One usecase that the Gaps In Care Reporting guide could help support is Medication Adherence measures. Today we could use the MeasureReport.evaluatedResource to provide data on related medications but there could be multiple ways to convey the information needed to act upon this type of gap. This is definitely a larger effort but would be required to standardize the required information we need in order to use gaps in care to report and close these gaps.

Suggested Solution: Add a portion of the specification that provides guidance on use cases that require additional details to be actionable for gap closure. Medication Adherence is a case that we have heard interest in.

• Specify a specific method for sending this data adding a profile to allow us to justify the resources use and extend it for care gap related content. I would recommend MedicationStatement (as we typically do not have full dispense information or medication administration knowledge). 
  • Extend the resource to add additional Medication Adherence Care Gap content:
    • Proportion Days Covered: The current Proportion of Days Covered (PDC) for the associated outcome. The expected range of values are 0-1 with decimal values allowed. 

• • • • Might be able to use MeasureReport.group.measureScore.extension-alternateScoreType 

• • • Is Impactable: Indicates if there are enough days left in the measurement year that a fill today could move the patient to meet the adherence threshold. Can also apply to episode-based measures with specific follow-up periods like FUH-7 days and FUH-30 days. 

• • • Is first fill: Indicates whether the patient has picked up one fill for an adherence medication and will be in the denominator for the corresponding measure when the second fill is picked up. Important for proactive outreach to patients for adherence measures early in a measurement year or immediately after patients are prescribed a medication for a chronic condition.  

• • • Next Fill Date: The expected next fill date for the medication. This is based on the last fill date plus the number of days supplied.