Various devices and forms of communication appear along with the words: Achieve Healthcare Interoperability with ActiveXCHANGE.

How Does ActiveXCHANGE Help Achieve Healthcare Interoperability?

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HealthWare Systems Blog

How Does ActiveXCHANGE Help Achieve Healthcare Interoperability?

Posted on Monday, October 12, 2020

ActiveXCHANGE is our solution for helping organizations achieve healthcare interoperability. Below you’ll find information on the basics of interoperability in healthcare, the challenges healthcare facilities face, and how we can help you solve them.

What Is Healthcare Interoperability?


According to HIMSS:

“In healthcare, interoperability is the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged. Data exchange schema and standards should permit data to be shared across clinician, lab, hospital, pharmacy, and patient regardless of the application or application vendor.

Interoperability means the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities.”

Why Is Achieving Interoperability Important?


  • Interoperability is vital to patient safety and public health and a lack of interoperability leads to poor health outcomes and higher healthcare costs.
  • Seamlessly sending, receiving, interpreting, and integrating data significantly improves the patient experience and patients often expect that their information will be readily available to them and their healthcare providers.
  • Federal efforts to achieve healthcare interoperability are aimed at giving patients access to and control over their own medical information.
  • Interoperable technology streamlines organizational workflows and increases efficiency, plus cuts costs, by eliminating manual and redundant steps in the process of exchanging data.
  • Better interoperability helps with reducing physician burnout, which is often tied to EMR frustrations and administrative burdens that can be traced back to interoperability problems (such as sifting through an overwhelming abundance of low-quality data to find the information they need and spending more time with the computer than with the patient).
  • The Office of the National Coordinator for Health Information Technology (ONC) states that “Seamless data flow will also accelerate progress on a range of national health priorities that include combatting the opioid epidemic, spurring clinical innovation, and accelerating science.”

What Are the Challenges to Achieving Interoperability in Healthcare?


Various devices and forms of communication appear along with the words: Achieve Healthcare Interoperability with ActiveXCHANGE.

Achieve healthcare interoperability with ActiveXCHANGE.

  • Disparate Technology Systems – there are numerous distinct EMRs in use today by different health providers and organizations, and most were not made for the purpose of integrating with others.
  • No Standardization – there has been no uniform method of identifying patients or shared clinical terminology used among different EMRs, resulting in inaccuracies when matching individuals to their health data, duplicate medical records/patient accounts, and costly repeat testing.
  • Fragmented Data & Information Delays – variations between systems in the way they handle information also leads to incomplete medical records and slows down the transmission of data.
  • Unstructured Data – information may be exchanged in a myriad of different formats, including fax, scanned images/documents, hard copies, and other non-electronic forms of unstructured data; many facilities are only able to integrate this information through manual work.
  • Design and Usability – the ONC found that barriers to interoperability identified by healthcare providers and other stakeholders include “the differences in user-interface design across developers variations in the design that make day-to-day use complicated when a health care provider uses multiple systems and the lack of developer engagement with end users of health IT regarding design needs.”
  • Cost of Replacing Technology – providers have made large investments in their EMRs and other health IT systems and may be unable or hesitant to purchase new solutions.
  • Security Concerns – providers are also cautious of maintaining patient privacy and HIPAA compliance when considering new solutions.
  • Information Blocking* – due to “legal and business incentives,” health “information networks and their participants often treat individuals’ electronic health information as an asset that can be restricted to obtain or maintain competitive advantage,” per the ONC.
  • Third Party Integration – challenges extend beyond the internal solutions used by the healthcare provider. Third party solution providers and service vendors introduce additional challenges for sharing information between systems.

*In accordance with the Cures Act and Interoperability and Patient Access final rule (CMS-9115-F), in late 2020 the Centers for Medicare & Medicaid Services (CMS) will start publicly reporting “eligible clinicians, hospitals, and critical access hospitals (CAHs) that may be information blocking” and “those providers who do not list or update their digital contact information in the National Plan and Provider Enumeration System (NPPES).”

How Does ActiveXCHANGE Solve These Challenges to Help Achieve Healthcare Interoperability?


