Abstract

Introduction:The introduction of electronic patient records in the ambulance service provides new opportunities to monitor the population. Approximately 36% of patients presenting to English ambulance services are discharged at scene. Ambulance records are therefore an ideal data source for syndromic early event detection systems to monitor infectious disease in the pre-hospital population. It has been previously found that tympanic temperature records can be used to detect influenza outbreaks in emergency departments. This study aimed to determine whether routine tympanic temperature readings collected by ambulance crews can be used to detect seasonal influenza.Methods:Here we show that temperature readings do allow the detection of seasonal influenza before methods applied to conventional data sources. The counts of pyretic patients were used to calculate a sliding case ratio as a measurement to detect seasonal influenza outbreaks. This method does not rely on conventional thresholds and can be adapted to the data.Results:The data collected correlated with seasonal influenza. The 2016/2017 outbreak was detected up to nine weeks before other surveillance programmes. The results show that ambulance records can be a useful data source for biosurveillance systems.Conclusion:Temperature readings from routinely collected ambulance patient records can be used as a surveillance tool for febrile diseases.

Highlights

  • The introduction of electronic patient records in the ambulance service provides new opportunities to monitor the population

  • The results show that ambulance records can be a useful data source for biosurveillance systems

  • Between 1 January 2015 and 30 April 2017, there were 375,740 electronic patient care records (ePCRs) generated by South Western Ambulance Service NHS Foundation Trust (SWASFT)

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Summary

Introduction

The introduction of electronic patient records in the ambulance service provides new opportunities to monitor the population. Ambulance records are an ideal data source for syndromic early event detection systems to monitor infectious disease in the pre-hospital population. South Western Ambulance Service NHS Foundation Trust (SWASFT) introduced electronic patient care records (ePCRs) in March 2015, making it possible to access and monitor all data recorded in near real-time. It has been demonstrated that the monitoring of body temperature on its own makes it possible to detect outbreaks of seasonal flu in emergency departments (Bordonaro et al, 2016). If syndromic surveillance systems were put in place in ambulance services, it might be possible to detect outbreaks of disease while it is still in the community, prior to detection by hospital-based systems (­Barishansky, 2009)

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