Telecommuting for CDI
Hi All,
I was wondering if anyone is telecommuting for a portion of their CDI work week? If so I would like to know how many days and any difficulities you are having.
Thanks!
Toni
Toni Valenti RN CCDS
North Florida Regional Medical Center
Gainesville, FL
I was wondering if anyone is telecommuting for a portion of their CDI work week? If so I would like to know how many days and any difficulities you are having.
Thanks!
Toni
Toni Valenti RN CCDS
North Florida Regional Medical Center
Gainesville, FL
Comments
I am fully remote and have been for a year when I relocated X-country. We do let some other staff remote in for weekend coverage and for other circumstances (weather, etc). The main issue is a lack of face-to-face but I think this would not be an issue for PT telecommuting as long as someone is on-site to answer MD questions and such. I find I am more productive but I really miss the social aspect. I would think a PT Telecommuting position would be perfect but this is what works for me right now. I am VERY grateful to have the opportunity. We are in the middle of 3 X-country moved in 30 months and I probably would not be working at all otherwise.
If you have any specific questions, please feel free to email me. Also, There was a presentation about a remote CDI program in Ca at last years ACDIS conference and you can see the PP slides on the website.
Good luck!
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
Hoping to implement later in April.
Do plan on having each CDS be on site for part of the time. Of course, have mandatory meetings that will need to be attended. With an essentially 100% EHR, and a lack of work space on units, the transition should be relatively easy.
One of the issues that remains to be seen how it will work out is the aspects of direct contact with physicians (mostly telephone). If not too frequent (as appears to be the case) for follow up on queries, plan on having one member of each sub team on site (11 FTE's, 3 service line sub teams -- cardiac, med surg IU/ICU & general medicine areas) to handle paging and communication with physicians for their respective sub-team.
I recognize there will be some difficulty with addressing queries that another CDS has developed, and we may decide to go with company cell phones if absolutely needed (dependent on volume of actually necessary calls).
The actual opportunity for casual direct, in person contact has markedly declined with the full conversion to electronic record.
Don
Donald A. Butler, RN, BSN
Manager, Clinical Documentation
Vidant Medical Center, Greenville NC
DButler@vidanthealth.com ( mailto:mDButler@vidanthealth.com )
We also have cell-phones for our team members. This means, even though I am in MD, I have a local Az number that the MD's or other staff can easily contact me on.
We also will be implementing on "on-call" Cell. With our rapidly expanding team we are allowing some scheduling flexibility.This means not everyone will be working a 8-4 schedule but we also will not have 24hr coverage. We will be eliminating the on-site team members cell but have an "on-call" cell that team members will trade off responsibility for. This will NOT be taken home but will be manned by an on-site CDS. It will be used as the recommended contact number for immediate query issues. This way MD's will be provided with the ONE number with which they will hopefully be able to reach a CDS that is in-house. If there are questions about a query that is not the CDS' that is reached and he/she has questions, it will be the responsibility of the "on call" CDS to contact the CDS that generated the query to help resolve the issue.
Keep us posted on how this works out for you!
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
I would love to see your draft policy for remote CDI. Since we went live with EPIC in June, my staff have been asking for a similar part-time work from home plan. We too have found that most communication w/providers is now via phone, text or e-mail. Is the hospital providing the computers and able to provide IT support at home? Do you have set "work hours"?
Thanks,
Linda
Linda Rhodes RN, BSN, CCDS
Manager Clinical Documentation Improvement
New Hanover Regional Medical Center
Wilmington, North Carolina
Office # 910-815-5544
Cell " 910-777-8344
e-mail : linda.rhodes@nhrmc.org
Leah Taylor, RN, CCDS, CCA
Data Integrity Specialist/ CDI & RAC Coordinator
Iredell Health System
557 Brookdale Drive
Statesville, NC 28687
704-878-7436 office
704-878-4624 fax
leah.taylor@iredellmemorial.org
I know you are not asking me but I'll tell you I have done
The hospital did provide my computer. We already had the kind of setup that is a laptop with a dock that connects it to a duel monitor setup. When people work from home, they can bring their laptop home or use a personal computer. I can call our HelpDesk for IT support.
My scenario is different as far as "hours" because of the time difference. Also, I am not primarily doing concurrent reviews. I don't have specific hours. However, if we were to expand it, I think we would have defined hours. Although, if I was the one setting it up, I would be amenable to setting a time block (7am-7pm?) in which they could choose their working hours.
I see the expansion of a PT remote option as a huge positive and hope to see it continue in the industry
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
I am happy to see we have addressed all the procedural issues you have
addressed. I think it is a great plan you have mapped out.
Please let me know how things go.
Thanks again
Toni
I would be interested how your on-call system works -- especially in regards to addressing another's query. Since we are using EPIC in basket, queries are not easily retrievable by the peer, which is one of the things we need to work out. Suspect it will involve printing to pdf and emailing and speaking with the peer who needs to make the call.
Worksheets are printed the day after discharge, so they can be scanned in for coder access. Will have someone on-site to handle those.
Don
I would love to see as well.