ActiveXCHANGE helps facilities achieve healthcare interoperability in the following ways:

  • Provides a bi-directional gateway for consolidating information from any source (this includes multiple scheduling systems, custom interfaces, HL7, FHIR, XML, web-based requisition systems, EHRs/EMRs, faxes, direct messaging, e-mail, hard copies, scanned documents/images, and verbal appointments).
  • Interprets all information and makes it actionable, regardless of the structured or unstructured format in which it’s received.
  • Automatically transforms all incoming information into an electronic format.
  • Performs “image cleanup” (e.g. corrects alignment issues, discards blank or irrelevant pages, “de-speckles” to remove unwanted marks) on graphic images and scanned documents and extracts key data from each page.
  • Intelligently manages information objects by using business rules to find and make usable relevant data, determining what to do with that information, and flagging errors and exceptions (for example, detecting missing signatures or required forms/documentation) for resolution.
  • Drives and automates processes and workflows based on business rules and triggered by incoming information objects.
  • Routes information through business rules and account matching to the appropriate destination (e.g. EMR, physician portals, document management systems, other third-party applications) in virtually any format and in a user-friendly form that the destination system can accept.
  • Operates bi-directionally to manage incoming and outgoing communication (e.g. automated voice message (TTS), text, e-mail, pagers, fax, traditional mail) between healthcare facilities, patients, physicians, affiliated organizations, remote workers, payers, and vendors – whether the recipient has an ActiveXCHANGE server or not.
  • Ensures the secure, HIPAA-compliant exchange of information.
  • Supports custom workflows and can be configured to meet the unique needs of each department across a client enterprise.
  • HealthWare Systems specializes in integrating proprietary and third-party patient access technologies and provides the platform for connecting disparate health IT systems and EMRs/EHRs, so there is no need to replace your investment in your current technology.
  • All costs (e.g. software, implementation, training, transaction fees, hardware) for our solutions are included in one monthly subscription payment and there are NO upfront fees, creating a more immediate return on investment for our clients.

As the ONC wrote, “Improved interoperability can strengthen market competition, result in greater quality, safety, and value for the healthcare system, and enable patients, health care providers, and payers to experience the benefits of health IT.”

Contact us today to learn more about how ActiveXCHANGE can help you achieve healthcare interoperability or schedule a live demo of our solution.


By Stephanie Salmich

This woman taking her daughter to see a doctor represents one of the responsibilities of some women as healthcare decision makers.

The Crucial Role of Women as Healthcare Decision Makers

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HealthWare Systems Blog

The Crucial Role of Women as Healthcare Decision Makers

Posted on Wednesday, January 22, 2020

In order to attract and retain the loyalty of an extremely important demographic, health facilities must recognize women as healthcare decision makers.  Many women determine not only where they will receive care, but where their family members will as well.

This woman taking her daughter to see a doctor represents one of the responsibilities of some women as healthcare decision makers.

Hospitals must recognize women as healthcare decision makers.


Consider the following statistics that illustrate the significant role of women as healthcare decision makers for their families:

  • Seventy-nine percent of mothers report that they usually choose their children’s healthcare provider, compared to 22% of fathers who report responsibility for this decision.
  • Seventy-seven percent of mothers report that they usually take their children to doctor’s appointments, compared to 24% of fathers who report responsibility for this.
  • Whether or not they are married or have children, 94% of women make healthcare decisions for themselves and 59% make healthcare decisions for others.
  • According to the CDC, 58% of family caregivers are women (although other estimates range from 53 to 68 percent).
  • In its study on women and healthcare decisions, the Center for Talent Innovation found that 58% of women who make healthcare decisions for others lack confidence in their ability to do so.

Based on the results of its study, the CTI report suggests ways in which healthcare professionals and organizations like doctors, pharmacists, and insurance and pharmaceutical companies could build more trusting relationships with their female patients and consequently improve their confidence.

Additionally, the authors recommend viewing women as the “Chief Medical Officers” of their families to ensure their roles as healthcare decision makers get the “notice or respect” they deserve.

When a hospital recognizes women as healthcare decision makers, focusing on appealing to female healthcare consumers makes sense.  Ideally, once you’ve earned the loyalty of your female patients, they will book their family members’ appointments with your organization as well.


Here are a few ways some facilities are appealing to female healthcare consumers:

Hospitals can’t afford to ignore the large influence women have over the health and healthcare decisions of their partners/spouses, children, elderly parents, and other relatives.  Recognizing and appealing to women as healthcare decision makers can help you gain more female patients and, importantly, numerous other patients related to them.


By Stephanie Salmich

You can improve patient engagement in older patients, like this doctor talking with his patient about her health.

Improve Patient Engagement in Older Patients

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HealthWare Systems Blog

Improve Patient Engagement in Older Patients

Posted on Wednesday, August 28, 2019

You can improve patient engagement in older patients, like this doctor talking with his patient about her health.

