Sustaining Training

You might say that Norco Virtual University was born of frustration. The Web-based training tool is used by Norco, a Boise, Idaho-based home medical equipment provider, to keep its employees updated on new rules and regulations.

But before the Web site was devised eight years ago, Norco, whose roots reach back to the 1940s and which has three other strongly regulated divisions — welding, safety and calibration gas — was struggling to keep hundreds of employees in diverse locations up to speed with ever-changing regulations. There were also problems with continuity of training and keeping track of who was trained in what procedure.

“We had an overwhelming training need. We couldn’t keep up with training our drivers, keep up with OSHA and all the regulatory and accreditation needs. We needed a tool to train our people effectively, so we looked at an online solution,” says CEO Jim Kissler.

The company teamed up with two respiratory therapists who were doing Internet work and created a Web site that offered up-to-date information, says Robbie Roberts, RT, Norco’s compliance officer.

“We initially designed it so that it would be information [employees] could use to understand and do their jobs,” says Roberts. “On a couple of occasions, we put together a series of courses for medical billers and managers, and they received a special certificate.”

Managers were required to complete the series as part of their bonus, Roberts says. Medical billers were rated in several areas, and that influenced their compensation as well.

The training was successful, so Norco kept adding courses to the site. Within a few years, it had attracted the attention of buying group VGM, Waterloo, Iowa.

“Basically, we decided to partner with Norco when we needed to provide an avenue for our members to have online education,” says Sara Bauer, VGM’s director of education. “We knew Norco was providing that to their employees, and they were doing it quite well.”

“We were able to brand some screens for [VGM]. They used Norco courses and developed some of their own,” says Roberts.

The two organizations now share courses and collaborate from time to time, Bauer says. “We use some of their accident courses that they have written with their expertise, and they have used some of our courses, like our [human resources] course,” she says. “It’s been a very beneficial relationship.”

NVU has now grown to be an integral part of Norco’s training efforts, according to Roberts. Employees can select from 72 course offerings with topics ranging from Medicare billing for DME to disease management programs and Department of Transportation driver training.

“All new hires have to take five different courses in order to understand the quality system at Norco, our benefits system, our safety. Then there are other [courses] they would take depending on their job function,” says Roberts.

Once employees have completed a course satisfactorily (yes, there are tests!), they get a certificate signed by Kissler and President Ned Pontius.

“They can do it from home or on the job. And as they go through the training curve at Norco where they need to be more knowledgeable and take on more job responsibilities, they can take more training,” Kissler says. “For example, we have Level One billers, Level Two billers and Level Three billers.”

Staff can also refer to the site for up-to-the-moment information on industry rules and regulations.

To date, more than 1,200 people have taken training on NVU, according to Roberts. He says the feedback from employees has been mixed. “Most of the comments are, ‘It’s nice to take the training at any time,’” he says. “Another comment is that it is consistent.”

Users also like the immediate feedback when they answer course questions, he notes. But those employees who are not what Roberts calls “techies” are very wary of NVU, he says, and it may take them a while to feel comfortable on the site.

Still, NVU has been an invaluable tool for Norco. With 700 employees and 42 stores in six states, “trying to make sure everyone was on the same page as far as training goes was a neat trick,” says Roberts.

NVU allows the latest information to be accessible to all employees at the same time. It has also aided the company in continuity of training, which is vital in keeping its accreditation.

“We found it difficult to demonstrate continuity at every one of our locations,” Roberts recalls, referring to the days before NVU. Different teachers stressed different things; information was sometimes more extensive at one site than at another.

With NVU, Roberts says, “we can point to one course that is taught the same way every time. It improves our competency, it improves our communication and it improves our turnaround time to be able to demonstrate that the training was completed.”

Training has become a simpler process, Roberts says, adding that it has improved the company’s ability to handle an accreditation site inspection or an FDA or DOT inspection. “We’ve been a lot less stressed because we know our people are trained, and we have the documentation to prove it. Now, with the new quality standards, you never know when they are coming out. A company has to be ready at all times for a visit.

“[Online training] allows an organization to take the stress off because they can figure out what they want their people to be trained on, how often they are trained. And, you can pull up reports.”

Through NVU, reports detailing who is taking a course and who completed a course are generated every month for managers, Roberts says. “We use it to monitor as well as to encourage,” he continues. “A manager is notified when the employee has completed the course, and that allows them to go back and say ‘thanks.’”

He also says managers find NVU’s record-keeping capabilities helpful when they are doing annual evaluations because “it gives us tangible evidence to point to on an employee’s training, knowledge and performance.”

But it’s not perfect. “Online training is not a panacea,” cautions Roberts. “It is not going to solve all of a company’s problems. It doesn’t replace hands-on training. [People] still have to know how to handle the piece of equipment, handle the servicing of it. Those portions we still do live.”

In fact, Roberts says, he has purposely not put everything online. “Monthly safety training is not put on NVU. The manager still does that at a monthly meeting,” he says. “We just think there is some training that is better done face-to-face.”

He recognizes, too, that an online training tool is not easily accomplished by smaller providers. There are record fees, hosting fees, licensing fees and the cost of the application, he points out. In addition, “you have to have someone who is dedicated to coordinating the training products.”

At Norco, one person spends about a third to one-half of her time working on the site. Courses are developed by Norco employees as well as experts in the industry, Roberts says. All of that is costly.

“If you have under 100 employees, you might not be able to cost it out,” he says. “If a provider can join an already established group, it would be easier to implement this.”

Despite the costs, the benefits of NVU have been so many that Norco has its eye on expanding the product. Perhaps Norco would put together training sites for others in the DME industry, Roberts suggests. But there is an even bigger dream.

“What we would like to do is take NVU to the next level,” he says. He envisions teaming with a university that does online training to offer a recognized certification program or even a degree related to the DME industry, such as a degree in applied sciences with an emphasis on DME, or certification in medical billing or equipment management.

Roberts thinks such a program would garner a lot of interest. “A lot of people would like to go back to school,” he says.

Especially if they could do so in their pajamas.