WSHIMA Member Pulse Poll Results

New Year’s Resolutions

Author: Tracy Stanley, RHIT

What was your New Year’s resolution?  Have you or are you achieving your goal(s)? or did you just “forget about it.”  We all have great intentions by setting goals, but sometimes life just gets in the way.  In this article, we look at what you, our WSHIMA members, shared as your New Year’s resolutions.

Professional or Career Resolutions

We had 27 participants in our latest survey.  Most respondents planned to further or complete their education (37%).  Others wanted to improve their skills and/or productivity (15%) or become better leaders and mentors (15%).  Some wanted to keep up with technology and finish job-related projects (7%).  Resolutions also included: better communication with peers, growing as a person outside of HIM, finding employment, and attending the WSHIMA Health Data and Information Conference in person.

Personal Resolutions

What would you personally like to improve?  Forty-four (44%) of respondents wanted to improve their self-care, exercise more, make better food choices, and to overall be healthy.  Other participants wanted to make new friends/partners, to become a better person, to learn new skills, to be more organized and job-focused, and to have better time management skills.  Respondents also want to promote diversity, travel, finish projects, find outside interests and/or hobbies, and let us not forget to keep moving forward.  Do some of these sound familiar?  I know they do for me!

Will 2022 be better than 2021?

The pie chart speaks for itself.  I am with the 89% that are hopeful.

What would you like to see from WSHIMA in 2022?

WSHIMA is here for you, our members, and you have spoken up. Seventy-one (71%) of participants want more educational offerings (46%) to include in-person meetings and conferences (17%) while providing reasonable/low cost/no-cost pricing (8%).  Respondents would also like updates on changes in HIM, more scholarship offerings, and a broader scope of interests outside of the hospital HIM setting.

Final Words…

We appreciate all your responses and please know that this information will be shared and discussed with the WSHIMA Board of Directors.  Please feel free to contact WSHIMA at any time you have a question, concern, or suggestion.  WSHIMA is here for you!

Telehealth

Author: Carrie Kaelin, MHA, RHIA

There is no doubt we have done a lot of pivoting in response to the Covid-19 pandemic. As a result, we were nudged in new directions personally and professionally and burgeoning services prior to the pandemic have now become much more mainstream. In this article, we will explore the results from WSHIMA’s most recent member pulse poll asking members to share their feedback about telehealth experiences.

Utilization of Telehealth Services

Out of 50 survey participants, 52% have had a telehealth visit in the past 12 months while 48% have not (see Figure 1 below). Feedback regarding the telehealth experience was mostly positive with technical issues, documentation integrity, and inability for the provider to touch/palpate the patient cited as the most common challenges. Many respondents mentioned they prefer face-to-face visits over virtual ones. It was noted that telehealth appointments were quick in comparison to commuting for an in-person visit and didn’t require taking time off from work. It also appeared that visits for straight-forward issues and when a patient was already established were easier and went more smoothly than complex/specialty and new patient visits. When survey participants were asked if they would schedule a telehealth visit again, 85% responded yes with 15% responding no. See Table 1 & 2 below for a breakdown of responses.

Storage and Access to Health Record

It seems logical that telehealth records would be stored and accessed the same as records from in-person visits and the responses from survey participants mostly supported this. Most respondents confirmed that their records are stored at their physician’s office or in an EHR and accessible via a patient portal such as MyChart. Others made mention of accessibility issues related to information blocking, which is currently being addressed via the 21st Century Cures Act.

Final Thoughts

There is still much work to be done in the field of telemedicine. However, it appears there has been headway in moving forward with the service which should allow for greater accessibility to care and reduced cost to patients. Health information professionals who have also been telehealth patients provide a unique lens into the benefits and challenges of services rendered through this delivery method. Additionally, there is still quite a bit of ironing out that needs to be done related to billing reimbursement concerns as well as insurance coverage limitations. Our profession is well positioned to take this on and successfully maneuver the hurdles along the way and it appears many of us have already embraced the challenge. See Table 3 below for breakdown of additional comments.

Figure 1: Have you had a telehealth visit in the past 12 months?

Table 1: If yes (to above question), how would you describe the experience?