Improve patient engagement in older patients by helping them view aging in a positive way.

You can improve patient engagement in older patients by helping them view aging in a positive way.  This coming month, “September is Healthy Aging® Month,” offers a special opportunity to do just that!

Here are a few ways you can improve patient engagement in older patients:

Celebrate aging –September is Healthy Aging® Month” is meant to draw attention to the positive aspects of aging and to assure people that it’s never too late to make healthy lifestyle changes.  Older patients should be encouraged to take control of their health at any age.

You may also wish to celebrate grandparents this next month, as Grandparents Day falls in September as well.  Remind older patients of the need to maintain their health so that they can continue to benefit their grandchildren’s lives for many years to come!  And make sure they know that this special relationship can benefit their own health, too. (Check out our previous blog on additional monthly health observances.)

Emphasize prevention, rather than reaction – Some of the most prevalent health issues affecting older patients, such as diabetes, hypertension, obesity, heart disease, malnutrition, and injuries from falls, are potentially preventable.  Yet, per the CDC, only 7% of older adults obtain all their recommended preventive health services.

Our blogs on increasing preventive screenings for men, improving male patient engagement, and increasing mammogram appointments can provide you with some excellent ideas for promoting preventive health services at your facility.

Improve family engagement – Family engagement can be especially important for older patients who may have family caregivers.  Family caregivers play a significant role in older patients’ safety and comfort.  Plus, patient and family satisfaction are related.

Address the social determinants of health – Some of the social determinants of health may affect older patients in different ways than younger patients.  For example, patient transportation needspatient housing needs, and dietary needs often change as patients age.

Provide technology information – A 2018 AARP survey found that 76% of U.S. adults age 50-plus want to stay in their own homes as they age.  Many older patients also want and believe they need access to health technology in order to manage their own healthcare.  Educate patients and their families about technology that can help them achieve these goals and keep them safe.

Implement the 4M Framework – The Age-Friendly Health Systems initiative encourages healthcare facilities to embrace the 4M’s when caring for older patients:

  • What Matters – Aligning care with the patient and family’s health goals.
  • Medication – Choosing age-friendly medications that don’t hinder the other three “M’s” of the framework.
  • Mentation – Addressing dementia, depression, and delirium.
  • Mobility – Ensuring patients move safely every day.

According to the Population Reference Bureau, there were 46 million Americans (15% of the population) aged 65 and older in 2016 and that number is expected to more than double by 2060, to over 98 million (24% of the population).

As the American Hospital Association pointed out in its publication “Creating Age-Friendly Health Systems,” improving care for older patients now can put your hospital “ahead of the curve” as the healthcare market shifts to accommodate our aging population.

September is the perfect time for exploring new policies that will improve patient engagement in older patients and ensure they have the best possible care at your facility all year round.


By Stephanie Salmich

Physicians hold a thumbs up sign for solutions that can streamline prior authorizations.

Streamline Prior Authorizations with a Pre-Arrival Workflow Solution

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HealthWare Systems Blog

Streamline Prior Authorizations with a Pre-Arrival Workflow Solution

Posted on Monday, July 1, 2019

The results of a recent survey conducted by the American Medical Association illustrate the importance of solutions that can streamline prior authorizations.


The 2018 AMA Prior Authorization Physician Survey found the following:

  • 91% The percentage of physicians who say the prior authorization process postpones patients’ access to necessary care.
  • 28% The percentage of physicians who say the prior authorization process has resulted in a serious adverse event for their patients (e.g., “death, hospitalization, disability/permanent bodily damage, or other life-threatening event”).
  • 86% The percentage of physicians who describe prior authorization burdens as high or extremely high.
  • Almost 2 Business Days (14.9 hours) The average length of physician/staff time that is devoted to prior authorization requirements per physician per week.
  • 36% The percentage of physicians who have employees who work solely on prior authorization tasks.

Clearly, health systems face many challenges related to preauthorization.  Patient safety is compromised when care is delayed.  Patient and physician satisfaction are at risk as patients endure frustrating waits for treatment and physicians deal with administrative duties that disengage them from their medical work.

And not only can each prior authorization be costly, but excess costs are also incurred in the forms of extra clerical staff and rework when prior authorizations are denied and must be resubmitted.


According to CAQH CORE, 88 percent of prior authorizations are completed either partially or completely manually; and, the majority of preauthorization issues are related to manual processes.

A pre-arrival workflow solution can automate manual processes and streamline prior authorizations.


With a pre-arrival workflow solution that can streamline prior authorizations, you can address the issues mentioned above:
Physicians hold a thumbs up sign for solutions that can streamline prior authorizations.

