Product methodology
ED Boarding and Ambulance Diversion Surveillance
Source contract, normalization path, entity-graph join, refresh posture, and publication limits for this Branmoor product.
Status
In service. This product has a functional preview or paid engagement surface in the current site. The full licensed product may still include private exports, alerts, APIs, or buyer-specific diligence that are not exposed publicly.
Distribution Scope
Nationwide where data exists; TN EMS layer; Nashville EMS/ED boarding watch
Product Question
Tracks ED throughput, ambulance diversion, and patient-flow stress.
Primary Sources
- State EMS diversion data (where required) — Hospital-level diversion hours and frequency
- CMS Hospital Compare ED throughput measures — OP-18 (door-to-discharge), OP-22 (left without being seen), boarding time measures
- Medicare and Medicaid claims (transfer patterns) — EMTALA transfer signal from claims
- FAA flight data + hospital-helipad mapping — Helicopter scheduling signal where derivable
- CMS staffing and survey data — Hospital nursing and physician staffing inputs to capacity
Entity-Graph Join
`ccn`, EMS destination IDs, county, helipad/geocode, transfer relationships.
Publication Rule
Branmoor does not treat raw public records as the product. A surface is publishable only when the source record is dated, normalized, source-linked, and joined to the relevant Branmoor entity identifiers with enough confidence to state the limits of the result.
Current Methodology Note
v1 surfaces every U.S. hospital ED with CMS-published throughput measures (OP-18b median arrival-to-discharge, OP-22 left-before-seen, EDV volume bucket) plus throughput-dependent acute-care measures (sepsis bundle compliance, stroke timeliness). National-percentile signal aggregation produces a per-hospital capacity stress flag. The paid v2 layer adds state EMS diversion data, EMTALA transfer patterns from claims, FAA flight data for helicopter scheduling, and real-time staffing signal.
Limits
Coverage follows the underlying source. Missing state portals, gated APIs, PDF-only filings, suppressed fields, lagged agency refreshes, and entity-name ambiguity can all limit product completeness. Pending products are not marketed as live until those limits are documented on the product surface.
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