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

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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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 doctor holds a smartphone showing online patient reviews.

Managing Online Patient Reviews: 5 Things to Avoid

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HealthWare Systems Blog

Managing Online Patient Reviews: 5 Things to Avoid

Posted on Monday, June 3, 2019

It’s important to monitor online patient reviews of your facility because first impressions in healthcare often begin online.  The majority of patients search online before making health appointments.  Are your providers and organization making a positive first impression when patients read reviews on third party sites like Google, Yelp, and Healthgrades?


A doctor holds a smartphone showing online patient reviews.

Managing online patient reviews can help you improve your online reputation.

When managing online patient reviews, here are 5 things you should avoid:


1.)  Don’t ignore online patient reviews.

Online patient reviews can feel stressful and unfair to providers and their validity is debated.  However, patients pay attention to these reviews, so you should too.

Some organizations reply to online reviews, but there are other actions you can take to manage them as well.  For example, you may appeal a negative review if it is in violation of the review site’s policies, and the site may remove it.  You should also encourage satisfied patients to leave positive reviews.  If you don’t have many online patient reviews, even one or two negative ones stand out.  But numerous positive reviews can outweigh a few negatives.

2.)  Don’t acknowledge that the reviewer is a patient at your facility.

If you choose to reply to a review, do not write anything that could signify the reviewer is (or was) your patient.  Even if a patient explicitly states that he/she received care from your organization in the review, you cannot confirm that fact in your reply or you will be in violation of HIPAA.

3.)  Don’t make any statements specific to the patient.

In an attempt to defend themselves against negative online patient reviews, many providers have inadvertently revealed private patient information in their replies.  Not only does this result in HIPAA violations, but also the loss of patients’ trust.

4.)  Don’t leave a lengthy reply.

Rather than diving into a long defense, keep your reply simple and professional.  Establish clear, HIPAA-compliant guidelines for staff who respond to reviews.  Digital Marketer Daryl Johnson provides this example for negative reviews:

“Dear John, thank you for your feedback. At Good Smiles Dentistry, we take patient satisfaction seriously. In order to protect our patients’ privacy, we prefer to handle situations like these offline.

Would you be willing to call my office at 555-555-1212 and ask to speak with me so I can better understand the situation?

Thanks in advance for your help – Dr. Smith”

Likewise, HIPAA expert Dr. Danika Brinda says you should “keep it brief, keep it general, and move the conversation offline.”

You can then work to resolve the complaint directly and privately.  If the patient is satisfied with your response after speaking with you, he/she may agree to remove the negative review or update it to reflect the positive outcome.  At the very least, other patients who view your reply online will see your attempt at remedying the situation and your commitment to patient satisfaction.

5.)  Don’t assume you can publish a patient’s positive review as a testimonial.

Although online patient reviews are public, your organization cannot share them on your own website or marketing materials without receiving written consent/authorization from the patient.  Again, doing so can result in HIPAA violations.


Your online presence plays a crucial role in reducing patient uncertainty about your facility and providers.  If you’re not monitoring your online reviews, patients may be getting the wrong idea about your organization.  Plus, these reviews can provide you with valuable insight into what matters most to patients and how you might improve your services.

Managing online patient reviews using the suggestions above (while avoiding HIPAA violations) can help you improve your online reputation and even mend relationships with patients who were previously unsatisfied.


By Stephanie Salmich

Appealing to Millennial patients: Millennials gathered at a table with smart phones and coffee.

Appealing to Millennial Patients

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HealthWare Systems Blog

Appealing to Millennial Patients

Posted on Wednesday, March 6, 2019

Appealing to Millennial patients: Millennials gathered at a table with smart phones and coffee.

Appealing to Millennial patients can help your facility keep up on the latest healthcare trends.

Appealing to Millennial patients is becoming increasingly important to a healthcare facility’s revenue cycle.  Not only do they number 83.1 million and make up over 25 percent of the U.S. population, but Millennials are also driving new healthcare trends.

One alarming trend is that many Millennials do not have a primary care physician or keep up on regular health appointments and exams.  Instead, a growing trend is their use of urgent care facilities.  As Dr. Niket Sonpal (speaking with CBS) explained:

“We found that Millennials tend to want to have access to care right away, they want it immediately and they want to be able to see a doctor quickly . . . When they feel well, they don’t want to go to the doctors, and they don’t.  So then when they feel unwell, they’re like I want to see a doctor right away and not wait for weeks for an appointment.”

Unfortunately, this trend has serious consequences.  While many Millennials are health-conscious, they may be missing out on recommended eye exams, blood pressure screenings, PAP smears, STD/STI screenings, mental health screenings, and IBS/digestive exams, as well as failing to get vaccinations on time.


