HEDIS & Care-Gap Closure Automation

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Care-gap & HEDIS closure

Close HEDIS gaps without a population-health platform.

If your practice has quality-bonus dollars tied to HEDIS measures, closing those gaps usually means staff logging into payer portals and outside systems to confirm what’s already been done and chase what hasn’t. Shadowbox automates that lookup — with the same logins your staff already has.

Book a 15-minute demo →See how it works
Primary carePediatricsOB/GYNNo platform required
What it does

The lookup, automated

  1. Logs into payer portals and outside systems with your existing credentials
  2. Confirms which measures are already closed
  3. Surfaces the gaps that still need attention
  4. Flags anything ambiguous for a person to decide
SOC 2 Type IIHIPAA · BAA signedNo API requiredWorks with your existing logins
Why it fits

Your team is the population-health platform. That’s the problem.

Most primary care, pediatric, and OB/GYN practices don’t have a data warehouse — just an EHR and the payer portals staff already log into. The proof of a closed gap is scattered across those systems, and someone has to go find it.

The manual reality today

  • Staff log into payer portal after portal to confirm what’s already been done
  • They chase the gaps that haven’t been closed, one system at a time
  • Bonus dollars slip when proof can’t be assembled before the deadline
  • Time that should go to patients goes to hunting for records

What Shadowbox does

  • Automates the lookup across the systems your staff already has access to
  • Confirms closed measures and surfaces the open ones in one place
  • Keeps a person in control — Shadowbox does the hunting, not the clinical call
  • Needs no integration, no data feed, and no new platform
A day on the same schedule, run both ways
A step that needs another loginThe re-work loopShadowbox does itHuman decision, kept on purpose
Today — by handevery blue card is a separate system someone signs into
7:30 AM
Tomorrow’s schedule
Pull tomorrow’s visit list out of the EHR
Roughly 40 patients, one at a time
7:45 AM
Chart scrub
Specialist on a different EHR — phone callNobody interfaced this one.
~20 minutes for a single patient, on the lines no feed finished
9:30 AM
The one-pager
Retype the findings into a sheet
Format it, print it, walk it to the exam room
Visit
In clinic
The physician sees the patient
Close-out
Audit packet
A measure you closed but cannot evidence does not hold upSo the hunting happens twice.
With Shadowboxthe logins do not disappear — a machine does them
7:30 AM
Tomorrow’s schedule
The list is built overnight, every patient pre-checked
Only the patients with something open surface
7:45 AM
Chart scrub
Every system read in seconds, in the same browser session
Ambiguous findings are held, not guessed
9:30 AM
The one-pager
Assembles itself from the scrub
A coordinator approves before it reaches the physician
Visit
In clinic
Unchanged — this is the part that should stay human
Close-out
Audit packet
Evidence is captured at the moment the gap closes
The packet is already assembled
5+separate systems signed into before a single visit
~20 minof hunting for one patient, on the lines a feed didn’t finish
3human checkpoints kept on purpose in the automated lane
0new platforms, data feeds or integrations required

Illustrative — these figures describe a representative primary-care panel, not a measured deployment.

Nothing reaches a physician or a payer unreviewed. This is automation with a control mechanism, not full automation — Shadowbox does the hunting, the clinical call stays yours.

What the chart doesn’t say

The care happened. Your chart only saw part of it.

One patient, eighteen months. The chip on each line is the channel that actually carried it. Every one of them did its job — and each one stops exactly where it was built to stop.

Feb 2025
Annual visit — blood pressure documentedCBPIn your chartEHR
The practice charted it itself. Native to the EHR, structured and current.
Apr 2025
A1c drawn, resulted into the chartHBDIn your chartLive
Delivered by the lab connection the practice already runs. No login, no lookup.
Jun 2025
Mammogram ordered — outside imaging centerBCS-ENot visibleBy hand
Ordered here, performed somewhere nobody interfaced. The name on file is a near-match, not exact.
Did she go?You ordered it. Nothing has ever told you whether it happened.
Sep 2025
Retinal exam at an ophthalmology practiceEEDNot visibleBy hand
A different EHR entirely. The measure looks open here, and the exam already happened.
Jun 2026
Admitted, then discharged three days laterTRCPartly visibleHIE
The HIE announced the admission inside an hour — that is what it was built to do. The notification is not the record: no discharge summary, no medication list, no consult.
Jun 2026
Beta-blocker prescribed at discharge — never filledNot visibleBy hand
Only gets checked at all if someone already knew about the admission. This is the one that gets missed.

Measure codes are NCQA HEDIS measures — CBP, HBD, BCS-E, EED and TRC. On the admission line, the CMS ADT Condition of Participation (42 CFR 482.24(d), effective April 30, 2021) requires the notification to carry, at minimum, patient name, treating practitioner and sending institution — which is precisely why a notification is not a record.

