Pelica
Care Gap Assist
Demo data
P

Patient (demo)

Demographics unavailable

IPA member
IPA203373
Line of business
Commercial VBC
Attributed PCP
Dr. Alicia Romero, MD
Risk score (RAF)
2.260
Mapping: Demo (no live patient context)IPA: Pelica IPA - Coastal
2
Open HCC opportunities
3
Adherence alerts
4
Quality gaps
+0.61
Potential RAF capture

HCC opportunities

Risk adjustment
HCC 18Diabetes with chronic complications
A1c 9.2% (3/2026) + active metformin/insulin; no E11.4x coded this year.
High priorityRAF +0.318
Confirm & document diabetic neuropathy / CKD link at today's visit.
HCC 108Vascular disease
Statin + antiplatelet therapy; PAD imaging on file, not coded.
Medium priorityRAF +0.288
Document peripheral vascular disease.

Medication adherence alerts

Pharmacy / PDC
PDC-DM (Diabetes)
Biguanides / SGLT2 · last fill 2026-04-22 · 30d supply
High priorityPDC 71%
Patient 18 days late on metformin refill — verify barriers, sync fills.
SUPD (Statin Use in Diabetes)
Statins
High priorityNo therapy
Diabetic 40-75 with no statin on file — initiate moderate-intensity statin.
PDC-RASA (Hypertension)
ACEI / ARB · last fill 2026-05-01 · 90d supply
Medium priorityPDC 79%
Below 80% PDC threshold — consider 90-day fill + mail order.

Quality gaps

HEDIS / Stars
Eye Exam for Diabetics (EED)
No retinal exam result on file for 2026.
High priorityDue 2026-12-31
Order/refer retinal eye exam.
Controlling High Blood Pressure (CBP)
Last BP 148/92 (2/2026) — not controlled.
High priorityDue 2026-12-31
Recheck BP today; document controlled reading if <140/90.
HbA1c Control for Diabetes (HBD)
Most recent A1c 9.2% (>9% = poor control).
High priorityDue 2026-12-31
Intensify therapy; reorder A1c in 3 months.
Colorectal Cancer Screening (COL)
No FIT/colonoscopy result in lookback window.
Medium priorityDue 2026-12-31
Offer FIT kit or schedule colonoscopy.

Chart evidence from eCW

Connect a live eCW launch to pull Conditions, Medications, Labs, and Encounters directly from the patient chart.

FHIR integration blueprint

Reference

Every eCW FHIR endpoint this app is scoped for, probed live for the launched patient. Each panel shows the exact request, HTTP status, record count, and the raw response — the precise contract the production pipeline will consume.

Launch from an eCW patient chart to populate live responses. See docs/FHIR-SCHEMAS.md in the repo for the full per-resource schema reference.

HCC, adherence, and quality gaps shown here are placeholder data representing the precomputed IPA warehouse output. Chart evidence is read live from eClinicalWorks when launched from a patient chart. You are viewing demo data.