You may also be interested in: “Attracting and Retaining Millennial Healthcare Employees (Part 1)

In order to help ensure Millennials receive the care they need, heed the healthcare trends that are appealing to Millennial patients. The following are a few ideas to help get you started:

Don’t Waste Their Time

Wait times – As noted, Millennials don’t want to wait for care.  The following common scenario is definitely not appealing to Millennial patients:  first waiting days or weeks for an appointment, then waiting 20-30 minutes in the waiting room, THEN waiting in the exam room even longer before the doctor actually shows up.  To prevent this situation from occurring, implement a solution like ActiveTRACK, which can lower wait times by 75%.

Telehealth – Offering telemedicine appointments is another way to help Millennial patients save time, something they highly value.  Millennials are technologically savvy and accustomed to immediacy and convenience, so telehealth options may be attractive to them.

Simplify the Financial Aspects of Healthcare

Payment plans – One factor that may be keeping Millennials from accessing healthcare is the high cost.  Offering payment plan options so that they don’t have to cover the cost of a large bill all at once can help Millennial patients afford the care they need.

Price transparency – Millennial patients want to compare costs between providers and obtain out-of-pocket estimates before receiving care.  They also want to understand their bills before they pay them.

Health insurance confusion – Many Millennials are confused about their health benefit options and medical bills.  Clearing up their health insurance confusion can really help you stand out from your competition.  An easy place to start is by educating patients that many plans cover annual physicals at no cost.

Stay Technologically Relevant

Online payment options – Millennials are more likely than older generations to pay their bills using technology or mobile devices and may see paper bills as inconvenient and outdated.

Maintain a mobile and online presence – Use social media in healthcare to improve patient engagement.  To help attract new patients, monitor online reviews of your facility and respond to any negative feedback.  (Over 75 percent of Millennials check online reviews before choosing a doctor.)

Interoperability – It is hard for a generation that grew up with constant technological progress to understand how healthcare has been unable to keep up.  In other aspects of Millennials’ lives, data can be instantaneously transferred with a click of a button.  Interoperability in healthcare will be expected too, and there is technology that can help you achieve it.


You may also be interested in:  “Attracting and Retaining Millennial Healthcare Employees (Part 2)”

In other industries, Millennials are used to having many choices.  They expect companies to offer convenience and respect their time, provide competitive and transparent pricing, and keep pace with changes in technology.  Health systems can learn from these consumer-centered practices that are standard in other markets.  Plus, these practices are becoming more attractive to other generations as well.

Appealing to Millennial patients will help your facility keep up on the latest healthcare trends, attract a large group of potential patients, and boost your revenue cycle.


By Stephanie Salmich

Prescription for celebrating the holidays in the hospital.

Celebrating the Holidays in the Hospital

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HealthWare Systems Blog

Celebrating the Holidays in the Hospital

Posted on Monday, December 3, 2018

Celebrating the holidays in the hospital can be tough for patients, their families, and your staff who take care of them this time of year.


Follow this prescription to help make celebrating the holidays in the hospital happier for patients, their families, and healthcare employees!

Help make the holidays happier for patients, their families, and healthcare employees!

 

The following ideas can make celebrating the holidays in the hospital happier for both your patients and employees:

Deck the halls! 

Put together a team of volunteers to decorate your facility.  Ask people to donate old Christmas and Hanukkah decorations – everyone usually gets a few new decorations each year and probably has some old ones to spare.  Better yet, display homemade decorations created by your pediatric patients!

Provide patients and their families with a list of hospital-approved ways they can bring the holiday spirit to their stay.

For example, candles may be prohibited so perhaps an electric menorah is the best option.  Can they bring in their own small Christmas tree or hang a few strands of lights?  What about playing seasonal music (at a reasonable noise level) and watching holiday movies?

Passing out a list of ideas is a proactive way to clarify any questions about what is/is not permitted up front.  In fact, patients may be pleasantly surprised that your facility allows quite a bit more than they expected.  And you are less likely to have to act as The Grinch later if they are reminded about a few rules before they have a chance to break them!

Set up a time for pediatric patients (who are able) to go caroling around the hospital.

This will brighten their day as well as bring joy to the other patients who get a visit!  Or, schedule a time for volunteer carolers to come in.

Plan a visit from Santa Claus!

Who better to lift everyone’s spirits than Old Saint Nick?  Invite children to write letters to Santa as well.

Conduct a Toys for Tots drive and fill your facility with the spirit of giving.

Did you know the December health observances include Safe Toys and Gifts Month?  Provide participants with guidelines for which toys are considered acceptable donations according to safety standards.  A Toys for Tots drive presents a timely opportunity to be charitable AND improve patient safety.

