with automation and data analytics to provide accurate, timely insights for diagnosis and treatment. Future success depends on investing in technology, training, and system integration. This study assessed Rwandan clinical referral laboratory’s readiness to adopt innovative technologies, gathering views from physicians and clinical laboratory professionals, and highlighted challenges and key factors impacting their adoption in meeting healthcare expectations.

Methods: A qualitative design was used, collecting data from three sources: (1) observations, (2) key informant interviews (KIIs) with laboratory professionals, and (3) a survey of physicians on laboratory services. Data from the three sources were initially coded separately and merged to generate subthemes using an inductive reflexive thematic approach (Braun & Clarke). Subthemes across datasets were aligned and refined into two final themes.

Results: Two themes were generated: (1) Repackaging and reshaping laboratories for quality and future readiness. In this theme key challenges described to affect laboratory services in Rwanda included inadequate infrastructure, shortages of specialised personnel, and difficulties in retention of staff. (2) Reflecting and addressing healthcare expectations. In this theme participants described key challenges to include interruption of services due to stock-outs, equipment breakdown, delays in test results, and the unavailability of certain diagnostic tests. These obstacles hinder the readiness of laboratories to adopt advanced technologies and meet healthcare expectations.

Conclusion: To optimize clinical laboratory services in Rwanda, key areas such as infrastructure, specialised professionals, equipment maintenance, and supply chain management need to be strengthened. Insights from multidisciplinary workforce that include laboratory specialists are essential to reshape services, enabling effective integration of advanced technologies and meeting evolving healthcare demands.