You must have Administrator rights to perform this task.

This help topic describes functionality that may not be part of the feature set in use at your company.

 

Edit Rule

The Edit Rule feature allows Administrators to edit Compliance Rules, Rule Sets, and Reminder Sets. Compliance rules are a way to evaluate patients' compliance status based on payer requirements.  A Payer is an insurance company or a benefits manager responsible for reimbursement. Rule sets are a way to manage health, usage and equipment rules for different patient sets.

Warning: Care Orchestrator is not a substitute for direct patient monitoring.

Edit Compliance Rules

To edit a compliance rule:

1. Click Administration, Settings, and Rules and Reminders.
   
   Rules and Reminders display with Compliance Rules shown by default.

2. Click the Edit button located near the rule.
   The Compliance Rule displays in edit mode.

3. Update the compliance rule by selecting the When options:

• Day 1 of the start of the compliance period:  Administrators can specify either First Therapy Date, Date of 1st Device Assignment, or Setup Date.

Note:  When the  assigned compliance rule has a start date of Setup Date and the setup date is modified the compliance status shall be reset and recalculated based on the new setup date.  

• Usage hours
• Usage percentage threshold
• Number of consecutive days
• Number of days for compliance

4. Select the Then options. Then options are actions that are triggered when rules are satisfied in Care Orchestrator. For example, a task to follow up with a patient is added when certain rules are satisfied. Available Then options include:

• Mark patient compliant

Note:  If a patient becomes compliant within the 'X' days of the compliance start period, the system will mark the patient compliant after the 'X'-day mark, when the next therapy download occurs. 'X' is configurable between 1 and 90, inclusive.

• Add a task to view the compliance report (may also set the priority for the task: very low, low, medium, or high)
• Repeat compliance evaluation every 'X' days

Note:  Administrators can trigger an optional repeat for enhanced compliance evaluation. To repeat the compliance evaluation and remind clinical users, select the check box and then specify the number of days that the compliance evaluation will be completed (between 30 and 365 days).

• Auto-dismiss all Patient Not Compliant tasks, when patient becomes compliant

Note: When the Auto-dismiss all Patient Not Compliant tasks is checked, the auto-dismissed tasks are logged to the patient activity log with a notation of auto-dismissed due to compliance achieved.

5. Click the Save button to save the edited rule in the system.

Edit Rule Sets

To edit a rule set:

1. Click Administration, Settings, and Rules and Reminders.
   Rules and Reminders displays with Compliance Rules shown by default.

2. Click on Rule Sets.
   Available rule sets are displayed.

3. Click on a Rule type:  Usage, Health, or Prescription.
   Available rules for the chosen category display.

4. Click the Edit button located near the rule.
   Rule displays in edit mode.

5. Update the rule information for the When options, as needed.

6. Update the rule information for the Then options, as needed.

7. Click the Save button to save the edited rule set  in the system.

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