A doctor wearing safety goggles and a face mask appears with the blog title: Patient Safety Challenges & Solutions

Patient Safety Challenges & Solutions

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HealthWare Systems Blog

Patient Safety Challenges & Solutions

Posted on Monday, March 15, 2021

Here are some of the patient safety challenges healthcare facilities are facing today, along with solutions for addressing these issues:

Patient Safety Challenge: Patients Delaying or Avoiding Medical Care


A doctor wearing safety goggles and a face mask appears with the blog title: Patient Safety Challenges & Solutions

What are your patient safety challenges? Chances are, one or more of our ActiveWARE products can help.

Patients missed health visits at alarming rates last year.

Research reviewed by the CDC found that by “June 30, 2020, because of concerns about COVID-19, an estimated 41% of U.S. adults had delayed or avoided medical care including urgent or emergency care (12%) and routine care (32%).” Consequently, the Becker’s Clinical Leadership & Infection Control editorial team included “missed and delayed diagnoses” and “low vaccination coverage and disease resurgence” on its top ten list of patient safety issues for 2021.

Besides worry about the pandemic keeping patients away, other barriers to healthcare access include a lack of (or inadequate) health coverage.

Solutions: A patient outreach campaign can bring patients back for preventive health services and encourage them not to forgo urgent care when they need it. Patients may be confused about the guidelines for seeking medical care during a pandemic. Receiving clarification directly from your organization will reassure them of the importance of obtaining routine and emergency care for their own health and safety. You can find patient outreach messaging ideas here.

HealthWare SystemsActiveXCHANGE solution can be bundled with our messaging platform to add automated voice message (TTS), text, email, pagers, fax, and traditional mail to create a physician and patient outreach engine for alerts, reminders, requests for information, and post-acute care follow-up.

When it comes to your uninsured and underinsured patient population, you can improve their access to healthcare by finding alternative funding sources for their medical bills. ActiveASSIST is our financial assistance screening solution that identifies which charitable programs patients may qualify for and manages the application process for them. This patient advocacy tool helps remove financial obstacles to healthcare access.

Patient Safety Challenge: Potential Exposure to COVID-19


While it may not be in a patient’s best interest to evade medical care altogether due to COVID-19 fears, there is still a risk of exposure to the virus when visiting a health facility.

Solution: Most health systems are now enforcing visitor restrictions to limit the number of people on site at their facilities. But have you considered reducing the number of employees on site as well?

Healthcare organizations have historically been hesitant to offer remote work opportunities due to concerns over uncontrolled access to PHI. However, you can enable healthcare staff to work from home in a HIPAA-compliant, secure remote work environment. Our off-site print management workflow solutions provide:

  • Controlled access to PHI.
  • Complete audit trails.
  • Elimination of intermediate hard copies/storage of paper forms.
  • Encryption of all information at all times.
  • Full transparency and productivity monitoring for management.

With fewer people on site, the risk of exposure to COVID-19 will be lower for both patients and healthcare employees. Patients will also be more willing to come in for medical care if they know every possible measure has been taken to limit their risk.

Patient Safety Challenge: Data Integrity & Interoperability Issues


Healthcare organizations continue to experience problems electronically exchanging information both externally (between different health systems) and internally (between different units/departments). Individual patient safety, as well as public health, depends on a provider’s access to accurate and complete data for each patient.

Unfortunately, “patient matching in the EHR” and “fragmentation across care settings” were included on the ECRI Institute’s top ten list of patient safety concerns in 2020.

Solutions: Our integration capabilities can introduce universal master patient indexes across disparate systems. This makes it possible to link episodes of care and supporting documentation across fragmented systems. Our electronic forms solution, ActiveFORMS, protects patient safety by enhancing patient data accuracy. ActiveFORMS uses barcode automation to correctly match patients’ medical forms to their accounts and auto-populates patient data on forms to prevent human error from manual entry or illegibility issues from handwritten forms. It also improves clarity by converting raw data into easy-to-read reports and transforming legacy reports into user-friendly documents.

With ActiveFORMS, healthcare facilities can easily pass Joint Commission audits.

In addition, our ActiveXCHANGE platform helps achieve healthcare interoperability in many ways, including by:

  • Providing a bi-directional gateway for consolidating information from any source (e.g. 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).
  • Routing 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.

HealthWare Systems specializes in integrating proprietary and third-party patient access technologies and connecting disparate health IT systems and EMRs/EHRs.

Patient Safety Challenge: Clinician Burnout


Physician burnout is tied to more medical errors, lower quality of care, and reduced patient compliance. Not only does it affect patient safety, but provider safety and health as well. This problem was on the rise before the pandemic and has understandably increased since it began.

Clinician burnout also appears on the Becker’s patient safety issues list for 2021.

