Telecommuting is becoming increasingly common in the workforce. In fact, a 2017 Gallup survey showed at least 43% of Americans work from home at least part time, a number that has been steadily rising. This is now common in the fields of information technology, finance, marketing and customer service, but the field of dentistry is quickly following suit. More and more dental employees are working from home, particularly those who perform administrative duties such as scheduling and billing.
Many employers still fear that allowing employees to work from home will result in lowered productivity and misrepresented time sheets. However, several studies have shown that allowing employees to work from home on occasion has numerous benefits, including improved morale, better employee retention and reduced employer costs.
But the question of whether to allow employees to telecommute often leaves employers uncertain about their responsibilities in terms of managing risk. Who is responsible if an employee becomes injured on the job? How is overtime calculated? What about HIPAA considerations?
The Dentists Insurance Company recently had a case reported to its Risk Management Advice Line in which a seasoned office manager was injured while working from home after tripping over a power cord. His employer allowed him to work remotely to plan the annual community outreach program, as there were fewer distractions in his home office than in the dental office. One day as he was reviewing papers, talking on the phone and walking around his home office, he stumbled over the power cord that was connected to his laptop and printer. The result was a badly sprained ankle, as well as hand, wrist and forearm contusions — not to mention broken computer equipment. The office manager was taken off work for several weeks and received conservative treatment over the span of seven months. He also filed a workers’ compensation claim.
Crystal Potch, TDIC workers’ compensation claims manager, said the incident could have been prevented had the dentist had a policy in place addressing telecommuting. In this case, the policy should have included a telework agreement and checklist as part of the office’s injury, illness and prevention plan. Prior to working from home, employees should be required to use the checklist to perform a safety inspection of their home-office workspace. The U.S. Office of Personnel Management offers a safety checklist and other resources for telework employees at telework.gov/federal-community.
For employees who work from home full time, this inspection should be conducted quarterly. “Employees should review the safety of their workspace to ensure it is free from hazards,” Potch said. “They should complete and sign a checklist confirming that this inspection was completed.”
In another case reported to TDIC, a special-projects coordinator was in charge of preparing a dentist’s presentation for a conference. She was allowed to work remotely to research, analyze and summarize the presentation material. Over the period of a few months, the employee began to suffer from excruciating pain in her neck, shoulders and wrists. Her pain became so severe that she was unable to perform her work. She filed a workers’ compensation claim due to her injuries and received treatment, which included injections, physical therapy and surgery to correct what was ultimately diagnosed as a cumulative trauma injury.
Her employer was surprised that she experienced such a severe injury, as he provided her with all necessary office equipment, including an ergonomic chair, for use at home. It was soon discovered that she failed to use the chair, instead working from her bed or couch, which did not provide her with the necessary ergonomic support to keep her in a neutral working position throughout her work day.
Potch said that employers who allow staff to work from home must outline the requirements of teleworking. Policies must be in place directing employees to work in ergonomic environments free from hazards. These policies must specify that employees who develop pain must follow up with their manager or supervisor, requesting an ergonomic evaluation. Employees should sign the policy acknowledging they understand and accept the conditions of telecommuting.
Another consideration regarding teleworking is regulating work hours and meal and rest periods. Nonexempt employees must still follow state and federal guidelines with regards to overtime and breaks, regardless if they work from home or in the dental office. This information should be outlined in office policies and signed by the employee.
The Health Insurance Portability and Accountability Act (HIPAA) is another crucial concern. It is an employer’s duty to ensure patients’ protected health information (PHI) is kept private, and that duty applies both within and beyond the dental office. The greatest concern with regards to telecommuting is the use of email. HIPAA recommends the use of encrypted email and messaging platforms, but should an employee use a personal, nonencrypted email service from home, it increases the likelihood that the PHI could be accessed by an unauthorized individual. Even the seemingly innocent practice of emailing a patient’s records from a company email to a personal email so that the file can be worked on at home puts the information at heightened risk of unauthorized access. To remain compliant, employers can install virtual private networks (VPN) on employee computers and specify that communication with patients should only be conducted via these encrypted systems, not via Gmail or other web-based email providers. Practices must also be diligent in capturing any relevant communications in patients’ charts.
Ongoing communication is key to preventing workplace injuries and protecting your practice from other liability claims — even when the workplace happens to be an employee’s home. Developing a formal telework policy, providing trainings and following up with regular emails, phone calls and video chats will keep your employees informed of their responsibilities as remote workers. Teleworking is a privilege that requires strict adherence to office policies in order to protect both your employees and your practice.