ACES User Manual - KFL&A Public Health Informatics

 Acute Care Enhanced Surveillance (ACES) USER INTERFACE MANUAL UPDATED MARCH 2015 ACES User Interface March 2015 ACES USER INTERFACE I.
LOGIN PAGE Figure 1: ACES Login page
Users can log into ACES (http://aces.kflaphi.ca/#/) using the username and password that was provided to them from the ACES administrators ACES User Interface March 2015 II.
MAIN LANDING PAGE Figure 2: ACES Main Upon logging in, the user will be directed to the main page (Figure 2). This page provides a simple overview of recent activity (past 2 weeks) captured by the surveillance system and notifies the user of any alerts. On the left side of the page, there are a series of charts that display all ED visit counts across Ontario, as well as ED visit counts broken down by five different syndromes (Respiratory, Gastrointestinal, Dermatological, Fever/ILI, and Asthma). The right side of the page displays a table with a list of the current alerts that have been generated by the system. Clicking on a specific alert will bring up a window displaying the alert graphically. Clicking the ‘Data’ tab within this window will provide additional details surrounding the alert. Using the grey arrow on the right upper corner of the alerts table allows the user to customize what information will be provided on this list (see Figure 3). Clicking on each individual heading will arrange the information according to that heading. ACES User Interface March 2015 Figure 3: Drop down menu to customize the alerts table.
The subsequent four sections of this manual pertain to the following tabs shown in Figure 4 below. To navigate to each page on the site, click on the appropriate tab. Figure 4: ACES features ACES User Interface March 2015 III.
EPICURVES Figure 5: ACES Epicurve page The Epicurves page allows the user to plot time‐series graphs of case counts for various geographic regions for any time interval. In this section, options in the box on the right side of the screen allow the user to select the syndrome, hospital, time period, and specific patient attributes they would like to view data for. Generating an Epicurve To generate an Epicurve, data parameters must first be defined using the options found at the right hand side of the page. At anytime, clicking Submit will generate the Epicurve with the desired parameters. Clicking Reset will reset all parameters back to the default setting. ACES User Interface March 2015 Epicurve Parameters – ‘Tools’ The Tools tab on the right side of the page includes the following sections: Health Unit and Hospitals The first option is to choose which hospitals data will be displayed in the Epicurve using the dropdown menu. There is also the option to view data from all hospitals in the selected Health Unit. Which hospitals data can be displayed in the Epicurve depends on your user rights assigned to your login credentials. Hospital users will only have the option to view their own hospitals data. Users from the local Health Unit, however, will be able to view each hospital within their Health Unit, as well as all hospitals together. Date Range Under this section, the user can choose the time period for which the data will be displayed. Clicking Date From and Date To will bring up a calendar to choose the desired dates. Gender Gender may be specified as either: Male, Female, or All using the associated buttons. The default is set on All Age Clicking on the dropdown menu in this section gives six age group options for the Epicurve: All, Child (ages 0 to 17), School Child (ages 5 to 17), Adult (ages 18 to 64), Senior (ages 64 to 130), and Adult + Senior (ages 18 to 130). Alternatively, the user can manually input the desired age range. The default is set to All ages. Classifications Under this category, the user is able to make more specific requests as to what syndromic data will be displayed. Under Syndrome, the dropdown menu gives options for which syndrome the ACES User Interface March 2015 user would like to analyse. The user may also choose to display all syndromes together, which will show data for all hospital ED visits and admissions. Under Classifier, the dropdown menu gives the option to either display syndrome data that was classified according to the older EDSS/RODS classifier by choosing EDSS Standard Syndromes, v2006, or by the new ACES classifier by choosing ACES Standard Syndromes, v2014. If the EDSS Standard Syndromes is selected, then only the 8 standard syndromes will be provided as options under the Syndrome dropdown menu (Respiratory, Gastrointestinal, Fever/ILI, Asthma, Derm Infectious, Severe Infectious, Neuro Infectious and Other). However, if the ACES Standard Syndromes classifier is selected there are over 80 syndrome options that the user can choose from (see Appendix B for a list and description of these). When the Classifier is set to ACES Standard Syndromes, the Bucket dropdown menu gives the user more options to customize the epicurve using pre‐defined groupings of certain syndromes of interest. These Bucket categories and their definitions are still a work‐in‐progress. Lastly, the Algorithm dropdown menu provides 5 options for