Healthcare organizations using electronic medical record systems (EMR) have quickly recognized the many advantages these computerized files offer. Caregivers and support staff have immediate access to complete, up-to-date information - generated not only by the primary care provider, but often gathered from disparate sources like consultation reports, radiological studies and laboratory results. The integration of this data allows the health care team to fulfill their duties more efficiently and effectively.

It’s no surprise, therefore, that the industry is applying this same concept - with the anticipation of reaping the same benefits - to employment, personnel and labor records.

Representing the next generation of integrated labor resource management solutions, an electronic employee record (EER) system creates a single record that contains comprehensive information relating to a staff member’s employment, from hire to retire and beyond. By partnering with a vendor that offers an integrated labor resource management solution like an EER, healthcare organizations can provide on-demand information to management, department heads and employees - making it significantly easier to proactively manage staffing needs, education requirements, budgeting and more.

This strategic approach provides the organization with a complete labor picture. By making employee information available through a seamless data flow, leadership can more readily monitor staffing patterns and other labor-related trends, anticipating and adjusting as needed. Ultimately, this allows the healthcare facility to utilize its human resources more efficiently and effectively.

A preliminary version of the EER is created when a prospective employee submits an application. If and when the employee joins the staff, the employee record is automatically populated with the basic demographic information that was part of the applicant record, as well as details relating to the individual’s position within the organization. The EER subsequently serves as the nucleus for all labor management functions, providing seamless access to other technology applications that affect the staff member’s day-to-day responsibilities, including time and attendance, payroll and staff scheduling. The EER is then updated throughout the employee’s tenure. And, when he or she eventually retires or leaves the organization for any other reason, the system can automatically complete termination procedures, including removing security access and triggering COBRA processing. Then, the employee record can be completed, closed and securely archived.

THE PROBLEM

Managing employees in a healthcare environment is a monumental task. There are overwhelming amounts of data, details and decisions that need to be documented, tracked and communicated within the organization. In many cases, relevant information about individual staff members is stored in disparate software applications. For instance, an employee’s application and work history may be kept in the HR system while continuing education requirements and credits are kept in a separate system managed by the education department. Information used to create schedules and staffing plans often remains in a separate staff scheduling system and pay scale information is stored in yet another system: payroll. HR staff and managers often need to toggle between these various applications to get all the information they need about a specific employee’s situation - an inefficient approach that can lead to errors and miscommunication. Because these systems are not linked, it is difficult - if not impossible - for leadership to access and share the information necessary to proactively manage staffing needs, accurately determine future budget levels, and develop appropriate and effective training programs.

In addition, healthcare organizations must ensure they are in full compliance with various regulatory directives - following federal and state employment laws, demonstrating that care is delivered in accordance with The Joint Commission guidelines and ensuring all employees have kept crucial licensure up to date. This matrix of variables can be a challenge even for the most competent HR professionals and department managers to address and will only get more complex in years to come. Providing seamless access to relevant employee data helps ensure no details are overlooked.

THE SOLUTION

HR and healthcare executives have long sought a solution that would allow them to keep on top of these variables and streamline the workflow associated with managing personnel. The EER model ultimately was born when visionaries recognized how integration of disparate labor management systems would benefit the organization as a whole.

The EER provides a healthcare organization with a single portal through which select staff members can access all employee information. Among other things, they can review the personnel file, check time and attendance issues, and send notices or alerts regarding issues that require attention. Employee information is secure and password protected with various levels of clearances to regulate access to highly confidential information.

Serving as a hub of the wheel, the EER allows healthcare organizations to centralize relevant employee data. HR personnel, frontline managers, directors and executive leadership - representing the rim of the wheel - have bi-directional access to the files. They are able to review and retrieve information according to approved access protocols, and modify or add information to the record as appropriate.

In addition, the pathways (or spokes) allow staff to route information among themselves and access additional data from other software applications if necessary. The portal is designed with a transparent interface so that users are not even aware if they have been transferred from the main portal to another data environment that contains the specific information they need.

By integrating employee information that previously had been housed in various databases throughout the enterprise, the EER allows leadership to access vital data quickly and easily. This allows them to conduct a comprehensive assessment of the labor picture, respond to emerging trends and devise effective short- and long-term management strategies.

HOW THE EER WORKS

When a new employee joins the organization, personnel managers use the data from the applicant database to create a file that contains basic information: name, address, emergency contacts, hire date, position, supervisor, etc. At the same time, the EER helps HR staff to determine pay grade and associated benefits. It also tracks vital paperwork associated with hires - ensuring that new employees have signed and returned W-4s, benefits forms and similar documents, for example. Throughout the staff member’s affiliation with the organization, the EER is updated to reflect promotions, salary adjustments, performance reviews, attendance record, disciplinary actions, security clearances and other relevant information.

In addition to standardizing data, innovative EER files can also be customized to reflect the specific information needs and requirements of individual healthcare organizations - verifying the currency of care providers’ licensure, and monitoring whether or not training and education standards are met. Throughout, the EER documents, coordinates and communicates actions to ensure a smooth HR workflow for healthcare organizations - and provides a solid foundation for strategic labor resource management.

EXAMPLE: REQUEST FOR LEAVE OF ABSENCE

If, for example, a clinical nurse specialist (CNS) requests leave because of illness within the family, a healthcare organization is compelled to grant family leave by law - but the legislation governing this right is complex. Besides ensuring that all federal regulations are met, the organization must also consider specific restrictions individual states may have enacted. HR staff must determine whether or not the CNS is eligible and, consequently, how the leave must be structured.

