We're excited to announce a major update to the Transitions of Care and Encounter Lenses that significantly enhances capabilities and introduce new features to better support patient care workflows. This release streamlines the aggregated encounters into clear, discrete, and summarized components, while adding powerful new clinical insights.

Key Changes

Data Source Change

MAJOR CHANGE: The Transitions of Care Lens now aggregates Encounter Lens resources instead of raw Encounter FHIR resources. This change provides better data quality and consistency by leveraging the deduplication and enrichment already performed by the Encounter Lens.

Benefits of this change:

• Enhanced Data Quality: Leverages deduplicated encounters with enriched encounter classifications.
• New Readmission Detection: Incorporates readmission logic from Encounter Lens.
• Improved Clinical Context: Access to enhanced hospitalization data including admit source normalization.
• Precision Location Tracking: Utilizes new location extensions, including which location the patient is at currently.

Enhanced Clinical Insights

We've added several new beta extensions to provide deeper clinical context:

• Behavioral Health Detection: Automatically identifies episodes involving mental, behavioral, or neurodevelopmental disorders.
• Nonelective Admission Classification: Determines if admissions were unplanned (emergency, direct, or holding) and identifies readmissions within 30 days.
• Current Participants: Includes participant information from the most recent encounter.
• Reason Codes: Aggregates all unique encounter reason codes across the episode.

Improved Location Handling

Location extensions have been added for better accuracy:

• Admitting Location Details: Now references the first inpatient encounter (previously "latest").
  • The current admittingLocation extension will remain and will be deprecated in the future.
• Emergency Location Details: Now references the first emergency encounter (previously "latest").
• Legacy admittingLocation and emergencyLocation extensions are marked for future deprecation.

Enhanced Diagnosis Information

Diagnosis data now improves the granularity of the clinical context:

• Added support for use and rank attributes when available
• Maintains comprehensive diagnosis aggregation across all encounters in the episode

Readmission Detection

Building on Encounter Lens capabilities, episodes now benefit from sophisticated readmission detection:

• Automatic identification of readmissions within 30 days.
  • While this does not yet adhere to the strict CMS definitions of readmissions, we are working towards this structure in the future.
• Enhanced admit source classification including admissions from an emergency department .
• Improved hospitalization context with categorized admit sources.

Updated Extension Structure

• Aggregated From: Now uses nested structure with aggregatedFromLenses URL to clearly indicate source is Encounter Lens resources

New Beta Features

The following features will be released in beta and may be updated:

Migration Impact

For API Users

• Query Impact: No changes to existing queries - the same API endpoints and filtering work as before
• Response Structure: Core fields remain the same, with new optional extensions added
• Data Quality: Improved data consistency due to building on Encounter Lens foundation
• Enhanced Context: Episodes now inherit sophisticated readmission detection and hospitalization context from Encounter Lens
• Precision Timing: Access to highest precision start/end times from underlying encounter data

What Stays the Same

• Core Functionality: Episodes are still created using the same grouping logic (visit ID matching + 36-hour temporal windows)
• Resource Structure: EpisodeOfCare resources maintain the same fundamental structure
• Tagging: Same summary tag (https://zusapi.com/summary|TransitionsOfCare) for easy identification
• Patient References: Continue to reference Zus Universal Patient
• Period Calculation: Same logic for episode start/end times
• Data Mart Access No changes to the structure of data in Zus Data Marts currently. We will make improvements to this structure in the near future with announcements.

Questions or Support

For questions about this release or assistance with integration, please contact our support team or refer to the updated Lens documentation:

• Transitions of Care
• Encounters

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This release represents our continued commitment to providing comprehensive, high-quality clinical data that supports better patient care coordination and outcomes.