Add a personal touch.

You can really brighten a patient’s holiday with personalized decorations or gifts.  A former Regional Director of PreAccess, Joyce Bryant, shared her experience while working in hospice:

“Our hospice foundation gave us money to make small Christmas trees for each patient.  My Patient Access department made 150 eight-inch trees.  We hot-glued small ornaments we bought at Michaels.  We also had employees donate ribbon and broken jewelry that we took apart.  We decorated some in line with some of the patients’ hobbies – fishing, sewing, cats, etc.  We did blue and white for our Jewish patients.  We glued a small gold bell on each tree for those patients who didn’t have sight but could hear the tree.”

Joyce recommended hospitals “look at what their non-clinical, support staff can do.  Some are just waiting to jump in and help!”  What a special way to bring joy to both patients and staff.


As noted by Becker’s Hospital Review, it may be increasingly important for healthcare facilities to improve the experience of holidays in the hospital due to crucial patient satisfaction scores.

Plus, the holidays bring feelings of gratitude, happiness, love, contentment, and joy.  Spurring those emotions in your patients will not only benefit their mental health, but perhaps their physical health as well.  Each of these feelings has been studied for positive physical effects.

We hope these tips will help your patients and employees in many ways this holiday season.  Happy holidays to all patients, families, clinicians, and staff celebrating the holidays in the hospital!


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

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

Reducing patient uncertainty: Healthcare providers connect puzzle pieces.

Reducing Patient Uncertainty: 6 Areas to Address

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HealthWare Systems Blog

Reducing Patient Uncertainty: 6 Areas to Address

Posted on Wednesday, May 9, 2018

Reducing patient uncertainty should be a high priority item for healthcare providers.  Feelings of uncertainty can affect the patient experience and lower patient satisfaction.

Most of us are uncomfortable with uncertainty and many visits to healthcare facilities are made with the purpose of diminishing it.  Patients seek out your facility hoping to find answers to health questions; the last thing they are looking for is even more confusion.

Reducing patient uncertainty: Healthcare providers connect puzzle pieces.

Reducing patient uncertainty can vastly improve the patient experience.

Below are 6 areas that can either increase or decrease patient uncertainty.
By reducing patient uncertainty through addressing these areas, providers can greatly improve the patient experience:

1. – Online Presence:

A strong online presence and positive online reviews can aid in reducing patient uncertainty by helping patients become more familiar with your facility and organization before they even visit.  Utilize your website and social media accounts to their full advantage.

For example, a study published in the journal Health Communication found that video biographies for primary care physicians were more effective in reducing patient uncertainty than the standard text biographies that most providers post on their websites.

2. – Wayfinding:

Navigating their way around an unfamiliar building can increase patients’ anxiety over their hospital visit.  Wayfinding solutions (such as digital signage, mobile apps that guide patients around your campus, and touchscreen kiosks that print wayfinding maps) can ensure that patients and their visitors don’t get lost, all while reducing patient uncertainty about finding their destination.

3. – The Waiting Room:

The waiting room offers numerous opportunities for reducing patient uncertainty surrounding many topics.  In the waiting room, uncertainty about wait times can be just as frustrating as the actual waiting.  Patients’ family members face uncertainty as well, about how long they’ll be waiting, about the details of a procedure, and about the outcome for their family member.

A patient tracking board and real-time text updates can be instrumental in reducing patient uncertainty and lowering waiting room anxiety for patients’ family members.  Patients can better gauge how long they’ll be waiting, and patients’ family members know their loved one’s status at each stage (e.g. “in prep,” “in surgery,” “in recovery”) of the encounter.

4. – Interoperability:

Patients should not have to face uncertainty regarding whether their doctor has all the information he/she needs to properly care for them.  Yet, only 46% of hospitals had required patient information from outside providers or sources available electronically at the point of care according to research posted by the Office of the National Coordinator for Health Information Technology.

With odds like these, patient uncertainty about transfer of medical records or if a physician’s order/referral will be received in time is warranted.  Reducing patient uncertainty can be accomplished by ensuring your facility can electronically send, receive, find, and integrate/use all necessary health information.

5. – The Discharge Process:

Researchers have created a new tool called the Uncertainty Scale to measure patient uncertainty and predict hospital readmissions.  Some of the major themes they’ve found in their work include patients’:

  • “Lack of clarity regarding self-management, such that patients are unsure how to deal with symptoms at home”
  • “Lack of self-efficacy, manifesting as patients not knowing where to go for help for certain symptoms”
  • “Lack of clarity about the decision to seek care, meaning that patients do not know which symptoms are serious enough to warrant seeing a health professional”

Improving patient education during the discharge process can help in reducing patient uncertainty about self-care, where to seek help, and when it is necessary to seek help, as well as lower readmission rates.