Have had several with mostly one healthcare organization. All were excellent clinical interactions. The way to navigate (both with the telephone and the computer) to the telehealth visit was not at all a uniform process among the various clinics and offices, which is often the case in large organizations. Would be more patient-centric if the access processes (all of them) were uniform throughout at least one organization.
Very easy….
Not good. I can’t get Zoom to work on my iPhone
Limited but useful.
Great! Easy to book the appointment, was able to show my doctor what I was referring to and was able to get the care I needed.
Good. The entire process went very smoothly.
Positive and very convenient and interactive compared to other visits I have had.
It was fine.
It was good but I prefer face-to-face encounters with my provider. The interaction is more personal and more involved in my opinion.
Just as good as in-person visits, except for situations requiring direct patient contact for assessment (e.g., listening to lungs, drawing blood, etc.). Significantly better than phone-only appointments, as well, as body language relays so much info.
Ok for some of the visits. However, Telehealth visit for establishing a new DX Diabetes, which was termed Diabetes Support including use of Glucose monitor, when & how to test your own BG, what BS should be, nutrition’s counseling all in 1 visit was not good in my opinion. This was done by Nutritionist. Follow up telehealth visit with GI was not ideal in my opinion either. Provider would not treat until biopsy was performed, and then only called in a Prescript which was outrageously expensive without any explanation of Dx or reason for this drug.
Except for a few glitches, like sound cutting in & out-not in sync, enjoyed the experience.
We were only able to have essentially a phone call because the video call wasn’t working, but still able to discuss the concerns prompting the telehealth appointment and come up with a plan.
On time, effective and efficient.
Ok. Determined I needed to be seen for bloodwork, so that visit was a waste.
Quick and everything I required.
I had a dermatology appointment where I had to take several selfies of my skin condition and then upload them. Now these photos are in my chart forever. But at least they helped the physician understand my problem. I couldn’t understand why they didn’t do a video visit.
A little rocky getting connected and the site didn’t have anything indicating one was in the waiting room. Once connected with the physician the video was of such poor quality that we completed the visit by audio only.
It was fine, there was nothing remarkable.
It was okay. It was for my annual wellness exam with a new provider.

Table 2: From an HIM perspective, what do you see as the biggest challenge regarding telehealth services?

Capturing all the critical notes and signatures.
Documentation of a physical examination.
The lack of physical interaction. For example, doctors can touch or feel the temperature of a wound or insect bite.
Seem to be many ways to bill Telehealth right now. Place of service telehealth or place of service where it would have normally been provided with modifiers on the CPT, I would like to see a definite on way or another and clearer guidance on reimbursement.
Getting proper documentation
Can’t make a visit with your particular phone iPad or computer
MDs not being able to palpate, feel my pulse, take my temperature and more.
Consent.
Patient computer literacy.
The biggest challenge I see is reimbursement and the many different requirements that must be met to be a billable service coupled with varying coverage policies and differences between Medicare and Medicaid funding.
Getting the proper documentation i.e.; informed consent.
That the documentation supports the true health of the patient.
Lack of exam.
Technological challenges.
Documentation.
Insurance coverage limitations, lack of sufficient or affordable broadband services.

Table 3: Any other comments regarding telehealth services you would like to share? 

I think telehealth is a great tool to have for patient care. In my personal experience, I went from having to take a half-day off work to have a 30-minute doctor’s appointment to being able to log in 15 minutes before my appointment. It has also opened up my provider’s schedule, since she now can have more appointments on her “virtual” days. I still have the option to go into the clinic if needed, but it saves a huge amount of time for me and I feel just as respected and well treated as a patient.
Telehealth is beneficial when there is pandemic and other circumstances when a patient has no means of transportation. However, face-to-face encounter is still the best way of providing care to patient, in my opinion.
It’s now a preferred mode of managing patient health for many providers and patients. Patients who struggle to keep in-office appointments (regardless of cause) are generally better able now to now attend and participate in their own care management. I sincerely hope this form of care maintains long past the need derived from the pandemic.
I feel Telehealth is difficult when using a specialist or other new provider/specialist that I have not used previously. Established care with my PCP was ok.
I always enjoy my visits with my physicians & feel I have better communication as it does not take as much of their time nor mine, plus I’m not in the waiting room for any length of time. I have a designated time (arrive 15 minutes early), though I’ve never had a physician online before our appointed time.
No. HIM really isn’t affected by telehealth in my opinion.
Best used for established patients.
It’s difficult to set up for children, especially if those children are with foster parents.

