Jan 8, 2026: Updated Diagnosis Ordering in Transitions of Care (TOC)

We’ve updated how diagnoses are ordered within Transition of Care (TOC) outputs to better reflect clinical prioritization provided by ADT data.

What’s Changing

For TOCs that include EpisodeOfCare (EOC) resources, diagnoses are now ordered using the following logic:

• Admitting Diagnoses are ordered by Diagnosis.rank, when available
• Discharge Diagnoses are ordered by Diagnosis.rank, when available
• If no rank is present*, diagnoses are ordered by datetime (descending)

Previously, diagnoses were ordered only by datetime, with no rank-based prioritization.

Scope

This change applies to:

• All newly created TOCs
• Any existing TOCs that are updated after this release
• Historical TOCs that are not updated will not be affected.

*Source of Diagnosis Rank

Diagnosis rank is sourced directly from ADT messages. As a result:

• TOCs generated from ADT messages may now present diagnoses in a different order than before.
• TOCs generated solely from EHR data will continue to use datetime-based ordering, as diagnosis rank is not available in those cases.

Customer Impact

This update may affect customers who:

• Consume TOCs via the API or receive TOCs through Zushooks and rely on a specific or stable ordering of diagnoses in downstream workflows
• Customers with integrations that depend on diagnosis ordering should review their logic to ensure compatibility with rank-based ordering when present.