3 Strategies for Virtual HIM Departments: From Reaction to Reality

Over the past two years, hospital departments, including health information management (HIM) departments, have been forced to restructure their operations using remote or virtual teams.

During this time, we’ve learned a great deal about how well-managed HIM departments function when relying primarily on virtual teams. In this article, we share three strategies to help HIM leaders create sustainable virtual HIM departments—not just for today, but for the long term.

Virtual HIM Characteristics

First, let’s define what a virtual HIM department is and how it differs from a traditional on-site department.

The most striking feature of such departments is that the workforce remains largely or completely remote. Team members communicate using a wide range of tools, including work collaboration tools embedded within videoconferencing platforms, visual project management tools such as Trello Boards, and standard options such as emails and phone calls.

A department may still need a team member on-site during business hours to answer questions from the facility and staff, and possibly to retrieve, file, and maintain any paper records. Existing team members may staff this function on a rotating or hybrid schedule basis.

Policies and procedures related to core HIM functions such as documentation reviews and patient privacy remain actively in place. However, to accommodate the dynamics of a virtual environment, HIM leaders have created, changed, and implemented new workflows for documenting, sharing, and storing records. These new workflows are also needed to foster a collaborative team culture and address the communication challenges that come from working remotely. Ongoing multidisciplinary analysis of current privacy and security practices and safeguards is another requirement to ensure compliance. 

To make virtual HIM departments perform effectively and efficiently, it’s important for leaders to adopt sustainable strategies that keep team members working at their highest possible levels of performance.

Track Performance

Tracking performance virtually can be tricky, so developing tools and techniques that work is important.

• Begin by identifying the key performance indicators (KPIs) that are critical to operational success. These should include but not be limited to productivity, quality of work, and attendance.
   
• Establish a pre-COVID-19 performance baseline. Identify a time frame that was not affected by the pandemic, such as January through March of 2019, and capture data on selected KPIs for that period. This baseline establishes performance levels in a normal operating environment.
   
• Capture data for the same KPIs for the next three months of the year or a relevant three-month period when COVID-19 impacted operations.
   
• Using the same indicators, compare your “active” KPIs to the data collected for the pre-pandemic period. When making this comparison, bear in mind that life changed dramatically when COVID-19 took hold. With shelter-in-place rules, school closures, and spouses working from home, remote work environments were different than they had been prior to the emergence of COVID-19.

It’s also important to measure performance over the full “active” period when COVID-19 became a part of daily life. While performance may have initially dropped as people adjusted to their home, school, and work environment, the key is to measure effectiveness once the new normal becomes “the normal.”

When making these comparisons, consider the following questions:

• What differences were identified between the pre-COVID-19 KPIs and data collected during the pandemic? Are these differences a result of any work volume differences that have now stabilized?
• Do the differences impact the overall effectiveness of operations?
• Do adjustments need to be made to operations to minimize the impact of COVID-19-related changes?

Next, select a final “post-quarantine” block of three months, which will allow you to look at the effect COVID-19 had on operations over time. Questions to ask include:

• Was there a decrease or increase in productivity, quality, work, and absenteeism?
• Was there improvement in employee engagement?
• Given what was learned through the analysis of performance before, during, and after COVID-19, would it make sense to bring staff back on-site, or is a remote work environment sustainable as a permanent solution? Or if staff returns, will they need to return home again if additional waves of COVID-19 emerge?

Create New Work Environments

Another critical step is to ensure that team members have fully functioning, secure, remote environments at home. With staff working from many different satellite offices, the set of challenges includes asset management, risk management, supply chain issues, internet speed and security, network connection protocols, and more.

To achieve optimal efficiency, it is necessary to update policies, procedures, benchmarks, and expectations. People need to understand new responsibilities and guidelines for accountability in a remote work environment.

In addition, consider what the work-from-home experience looks like for remote staff. Data may be displayed differently. Access to systems may not be the same. It’s important to provide a similar look and feel to technology.

Here are general criteria to consider when supporting HIM staff in a remote access environment:

• Policy and Procedure: Workspace requirements, devices, disclosure of persona health information, work schedules, incident reporting, remote access/confidentiality agreement, and other related guidelines.
• Workspace and Devices: Perform routine updates and maintenance on all devices to meet privacy and security requirements.
• Connectivity and Authentication: Functional, secure internet access with secure passwords and multi-factor access to your network.
• Education and Training: Virtual sessions and training modules; current reference materials and updates.

Support Communication

Communication is the most crucial piece that HIM leaders must successfully manage in a virtual environment. Communication between team members must be consistent, regular, and timely to replace the team building, bonding moments, and interaction that automatically come with an in-person setting.

A meaningful part of being in the office is the on-site collaboration that occurs every day, such as “water cooler” discussions and “in the moment” spontaneous teamwork. You can overhear someone’s phone call or conversation and jump in to help them out. You can go to your colleagues’ desks and ask for input. When working from home, those opportunities disappear or exist only virtually.

HIM leaders can help to create virtual teambuilding opportunities in multiple ways. Tools that can help support and accomplish these goals include messaging apps such as Microsoft Teams and Skype for Business or meeting apps such as WebEx or Zoom. Below are a few suggestions on how to use these tools to strengthen your virtual team. 

• Schedule regular phone calls or videoconferencing with individual team members and the entire team.
• Set communication expectations.
  • When are cameras required to be turned on/off? Staff are more likely to feel connected when they see each other.
  • What are the expected response times for emails, messages, and phone calls?
  • What is the dress code?
  • What is preferred communication engine—phone, email, or instant messaging?
• Schedule a virtual event or activity that is not work-related such as a virtual escape room or a virtual celebration for a birthday or other milestone.

The New Normal

While the pandemic may be receding, virtual HIM departments will continue to mark a permanent place in the workplace of today and into the future. In fact, for many organizations, it is the new normal. 

New remote work benchmarks and management styles will evolve as hospitals and health systems fine-tune their virtual teams, policies, and procedures. They will also need to communicate and over-communicate—to be sure everyone on their team knows what goals need to be met, and how they can be achieved in a virtual environment.

With the right strategies in place, virtual HIM departments are sustainable.

Kim Engle is the assistant director of HIM and EHR operations at Cleveland Clinic.

Angela Rose is the vice president of client success at MRO