EPIC EHR individualization and mutuality

[JBMmom, MSN, NP]

My organization went to the EPIC EHR a few months ago. I also worked at a previous hospital and used it and while I worked there I was told that the "Individualization and mutuality charting" questions like "do you have any questions about your healthcare?" "what information can we provide that would help you with your care?" and patient specific goals- are a key component that JCAHO looks at when evaluating the EHR for meaningful use and reimbursements. I've been search ing to find more information because I would like to share accurate information with my colleagues about the importance of this data. (currently those questions are often left blank) I'm not finding any specific references to individualization and mutuality EHR with JCAHO. I understand that these questions are where we show that we are providing care individualized to the needs of the patient, whether it's something like "John prefers to be called Jack", or "patient prefers to sleep until 8am if possible and will ambulate later in the morning" but does anyone know where this might be identified as a real goal for JCAHO. I think maybe management just threw that around to sound official.

[klone, MSN, RN]

It's more likely a CMS requirement - you may want to start there.

[CelticGoddess, BSN, RN]

TJC has nothing to do with reimbursements, they are an accrediting body. CMS is about reimbursements and if you go to the CMS website (or search CMS and EHR) you should find plenty of information.

[AJJKRN]

Yep, CMS = HCAHPS (Not saying that the individuality questions are part of HCAHPS but almost anything reimbursement does). FWIW, my EPIC has similar questions available too, and so many many more!

[MunoRN, RN]

Meaningful use refers to the capabilities of an EMR and it's ability to be used, mainly for data abstraction, to support outcome improvement. While Epic is highly customizable, the functionality that makes it Meaningful Use compatible can't really be customized out, so really all Epic is Meaningful Use compliant.

It's certainly good practice to individualize the plan of care, the extent to which you do so does not affect reimbursement. Keep in mind that the JC performs two functions when they accredit; they accredit for CMS defined requirements and they also offer 'feedback' about things they would like to see are in no way enforceable through against the organizations CMS accreditation or any sort of regulatory enforcement since they have no regulatory powers.

[JBMmom, MSN, NP]

Thanks everyone. I appreciate the responses. I guess the bottom line is that while it's nice for people to do to provide the best care, no one is really looking at it that closely as an endpoint.

[Susie2310]

Thanks everyone. I appreciate the responses. I guess the bottom line is that while it's nice for people to do to provide the best care, no one is really looking at it that closely as an endpoint.

The care plan is important. Providing quality care that is individualized to the patient is important.

The patient's attorney would be looking at the chart closely. The patient or their family member may look at the chart too.

I think it's a big mistake to only ascribe importance to the aspects of a patient's care that pertain to reimbursement.

[mmc51264, BSN, MSN, RN]

I was just going to mention that. We are focusing on making sure that care plans are personalized, not just "progressing" We are working on fewer clicks

[JBMmom, MSN, NP]

I certainly wasn't trying to say that providing personalized care isn't important, I'm just trying to find additional justification in a presentation I'm building for my coworkers about why we should be filling it out. Management doesn't seem to get on board until it affects our bottom line, though, so getting buy in from others about answering the questions hasn't been easy. I don't always have a chance on third shift to have interactions that lead to the answers to those questions, most people aren't interested in a conversation about their care at midnight. Thank you for your feedback.