A pragmatic approach to timely disease surveillance in the emergency department

Computerised emergency department (ED) logs have been in use for more than 20 years. Despite this, public health authorities have failed to fully utilise this important surveillance tool.

Alice Ho Miu Ling Nethersole Hospital (AHNH) is a 500 bed community hospital with ED attendance of 350-400 patients a day in Hong Kong.

After the introduction of an ED computerised management system across Hong Kong in 1997, AHNH monitored common presentations using standard statistical software. Deviations from average attendance frequency were reported to public authorities. Experience during 1999 and 2000 calendar years is reported.

Apart from the usual seasonal variation in presentations such as respiratory tract infection and gastroenteritis, specific public health interventions appeared warranted in presentations related to dog bites, bee stings, rubella, hand foot and mouth, chicken pox, and scooter injuries.

ED computer information systems should be an effective tool for disease surveillance. In communities where this is not the case, public health authorities should insist on timely access and reporting of ED attendance data.