Monday, April 14, 2008


Several months ago, I read about Jet Blue's use of homesourcing in Thomas Friedman's book , The World is Flat. The idea is simple and elegant. For some staff functions, those relying mainly on computers and telephone, why not allow people to work from home and avoid the mess of commuting? Also, people who are otherwise tied to home for physical or family reasons can be active members of the workforce and get better jobs if they are permitted to work from home.

We decided to run a pilot for some of our coders (the people who review medical procedures to provide proper billing formats for the insurance companies), and our CIO, John Halamka, writes about the experience in CIO Magazine. As you can see, doing this for a hospital is a bit more complicated that for an airline, because there are major and important concerns about privacy that have to be met. As John notes in the article, "If employees are to access sensitive health data from their homes, I need to investigate biometric devices, re-examine application time-outs, strengthen surveillance of audit logs and ensure end-to-end security from data center to the home."

The results overall were very positive on many fronts. "The flexible work arrangements improved employees' quality of life. They're not stressed or tired from commuting so much, and they're saving money on parking and gas." Also, "Coders are challenging to hire in Boston due to the large number of hospitals competing for a small number of qualified employees, so flexible work arrangements enable us to hire without geographic restrictions. Given the IT job market and the difficulty of recruiting replacements, the benefit of such flexibility cannot be overstated when you have a seasoned employee who knows your systems well. We were able to retain a coder who moved and we included her in our pilot."

But it is important to be sensitive to and respectful of individual preferences. As John notes, "One coder who lives by herself said she felt distracted at home and missed the social interaction with coworkers. Another coder who also lives alone loved working at home since she experienced no interruptions and got more done."

Please read the article for a full description and see if this might make sense for your organization.


Anonymous said...

What a terrific idea! The flexibility can provide win-win scenarios for employee and organization. Friedman's book is amazing. I hope your comments will prompt more people to read his work.

Anonymous said...

I believe that there are a number of roles where this approach can be successful. Medical transciption, for instance, can certainly be done remotely - anywhere in the world.

I do, though, think that medical coding is most successful when the coding professionals are directly involved - onsite with the clinician - at the "point of service." The education of clinicians, and their subsequent ability to maximize coding accuracy supported by appropriate documentation, is enhanced by having coding professionals right in the clinical units with them as clinical services are being provided.

Anonymous said...

There are different aspects of the coding job. Agree some are better on site.

Ja Sto said...

I think that would prove a great opportunity for people to work from home. I am only a Masters of Health Services Administration grad student but I can see how this could make a major impact. My wife just showed me your blog and I am excited to dive into it because I have expectations to be in hospital administration.

On a subtopic of home based work, by allowing for coding to be performed at home, the market of interest for this position will grow especially in larger cities. A large portion of the working class live in suburb areas and this would provide a large economical boost because of the elimination in gas expense and car maintenance expense. Flexibility in shift hours might also increase the marketability of home medical coding. How do they typically get paid? Is it by work load amount processed or salary based? Thanks.

Anonymous said...

I wish more companies would embrace this concept. In addition to reduced stress and savings for the employee on gas, car maintenance and, of course, commuting time, if enough employees are able to work from home at least some of the time, it would also help to unclog the roads and improve traffic flow during rush hours for those who must drive to work.