Solutions: Major causes of clinician burnout include too much paperwork, administrative burdens, spending excessive time on EHR tasks, and working long hours.

Many EMR frustrations and administrative burdens can be traced back to interoperability issues (e.g. sifting through an overwhelming abundance of low-quality data to find relevant information, spending more time with the computer than with the patient).

ActiveXCHANGE increases physician satisfaction by:

  • Improving interoperability.
  • Intelligently managing information objects by using business rules to find and create actionable data, determining what to do with that information, and flagging errors and exceptions (e.g. detecting missing signatures or required forms/documentation) for resolution.
  • Handling incoming physician orders/third party documentation to greatly reduce physician complaints related to lost or incomplete orders.

ActiveXCHANGE also does not require referring physicians to change their behavior or learn new software.

You can further reduce providers’ workloads by outsourcing credentialing, which is another time-consuming and exhausting clerical responsibility for clinicians.


Solve Your Patient Safety Challenges with ActiveWARE by HealthWare Systems

Which patient safety challenges are you facing? Chances are, one or more of our ActiveWARE products can help. Contact us today to learn more, request a live demo, or schedule a free consultation – together, we can improve patient safety and enhance the patient experience at your healthcare facility.


By Stephanie Salmich

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

A remote worker smiles as she enjoys the benefits of remote work solutions that enable healthcare staff to work from home.

11 Reasons to Enable Healthcare Staff to Work from Home

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HealthWare Systems Blog

11 Reasons to Enable Healthcare Staff to Work from Home

Posted on Wednesday, April 15, 2020

Not all healthcare employees need to be on site to complete their work. When you enable healthcare staff to work from home, your employees, organization, and community will benefit!

A remote worker smiles as she enjoys the benefits of remote work solutions that enable healthcare staff to work from home.

Everyone benefits when you implement remote work solutions that enable healthcare staff to work from home.


Here are 11 reasons why you should implement solutions that enable healthcare staff to work from home:


1.) Limit the number of people on sitethe COVID-19 crisis has caused numerous organizations to reassess how many employees are actually necessary to keep on site. Moving workers off site now will help protect patients and employees from the current coronavirus; and, it will establish a more proactive approach for any future public health emergencies by ensuring staff who can work from home are already set up to do so when another new disease strikes.

2.) Maintain HIPAA-compliancethe healthcare industry has been reluctant to offer remote work opportunities due to concerns over PHI security. HealthWare’s remote work solutions enable healthcare staff to work from home by providing controlled access to PHI, encryption of all information at all times, complete audit trails, and full transparency for management.

3.) Increase productivity many studies demonstrate the positive effects of working from home on productivity. For example, a Stanford paper reported a 13% performance increase when employees switched to remote work and Airtasker’s survey of 1,004 full-time employees found that on average, remote workers put in 1.4 more days of work each month (16.8 more days each year) than those working in an office. Plus, remote work has the potential to facilitate a more flexible schedule, so many remote workers can choose to accomplish some of their work outside of the typical “9 to 5” business hours if they feel more motivated in the early morning or late at night, with the result of producing higher quality work. (Our remote work solutions provide management with productivity monitoring for real-time oversight, so you can really be certain your remote workers are delivering.)

4.) Expand your pool of job applicantsif your employees can work from home, you aren’t limited to hiring workers who live within commuting distance of your facilities.

5.) Recruit top talentin addition to more potential candidates, you’ll also attract the best contenders. According to Indeed’s 2018 survey, an organization’s remote work policy is an important factor for 47% of employees in their job search and 40% would even consider taking a pay cut if it meant they could work from home. And if you can offer a work from home incentive, you’ll especially appeal to Gen Z and Millennial healthcare employees who have joined or are entering the workforce at a time when remote work opportunities are increasingly common.

6.) Reduce your footprintcommuting and company offices are major contributors to greenhouse gas emissions. Moving some of your healthcare staff off site will make a significantly positive environmental impact. These remote workers’ homes will double as their office space and they will travel fewer miles, use less gas and oil, and reduce their contributions to air pollution.

7.) Keep workers healthyworking remotely means your teams won’t be exposed to workplace (or public transportation) germs. This is especially enticing for employees who work in the healthcare field and would otherwise be vulnerable to germs from both colleagues and ailing patients. And on top of the physical health advantages, remote workers experience mental health benefits related to stress (e.g. no commute/traffic, more free time, better work/life balance). Physically and mentally healthy employees can better concentrate to produce superior work.

8.) Decrease sick days and absencesemployees are not only less vulnerable to getting sick in the first place when they work remotely, but they’re also more apt to work through a mild cold or sickness if they can do so in the comfort of their own home. In fact, the reason some employees may choose to call in when sick is not because they don’t feel up to working, but simply to avoid spreading the illness to their coworkers – a concern that remote workers don’t have to worry about!

