ED boarding kills people, measurably. Combine state EMS data, CMS throughput measures, and transfer-pattern signals into a hospital-level ED capacity stress index.
What it is
ED Boarding and Ambulance Diversion Surveillance is a hospital-level ED capacity stress index, built from the state EMS diversion data that some jurisdictions require, CMS ED throughput measures (OP-18, OP-22), EMTALA transfer patterns visible in Medicare and Medicaid claims, helicopter scheduling data where public, and hospital staffing patterns from public sources.
The free surface helps EMS systems and patients route around hospitals running stressed. The paid surface serves EMS agency leadership optimizing transport decisions across a market, health systems benchmarking their own ED throughput against named competitors, and — the largest revenue line — payers absorbing avoidable inpatient admissions caused by boarded ED patients deteriorating in the hallway.
The methodology is the product. State EMS data is wildly inconsistent; CMS measures are lagged; helicopter scheduling is only partially public. Normalizing them into one capacity index, with disclosed confidence bands, is the value-add.
Primary data 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
Buyers
- EMS agency leadership
- Patients and families during acute events (free)
- Health systems benchmarking ED operations
- MA and commercial payers managing avoidable inpatient admissions
- State EMS regulators
Methodology
Capacity stress index is published with methodology and component weights. State coverage is uneven and disclosed.
Inquire about access
ED Boarding and Ambulance Diversion Surveillance is sold under named institutional license. Pricing is scoped per engagement. Reach out with the institutional context (organization, role, intended use) and we'll route a relevant scope of work.