Vol. 12 •Issue 19 • Page 20
Hands-on Help
The Remote Coding Project Manager’s Role
Leslie: Implementing a remote coding program is an important strategic initiative. Hospitals suffering from recurrent coding backlogs and slow cash flow are desperate for a solution. Remote coding makes great inroads in solving coder recruitment and retention problems. It also serves as a major e-HIM project, often launching the HIM department’s transition to an electronic practice environment.
Patty: Due to the mission critical role of coding, remote coding projects require top down commitment, a sense of urgency to implement and a project plan.
Leslie: Do you think remote coding projects require dedicated project managers?
Patty: Transitioning to remote coding does require a dedicated project manager because it is a complex change project. A dedicated project manager provides the necessary planning, coordination and leadership that the project requires to be successful.
Leslie: Should the coding manager spearhead this project?
Patty: A coding manager who is expected to take on remote coding implementation will be challenged to keep up with current coding demands. She will also find it difficult and time consuming to get buy-in from other managers and departments to change their current processes. In a transition to remote coding, the coding manager best plays the important role of motivating her staff and preparing them for change. She also plays a significant role in the re-engineering of coding processes to support remote coding.
Leslie: That is an interesting perspective Patty. In the past, the coding manager would have been the obvious choice to implement any changes related to the coding function. But remote coding affects every process in the department. While the coding manager is capable, they have limited resources to be able to free up their time to act as a change agent in other functional areas. Do you recommend remote coding project managers be dedicated to this project solely or can they have other responsibilities as well?
Patty: Ideally, this is the only project the project manager is assigned. HIM directors tend to underestimate the amount of process re-engineering required to implement a successful remote coding program. Often the functional areas that need to re-engineer their workflow require dedicated assistance so that the re-engineering process doesn’t get bogged down. A project manager who is managing multiple projects will be less accessible and find it a difficult task keeping re-engineering efforts coordinated and on track.
Leslie: I am surprised to hear you recommend that the remote coding project manager be dedicated to only this one project. Given all the multi-tasking HIM professionals have to do, is this realistic?
Patty: Well, it’s the ideal but I realize in today’s environment it is not often possible. So, if a project manager has multiple projects and/or responsibilities, it is imperative that the director selects a project manger who has the time to dedicate to the project, a proven track record as a change agent and the ability to collaborate with key departments such human resources (HR) and information technology (IT). Most important, the project manager must have project management experience and the proven ability to use project management and leadership skills to produce desired outcomes.
Leslie: Experience in project management is a very important attribute. According to a 1997 Gartner Group study, 50 percent of projects that lack trained project managers consume at least twice their initial budget and resources; projects take twice as long or are cancelled.
Patty: Untrained project managers lack the necessary skills required to lead cross-departmental re-engineering efforts. They often don’t know which of the project management techniques or tools to use or how to motivate people who are not directly accountable to the project manager. I think the greatest challenge for a remote coding project manager is the interdepartmental coordination necessary to modify workflow process.
Leslie: I would agree. This is a greater challenge than collaborating with IT or HR. HIM workflow changes create the most headaches during the transition to remote coding. But in the end, the headaches are well worth it. If workflow is not addressed, inevitably migraines occur from automating a less than efficient manual process.
Patty: Technology provides us with the opportunity to improve our processes yet it is so common to implement technology and then think about the processes. Automating inefficient processes yields less than stellar results and extends the length of time to fully realize the benefits of technology. Workarounds are often implemented adding more layers of work on top of already flawed process.
Leslie: What should our readers do if they are interested in leading a remote coding project or are approached to be a project manager for remote coding?
Patty: Before taking on the role of project manager, our readers should meet with the director to understand the short- and long-term goals of the project and what will be expected of them as a project manager. They need to ask about the importance of the project to the organization and where it fits into the organization’s overall strategic initiatives. They should find out from the director what challenges he/she anticipates and the kind of support and resources that will be provided during those challenges. It will also be crucial to obtain information about executive sponsors and understand the sponsor’s expectations.