Once all these variables have been sorted through, HR must update the employee’s file with the request, and factor in the impact it will have on other labor management issues like paid time off (sick, vacation and personal leave), benefits and performance appraisals. In addition, the CNS’s manager must be brought into the process, and department schedules must be revised for the duration of the employee’s leave. Finally, the payroll system must be alerted so that compensation can be modified as necessary.

In short, dozens of processes might be affected by a single request from a single employee. Of course, healthcare organizations typically employ hundreds, if not thousands, of staff members - and the complexity of the situation increases exponentially with a larger facility.

In a traditional environment, HR personnel and managers may need to access several software applications or paper files to retrieve information that has a bearing on each request. Then, they must share this information with the appropriate parties and prompt them to take action if necessary. Accomplishing this ordinary task - approving a simple request for leave - takes hours of staff time and requires a significant investment of resources.

With an EER, however, the process is automated. The request is entered, and the file alerts all affected parties. The record immediately prompts input from all systems that will be affected - like the HR program, the scheduling application and the payroll system - and delivers critical information to decision makers. It ensures that important considerations aren’t overlooked - and that efforts aren’t duplicated, which wastes both time and resources.

EXAMPLE: PERFORMANCE APPRAISAL

Here is a second example: a two-year employee serving as a medical assistant on a surgical unit is due for her annual performance appraisal. The EER would generate a reminder to her manager and then provide access to the wide variety of information she will need to collect to prepare for the assessment. For instance, the manager will want to review:

• how many times the employee called in sick, been tardy or charged with an unscheduled absence?
• how often she agreed to - or refused to - cover a shift when patient load or acuity required additional staffing;
• if she has kept pace with clinical education requirements;
• whether or not she has attended mandatory internal training sessions; and
• if any commendations or complaints have been entered in her file since the last evaluation. 

In addition, the manager will need to review the employee’s previous appraisal, as well as her salary grade and benefits.

The EER would continue to send the manager reminders if the review was late. In fact, EER functionality allows the organization to establish “escalation parameters,” which notify appropriate parties when tasks become overdue or persistent problems slow the system. Each facility can determine its own escalation parameters and counter measures that reflect internal reporting and accountability structures.

Once the appraisal is finished, the EER ensures that all documents are completed and appropriate signatures are attached. It then forwards relevant information to the appropriate parties, departments and systems. Pay increases are sent to the payroll department, for instance, while training staff is alerted to any educational requirements that have not been met.

EXAMPLE: OVERTIME ANALYSIS

This example highlights how executives can benefit from an EER. In a large healthcare organization, overtime costs have been slowly, but steadily, rising. With even a small percentage increase in overtime costing tens of thousands of dollars, the executive team needs to reverse the trend. For them, it’s not enough to know what the organization’s overtime costs are. Instead, they need to know the details behind the overtime costs so that they can implement the right programs to reduce this costly labor expense.

Although all overtime expenses can appear the same from a dollars and cents standpoint, it’s important to understand what type of overtime it is - scheduled (part of the staffing plan), unscheduled (caused by last-minute changes in acuity/census or employee no-shows) or incremental (employees coming a few minutes early or staying a few minutes late). By comparing staffing plans to actual hours worked - information that’s integrated with the EER approach - the team can determine how the overtime is being incurred. Armed with that knowledge, they can implement programs and policies to correct the situation. For example, scheduled overtime can point to a need for new hires or an evaluation of staffing ratios. Unscheduled overtime might be remedied with better day-to-day resource management and nurse floating programs. And, incremental overtime might require some policy changes and staff training.

ADDITIONAL BENEFITS

Executive leadership, HR staff and frontline managers are not the only ones who benefit from the EER. With all employee-related data in a single place, staff members can also access their relevant personnel information via an employee portal. This self-service functionality empowers them to update and review their own information.

Through this special user interface, employees can:

• access benefit enrollment forms;
• check benefit eligibility status;
• review time and attendance records;
• monitor overtime levels;
• receive notifications regarding certification;
• retrieve on-line pay stubs; and
• enroll in education courses.

By providing employees direct access to self-service information, healthcare organizations can save time and money, since paperwork is minimized and reliance on HR and payroll personnel will decrease significantly.

Additionally, current EER technology is designed to minimize any burden on in-house IT staff. EER vendors provide sophisticated software and seamless interfaces, and work closely with all stakeholders to ensure implementation progresses smoothly. Internal staff can consult with EER partners to evaluate current workflow, customize improved processes and design templates and reports to meet the organization’s unique needs.

Finally, the EER gives executives a more complete organizational labor picture. This wealth of employee-related information makes it easier to analyze, track and manage trends and create forecasts that improve HR and staff utilization. Use of an EER also gives executives access to the data required to increase organizational effi ciencies at every level of the enterprise, resulting in increased productivity and a healthier bottom line. Additionally, streamlining the flow of employee data can improve employee satisfaction and increase morale, which is especially important as the industry experiences clinical staffing shortages across the country.

In short, healthcare organizations can reap substantial benefits from EER. HR personnel and management are granted immediate and secure access to comprehensive, up-to-date information on employees from a single portal. The record automatically forwards relevant data to other individuals, departments and systems - updating files and triggering alerts when appropriate. Staff members at all levels of the organization have access to self-service functionality, allowing them to complete routine tasks that would otherwise consume HR resources. In the end, because employee data is stored and managed in one central location, leadership can be confident that all personnel issues are handled as effectively and efficiently as possible.