The Executive Suite: Reassessing traditional bricks and mortar

The unforeseeable arrival and impact of the COVID-19 pandemic has resulted in a multitude of permanent changes to every aspect of daily life. The demands of the circumstance has forced businesses in virtually every industry sector to reconsider how they should operate to purely remain solvent, whilst balancing some level of employee and customer safety. The healthcare industry has far more grievous challenges - constant supply disruptions with a broad variety of resources, both material and human, coupled with rapid spikes and influxes of demand with acutely ill patients (COVID-19 Forecasts: Deaths 2021). As the pandemic continues to evolve, many healthcare systems followed other industries, allowing non-patient-facing employees to work remotely. Non Direct patient care employees have proven to be effective even if they are not physically located in the clinic, hospital, or administrative support facilities. Early estimates purport the possibility of many of these roles remaining in a remote fashion indefinitely (Surprising working from Home Productivity Statistics (2022) 2022). This in turn begs the question; how will healthcare organizations manage work location requirements in the long run? Can productivity be maintained? Is remote work a morale and retention booster?

Ergo, can facility leases and physical footprints be reduced or repurposed?

The idea of remote working has generally been a foreign concept for healthcare organizations, which the ongoing pandemic has challenged into existence. At present, there are a growing number of healthcare industry employees who are working in either a semi-hybrid or entirely remote fashion, and organizations have differed on long-term policy planning. A growing swell in business journal reporting denotes a need to encourage a return to in-person work, and the benefits of in-person interactions on productivity. This increase in remote work has set off a phenomenon known as the “donut effect,” where remote workers are leaving the city for more suburban or rural areas and bigger houses (Murphy Jr., 2022). Some workers are even choosing to move to different states entirely or out of the country due to new relocation incentives provided by local governments (Murphy Jr., 2022).

Is the nation's largest industry sector able and willing to continue forward without employees working physically present or co-mingled in brick and mortar space (Deutsch, 2021)? While not all healthcare organizational roles warrant the possibility of effective remote work; it should be noted that there was already considerable migration of administrative functions to off-campus locations or even entire outsourcing prior to the pandemic. This has been most evident in functions such as patient scheduling, revenue cycle billing, credentialing, supply purchasing, etc. If not entirely remote, more often than not, these administrative units often work in large cube farms located on or near a healthcare organization’s campuses. Can or should these and other services migrate further to a completely virtual environment? Can management controls be maintained and associated expenses, apart from physical space be recognized?

Having a remote workforce has many potential benefits in addition to sizable cost savings. University of Washington Medicine has reported a total cost savings of $150,000 per month by switching their IT infrastructure to a completely remote setup (Dyrda & Drees, 2020). Additional benefits include the ability to attract a wider pool of employee talent (regardless of geographic location) and a potential reduction in employee turnover with greater engagement (Leek, 2021). However, a remote workforce can introduce an array of potential compliance and security considerations (Ijaz, 2019). These can impact everything from business tax to worker compensation (10 compliance considerations for businesses with Remote Employees 2021). If indeed a largely virtual structure can be established, can or should healthcare organizations reduce or repurpose their physical footprint? With these important workforce and workflow considerations can a virtual healthcare workforce be further expanded to outpatient clinical practices and other comparable settings?

Telehealth; a segment of healthcare that was already on the rise even before the pandemic has entered a crossroads with a remote healthcare workforce. With the rise in demand, a plethora of telehealth-focused companies have emerged. Studies show that 82% of young adults prefer virtual visits to office visits for various reasons (Ellison, 2014). The primary consumer reason is largely convenience, but during the pandemic telehealth visits alleviated some fears of contracting hospital-facility acquired illness from others including Covid (Hafner, 2020). In addition, there are consumer and healthcare provider concerns surrounding telehealth. Such concerns include clinical quality, technological reach, and the ability for reimbursement. While these factors may partially constrain more rapid growth in virtual health, it is prudent to examine the breadth and depth of telehealth infrastructure with remote workforce capabilities (Rubin, 2020). With the industry progression into digital care, will the trajectory continue after the pandemic has been mitigated?

Will more clinical support staff - RNs, LPNs, MAs, have the ability to work remotely?

