How do you identify gaps in care?

Response: The Population Health advanced module was built to support the shifting payment models that place a larger emphasis around primary care. This module helps providers and healthcare systems that are taking on risk either through formal payment channels such as VBP, accountable care, capitation, etc. or informally through internal quality initiatives. Built at the core is a care coordinator workflow that identifies high utilization, ability for outreach, and risk stratification among chronically ill patients. Leveraging knowledge assets from content providers, the Population Health module identifies patients that are out of compliance with the standard of care for a given condition. Identifying those patients lets the provider intervene to fill gaps in care.