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This article reflects the proceedings of a breakout session, ''Beyond ED Categorization-Matching Networks to Patient Needs,'' at the 2010 Academic Emergency Medicine consensus conference, ''Beyond Regionalization: Integrated Networks of Emergency Care.'' It is based on concepts and areas of priority identified and developed by the authors and participants at the conference. The paper first describes definitions fundamental to understanding the categorization, designation, and regionalization of emergency care and then considers a conceptual framework for this process. It also provides a justification for a categorization system being integrated into a regionalized emergency care system. Finally, it discusses potential challenges and barriers to the adoption of a categorization and designation system for emergency care and the opportunities for researchers to study the many issues associated with the implementation of such a system. ACADEMIC EMERGENCY MEDICINE 2010; 17:1306-1311 ª 2010 by the Society for Academic Emergency Medicine DEFINITIONS W e begin with definitions of key terms used in discussions of regionalization and categorization of emergency care. Definitions assist in research, planning, and political processes by ensuring that the terms used have the same meaning for administrators, investigators, and policy-makers who may be involved in the planning of integrated networks of emergency care. CategorizationCategorization is a process for inventorying, assessing, and cataloguing the emergency care resources, services, capabilities, and capacities of medical care facilities in a community or region, using a criteria-based classification system over a range of emergency care conditions. This process is used to assist physicians, hospitals, health departments, and emergency medical services (EMS) agencies in making informed decisions on how to develop, organize, and appropriately utilize health care resources for the emergency care system. Categorization may be accomplished using self-survey and selfdeclaration by facilities, by external agency survey and verification, or by some combination of the two. DesignationDesignation is a process for granting a charter as a preferred prehospital receiving facility and ⁄ or local or