Journal of AHIMA - September 2011

The EHR’s Impact on Staffing Models

By Diana Warner, MS, RHIA, CHPS, FAHIMA

AS FACILITIES TRANSITION from paper to electronic records, HIM departments must review job functions and staffing mod- els. EHRs enable automation and ease of access and affect how the HIM department operates. From Clerical to Qualitative In an electronic environment paper HIM functions such as abstracting, assembly, and analysis will be notably reduced, though not eliminated. For example, EHRs capture and file re- ports and results electronically, eliminating the need for a night clerk to make rounds to pick up all paper files for assembly. Many of the functions that were performed manually may now be automated. HIM departments may need to review and re-review functional considerations, such as abstracting, assembly, and analysis. In order to maintain, update, and ensure data integrity, HIM staff must be trained on the EHR and other technologies that interface with the EHR.

As HIM departments have less need for positions focused on production, they are shifting emphasis to qualitative outcomes. New positions that support the EHR include health information service technician, clinical health analyst, and clinical applications coordinator. New job descriptions will be needed as clerical functions transition to more qualitative job functions.

During the transition, staffing models also need to be re-eval-uated to ensure efficiencies are gained with the EHR. Understanding staffing needs is crucial to maintaining functions.

Relocating Files and Staff

As more health information becomes electronic the need for physical space for paper files may be reduced. The EHR transition also provides an opportunity to relocate staff to a central

location off site, have staff work remotely from home, outsource the work, or use some combination, freeing up physical space for the facility. Some roles are already set up for telecommuting, such as coding and transcription.

The HIM department may require only one or two staff members concurrently on site between 8 a.m. and 5 p.m. to cover customer service needs. Other staff may cover the department around the clock remotely.

One advantage to allowing staff to work from home is improved staff satisfaction. Flexible work schedules and time gained formerly spent driving to and from work improve job satisfaction, which can produce additional advantages.

Higher job satisfaction often yields lower staff turnover, which equates to tremendous savings for both the department and the organization. The Society for Human Resource Management reports that the costs of turnover for an $8/hour employee is $3,500 and the average cost to hire a new employee is $7,123.1

Remote staffing models offer other advantages for organizations with multiple facilities, such as the ability to perform tasks for more than one provider or facility. This flexibility may reduce the need for staffing based on volume peaks and paying high overtime rates.

For most facilities, the EHR transition will likely happen in phases. However, before beginning, organizations must consider the transition’s entire scope and its impact on operations. Staff skills need to be assessed throughout the process to ensure the transition is successful.