A pre-arrival workflow solution can streamline prior authorizations and improve staff and physician satisfaction.


Support your physicians by utilizing solutions that make their jobs easier.  Implementing time-savers for physicians can go a long way toward reducing physician burnout, which is often related to stressful and time-consuming administrative workloads.

In addition to increasing physician and employee satisfaction, a pre-arrival workflow solution will improve your revenue cycle and patients’ access to care they need.

Hospitals can no longer afford to delay employing solutions that will streamline prior authorizations and benefit all stakeholders in their organizations.


By Stephanie Salmich

A daughter and mother celebrate the health benefits of a clean home.

Spring Cleaning! The Health Benefits of a Clean Home

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HealthWare Systems Blog

Spring Cleaning! The Health Benefits of a Clean Home

Posted on Monday, April 1, 2019

Spring cleaning season is here!  This is a great time to educate your patients on the health benefits of a clean home and encourage them in their spring cleaning goals.

A daughter and mother celebrate the health benefits of a clean home.

The health benefits of a clean home are both mental and physical.


Promote the Health Benefits of a Clean Home

A clean home is beneficial to both your patients’ physical and mental health!


Here are a few of the health benefits of a clean home:

Improves respiration – Common asthma triggers include dust, pet dander, mold, and mildew.  Decluttering, dusting, and vacuuming can all help asthma and allergy symptoms.

Prevents sickness – In order to stop the spread of an illness after someone in their home has been sick, it’s important that patients thoroughly clean and disinfect (especially areas of the house that are frequently touched, like doorknobs, counters, and cellphones).

Better sleep – A National Sleep Foundation Bedroom Poll found that “respondents who say they make their bed every day are 19% more likely to say they get a good night’s sleep every night than those who don’t.”  Furthermore, at least two thirds of respondents believed clean, allergen-free air and a clean bedroom are important for a good night’s sleep and 71% of respondents said “they get a more comfortable night’s sleep on sheets with a fresh scent.”

Enhances concentration – Both children and adults can have trouble focusing on tasks when surrounded by clutter and mess.

Boosts mood – A study published in the Personality and Social Psychology Bulletin analyzed couples’ descriptions of their homes.  Women who described their homes as “stressful” (cluttered, with unfinished projects) “had increased depressed mood over the course of the day.”  Women who described their homes as “restorative” “had decreased depressed mood over the day.”

Lowers stress – Not only can having a clean home lower stress, but so can the cleaning process itself.  Some people practice meditation or gratitude exercises while cleaning.  Cleaning can also give us a sense of control over our environment.  Plus, cleaning is a physical activity, which is a de-stressor.

Provides exercise – While not recommended as a patient’s only form of physical activity, household chores can burn some extra calories and even stretch and tone muscles.

Prevents injuries – According to the CDC, more than one out of four people aged 65 and older falls each year and one out of five falls results in serious injury.  Patients can reduce some risk factors by keeping floors and stairs clear of clutter.

Provide Patient Education for Safe Spring Cleaning

Along with the health benefits of a clean home, advise your patients about cleaning safety.  Unsafe cleaning practices can lead to health risks and injury.

For example, direct them to guidelines for poison prevention (particularly related to ventilation and handling and storage of cleaning products that contain chemicals).  Or, perhaps your doctors have recommendations for chemical-free products.

Other cleaning safety considerations include proper indoor and outdoor ladder usage and appropriate disposal of expired items (such as paint, medicine, and batteries).

Equipped with this knowledge, your patients can pursue the health benefits of a clean home without putting patient safety at risk.


The social determinants of health include patient housing and living conditions.  One way to address these is to arm your patients with the knowledge they need to keep their homes safe and clean.

Many of us are extra motivated to get our homes in order when spring cleaning season rolls around.  Foster this enthusiasm in your patients now, but encourage them to also maintain adequate cleaning (and cleaning safety!) habits throughout the year.  Your patients will be grateful to enjoy the health benefits of a clean home all year round, and you can enjoy the benefits of better health outcomes for patients at your facility.


By Stephanie Salmich

This doctor talking to his patient is taking proactive steps toward increasing preventive screenings for men!

Increasing Preventive Screenings for Men at Your Facility

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Increasing Preventive Screenings for Men at Your Facility

Posted on Thursday, November 1, 2018

Increasing preventive screenings for men at your facility can save patients’ lives.  “Movember” is the perfect time to start working toward this goal.