In our concluding thoughts, we submit that progressive healthcare leaders will critically reassess the following gauges for an optimal workforce structure:

What is our current and future horizon (36 months) commitment to telehealth and digital healthcare delivery?
How can we gauge our current organizational appetite towards remote work? Can we quantifiably measure or survey our employees' work structure preferences?

Can we litmus test multiple work-roles throughout our organization for remote work? (i.e. can functions and tasks be completed in a compliant fashion remotely)
What would be the ‘non-people’ savings opportunities for shifting an entire department or clinical support unit to a remote or hybrid work structure? (i.e. accounting statement of realized savings in lease, supplies, utilities, furniture etc.)

References - Resources

Centers for Disease Control and Prevention. (2021, December 29). COVID-19 Forecasts: Deaths. Centers for Disease Control and Prevention. Retrieved January 5, 2022, from https://www.cdc.gov/coronavirus/2019-ncov/science/forecasting/forecasting-us.html

Centers for Medicare & Medicaid Services. (2020, April 30). Press release trump administration issues second round of sweeping changes to support U.S. healthcare system during COVID-19 pandemic. CMS. Retrieved January 5, 2022, from https://www.cms.gov/newsroom/press-releases/trump-administration-issues-second-round-sweeping-changes-support-us-healthcare-system-during-covid

Deutsch, A. L. (2021, December 30). The 5 industries driving the U.S. economy. Investopedia. Retrieved January 11, 2022, from https://www.investopedia.com/articles/investing/042915/5-industries-driving-us-economy.asp

Dyrda, L., & Drees, J. (2020, August 24). The strategic vision for long-term remote work at 12 Health Systems. Becker's Hospital Review. Retrieved January 12, 2022, from https://www.beckershospitalreview.com/healthcare-information-technology/the-strategic-vision-for-long-term-remote-work-at-12-health-systems.html

Ellison, A. (2014, May 14). 82% of young adults would prefer telehealth to in-person visit. Becker's Hospital Review. Retrieved January 5, 2022, from https://www.beckershospitalreview.com/healthcare-information-technology/82-of-young-adults-would-prefer-telehealth-to-in-person-visit.html?oly_enc_id=9841H3846012I6N

Hafner, K. (2020, May 25). Fear of covid-19 leads other patients to decline critical treatment. The New York Times. Retrieved January 5, 2022, from https://www.nytimes.com/2020/05/25/health/coronavirus-cancer-heart-treatment.html

Ijaz, R. (2019, July 30). Working from home in healthcare: Can you adapt to remote work? Working From Home In Healthcare: Can You Adapt To Remote Work? Retrieved January 12, 2022, from https://www.healthworkscollective.com/working-from-home-in-healthcare-can-you-adapt-to-remote-work/

Leek, D. (2021, September 2). What to expect with continuing remote work in Healthcare. What to Expect with Continuing Remote Work in Healthcare. Retrieved January 12, 2022, from https://healthtechmagazine.net/article/2021/09/what-expect-continuing-remote-work-healthcare

Murphy Jr., B. (2022, January 8). A Stanford economist who studies remote work says half of all workers will make this big change in 2022. A Stanford Economist Who Studies Remote Work Says Half of All Workers Will Make This Big Change In 2022. Retrieved January 12, 2022, from https://www.inc.com/bill-murphy-jr/a-stanford-economist-who-studiesremote-work-says-half-of-allworkers-will-make-thisbig-change-in2022.html

Rubin, R. (2020, July 28). Covid-19's lasting impact on medical practices. JAMA. Retrieved January 5, 2022, from https://jamanetwork.com/journals/jama/fullarticle/2767633

Surprising working from Home Productivity Statistics (2022). Apollo Technical LLC. (2022, January 2). Retrieved January 5, 2022, from https://www.apollotechnical.com/working-from-home-productivity-statistics/

Wolters Kluwer Logo. (2021, November 17). 10 compliance considerations for businesses with Remote Employees. 10 compliance considerations for businesses with remote employees. Retrieved January 11, 2022, from https://www.wolterskluwer.com/en/expert-insights/6-compliance-considerations-for-remote-employees