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Focused Action Forums

Improving Working Conditions

Posted by Moderator MT Coalition on November 17, 2017 at 1:50 AM Comments comments (6)



Home-based workers in MTSOs have indicated improvement needs in the following areas:


1. Market-based wages comparable to peers in healthcare organizations commensurate with the education, skills, and knowledge required for similar positions (Reference Bureau of Labor Statistics).


Many healthcare facilities employ telecommuting MT/E employees, and pay at the same rate as their inhouse employees.  Traditional, in-office positions do not factor in commuting or office wear into their salaries, and this should not be used as a reason for reduced pay.  Employers realize savings from reduced office space expense, overhead, and in many MTSOs, equipment, furniture, references, and telecommunication costs.


2. Hourly wages that include currently noncompensated time for adding demographics, researching terms and names, training, correspondence, QA review feedback, timekeeping, breaks, etc.


3. Working conditions such as those found in #2, that reduce the negative impact of continuous, repetetive, robotic work such as repetetive strain injury, fatigue, and reduced focus leading to errors and reduced productivity. 


4.  Affordable, customary, market-based benefit packages.


5. Performance incentives, if used, are beyond hourly wages to reward additional and exceptional effort, and are not punitive by wage or benefit reductions. Workers can count on their wages and benefits remaining stable until uncorrected poor performance results in transfer or termination.


6. Performance metrics are reasonable and weighted for the complexity and/or variability of work performed, and the time and effort required. Measurements are transparent, verifiable, and nonmanipulated.  Workers can easily check and self monitor productivity, work volumes, and turnaround, and verify quality reviews and challenge results.


7. Performance metric feedback is given at reasonable intervals so that they become meaningful and productivity enhancing versus micro-managing, reactionary versus self adjusting over time, and productivity sapping due to stress (e.g. monthly or quarterly as opposed to daily to biweekly, particularly for experienced workers versus the novice and/or those in new account training).


8. Individual metrics should not be rigidly applied, rather used as guides and goals to identify overall needs in coaching, training, and performance rewards or improvement.   Metrics should factor in extenuating or changing circumstances, variable conditions, and be balanced with other metric measurements (production, quality, attendance, team effort, etc.) for an overall individual contribution.  


Having the ability to monitor every keystroke, pause, and error doesn't necessarily mean it should be done or is an accurate or effective means of human resource management.  A shift to a focus on overall team performance, company turnaround time results, and quality may be effective.


9. Work assignment changes due to account changes should be weighted as ramp-up time in performance measurement and compensation systems.  Production credit is given for computer-caused retyping and speech recognition jobs that become essentially straight typed.


10. Access to coworkers, managers, technical assistance, and trainers with collaborative input into work processes, performance measurement, feedback, and compensation.  Workers know their processes best and how well technology and systems actually work for them.  They should be involved in systems design and process and performance measurement, rather than persons far removed from the process. 


Training materials and company information should be uniform, current, and easily accessible.  Communications should be efficient and timely including response to questions and notification of stat work via messenging systems.


11. Work relationships based on mutual respect, trust, and collaboration, rather than statistics, authoritarianism, and fear.  Remote location workers, effectively managed, should not require more stringent monitoring and micromanaging, or reduced pay and benefits than in-office workers.  


12.  Annual review of wage rate with cost of living adjustment. 


13.  Protections from employment or contract termination due to account losses with provisions for transfer, job reassignment, severance pay, etc.


14.  Use of ethical outsourcing methods:  Promises to healthcare organizations as to quality and productivity gains should be realistic, verified, and specific to each MTSO, account, platform, and workflows. Organizations should understand that human error occurs, and that excess customization in an outsourcing environment with rotating workers working across multiple healthcare accounts adds to the likelihood of error as opposed to a steady and stable workforce.  Complaints by customers are often factored into MT/E metric performance, which may not necessarily be a worker issue versus a sytemic issue. 


Outsourcing healthcare organizations should be aware that promises as to pay and conditions for their outsourced former employees may not last once employees are absorbed into and reassigned within the MTSO.  Outsourcing organizations should specify in contracts and verify that all workers on their accounts are receiving market pay and fair working conditions.  MTSOs should provide transparent evidence of fair billing and compensation methods to outsourcing organizations and their employees or contractors.  


Offshoring to other countries, which can increase the labor and costs required to train and supervise workers, pose increased risks to quality, security, and privacy, and be more difficult and expensive to enforce HIPAA/PHIPA and other privacy laws, should not be used as a means to avoid market base, living, or minimum-wage wages, and is inconsistent with public interest in supporing local and national economies.


15.  There are existing studies which identify the negative impact on employee morale and performance when they are in a punitive atmosphere, or impoverished and/or underpaid in comparison to equivalent peers for the technical knowledge, skill, and responsibility required (impact on patient care and HIPAA/PHIPA).


From 8 Principles of Collaborative Leaderships: "Treat people like human beings, not human resources. People are not assets. They are human beings. Without them, there is no organization. The health and well-being of your team or organization is dependent on the health and well-being of its members."


"I pity the man who wants a coat so cheap that the man or woman who produces the cloth will starve in the process."   President Benjamin Harrison


Without being company specific here, what would you add or modify to the above identified needs that you want to become the standard in existing or future MTSOs?  


Please share your thoughts and ideas in the comments above (or via the contact form).