Consider these ideas for increasing preventive screenings for men at your facility:


Educate your patients.  Patients may be unclear on the correct or most-up-to-date recommendations for preventive screenings and may not realize when it is time for them to start discussing these topics with their doctor.  Make sure your clinicians initiate the conversation when patients reach the proper age to begin making decisions about testing in case patients forget.

Improve patient engagement with preventive health by utilizing social media in healthcare.  Share preventive health tips, educational materials, and powerful statistics demonstrating the importance of early detection of male health issues.

(Check out our previous blog for more information on male patient engagement.)

Ensure patients are aware that most health plans are required to cover the cost of many preventive screenings (when performed by an in-network provider).  Highlight the fact that most plans cannot charge a copayment or coinsurance for these services even if the patient has not met his yearly deductible yet.  Instruct patients to check with their insurance company.  Additionally, help patients find out if they qualify for financial assistance and facilitate the application process for them.

Use their time in the waiting room as an opportunity to reach your patients.  For example, print educational materials on the back of wayfinding maps.  If you use a lobby display screen or patient notification board, feature male preventive health facts periodically throughout your rotation of announcements.  Or, incorporate moustaches into the backdrop of your screen to draw more attention to Movember and male health issues.

(Read here how one acute care facility used ActiveTRACK to promote customizable messages to patients in their waiting area.)

Accommodate your patients.  Allow for evening and weekend appointments.  Besides providing interpreters and educational materials in various languages, train staff to understand how culture affects health and healthcare decisions.  Don’t let inconvenience or cultural barriers stand in the way of accessing preventive health care.

Talk to female patients about preventive screenings for men.  Women make approximately 80% of household healthcare decisions.  Since women can have such a large impact on male health, clinicians may want to bring up the topic when meeting with female patients.  This could trigger a reminder for female patients to schedule appointments for their loved ones, or simply provide them with pertinent preventive health information to pass on to the men in their lives.

Start the Movember Healthcare Challenge at your facility.  Compete against others in your industry to raise money to improve male health through the Movember Foundation.  Raise awareness by growing a (or wearing a fake) moustache!  Use the hashtag #Movember when you share the pictures on social media.

(You can also find ideas for promoting other health observances throughout the year here, and a detailed calendar of this year’s health observances and recognition days here.)

Most of the above ideas can be implemented all year long!  Increasing preventive screenings for men is an important goal to strive toward and November is a great time to start.

This doctor talking to his patient is taking proactive steps toward increasing preventive screenings for men!

Take proactive steps toward increasing preventive screenings for men!


By Stephanie Salmich

Increasing mammogram appointments… a woman holds a sign reading “Have YOU scheduled your annual MAMMOGRAM?”

Ideas for Increasing Mammogram Appointments

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HealthWare Systems Blog

Ideas for Increasing Mammogram Appointments

Posted on Monday, October 1, 2018

Increasing mammogram appointments… a woman holds a sign reading “Have YOU scheduled your annual MAMMOGRAM?”

Take proactive steps toward increasing mammogram appointments!

October is the perfect time to focus on increasing mammogram appointments.  During Breast Cancer Awareness Month, prioritize preventive care using the suggestions below.


Consider these ideas for increasing mammogram appointments at your facility:


Educate your patients on breast cancer prevention.  Patients may be unclear on the correct or most-up-to-date recommendations for mammography screening or may have heard conflicting instructions from different organizations.  Make sure your clinicians clarify.

“Current guidelines from the American College of Radiology and the Society for Breast Imaging recommend that women receive annual mammograms starting at age 40 — even if they have no symptoms or family history of breast cancer.”

Ensure patients are aware that most health plans are required to cover the cost of a breast cancer mammography screening for women over 40 every 1 to 2 years (when performed by an in-network provider).  Highlight the fact that most plans also cannot charge a copayment or coinsurance for this service even if the patient has not met her yearly deductible yet.  Some states even require insurers to cover 3D mammograms.  Instruct patients to check with their insurance company.  Additionally, help patients find out if they qualify for financial assistance and facilitate the application process for them.

Send mammogram reminders through texts, emails, letters, postcards, and/or phone calls. A study conducted by Kaiser Permanente found mammogram reminders to be very effective in increasing mammogram appointments, especially when sent to patients whose mammogram appointments were coming due.

When patients check in, instruct registrars to ask them if they’ve scheduled their annual mammogram exam yet; and if not, have registrars try to schedule one with them.  Additionally, registrars should confirm they have the correct mailing address and phone number for the patient in the system used to send mammogram reminders.

