Gaps in Care

Jiva applies evidence-based rules to specific conditions to evaluate whether an individual is receiving quality care and/or services. The Sentinel Rules Engine (link) analyzes patient information, such as assessment responses and claims data, to determine gaps in standard care pathways and then indicate any deficits or missing elements. For example, if a person with diabetes should have a foot exam this year, their Care Reminder will state when it is due and how long before it becomes a gap in quality care.

More than 100 gaps in care and care alert pathways are offered in Jiva today, making it an additional resource for healthcare organizations looking to improve their HEDIS or Star scores. Jiva Gaps in Care includes rules for managing individual chronic conditions, such as:

  • Asthma
  • Diabetes
  • Depression
  • Heart disease
  • Heart failure
  • Low back pain
  • Pulmonary disease
  • Stroke

Gaps in Care are additionally provided for pediatric, wellness, and preventive health services. Examples include, but are not limited to:

  • Immunizations
  • Lead screening
  • Well-child visits
  • Breast cancer
  • Colorectal cancer
  • Influenza vaccination