Leslie: Our readers should be wary if there is no executive sponsor and seek information about the plan to obtain sponsorship. Without executive sponsorship, a remote coding project will not succeed over the long term.
Patty: Definitely. We covered this concept several times in the past two years in the Hands-on Help column. Once a prospective project manager has a good understanding of the project goals, the role of the remote coding project manager, the current status of the project (if the technology has been selected, staff acceptance, current players), the sponsor’s expectation and the importance of the project to the organization, she will have the first indications of the probability of project success. Then the prospective project manager can determine if she can successfully lead the project.
Leslie: OK, so the discussion with the director goes well and the information provided reveals that this is an important project to the organization. Executive sponsors are well informed and play an active role in communicating to other executives as well as ensuring the proper resources for the project and the project manager is up to the task. Now what?
Patty: It’s time to get started! The point at which a project manager enters the project determines the first set of activities. For example, you may take on this role after the technology has been selected and a project team is in place. If this is the case, you will want to assess the status of the project plan and ensure that the key remote coding activities are in progress and are categorized in an overall work breakdown structure or WBS. If you are coming on board from the get go, you will have the opportunity to work with the director and managers to select the project team, develop the vision, select technology and create the sense of urgency necessary for all change projects. You will then move on to the planning phase of the project.
Leslie: I remember a discussion of WBS in a Hands-on Help article titled “An Introduction to Project Management.” (See www.health-information.advanceweb.com Hands-on Help 2000.) How is this concept used in a remote coding project?
Patty: This is an important concept for project managers as it provides structure to the remote coding project plan. A WBS represents the overall functional categories of a project and the deliverables necessary to meet the project goals. It is an organized way of developing a project plan. There are at least seven functional categories in a remote coding WBS. They are:
•Human Resources policies and procedures
•Discharge processing workflow and staffing plan
•Coding workflow and staffing plan
•Managing the coding function remotely
•Information technology selection and implementation
•Roll out strategies
•Training programs
•Change management strategies
Within these categories the activities or tasks are defined. For example, under the category of “Discharge processing workflow and staffing plan,” activities could include: assessing the current flow of records from discharge to coder distribution; increasing the receipt of emergency department records from 50 percent to 100 percent within two days of encounter; identify scanning staff and develop scanning staffing schedule. Each of the WBS categories should have an owner and each activity should have a timeline and responsible party. If sequencing activities is an issue, consideration should be given to the order of each activity.
An organized project plan facilitates communication to sponsors and all those affected by the implementation of remote coding. In addition, as activities are identified or changed, a well-structured WBS can integrate changes and updates effectively.
Leslie: Managing a project involves a great deal of planning, task and budget management, communication and working through obstacles. But most importantly it involves people and the ability to lead people through change, such as the change resulting in the implementation of a remote coding program.
Patty: In our column earlier this year titled “Project Managers Must Be Good Leaders,” we discussed the attributes of good leaders as defined by John P. Kotter: 1. setting direction; 2. aligning people; and 3. motivating and inspiring people to move in the right direction despite obstacles.
Leslie: Leadership skills are indeed critical in project management. Successful project managers have mastered both project management skills and leadership skills.
Patty: Strong skill sets in these areas are learned on the job and complemented by formal training. Professional development in project management is abundant on the Internet and in classroom and workshop settings. Fine-tuning leadership skills takes personal commitment, a set of values that guide one’s behavior and the ability to reflect on one’s own leadership strengths and create professional development plans for areas requiring further development.
Leslie: Project management is both demanding and rewarding. For the dedicated project manager, seeing a remote coding project become a reality is the light at the end of the “coding shortage tunnel.”
Leslie Ann Fox is president and chief executive officer and Patty Thierry is vice president of operations and chief information officer, Care Communications Inc., Chicago. They invite readers to send their thoughts and opinions on this column to [email protected] or [email protected].