Use their time in the waiting room as an opportunity to reach your patients.  For example, print mammogram reminders on the back of wayfinding maps.  If you use a lobby display screen or patient notification board, include mammogram reminders and breast cancer prevention facts that appear periodically throughout your rotation of announcements.  Or, use a mammogram reminder as the full-time backdrop of your screen.

(Read here how one acute care facility used ActiveTRACK to promote customizable messages, including encouragement of mammogram appointments during Breast Cancer Awareness Month, to patients in their waiting area.)

Improve patient engagement with preventive health by utilizing social media in healthcare.  Share mammogram reminders, educational materials, and powerful statistics demonstrating the importance of early detection.  For instance, according to the American College of Radiology, “mammography has helped reduce breast cancer mortality in the U.S. by nearly 40% since 1990” and “skipping a mammogram every other year would miss up to 30% of cancers.”

Accommodate your patients. Allow for evening and weekend mammogram appointments.  Besides providing interpreters and educational materials in various languages, train staff to understand how culture affects health and healthcare decisions in order to reach patients of all backgrounds.  Don’t let inconvenience or cultural barriers stand in the way of accessing preventive care.

Emphasize your goal of increasing mammogram appointments to your staff. Stratis Health suggests providing your clinicians and registrars with “missed opportunity” reports, which would demonstrate the number of patients who visited throughout the month who were due/overdue for their mammogram appointments but did not get scheduled.


October is the opportune time to launch a breast cancer awareness campaign!  Of course, the suggestions above are best used throughout the entire year to help you in your goal of increasing mammogram appointments and improving your rates of early detection to save lives.


By Stephanie Salmich

The effects of nurse burnout: A nurse crossing her arms experiences nurse burnout.

The Effects of Nurse Burnout

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HealthWare Systems Blog

The Effects of Nurse Burnout

Posted on Wednesday, September 12, 2018

The effects of nurse burnout: A nurse crossing her arms experiences nurse burnout.

The effects of nurse burnout reach your nurses, patients, and bottom line.

The effects of nurse burnout are far-reaching.  Everyone, from your patients and their families to your nurses and the entire facility, can be affected by nurse burnout.


The Effects of Nurse Burnout Reach Your Nurses, Patients, and Bottom Line…


Here are some of the effects of nurse burnout:

Nurse Well-Being Nurse burnout can lead to feelings of dread about work, mental and physical exhaustion, sleep issues, and depression for your nurses.  The effects of nurse burnout also include compassion fatigue, causing your nurses to disengage from your patients.

Patient & Family Satisfaction Interactions between your nurses and patients and their family members are crucial to the patient experience and patient satisfaction scores.

A study published in the journal Medical Care found the following relationship between nurse work environment, nurse burnout, and patient satisfaction with nursing care:

“Patients cared for on units that nurses characterized as having adequate staff, good administrative support for nursing care, and good relations between doctors and nurses were more than twice likely as other patients to report high satisfaction with their care, and their nurses reported significantly lower burnout. The overall level of nurse burnout on hospital units also affected patient satisfaction.”

Patient Safety Clinicians suffering from burnout may be less motivated and/or may experience lower cognitive functioning due to emotional exhaustion, putting patient safety at risk.

An article published in the American Journal of Infection Control found a significant association between nurse burnout and UTIs and surgical site infection.  According to the researchers, “hospitals in which burnout was reduced by 30% had a total of 6,239 fewer infections, for an annual cost saving of up to $68 million.”

Reducing nurse burnout can decrease the likelihood of medical errors and improve patient safety at your facility.

Turnover & Nursing Shortage According to the American Association of Colleges of Nursing, factors contributing to the national nursing shortage include insufficient nursing school enrollment and faculty, high retirement numbers, the aging population’s need for more healthcare workers, and high turnover/number of nurses leaving the profession altogether.

Almost 1 in 5 new nurses leaves his/her first job within the first year, and about 1 in 3 leaves within the second year.  In a national study conducted by RNnetwork, “half of the nurses surveyed have considered leaving nursing.”  According to the survey, “the number one reason for wanting to leave is feeling overworked (27 percent), followed by not enjoying their job anymore (16 percent) and spending too much time on paperwork (15 percent).”

Unfortunately, there is a cyclical relationship at work here: the national nursing shortage increases nurse burnout for those who are working in the profession as their workloads consequently grow.


As you can see, the effects of nurse burnout have a critical impact on nurse well-being, patient satisfaction, patient safety, and the national nursing shortage.  Please read our next post on how to prevent and address nurse burnout to ensure your health system can avoid the dire effects of nurse burnout mentioned above.


