he medical records department at the Hospital of St. Raphael began a telecommuting pilot program in April after looking for ways to attract and retain qualified coders. If the pilot is successful, other departments at the hospital will establish their own telecommuting programs.

Karen Lawlor, director of medical records said that certified and experienced medical record coders are in high demand, so St. Raphael was looking to use telecommuting as an option for coders in her department. The work these coders do involves reviewing hospital data on inpatient and outpatient services and then applying reimbursement methodology and sending the patient's records to hospital billings for payment processing. "We have a very robust hospital information system, which includes all the documents we would need to review the patients' care. So this work was ideal to begin talking about telecommuting, because it's portable work," Lawlor said.

With respect to the issue of security of patient information, the hospital's computer network already has internal controls in place for system access and monitoring of which files have been accessed. "You're taking the same technology that you have in place and moving it to the home," Lawlor said. "It's as if a person is sitting in another building, that's the way we're treating it."

With the help of Telecommute Connecticut! consultants, the hospital was able to put together the goals, policies and procedures and telecommuting agreements necessary to put a formal telecommuting program in place and make it work. The consultants also gave St. Raphael's support in developing criteria for selecting good candidates among those employees interested in telecommuting. "Through them and their experience, we have the benefit of how other companies created effective telecommuting arrangements," Lawlor said. "I don't think we would have thought of all those pieces of criteria recommended to us."

Some of the criteria that came out of the development process were:

• Does the person have the right personality to work a defined eight-hour day?
  
• Would the prospective teleworker have the appropriate household support to telecommute?
  
• Do they have a defined workspace in their home?
  
• Does the home office conform to physical security requirements?

"In order for telecommuting to work it has to be a top-down commitment. And in this case the commitment was not only given in the project's concept, but to making sure the employee had everything they need to do their job, and that included the desk, the phone, computer, printer and shredder," Lawlor said. "We were very firm on that, and we didn't get any disagreement on that at all."

There are two coders ready to begin telecommuting, and depending on the outcome of this pilot period the program will either continue as is or some changes will be made to it. "I promised management I'd be back to them in six months, when a follow-up assessment will be done by the consultants on how we are doing," Lawlor said. "The other managers will look at how we were doing, so part of this could roll out to different departments and other tasks."