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Quick take: 4 steps to working from home success for ambulance service support staff

Working from home is the new normal for support staff: Lifestyle, office setup and HIPAA are key factors for being productive and compliant in the home space


The ability to create a near-normal office function, albeit socially and geographically distanced, will aid operations as well as assuring the organizational continuity of operations.

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By Rob Lawrence

While our remarkable operational and frontline staff are out in the thick of the COVID-19 response, most support and back-office staff have been sent home to maintain distance and space. These important staff members are tasked with keeping the administrative lifeblood flowing through the organization and keeping the business side of any agency running. Cash flow will become a problem if human resources and administrative staff members can’t do their jobs to process reimbursement and payroll.

In a recent podcast, seasoned home worker, Virginia Commonwealth University (VCU Health System) IT Project Manager (and former Plans Captain at the Richmond Ambulance Authority), Kevin Pannell, produced a webinar highlighting the basics of establishing a routine and workflow for homeworkers new and old.

Takeaways on working from home for ambulance service support staff

Here are the top takeaways from Pannell’s presentation.

1. Create a daily routine

First and foremost, get up every (working) day as if you are going to go to the office – exercise, shower and grab your coffee, have your breakfast and dress (probably not in a suit, but remember you could be appearing on a video conference as the day goes on) – as all of the above helps your mind get into work phase. Additionally, the creation of a routine assists with other essential parts of the new world order we are, and cleanliness and essential stress-busting exercise is an important component in this troubling time.

2. Designate office space

Depending on the size of your accommodation, if possible, set up a separate working/office space. This ideally is a place you can go and shut the door, away from distraction and again, create the demarcation between work and leisure. As we could be in a medium- to long-term situation, employers may also allow the transportation home of computers, monitors, docking stations and other mission essentials (don’t forget the leads, plugs, headsets, dongles and cables as well).

If this is not possible and the best spot is the kitchen table, then headphones with relaxing music may create the atmosphere to be productive. Playing music adds to the background and replaces the social buzz that previously office-based staff are used to. Alexa, Pandora and Google can quickly “play easy listening” or “coffee shop music” on request.

Everyone has a cell or smartphone to make calls and much more, but, if you have the ability, also have the office desk phone forwarded as well to assist with the creation of administrative normalcy. This also allows you to give out your work number versus a personal cell number for business activity. As the world has moved to a virtual one, the internet, bandwidth and speed are going to govern the ability to function in a home environment. Check on your internet speed and availability, and as an emergency backup, perhaps a phone hotspot for temporary connectivity if necessary.

As the home office or table is established, the home worker should establish if there is a virtual private network access (VPN) access to essential work files and If not, what is the policy (and required encryption level) for file sharing? Also, understand the policy for housing files on the hard drive of the desktop or laptop in the home space. For home filing, a backup routine and process should be established as well.

3. Build-in breaks to improve productivity

Once underway, make sure that you set break times about every hour to get up, stretch and walk about. This provides a quick mental refresh. As Pannell points out, during classes and courses, there are natural breaks at about the 60-minute point as it’s about as much as the mind (and body) can take in one hour.

Homeworkers should not be cast off and left to get on with it. Supervisors should set expectations when staff are to be logged in and what the reporting and communication guidelines are. Consideration should be given to enabling interoffice communication for routine chatter with such systems as What’s App or Messenger. Supervisors should also create regular check-in times (or coffee chats or happy hours!). Homeworkers should also become proficient in using conferencing platforms, Zoom, Skype, Webex, GoToMeeting, etc.

4. Take care with HIPAA at home

Now that we are set up and ready to be productive, the nature of EMS means that many documents passing over the desk or computer screen may contain patient sensitive information. The wholesale transfer of reimbursement activity in many agencies to home-based employees could present many risks, and, as remote employees are not exempt from HIPAA rules, extra care must therefore be taken. The Compliancy Group offers the following checklist for home working:

  • Encrypt home wireless router traffic
  • Change default passwords for wireless routers from the existing passwords
  • Encrypt, and password-protect, personal devices employees may use to access PHI (Personal devices should be configured before allowing those devices to access the network. Covered entities can also specify what brands and versions of personal devices are permitted to access company data.)
  • Ensure all devices that access your network are properly configured (i.e., are encrypted, with the password, firewall and antivirus protection)
  • Encrypt all private healthcare information (PHI) before it is transmitted
  • Require employee use of a VPN when employees remotely access the company Intranet

Additional steps employers can take include:

  • Develop policies and procedures prohibiting employees from allowing friends and family from using devices that contain PHI
  • Have employees sign a Confidentiality Agreement before they begin work
  • Create a Bring Your Own Device (BYOD) Agreement, with clear usage rules
  • Provide lockable file cabinets or safes for employees who store hard copy (paper) PHI in their home offices
  • Provide HIPAA-compliant shredders for remote workers so these workers can destroy paper PHI at their work location once the PHI is no longer needed
  • Develop and require adherence (through a sanctions policy) to a media sanitization policy
  • Ensure employees disconnect from the company network when their work is complete – this can be done by applying measures such as IT configuring timeouts
  • Maintain and periodically review logs of remote access activity

In all cases, agencies should create their own guidelines and policies covering information security, HIPAA and the requirement for staff to comply and follow all instructions given. As we have heard, this event will get worse before it gets better and the ability to create a near-normal office function, albeit socially and geographically distanced, will aid operations as well as assuring the organizational continuity of operations.

Additional resources on working from home

Learn more about working from home for an ambulance service with these resources:

Rob Lawrence has been a leader in civilian and military EMS for over a quarter of a century. He is currently the director of strategic implementation for PRO EMS and its educational arm, Prodigy EMS, in Cambridge, Massachusetts, and part-time executive director of the California Ambulance Association.

He previously served as the chief operating officer of the Richmond Ambulance Authority (Virginia), which won both state and national EMS Agency of the Year awards during his 10-year tenure. Additionally, he served as COO for Paramedics Plus in Alameda County, California.

Prior to emigrating to the U.S. in 2008, Rob served as the COO for the East of England Ambulance Service in Suffolk County, England, and as the executive director of operations and service development for the East Anglian Ambulance NHS Trust. Rob is a former Army officer and graduate of the UK’s Royal Military Academy Sandhurst and served worldwide in a 20-year military career encompassing many prehospital and evacuation leadership roles.

Rob is a board member of the Academy of International Mobile Healthcare Integration (AIMHI) as well as chair of the American Ambulance Association’s State Association Forum. He writes and podcasts for EMS1 and is a member of the EMS1 Editorial Advisory Board. Connect with him on Twitter.