which algorithm was used to categorize the visits into the selected syndrome. The algorithm options are: Balanced Winnow, C4.5 Decision Tree, Maximum Entropy, Naïve Bayes, and Winnow2. Maximum Entropy is the default setting and was used in the old EDSS/RODS system. Descriptions of the new algorithms will follow in our User Manual once completed. CTAS CTAS stands for Canadian Triage Acuity Score. Under this section, the user can choose whether the epicurve will only display data from one of the 5 CTAS categories, or whether visits for all CTAS scores will be displayed. All is the default setting. ACES User Interface March 2015 Epicurves Parameters – ‘Advanced’ Clicking on the Advanced tab at the top of the box on the right hand side of the screen provides more options to customize the Epicurve. NOTE: One of Patients or Hospitals will always have to have a ‘local’ option chosen. Locality In the Patients dropdown menu, the user can choose whether the Epicurve will display data from patients who are Local PHU Patients (i.e. reside in that particular Health Unit), Province Wide (i.e. reside anywhere in Ontario, essentially an ALL category), or Outside of PHU Patients (i.e. patients who do not reside in that particular Health Unit, essentially shows patients who are visiting that health unit). The Hospitals dropdown menu provides 3 options for further breaking down the data. Choosing Local PHU Hospitals will add additional lines to the Epicurve that show data broken down by hospital in that Health Unit. The legend will appear at the top right corner of the graph. An example of how this would look is shown in the next section below with the three hospitals in the KFL&A Health Unit. Province Wide will show data for local patients who go to any hospital that is connected to ACES. Outside of PHU Hospitals will show data for local patients visiting hospitals outside of their health unit of residence. FSA FSA stands for Forward Sortation Area, which are the first three digits of a postal code. This dropdown menu lists all FSAs in the selected Health Unit. By selecting a specific FSA, the epicurve will display the hospital visit data from patients who reside in that specific geography. ACES User Interface March 2015 Moving Average and Standard Deviation At the top of the Epicurve there are options to add lines on the graph that display the Moving Average and/or Standard Deviation. Users can select a moving average of either 7 days, 14 days, or Max (gives an overall average for the data and time period selected). Lines showing either 1 Standard Deviation (Std 1), or 2 Standard Deviations (Std 2) can also be chosen. There is also the option to Normalize the data. By selecting ‘on’, instead of graphing the total number of cases for a given syndrome, which has natural variance (e.g. by day of the week), this will plot the number of cases as a percentage of the total visits per day. NOTE: The graph for All visits is unaffected by this feature. Epicurve Examples Figure 6 shows an example of an Epicurve. The epicurve displays visit counts for all hospitals in the KFL&A Health Unit with the following parameters: Syndrome = RESP (respiratory) Gender = All Age = Adult Date Range = December 15, 2014 to January 15, 2015 Figure 6: Example epicurve ACES User Interface March 2015 The time period is displayed on the x‐axis and the number of visits for the syndrome is on the y‐
axis. The red line displays the visit counts over the specified time period. The dotted line is displaying the 7 day moving average (average number of reported cases for the current and preceding six days), and the dash + dotted line is displaying all cases plus 2 standard deviations. By using options in the Advanced tab, the graph below in Figure 7 shows the Epicurve for the RESP (respiratory) syndrome in adults of all genders, now broken down by hospital in the KFL&A Health Unit. This was done by choosing the option Local PHU Hospitals option under the Hospitals section. Also, by selecting Local PHU Patients in the Patients section, the graph is only showing the user a graph of residents in that health unit that are being seen at that health units local hospitals. The black line represents data from all hospitals combined. The red line represents data from Hotel Dieu Hospital, the green line represents data from Kingston General Hospital, and the blue line represents data from the Lennox and Addington County General Hospital. Figure 7: Example epicurve broken down by hospital
ACES User Interface March 2015 Additional Features  Located below the Epicurve is a Focus Chart. This chart allows the user to easily adjust the graph to focus on a narrower time period without having to make a new graph. Clicking on the desired date(s) on the Focus Chart creates a window that can slide back and forth to either widen or narrow in on the date range. 
Hovering the mouse over a point on the Epicurve line will prompt a box that displays exactly how many visits there were on that day for that syndrome. In this box, selecting ‘Click to see line listings’ will open the line listings for that day, giving more details surrounding each visit for more in depth analysis. 
