There is a difference between the two: "Patient Characteristic Expired" simply indicates that the patient is dead. An encounter with "Discharge Status: Expired" indicates that the patient died during the encounter. For some measures, this distinction may be important. That said, "Patient Characteristic Expired" during "Occurrence A of Encounter, Performed: <valueset>" would also indicate that the patient died during the encounter (and is the approach that NQF1354 takes). Perhaps there might be a clinically relevant reason a measure would prefer using the discharge status versus the above – I don't know. If not, however, it might make sense for measures to harmonize on one preferred representation where possible (and I suspect "Patient Characteristic Expired" would be the more reliable way to go). This, however, is likely a conversation for another day! Regarding QRDA Cat I, I expect that it's not an "either/or" situation-- if the patient is dead, you should report "Patient Characteristic Expired" with the expiry date/time, and if they were discharged due to death, you should also report the "Discharge Status: Expired" on the relevant encounter (assuming the measure asked for that information). The measure use of datatypes and timing will be reviewed at the next annual measure update and amended according to the steward's discretion.