DrCloudEHR provides quality management features that enable you to ensure that forms used in encounters comply with internal and external procedures and regulations when billing claims. Quality management features help you avoid potential issues when undergoing an audit or when submitting claims to insurance providers. 

You can define rules, known as Golden Thread rules, to require that specific forms be completed for selected facilities or programs, as well as the frequency or time frame for which the forms must be completed. You can also define form completion criteria requiring the completion of specific fields in a form based on business, clinical, regulatory and workflow requirements. Golden Thread rules and form completion rules work in tandem to ensure the documentation associated with an encounter is complete. 

You can configure Golden Thread rules and encounter form completion rules to prevent users from submitting claims if the rules are not satisfied.

This topic contains the following sections:

Add a Golden Thread Rule

Create a Golden Thread rule requiring that specific forms be completed for selected facilities or programs, a specific time frame, or for an encounter category.

When you create a rule, you specify:

• Settings for the rule.
• How to notify users when a golden thread rule is violated.
• Encounter categories that are exempt from the rule.

Click Save or Update when you are finished creating or updating a rule.

Create the Rule

1. Click the Practice tab.
2. In the left hand navigation menu, expand the Golden Thread tab, and then click Golden Thread Rules. The Golden Thread Rules page opens.
3. Click the Add Golden Thread Rule button.
   
   
   
   
4. Enter a name for the rule.
5. Select Form as the rule type.
   
   
   
   
6. Enter the starting date on which the rule takes effect. You can optionally enter an end date. If you do not specify an end date, the rule remains in effect.
7. Click the Notifications tab in the Add Golden Thread Rule dialog, and then configure how and to whom notifications are sent if the rule is violated. 
   
   
   
   
8. Click the Exceptions tab in the dialog, and then select the categories to ignore when applying the rule.
   
   

Configure the Rule Settings

1. Click the Settings tab if not already selected.
2. Select the facilities or programs to which to apply the rule. 
   Specify the AND operator to apply the rules to all selected facilities.​​ Use the OR operator to apply the rule to at least one facility.
   
   
   
   
3. Select the forms that must be submitted. 
   Specify the AND operator to require a user to complete all of the selected forms.​​ Use the OR operator to require that at least one of the selected forms be completed.
   
   
   
   
4. Select the frequency at which the forms must be completed.
5. Select Must meet the form completion criteria to require that the selected encounter forms meet any form completion criteria.
   Form completion criteria are defined in the Forms Settings page. For more information, see Define Encounter Form Completion Criteria.
   
   
   
   
6. Specify the message to display in notifications if the user fails to follow the rule. 
7. Select Block from being billed to prevent users from submitting a claim if the rule is not complete. 
   
   

Configure the Rule Notifications

Specify how to notify staff when a golden thread rule is violated.

1. Click the Notifications tab.

2. Select one or more notification methods described in the table below:

   Option	Description
   Billing Manager	Display a yellow triangle in the encounter entry in the Billing Manager. Users can mouse over the yellow triangle to view error details.
   Past Encounters List	Display a yellow triangle in the encounter entry in the Past Encounters page, which displays when you select Past Encounter List from the Encounter History menu for a patient. Users can mouse over the yellow triangle to view error details.
   Inbox	Add a message in the DrCloudEHR Inbox of selected users. Select the users to receive the message in the Who Should Be Notified? section of the dialog.  The message contains the text set in the Step 4: Action To Take When Rule Fails field when the rule was created.
   Email	Send an email to selected users. Select the users to receive the message in the Who Should Be Notified? section of the dialog. The message contains the text set in the Step 4: Action To Take When Rule Fails field when the rule was created.
   Counselor Dashboard	Display the status icons for selected forms in the dashboard. You can click the icon at the top of the dashboard to view a legend describing the meaning of each icon.
   Alert while adding a form to the billable encounter	Display an error message when a form with rule violations is added to an encounter.
   Chart Alert - Passive	Display rule violations in the Golden Thread Alerts section on the right side of the selected patient's Summary Chart page.
   Chart Alert - Active	Display a pop up message containing rule violations when the user opens a patient's Summary Chart page. Use this option only for important rules, because users often close the pop up message without reading it.

   
   

3. Select to apply the rule to forms related to all admitted and discharged patients, or to admitted patients only. The setting applies only to email, inbox, and chart alert notifications.

Specify the Rule Exceptions

Select any encounter categories to exempt from the rule. 

1. Click the Exceptions tab.

2. Select one or more categories in the left field, and then use the arrow button to move them to the right field.

View Golden Rule Error Reports

You can generate a report listing Golden Thread rule errors that occurred based on the criteria you specify. You can export the report data to a .csv file.

1. Click the Practice tab.
2. In the left navigation menu, expand the Golden Thread tab, and then click Golden Thread Error Report.
3. Specify the criteria to use to generate the report.
   By default, reports are generated for the current day, with the billing status set to Unbilled.
4. Click Search to generate the report.
   
   
   
   

Define Encounter Form Completion Criteria

You can define rules specifying that specific fields be filled out in an encounter form for the form to be considered complete. 

1. Click the Practice tab.
2. Click the Administration tab, and then click Forms Settings.
3. Click a form name in the table. 
4. Click Add.
   
   
   
   
5. Enter the starting date on which the rule takes effect.
   You can optionally enter an end date. If you do not specify an end date, the rule remains in effect.
6. Select Block from being billed to prevent users from submitting a claim if the rule is not satisfied.
7. Select the checkbox for each field in the form you want to require be completed.
   
   
   
   
8. Click Save.