Working from Home

Authors: Taylor Lichneckert and Harsha Velpula

More than 12 months have passed since the World Health Organization declared COVID-19 a pandemic. While many aspects of our day-to-day lives have altered, arguably one of the most controversial changes is the switch from in-office to working remotely. But how has this affected those working in the field of HIM? In this article, we will explore the results from WSHIMA’s most recent member pulse poll asking members to share their feedback about working remotely.

Best Practices for Working Remotely

Out of 63 survey participants, 84% are currently working from home at least 80% of the time. A distribution of where respondents work can be seen in Figure 1 below. While working from home looks different for each person, what members have found to be best practices are very similar. One of the key elements to successfully working from home is developing and following a schedule. Having a defined start and end time and keeping this consistent helps WSHIMA members manage their work-life balance. Setting boundaries between work and home life is essential. Going hand-in-hand with this is setting a designated work space. Members recommend creating your home office in a quiet location, with a separate work computer and multiple large monitors, and treating the space as a place for work only. Other best practices include getting dressed everyday (rather than working in your PJs), taking breaks, and keeping communication lines open with your colleagues. See Table 1 below for a detailed breakout of responses.

Biggest Challenges to Remote Work

It is no secret that working from home has brought many new challenges. According to our WSHIMA members, one great challenge has been the substantial decline in human interaction. While this may enhance productivity (no side–bar office chatting), this can bring about feelings of isolation, disconnection from staff and students, and difficulty connecting with your peers. Distractions can also make remote working difficult. Having your spouse, children, or other family members at home can severely affect productivity. More challenges members are facing include difficulty managing their time, sedentary lifestyle, and difficulties with technical support. See Table 2 for a detailed breakout of responses.

Final Thoughts

In the midst of the challenges working from home can bring, it is easy to lose sight of why we are doing it. We are living in a pandemic and working from home is asmall price to pay for keeping our friends and family safe and healthy. Take care, stay safe, and limit your exposures.

Figure 1. In what area do you work?

Table 1. What is a best practice you would like to share regarding working remotely?