By Stephanie Salmich

The social determinants of health are listed.

The Social Determinants of Health & Their Effect on Health Outcomes

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HealthWare Systems Blog

The Social Determinants of Health & Their Effect on Health Outcomes

Posted on Friday, August 17, 2018

The social determinants of health are increasingly on the radar of health professionals and health systems.  The National Academy of Medicine (formerly the Institute of Medicine) even recommends this information be included in patients’ medical records.

Hospitals can utilize screening tools to collect patient data concerning the social determinants of health.  While a provider may not be able to resolve all social issues faced by a patient, identifying them can help inform healthcare decisions.  (Providers should also have a list of resources that attend to social needs available to provide the patient when asked.)

When health systems consider the social determinants of health when caring for their patients, all parties benefit.  Patients have better health outcomes, communities improve, and health systems become advocates for their patients (improving patient satisfaction) while saving money.  The social determinants of health not only impact the health of patients, but also the health of a hospital’s revenue cycle.


Social factors that influence patients’ health & healthcare decisions include:


Employment – A good job can provide a patient and his/her whole family with health benefits and insurance.  Unemployment negatively affects physical and mental health.

Income – A steady paycheck allows a patient to pay for many of the other factors in this list, such as adequate housing, nutrition, and transportation, as well as healthcare costs.  (Financial assistance screening tools can help patients find out if they qualify for charitable programs to help offset the cost of care, and enable hospitals to facilitate the application process for their patients.)

Housing – Poor living conditions increase the risk of infectious disease, injury, chronic illness, pest and mold problems, and indoor air pollution.  And each year, 1.48 million Americans have no home at all.  (Here are some examples of how hospitals can help meet patient housing needs.)

Violence – The area in which patients live also can affect their exposure to violence or abuse.  Victims or witnesses to acts of violence may experience mental, physical, and/or economic consequences that affect their overall health.

Nutrition – A lack of consistent access to healthy food can negatively impact health outcomes and increase the risk of many adverse health conditions.  Over 12.7 percent of U.S. households were affected by food insecurity in 2015.  (Read our previous blog for more information on how to reduce patient malnutrition.)

Transportation – Access to reliable transportation can govern a patient’s access to medical care.  Approximately 3.6 million Americans miss or postpone medical care due to transportation issues.  (Check out these ideas for addressing patient transportation needs.)

Social Support – As reported by NPR, in a recent nationwide survey conducted by Cigna “nearly 50 percent of respondents” said “that they feel alone or left out always or sometimes.”  Two in five respondents “felt like ‘they lack companionship,’ that their ‘relationships aren’t meaningful’ and that they ‘are isolated from others.’”  Patients who feel unsupported are more vulnerable to poor health outcomes.  (Read how physician empathy can generate better health outcomes.)

Language/Culture – Culture influences our beliefs about health and healthcare.  A patient’s ability to communicate with health professionals may be impeded by language barriers.

Education – According to the CDC, people with higher levels of education are more likely to choose healthy behaviors and refrain from unhealthy ones.  People with lower levels of education are more likely to be obese and more likely to smoke.

Health Literacy – People with lower education levels are also more likely to have inadequate health literacy skills.  People who are limited in health literacy have higher rates of hospitalization and emergency room use and they use preventive care less.  (Read our blogs on reducing patient uncertainty and addressing health insurance confusion for ways to help improve your patients’ health literacy.)

Patient Engagement – A patient must have health literacy skills in order to be actively engaged in his/her healthcare.  Better engaged patients tend to see better health outcomes.  (Promoting health observances, using social media in healthcare, and educating patients about preparing for a doctor’s appointment are a few methods for improving patient engagement.)

Sex/Gender – Many health conditions affect men and women differently and certain treatments may be more or less effective depending on the sex of the patient.  Plus, men are less likely than women to see a doctor for a specific health concern, preventive healthcare, or a standard annual exam.  (Consider these tips for improving male patient engagement.)


The social determinants of health are listed.

The social determinants of health are key to improving health outcomes and the revenue cycle.


It’s not difficult to imagine how the above factors might influence one another.  The social determinants of health are interconnected and work together to impact a person’s health and healthcare decisions.

Patients whose social needs are unfulfilled are more likely to utilize healthcare resources at a higher cost (including the Emergency Department), be readmitted, miss appointments, and have poor health outcomes.

Hospitals that address the social determinants of health can create better health outcomes, reduce hospital readmission rates, and improve patient engagement while lowering no-show rates and enhancing revenue cycle management.


