Inpatient medical specialties are increasingly narrowly defined and homogeneous, which lends itself to highly-focused clinical research; for example, paediatrics and geriatrics are defined by their patient age group, cardiology is defined by an organ, and diabetology by a pathology. Emergency medicine (EM), however, is defined by time, urgency and heterogeneity.

Unfortunately, the scale of what we don’t know vastly outweighs what we do. There is minimal clinical epidemiological knowledge regarding emergency patients. The NSW Bureau for Health Information (BHI), for instance, uses the same data to inform both the clinical and the non-clinical community about ED patients as is used by the AIHW – data on attendance numbers, age, sex, triage categories and length of stay – using almost no clinical information at all. In fact, decisions are made daily regarding staffing and models of care, through to planning for new facilities and major infrastructure spending, based on the most scanty, non-patient-based data.

Comprehensive knowledge which describes all of our patients, not only in regard to triage categories and principal diagnoses, but granular details of illness, intervention and outcome, should be key to our daily work in caring for these patients. Outside of periodic snapshots of specific issues such as overcrowding and access block, the impact of alcohol on ED patients, dyspnoea, falls and toxicology, most clinical epidemiology in EM is either in the domain of cardiac arrest or severe trauma, areas which are informed by registry data collection. There are markedly more papers on the general epidemiology of large groups of emergency patients in countries such as India, Spain , Norway, Hong Kong, Canada, the United Kingdom and Botswana than there are in Australasia

Here at SWERI, epidemiology of South West Sydney is one of our main research focus. We have a particular focus on the epidemiology of patients presenting to South West Sydney Emergency Departments.

To do this, we have built the Multicultural Emergency Medicine Epidemiology (MEME) database, and are currently constructing the Comprehensive Emergency Dataset for Research Innovation and Collaboration (CEDRIC) . MEME links electronic medical record data from the emergency department, inpatient wards, intesive care units, coronary care and multiple inpatient services. MEME data follows the patient as their journey takes them through the whole hospital system. Using the databases allows SWERI  researchers to study the the problems that SW Sydney patients suffer from, how unwell they are, what interventions we make to treat them, what their investigations show, and what their outomes are. We also study aspects of  healthcare vital to sick patients in our area, such as the impact and effect of multiculturalism on patient outcomes, and   the health economics of patient care.