APPEARANCE
Get dressed for the day even if you’re not on camera.
I would think dress and act as though you are in the physical office environment so that you stay focused and appropriate in video meetings as well as productivity. I don’t work remotely but I am hoping to improve WIFI to get a remote job
Get dressed every day. Don’t work in your pajamas, it makes you feel lazy! Take your lunch break. Try to get outside if you can. It’s easy to just get lost in the work and forget to take much needed breaks.
Act like you are going into an office. Get dressed, brush your teeth, comb your hair
BREAKS
Take several small breaks during the work day (if you are able).
Try to remember to take breaks…
COMMUNICATION
Respond to emails quickly.
Don’t forget to keep communications open. Tones can’t be heard in emails.
Continued need to keep adjusting to make remote work possible and successful. Weekly check ins with team members. Weekly report out of workflow status.
My team and I meet daily for about 30 minutes. This has given us all time to check in, ask for help and socialize just a bit.
Have regular “huddles” to keep in touch and exchange information, via MS
Teams, Skype, Zoom, etc. This was particularly helpful to us a year ago, when we all felt bereft of our usual habits and coworkers. Now, we only have a huddle once a week.
Don’t be afraid to ask for help.
Keeping in contact with other remote employees to build the teamwork
Regular meetings are important!
Writing is your key to communication…and the only way.
FOCUS
Have standards and goals that can be monitored to assure productivity standards can be met
Using visual examples with directions
Focus
Limit distractions. Be disciplined.
Even though working remotely requires discipline and being pretty self-sufficient to get the work done, it’s rewarding when tasks are accomplished which all goes toward the end result.
LOCATION / SETUP
Be sure to have a quite location away from activity in the house. Also set a schedule and stick to it.
Have a workplace separate from all distraction — a “tech nook” has served me best.
Have a separate office where you can concentrate on your work. You will need a quiet space with a locked desk, separate computer, phone at the minimum, and hopefully a door. Let people know when your door is closed that you are working and not available for interruptions, social media, or visits.
Get ergonomic aids especially for hands/wrists. Set up definitive times to log off and log out. Work creep can take over.
To stay focused and not be distracted by home surroundings.
Have big monitors and an adjustable desk if possible.
Have a designated desk/area to do your work. Just working from a laptop on the sofa isn’t conductive to productivity or posture.
Able to work in an environment that is quite quiet for me to read & not have to re-read working in a noisy office
Isolate yourself when working
Having a designated space.
Set up a place where you are comfortable. Have all your tools within reach.
Use OneNote and Electronic Sticky Notes. Don’t use any paper at home at all because you may accidentally write down some PII and then you have to take that to work to destroy
Practice ergonomic seating and keyboarding
Treating the space and time like a work place.
Get a really comfortable chair and an adjustable desk.
Screen teleworkers prior to teleworking to ensure their workflow, practices and set up are secure.
1. Have a separate workplace if possible so you can focus when working. 2. Designate a space for lunch so you feel like you got away from your work for a few minutes. 3. If mentally drained try going out for a walk or do something relaxing/mindless to unwind and then go back to the task at hand.
Learn how to be 100 percent paper free, before, you work from home.
Have a good internet connection.
Technology can make or break you. Outfit your teams with the right equipment backed by 24 /7 support. Dual monitors, robust VPN access, webcams, and even the right desk chair, makes every difference to a remote worker.
SCHEDULE
Have a defined start and end to your day so you aren’t working around the clock. Have a designated area where you do your work, not in the family area.
Keep regular hours. Treat it like an onsite job separately on and off time.
Try to keep a consistent schedule to help keep boundaries between work and home life. Don’t forget to take breaks.
Follow a schedule
Keep a regular work schedule, just as if you were really going into your place of work.
Keeping a schedule
Get up and do your normal morning routine before beginning work. It helps to get you in the right mindset to work.
While there is some flexibility, I like to have a dedicated schedule for the week.
Set a schedule/routine to keep focus. I use alarms for my lunch break, time
To clock out etc. Keep to the routine as close to in person as possible.
Make a priority list, take advantage of the tools MS Outlook has like flagging your emails
Set a schedule and stick to it

Table 2. What has been the biggest challenge to working remotely for you this past year?