By Stephanie Salmich

A healthcare worker and the blog title appear: How Can Hospitals Address Patient Housing Needs?

How Can Hospitals Address Patient Housing Needs?

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HealthWare Systems Blog

How Can Hospitals Address Patient Housing Needs?

Posted on Wednesday, August 8, 2018

Hospitals can significantly improve the health of patients suffering from housing instability by actively addressing patient housing needs.  A patient’s living situation, conditions, and location affect many aspects of health.  Poor housing quality increases the risk of infectious disease, injury, chronic illness, pest and mold problems, and indoor air pollution.  Neighborhood conditions are related to rates of violence, crime, noise, and opportunities for physical activity.

Improving patient housing situations can result in better health outcomes and quality of life for patients and their families.  Plus, there are financial incentives for addressing patient housing needs.  According to the American Hospital Association’s Social Determinants of Health Series:

“The economic benefits for hospitals can be significant, since homeless or unstably housed individuals are more likely to be uninsured, be hospitalized more frequently, have longer lengths of stay in the hospital, be readmitted within 30 days and use more high-cost services. Reducing homelessness and other forms of housing instability—through case management, supportive housing (supportive services combined with housing), housing subsidies or neighborhood revitalization—improves health outcomes, connects individuals with primary care and reduces these high levels of utilization. When hospitals and health systems focus their resources on housing supports and case management, the cost savings can offset the expenditures by between $9,000 and $30,000 per person per year.” (p. 8)

A healthcare worker and the blog title appear: How Can Hospitals Address Patient Housing Needs?

Hospitals can significantly improve the health of patients suffering from housing instability by addressing patient housing needs.


Here are a few ways hospitals can address patient housing needs:


Contribute to neighborhood improvement projects.  Collaborate with your local government and other organizations that hold a shared interest in the state of your community.  Get involved or make monetary donations to make a difference.

Provide home assessments and patient education for vulnerable populations.  For example, the Seattle-King County Healthy Homes Project targeted low-income households with asthmatic children.  The initiative sent a nurse and community health workers to patients’ homes to educate the families about asthma and self-management and to identify and address environmental triggers (with resources like bedding covers, vacuums, and cleaning supplies).  The goal was to improve health outcomes for patients with asthma and to reduce the use of healthcare services such as urgent care.

Set up a home repair referral program.  Don’t stop at simply assessing patients’ homes for health and safety risks; refer them to a local business that can take care of necessary home renovations for them.  Establish partnerships with businesses who will offer their services at a reduced rate to your referrals or find charitable organizations like veterans’ clubs and churches that may have volunteers who could do the work for free.  The One Touch e-referral program has seen success in linking government and nonprofit groups like Habitat for Humanity to create healthier homes.

Bring care to homeless patients via a mobile health center.  Visit shelters, churches, and community centers and offer primary and preventive health services to at-risk patients.  (Take a virtual tour of the Calvert Health System Mobile Health Center.)

Create a transitional arrangement for homeless patients whose conditions require they be discharged from the hospital, but who are not yet well enough to go back to a shelter or live on the street.  St. Joseph Health created a Medical Respite Program consisting of 15 beds set at three different locations to meet this need.  As its website explains, these beds are for homeless patients “who are being discharged from the hospital, and who need the opportunity to rest in a safe, healing environment while accessing medical care and other supportive services post-hospitalization.”

Invest in your own affordable patient housing.  According to its website, Bon Secours Baltimore “has developed and now owns and operates more than 720 apartment units for low- and moderate-income seniors, families and people with disabilities.”  The heath system has committed to “revitalize West Baltimore.”

Compile a list of affordable patient housing options near your facility.  UW Medicine created a list of both short-term and long-term housing options to help patients, as well as their family members and caregivers, find lodging.  Some of their local hotels even offer a discount to patients’ families and a shuttle service to and from the hospital.


Many of the above ideas for addressing patient housing needs are suggested by and discussed in further detail in the AHA’s guide, “Housing and the Role of Hospitals.”  This guide also outlines steps hospitals should take when determining which method(s) would best address the patient housing needs in their own communities (p. 10-11).

Ensuring patients go home to safe, clean environments is critical in helping to reduce hospital readmission rates, which is crucial to reimbursement.

Patient housing instability is one of multiple interconnected social factors that affect health outcomes and healthcare costs.  Along with patient housing needs, health systems should attend to other social determinants of health by, for example, addressing patient transportation needs and working to reduce patient malnutrition.


By Stephanie Salmich