9.) Improve employee satisfaction and retentionemployees who enjoy the perks of remote work will be more satisfied, more loyal to your organization, and less inclined to leave their positions.

10.) Save moneycost savings come in the form of less office space/equipment/supplies, reduced turnover, fewer absences, increased productivity, and recruitment of better talent, to name just a few areas in which you’ll see major returns on investment. (We estimate savings of $10,000 per year per worker when you employ our remote work solutions.)

11.) Remote work is the futurebetween 2005 and 2017, remote work increased by 159% in the United States. A recent study projects that 73% of all teams will include remote workers by 2028.

The time has come to embrace work from home solutions in order to remain competitive in the eyes of prospective employees – you simply can’t afford to resist this inevitable change to the workforce.

Remote Work Solutions for Healthcare


Which parts of your operation would you move off site if you could? HealthWare Systems can analyze your paper and fax-based workflows and offer alternative solutions that enable healthcare staff to work from home in a HIPAA-compliant, secure environment.

Schedule a phone consultation and we’ll help you determine how you can enable healthcare staff to work from home, and which departments to target, so you can start reaping the benefits listed above as soon as possible.


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

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

A doctor shows a patient a healthcare form on a tablet and the blog title appears: Lower Hospital Costs with the Benefits of Electronic Healthcare Forms

Lower Hospital Costs with the Benefits of Electronic Healthcare Forms

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HealthWare Systems Blog

Lower Hospital Costs with the Benefits of Electronic Healthcare Forms

Posted on Wednesday, May 23, 2018


A doctor shows a patient a healthcare form on a tablet and the blog title appears: Lower Hospital Costs with the Benefits of Electronic Healthcare Forms

The benefits of electronic healthcare forms include reducing paper usage and improving workflow automation; both can significantly lower hospital costs.


There are numerous benefits of electronic healthcare forms that can help lower hospital costs related to the production and inefficiencies of paper forms.  Two of these, reducing paper usage and improving workflow automation, are outlined below:

Lower Hospital Costs with the Benefits of Reducing Paper Usage

Electronic healthcare forms greatly reduce the number of pages that need to be printed, which means providers can lower hospital costs related to all aspects of printing:

  • Besides the cost of the paper itself, facilities can save money on toner, ink, and printer maintenance and service fees.  A hospital may not even need as many printers, thanks to the benefits of electronic healthcare forms.
  • Electronic healthcare forms can easily be printed on-demand if a physical copy is necessary, so there is no need to stockpile pre-printed forms that may go unused.
  • Storage space and costs are no longer necessary since pre-printing is avoided.
  • Changes and updates to forms can be made electronically and in real-time, saving providers from the cost and waste of destroying old pre-printed versions that can no longer be used due to new revisions. (Read here how BJC Healthcare, which uses over 3,000 forms, utilized ActiveFORMS to solve this problem.)
  • The cost of blue cards and labels is also eliminated thanks to barcode automation.
  • Electronic healthcare forms enable healthcare facilities to use electronic signature instead of paper consent forms, significantly reducing paper usage.  Patients will also be impressed by, and enjoy the convenience of, an electronic signature option.

Lower Hospital Costs with the Benefits of Workflow Automation

Electronic healthcare forms allow providers to replace time-consuming and costly manual processes with workflow automation:

  • One of the benefits of electronic healthcare forms is that hospitals can automate the selection, generation, and routing of forms.  This ensures the correct, visit-specific documentation is produced every time (saving on costs associated with rework and denials due to missing paperwork/consents) and relieves the registrar from the burden of remembering selection criteria for every form used (saving on training costs and time spent searching for and gathering documents).
  • Standard patient demographic data and barcode identifiers on electronic healthcare forms prevent forms from being confused between different charts and save staff time from needing to label or handwrite the same patient data on every form.
  • Electronic healthcare forms that are barcoded, clean originals streamline the scan/capture process used by electronic document management systems (EDMS).  Separating multi-part forms or dealing with fourth generation copies that are barely legible can become issues of the past.
  • Improving workflow automation increases productivity and saves employees time, creating opportunities to reduce or repurpose FTEs(Read here how Advocate Good Samaritan Hospital grew its surgery department by 20% without an increase in FTEs, thanks to workflow automation and ActiveFORMS.)

The benefits of electronic healthcare forms are many; reducing paper usage and improving workflow automation will not only help providers to lower hospital costs, but also help hospitals to reduce or repurpose FTEs, increase efficiency, increase employee satisfaction and retention, reduce hospital waste, appeal to the healthcare consumer’s attraction to corporate social responsibility, improve accuracy and patient safety, and increase patient satisfaction.


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