Note from the editor: Three tips for working from home

Wednesday, April 8, 2020

by Nicole Votta

Like many revenue integrity professionals, NAHRI leadership has made the transition to working from home. Working from home allows us to follow critical social distancing guidance as the nation faces the novel coronavirus (COVID-19) pandemic. But working from home full time brings a new set of challenges to an already tough situation.

As I’ve been checking in with NAHRI members (there’s your first work from home tip—stay connected!), I’ve asked them to share their tips for working productively from home as well as some of the challenges they face.

  1. Keep in touch. Even during the best of times, staff who work from home may feel lonely and miss the camaraderie and informal brainstorming they took for granted in the office. That feeling of disconnect can hamper productivity, according to Stanford Economist Nicholas Bloom, and exacerbate the strain of isolation. It can also make it challenging to stay organized and keep on top of routine work and special projects. To help address those challenges, make frequent check-ins a must.

    “I have a daily 30‒45 minute call with my team that is scheduled after the clinical daily huddle and COVID update call so I can share organization updates as well as department updates,” says Tracy Cahoon, MBA, CHRI, director of revenue integrity at Southwest General Health Center in Middleburg Heights, Ohio.

    Mia Reddick-Smith, MBA, senior director of revenue integrity at Lifepoint Health in Brentwood, Tennessee, says that her team also uses technology for one-on-one messaging, group chats, and video conferencing. Her team also connects for a virtual lunch and meetups several times a week.

    For managers, staying in touch is even more important. It can be difficult to tell when a remote staff member is struggling. Remind your staff that you’re there to help them during this difficult time and will support them even as priorities shift.

    Your team looks to you to provide an example—so make sure it’s a good one, advises Julie Hall, COC, principal of Integrated Revenue Integrity in Marlborough, Massachusetts.

    “There will be bumps along the way where connectivity issues or access to certain information which was available under normal circumstances may be interrupted,” Hall says. “As a manager, it will be important to be supportive and understanding without feeding into the negativity and frustrations that staff may have.”

  2. Make space. The couch might be an acceptable workspace if you only work from home once in a while, but it doesn’t cut it for longer periods of time. After a few days working from home, many people might find themselves longing for their cubicle walls. Duplicating your in-office set up at home might not be possible, but make sure your at-home work space is comfortable and organized.

    “Create a work space away from frequently trafficked areas of the house to avoid distractions,” says Adriane Martin, DO, FACOS, CCDS, vice president of Enjoin in Eads, Tennessee. “This also addresses the required HIPAA rules and guidelines to ensure any protected health information (PHI) is private and secure.”

    If you find that you’re missing essential equipment or need guidance on securing PHI in a home office, contact your IT department and privacy or security officer.

    Even if you’re working in your living room, take simple steps to ensure that work hours and off hours are separated.

    Maintain healthy work habits, including an ergonomic-as-possible computer setup and breaks to stand up. Take time to focus on self-care, Cahoon recommends.

  3. Set a balance. Working from home is even more of a challenge if you’ve found yourself with a second job as a teacher. With daycares and schools closed, many parents are struggling to find the balance between taking care of their children and staying on top of their work.

    Stick to a routine and set realistic expectations for your new work-life balance. You might need to adjust your work hours and schedule to allow for more time spent on meal prep and clean up and checking on homework.

    “I think it’s important to be up front with your managers, bosses, colleagues, clients, etc., about what your situation at home is,” recommends Jugna Shah, MPH, CHRI, president of Nimitt Consulting, Inc., in Spicer, Minnesota. “So far, everyone I’ve talked to says they completely understand there will be interruptions and children’s voices in the background.”

    In fact, just days after virtual meetings became the norm Shah got a demonstration of this new understanding. “I was part of the ICD-10 Coordination and Maintenance Committee meetings, and after one and a half days of behaving perfectly my son chose exactly the moment that I was taken off of mute to make comments to run into my office hollering, ‘I want you to put me to nap!’,” she says. “I was mortified and thought this is a Murphy’s Law moment. Why now, why when it’s my turn to make a statement? I tried to shush my son while my husband ran in and grabbed him like a football under his arm, and out they went with my three-and-a-half-year-old screaming bloody murder. In that moment, I wondered what in the world are people going to think. But later that day I heard from several colleagues who said it wasn’t bad at all and, in fact, what a relief because this type of thing is our new reality and it’s likely going to happen to everyone at one point or another given the new conditions we are all living under.”

    Even with understanding peers, adapting your schedule is challenging. Decrease your stress by asking for longer timeframes to get deliverables completed. What may have taken an hour in the past may take double the time simply because you may have more interruptions, Shah adds.

    A schedule similar to a regular school day can help children understand the new rules and expectations. Shah says that they’ve written a schedule on a chalkboard so that their son can look at it daily and see when there is free play, lesson time, meals, nap, and more play time. She’s also adjusted her own schedule by going to bed sooner in order to get up two to three hours earlier to catch some valuable quiet time to work and by taking a longer midday break for family lunch and playtime.

    Reddick-Smith says that she’s working on a structure that suits her and her school-aged son, who is also working from home after his school switched to a virtual classroom.

    “I try to get my son started on Google classroom around 9 a.m.,” she says. “I get up first and get online for work. Once I am adjusted and can look at my calendar, I can then get him started. He can do some work independently, but I usually check all work before he turns it in.”

    Cahoon and her husband, who is also working from home, take childcare in shifts, swapping throughout the day. She’s also adjusted her work schedule to start earlier and end later.

    Most importantly, accept that your family’s routine may be a work in progress for a while. Take the time to figure out what works for everyone, and don’t be surprised if you find yourself wondering how you can integrate the best parts into your daily life once things go back to normal, Shah says.


Editor's note: To talk to your peers about COVID-19 implications, visit the NAHRI Forums (for members only; log in with your username and password) or HCPro Forums (free forum membership). Please reach out to NAHRI Director Jaclyn Fitzgerald at with suggestions on how we can best meet your needs during this time. Visit the HCPro Coronavirus Response Solutions Center for a comprehensive list of training and education solutions. 

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Program Management, Revenue Integrity