BALANCE
Keeping home life and work life separate, it can be a challenge.
Keeping home life and work life separate in a small space.
Working while having children at home that have needs. Having everyone think you aren’t “working hard” because you “just work from home in your pajamas, how hard is that”. It takes away from being seen as a productive and strong female member of the work force.
COMMUNICATION
Lack of timely information from the clinic. Co-workers who stop doing parts of their job because they’re not in the office and can’t be seen.
Communication
CONNECTIVITY
Connectivity with the rest of the workforce.
Remote desktop is not able to be broadcast onto dual screens.
Good internet.
The technology is still a challenge. We continue to work with IT to get full access to both monitors, the ability to save documents sent in email, and manage time when it is difficult to connect.
WIFI and feeling confident to find a job that I can accomplish remotely especially since I live with and care give my elderly mother
Tech services and apps not working together like they are supposed to.
Moving from paper to electronics.
DISTRACTION
Distraction due to my husband needing to work from home during a Covid exposure and caring for my daughter while daycare was closed. It was a fine-tuned juggling act that I don’t wish on my enemy.
Family at home while working
Household distractions with other family members also teleworking.
Having to help with school work along with working.
I have to go into an office and occasionally work remote. To be working remotely is distracting since I cannot duplicate the office space at home due to the cost of the city.
The constant emails. I am trying to do my work, but constant distractions with lots of emails due to my boss makes it mandatory to respond within a certain time frame
FORGETTING BREAKS
The lack of movement in my day.
The biggest challenge has been taking rest and exercise breaks during working hours.
Forgetting to take breaks
Taking time for myself. I feel like I am on all day, all the time, and never get a moment to unplug.
Disconnecting from work…
Stopping work when the day is over
LIMITED INTERACTION
Being unable to travel and visit clients onsite.
Feelings of isolation. Need to effectively use team tools Zoom, Teams etc. to prevent isolation
Not seeing my students face-to-face.
Moving to a new team and never meeting in person. I wish I could get to know them better.
Onboarding with a new organization while remote
Seeing people in person and good communication
Isolation
Remaining connected to coworkers and networking across the organization
Staff connectivity. We seem to have lost team collaboration. Folks tend to work in their own silo and no longer reach out to each other to collaborate for day-to-day work assignments, work flows, etc., which is affecting consistent work production. Productivity has also decreased. Privacy and security have also been challenged due to worrying about off-site employees having PHI essentially in their homes without adequate monitoring.
It takes a while to get used to being “alone” without your peers around for support and camaraderie. Staying focused is key and that can be challenging at times.
Miss co workers
Lack of human contact.
Networking with other professionals
Not being able to see my co-workers in person for our quarterly meetings.
Disconnected from staff. Way to understand if staff have enough work or not. Supporting staff adequately while things continuously changed through the pandemic.
Not much social interaction
Isolation. No longer able to bounce ideas off colleagues
It is somewhat isolating and I miss seeing my coworkers once in a while.
Just feeling stuck at home all the time.
The biggest challenge working remotely this past year has been the lack of connection with people. That just goes with the territory when you work from home but the COVID lock downs severely intensified it.
NONE
I work more efficiently from home, focus-ability is key. With time and patience, all challenges of remote work were overcome.
I’ve worked remotely for many years, so this year did not present any particular issues.
I haven’t had any challenges. With the right technology, there is no difference at all. Face to face is nice, but not required with Teams, Zoom, and other platforms with video.
I’ve been working remotely since 2014, so no difference for me, other than my daughter and wife are now also home all day.
Nothing, I have been working remotely for more than 3 years
None for me. I already worked remotely since 2012, so not much change.
I have had no challenges. Even when I was working in the office, most of my conversations were over the phone or on Zoom type of meetings.
SCHEDULE
Actually, had less hours due to a COVID 25% decreased hours forgetting solid internet connections that would support video calls like zoom
Lack of work as I am an independent contract coder.
Going into work with potential of getting exposed
I already support facilities in 3 states, so much of my interaction is by email, MS Teams, etc. Shifting back to being on site in the past 3 weeks has been more difficult than I expected – a busier, faster pace now seems pressured. I wasn’t less productive at home but felt more relaxed.
Time management

Table 3.  Any other comments you would like to share?

POSITIVES
We’ve been transcribing and coding remotely for years. Now we’ve seen that all but the most needed onsite HIM functions can be done remotely, we can open our workforce to people anywhere!
Many organizations have gone to fully remote positions, permanently and I am wondering how this will affect “new hires” in the future
Teleworking has allowed for continued work during COVID which has been awesome for the facility and the employees as there has been very few positive cases in my section due to less exposure.
Enjoy your time without a commute. Be thankful for what you have today.
Just went back to being on-site in Feb. I have the option now of working either location, depending on needs, which is great.
I’m very happy with working from home and not spending my time with commuting over an hour each way to the hospital.
I feel so go about reducing my carbon footprint by working from home. With advancements in attitudes towards virtual meetings, working from home is more accessible.
Remote working isn’t for everyone, but it can be very rewarding and certainly convenient in many ways.
PRODUCTIVITY
Being remote is far more efficient than commuting to an office every day. I am more productive with less stress since I do not deal with traffic any longer.
Working remotely is only appropriate for people whose personality fits and have an independent work ethic. If a person needs little oversight at the office and consistently hits their production targets, they would be a good remote work candidate.
People often worry about productivity. We run reports daily to keep a watch on anything that can be measured. I have found that my staff enjoy the at- home environment and our huddles. They remain productive and happy.
Zoom meetings are a double-edged sword; travel time to a meeting is reduced, but the number of meetings has increased. One reason, I think, is that because travel time is reduced, the perception of being able to cram more meetings into a day is elevated.