This is what interoperability looks like when it is working. One interface per counterparty, one payload per interface, and an organization you have no interface with may as well not exist. There is no configuration of feeds that reaches all of it — which is why the last mile has always been a person.

The same patient, the morning of the visit

Every line closed, before she walks in.

The same eighteen months, after Shadowbox has read the systems the practice already has access to. The feeds that worked still work; Shadowbox covers the rest, and the blue note on each line is what it would otherwise have cost somebody. The dependency is worth stating plainly: Shadowbox works a portal because your staff already has an account on it. Where there is no account, that line stays a phone call.

Feb 2025
Annual visit — blood pressure documentedCBPClosedEHR
Already in your EHR. This one was never in question.
No chaseNothing — the chart already had it.
Apr 2025
A1c drawn, resulted into the chartHBDClosedLive
Arrived on its own through the lab connection the practice already runs.
No chaseNothing — this feed already worked.
Jun 2025
Mammogram ordered — outside imaging centerBCS-EClosedShadowbox
Shadowbox read it from the imaging center’s portal. The name was a near-match, so it was held for a person to confirm rather than filed automatically.
Loop closedShe went. The record came back — before the visit, not after it.
OtherwiseA phone call to the imaging center to confirm it is the same patient.
Sep 2025
Retinal exam at an ophthalmology practiceEEDClosedShadowbox
Shadowbox found it in the ophthalmology practice’s portal — the measure was already satisfied.
OtherwiseTwo portal logins, or a fax request and a wait, to prove something that had already happened.
Jun 2026
Admitted, then discharged three days laterTRCClosedShadowbox
The HIE gave the alert; Shadowbox went and got the record — discharge summary and medication list from the hospital’s community portal, reconciled.
OtherwiseA call to release-of-information, then a wait for the records to come back.
Jun 2026
Beta-blocker prescribed at discharge — never filledClosedShadowbox
Shadowbox checked the pharmacy fill history. The gap is real, and now it is visible before the visit.
OtherwiseNobody would have checked. It only gets looked at if someone already knew about the admission.
Tomorrow
She arrives for a 6-month follow-upClosedShadowbox
Shadowbox assembles one sheet; a coordinator reviews and approves it before it routes.
OtherwiseAround 20 minutes of hunting for this one patient — or the visit happens without the answer.
4measures resolved that no feed reached on its own
0phone calls needed on these six lines
0new logins — Shadowbox uses the accounts your staff already holds
1sheet on the desk before she walks in

Illustrative — one composite patient, not a measured deployment. Which lines Shadowbox can close depends on the portal accounts the practice already holds.

Two of these were already satisfied somewhere the practice could not see — chasing them would have wasted the morning. One was genuinely open and invisible. Shadowbox does the hunting and shows its work; the clinical call, and the sign-off before anything routes, stay with your team.

Proof

A proven platform, aimed at the lookup.

Shadowbox is live and measured with labs and their clinics. The figures below are from those published lab-ordering case studies — the same login-only engine that does the care-gap lookup.

412%
ROI, payback in months — PGL/PCL (lab ordering)
21%
fewer claim denials — PGL/PCL (lab ordering)
4-day
average go-live per clinic — PGL/PCL (lab ordering)

Source: PGL/PCL case study — 25,000+ transactions across 50+ clinics and 13 different EHRs, $336,000+ in direct financial impact in the first year (2024). Results vary by customer.

Questions

Care-gap & HEDIS FAQ

How does Shadowbox help a practice close HEDIS and care-gap measures?

Most primary care, pediatric, and OB/GYN practices have no population-health platform — just an EHR and the payer portals staff already use. Shadowbox automates the manual lookup behind quality measures: it logs into those payer portals and outside systems with the credentials your staff already has, confirms which gaps are already closed, and surfaces the ones that still need attention. Your team reviews and acts on what it flags; Shadowbox does the hunting, not the clinical decision. No new integration, data feed, or population-health platform is required.

Do I need a population-health platform to use Shadowbox?

No. Shadowbox works with the EHR and payer portals you already have, using the logins your staff already uses. There is nothing to integrate and no data warehouse to build.

Which specialties is care-gap closure a fit for?

HEDIS and quality measures attribute overwhelmingly to primary care, pediatrics, and OB/GYN, so those panels are the natural fit. It is genuinely their daily workflow rather than a stretch.

Does Shadowbox make the clinical decision?

No. Shadowbox does the login and lookup and flags what still needs attention. A person on your team reviews and makes every clinical decision.

See it on your workflow

Spend less time hunting for proof.

Bring your quality-measure workflow. We’ll show you Shadowbox doing the payer-portal lookup — logins only, nothing to integrate, your team in control.

Book a demo →See results