6. – Payments:

Patients want price transparency and as wise healthcare consumers, they have the right to be informed about the use of their healthcare dollars.  Confusion about health insurance and how much money they owe for health services, even after they’ve received a bill, is a source of patient uncertainty.  Patients may have great clinical outcomes, yet, if they are surprised when the bill is larger than expected, their satisfaction surveys will reflect low scores.

Providing estimates for out-of-pocket costs upfront, helping patients with insurance issues, preventing insurance-related errors, and helping patients identify and apply for financial assistance opportunities can all help in reducing patient uncertainty about cost.


Uncertainty is unfortunately a common experience in healthcare for those with undiagnosed conditions and symptoms for which an explanation is unclear.  The six areas outlined here are within your control; by reducing patient uncertainty in these areas, your facility can greatly improve the patient experience.


By Stephanie Salmich

A doctor and patients smile behind the blog’s title: ADDRESS PATIENT TRANSPORTATION NEEDS TO CREATE BETTER HEALTH OUTCOMES.

Address Patient Transportation Needs to Create Better Health Outcomes

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HealthWare Systems Blog

Address Patient Transportation Needs to Create Better Health Outcomes

Posted on Wednesday, April 18, 2018

Patient transportation needs can critically affect access to care and health outcomes; approximately 3.6 million Americans miss or postpone medical care due to transportation issues.

Improved access to transportation benefits patients, health facilities, and communities.  Health systems that address patient transportation needs are advocates for their patients, produce better health outcomes, lower readmission rates, reduce no-show appointments, and improve the general health of the community.

Efforts should begin with screening patients to determine their need/eligibility for transportation or other financial assistance.


Here are some specific ways your facility can then help those patients and create better health outcomes:


A doctor and patients smile behind the blog’s title: ADDRESS PATIENT TRANSPORTATION NEEDS TO CREATE BETTER HEALTH OUTCOMES.

Educate Patients About Transportation Options


Compile a resource list of patient transportation options available in your area.  For example, many senior centers and churches provide free or low-cost transportation and Pace offers a “Call-n-Ride” service in the Chicago suburbs for as little as $2.00.  What affordable local transportation options could you suggest to your patients?

Promote patient transportation options through flyers, posters, or digital signage at your facility.  If you use a lobby display screen or patient notification board, include notices for patient transportation options that appear throughout your rotation of announcements.

Assign staff members to address patients’ needs, one-on-one.  These employees can help patients determine which transportation assistance programs they may be eligible for (e.g. Medicaid non-emergency medical transportation (NEMT), the American Cancer Society’s Road to Recovery program), help them apply or sign up for assistance, and help them understand their existing benefits or coverage (e.g. how ambulance transportation may or may not be covered under Medicare).

Promote patient transportation options through your hospital’s social media accounts.

Create New Patient Transportation Options


Institute a driver volunteer program to provide rides to eligible patients, as Grace Cottage Family Health & Hospital and Green Mountain RSVP have done.

Start a hospital van service, like the one Taylor Regional Hospital created to deliver prescriptions and bring patients to and from the hospital.

Partner with an on-demand transportation service, like Maryland Health System has with Uber and Denver Health has with Lyft, to offer free or discounted transportation to qualifying patients.

Provide shuttle, bus, or taxi travel vouchers.  Create an incentive program for eligible patients who keep their appointments.

Participate in local government and community planning projects.  The American Hospital Association suggests hospital representatives “participate in local or regional transportation planning initiatives and educate decision-makers about how health can be affected by transportation” to encourage the development of new patient transportation options (such as more walkable routes, bike lanes, bike-sharing programs, bus or shuttle services, etc.).

Alleviate Patient Transportation Needs by Bringing Care to the Patients


Invest in a mobile health center, as Calvert Health System has; the Calvert Health System Mobile Health Center brings primary and preventive health services to patients by visiting churches and community centers.

Create a prescription delivery or mail service, or provide pharmacy services on site to cut travel for patients, as the American Hospital Association advises here (p. 12).

Provide more telehealth opportunities and encourage use of the patient portal for minor questions.


Make a commitment to address patient transportation needs using the suggestions above, and your patients, community, and facility will all enjoy the benefits of better health outcomes.

You can read in further detail how the health systems mentioned above (Grace Cottage, Taylor Regional, Denver Health, and Calvert Health) address patient transportation needs in the case studies provided by the American Hospital Association.


By Stephanie Salmich