As the world made the shift to move employees out of shared office space, for proper social distancing amid COVID-19, the shift for India-based employees provided a larger challenge. Leading up to Spring 2020, various aspects of healthcare operations completed in India were handled within larger office complexes with centralized technology resources and communications. When it was clear the safety of employees meant the decision to close these various offices, a major issue surfaced throughout the vendor community serving from India locations.

While many organizations faced the daunting challenge of moving massive India operations to home offices, the TrustHCS sister company, Visionary RCM, deployed an effective plan for transition. They worked through a quick response to create secure, dependable work-from-home (WFH) operations for their 2,191 employees who provide various revenue cycle functions for clients in the United States.

The shift started on Monday, March 23th, when the Visionary RCM team was asked to move to home-based-offices. A nationwide lockdown period in India was to begin on Wednesday, March 25th, leaving little time to make the move. Within 72 hours of this team-wide mandate, WFH operations were up and running for the Visionary RCM team.


Focusing the Team with Fundamentals

Visionary RCM compiled a cross-functional team that included business-line leaders, Information Technology (IT), Human Resources (HR), communications and facilities to plan for various scenarios. After reviewing each scenario, a final plan was selected and further optimized to ensure minimal impact on business when remote connection was to be established.

Going back to basics on team management principles was helpful during the plan execution. Focusing on the following helped keep the team on course for a timely transition:

  1. Set clear goals for everyone in the organization
  2. Ensure each goal is supportive of the overall strategy
  3. Measure progress toward the goals on a regular basis
  4. Define clear accountability for progress towards the goal
  5. Develop a “Plan B” for every action item


Deploying the Infrastructure

The 72-hour plan included deployment of the tested WFH infrastructure that Visionary RCM sister organizations TrustHCS and RevCycle+ had honed over the past decade. The IT team and leadership worked with each of the 2,191 India-based team members to ensure they had:

  • Approval: From federal authorities to move the hardware out of the bonded IT parks
  • Necessary Hardware: Laptops, mobile phones, and all applicable chargers
  • Internet Connectivity: To support both service delivery and necessary secure video conferencing. The employees were provided wireless internet equipment in phase I and then moved to high speed physical broadband connection
  • Company Access: Secure access to company intranet and other necessary role-related tools. Deploy a thin client solution for users to eliminate latency issues, if any.
  • Personal Access: To work-related files, systems, equipment, and passwords for secure client connection and service delivery


The change also included a shift in team member operations related to the work-day protocol for operations. New guidelines were quickly deployed including:

  • Training on usage of confidential data and company assets
  • Secure communication channels & collaboration tools
  • Methodology for employees to identify roadblocks or issues when working remotely (EXAMPLE: Self-help videos on addressing basic hardware fault)
  • Remote operation protocols for maintaining productivity, quality, and other SLAs
  • Clarification on full and partial workdays and the use of leaves


Given the change to home-based offices with high potential for personal interruptions, clarifying what was expected for a full and partial workday was an important piece of the transition.


Keeping Communications Open and Regular

The success of the transition would have been at risk if Visionary RCM could not keep the almost 2,200 employees properly connected to answer questions and stay on top of any process modifications. To combat this scenario, team members were asked to stay logged into company-wide communication channels during core working hours. They also made themselves available through the day over calls, emails, and chat. All regular internal meetings took place via video conference as well.

Various tasks were planned and assigned among team members so that goals and deliverables were clearly defined. Team leads also checked in with employees at regular intervals to simply stay connected, share wins, and help address issues.  Employees were properly prepared that the new scenario would require some adjustment from everyone involved. The team was ready for the extra coordination and patience needed as they worked through technical glitches.

Communication plans also included outreach to the Visionary RCM team to understand their overall well being related to the transition home. A team-wide survey found 88% of the team were satisfied with the WFH arrangement. Additionally, 74% of the team reported feeling more optimistic only one week after the WFH were implemented.


Lessons Learned

TrustHCS and Visionary RCM leadership recently produced a video interview on the colossal 72-hour accomplishment. Some of the lessons learned from the process that could be beneficially to other organizations facing an impending shift to WFH operations came out of the interview. Below are the points pulled from the interview and additional discussions with the Visionary RCM team.


1. Remaining Nimble is Important:

Amidst the massive undertaking to move the Visionary RCM team to WFH operations, it proved important to maintain the ability for each group to quickly adjust approaches and make decisions towards the goal. The team found creative ways throughout the 72 hours to help achieve the end goal of secure, WFH operations. In times of rapid response, the lean towards team member empowerment and away from micro-management is helpful.


2. Success Does Not Equal 100%:

While 2,191 team members successfully made the move to WFH operations there were still some needing additional assistance to setup operations. Overcoming challenges that face teams can be measured in many ways. The goal for this 72-hour transition was to establish appropriate support to maintain Visionary RCM client operations. The whole Visionary RCM team was not transitioned in the 72 hours period; however, with 97% of the team successfully making the move client operations did not take a negative hit. That was an appropriate win for this challenge.


3. Keep Information Updated:

In the transition it was clear some of the home addresses and contact information for the almost 2,200 member team needed updating. Adding steps as part of other routine employee engagement (EXAMPLE: as part of bi-annual HIPAA training) can confirm or update key contact points for employees including a proper address and personal phone. In some cases, having prior home addresses for team members caused additional steps for delivering hardware to the Visionary RCM team.


4. Your People Are Ready:

In the face of COVID-19 there are numerous stories across the world of people stepping up to face the unique challenges of the pandemic. As with the Visionary RCM team, people are more ready than one might think to take on these types of challenges.


Access to the Visionary RCM interview with TrustHCS is provided below. You will be able to hear the first-hand accounts of this 72-hour transition.  Visionary RCM leaders Rajan K.S. and John Wallace discuss with TrustHCS team member Torrey Barnhouse and Greg Goodale the reality of the transition and lessons learned in the interview.



Don’t miss these interview highlights:

  • The first 24 hours @ 1:58
  • No contingency plan for pandemics @ 5:16
  • How WFH has been received in India @ 7:03
  • The S.W.A.T. response from micro-teams @ 9:28
  • Interaction with the police @ 11:04
  • Changes in hindsight @ 12:40
  • Initiative and queuing with chairs @ 15:45
  • The numbers from the effort @ 16:55