Thanks, Susan
Susan Fantin, RN, BSN, MSA, CCDS, CDIP
Senior Director, Clinical Documentation Improvement Specialist, Performance Technologies
The Advisory Board Company
202-266-5862 direct | 248-321-0256 mobile | 202-266-5700 fax
fantins@advisory.com | www.advisory.com
Stay in the know
a time framework-7-7.
Thanks,
Linda
Linda Rhodes RN, BSN, CCDS
Manager Clinical Documentation Improvement
New Hanover Regional Medical Center
Wilmington, North Carolina
Office # 910-815-5544
Cell " 910-777-8344
e-mail : linda.rhodes@nhrmc.org
started....me too....we are always looking for fresh ideas and updates
to our program to keep it at pace with the industry
Nancy
Nancy Wright, RN, BHA, MBA
Clinical Documentation Specialist
Health Information Management
Saint Mary's Health Care
200 Jefferson SE
Grand Rapids, MI 49503
PH: 616.685.6687
FX: 616.685.3014
wrightna@trinity-health.org
www.smhealthcare.org
I'd be willing to share the draft policy -- once final revisions are approved by my Administrator. Hopefully by the end of the week.
I've never had set work hours -- salaried/exempt -- with flexibility of current hours (starting varies, from 5 to 8am, requirements 1 -- be available & able to contact physicians and 2 -- get work done).
On phones -- I am not willing to consider asking employees to use their personal phones (land line or cell) as I don't want their personal numbers 'getting out' for privacy and personal reasons. Also can't be fully certain that smart phones can't be hacked or infected ... again, privacy issues.
Don
Thanks.
Paul Evans, RHIA, CCS, CCS-P, CCDS
established).
Good idea ...
I'd be willing to share the draft policy -- once final revisions are approved by my Administrator. Hopefully by the end of the week.
Don
Our queries are housed in Cerner and we are able to see each others queries (although we did have to do some searching to figure out how to do this because they do not show under our documents tab until they are signed by the MD). We have been dealing with this issue for awhile because the our queries currently list all the CDS' phone numbers. The MD's often just dial one of the numbers without looking to see who actually sent the query so we often have to respond to questions on queries that are not ours personally.
Could you use a shared drive where the CDS could place an E-copy of the query for the team to access?
One big thing this brought up for us was the importance of making sure that the CDS includes all relevant data into the query. Ideally, the query should tell the complete story so if the query is available to all staff-members, this should provide sufficient information in most cases for the rest of the team to respond.
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
Linda
Linda Rhodes RN, BSN, CCDS
Manager Clinical Documentation Improvement
New Hanover Regional Medical Center
Wilmington, North Carolina
Office # 910-815-5544
Cell " 910-777-8344
e-mail : linda.rhodes@nhrmc.org
How do you get your assignments at home? Currently, ours prints out to the office printer and has to be divided between the 3 of us. Is your emailed? Faxed? Printed to home computer? To one person who divides between the CDI? Too each CDI? ETC.
We are in the information gathering stage......
Thanks in advance!
Jill Lindsey, RN, BSN, CCDS
Phoenix Children's Hospital
Clinical Documentation Specialist
Ext. 3-0725
Agreed, the query should include relevant data that supports the question. However, I do feel that a more in-depth understanding of the chart & clinical picture are important (more than what should be expected in the query) when discussing a case with a physician. Could be off on this, as we've not had experience with cross covering queries like you have.
We will be implementing CAC/CDI software -- tentatively Jan 2014, so are looking at this kind of question more from an interim solution than long term standpoint.
Don
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
With the "on-call" phone system, the providers will have one number listed on the queries and that will put them in touch with a CDS. If the CDS is unable to answer the question appropriately, they (not the MD) will be responsible for contacting the original CDS and getting the information to relay to the MD or putting the CDS in contact with the MD. The goal is to make this a simple as possible for the MD (we hope).
We have not implemented the "on call" phone system but this is already how we handle calls on queries that are not our own.
We are also implementing a CAC/CDI software (hopefully this fall). We are going with Dolbey. Which one are you implementing?
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
The work list is 'live' as far as ADT feed, interactive, allows each to identify their own cases (based on agreed upon sorting -- mostly based on service line with some geographic floor factors thrown in -- though this piece is not automated in the software, everyone can see what each staff has picked up & therefore what is left open), as well as to use a set of custom built priority codes as well as status codes to help organize and prioritize one's personal worklist at a glance. Also allows us to flag cases for follow up after coding is completed.
This has been a real efficiency boost -- have had for several years, and saves at least an hour per person per day.
As far as how the work load distribution is arranged -- I task each sub-team (there are 3 among the 11 FTE's) to develop their own process. I provide some data support and am perfectly willing to be involved in the conversation if requested.
Depending on what you have available, something similar I am fairly certain can be built within an EHR or other software systems.
The one required starting point would be some sort of electronic list that is automatically distributed. At that point, should be able to develop any of a number of systems -- first letter of last name, last number of patient encounter number, floor(s), service lines, etc. Would make sure to have a safety mechanism to make sure something isn't missed.
Don
I would love to a draft policy as well. We are looking at doing somehting simular.
Tiffany
Supervisor- UNCH CDS