At the bottom left corner of the page, clicking on the button ‘Download Chart’ will download a picture of the current epicurve that the user has created. This allows the user to save their work in picture form to be used in presentations or reports. ACES User Interface March 2015 IV. LINE LISTINGS Figure 8: ACES Line Listing Line listings display emergency department visits as a textual list with the standard patient information we receive directly from hospitals (Date, Time, Age, Gender, FSALDU, Hospital, Syndrome (assigned by ACES after classifier has ‘read’ the chief complaint), Complaint, CTAS, FRI, EMS Arrival, and Patient LHIN). When the user first navigates to the Line Listings page, they are presented with data from the past week for their assigned user role (i.e PHU, Hosp. only etc.). The box on the right‐hand side of the screen allows the user to set the parameters to generate the line listing which are the same as those described in the Epicurves section. Generating a Line Listing To generate a line listing, enter the desired parameters into the box on the right side of the screen. Selecting ‘Submit’ at any time with generate the Line List with the details provided. Selecting ‘Reset’ will reset the screen to the default settings. ACES User Interface March 2015 Health Unit and Hospitals The first option is to choose which hospitals’ visit details will be shown. There is also the option to view data from all hospitals in the selected Health Unit. Which hospitals information can be displayed in the line listing depends on the user accessing ACES. Hospital users will only have the option to view their own hospitals data. Users from the local Health Unit, however, will be able to view each hospital in their Health Unit, as well as all hospitals together. Date Range Under this section, the user can choose the desired time period. Clicking Date From and Date To will prompt a calendar to choose the desired dates. Gender Gender may be specified as either Male, Female, or All. Age Clicking on the dropdown menu in this section gives six age group options: All, Child (ages 0 to 17), School Child (ages 5 to 17), Adult (ages 18 to 64), Senior (ages 64 to 130), and Adult + Senior (ages 18 to 130). Alternatively, the user can manually input the desired age range. Classifications Selecting a specific Syndrome from the dropdown menu will list the visit details for patients whose chief complaint or admission diagnosis was categorized into that syndrome. The user may also choose to display all syndromes together, which will list visit information for all hospital ED visits and admissions. Under Classifier, the dropdown menu gives the option to either display syndrome data that was classified according to the older EDSS/RODS system by choosing EDSS Standard Syndromes ACES User Interface March 2015 v2006, or by the new ACES system by choosing ACES Standard Syndromes v2014. Please refer to the Epicurves section above for further information on the Classifier, Bucket and Algorithm options. CTAS CTAS stands for Canadian Triage Acuity Score. Under this section, the user can choose whether the line listing will only list visits that were categorized into one of the 5 CTAS categories, or whether visits for all CTAS scores will be displayed. Advanced The ‘Advanced’ tab allows users to further specify which hospital visits will be included of their line listing. Please refer to the Epicurves section above for further information on the Locality – Patients, Locality – Hospitals and FSA options for your line list search. ACES User Interface March 2015 V. MAP Figure 9: ACES Map page The Map page (Figure 9) allows the user to examine the spatial distribution of ED visits and admissions. When the user navigates to this page, they are first presented with a map view of Ontario. Users can move the map to the desired location using their mouse. The bar on the top left side of the page allows users to zoom in or out of the map. The picture of a house above this bar takes the map to the default view. The right side of the page contains a box with various features that allow the user to manipulate the map tool – these features are described in the next section. ACES User Interface March 2015 Map Features – ‘Data’ The box on the right hand side of the page provides options for customizing the map. In the ‘Data’ tab of this box, under each heading is a drop down menu providing options for that category. Entering the desired parameters will give the necessary information to customize the map. Mapping Style There are two options on how the data can be visualized on the Map: Chloropleth – This option displays the ED visits for the selected syndrome by colour, with darker colours representing more visits in the region compared to lighter colours (Figure 10 is showing ‘ILI’ syndrome data by ‘Health Unit’ level of geography). Hovering the mouse over one of the outlined regions will provide more details on: total visits for the syndrome, total ED visits, and the percentage of total ED visits that are for the selected syndrome. Figure 10: Example of Chloropeth mapping style
ACES User Interface March 2015 Proportional Symbols – This option displays the ED visit data for the selected syndrome as a circle over the geographic region, with the circle size increasing with increasing number of visits for that syndrome (Figure 11 is showing the same information as Figure 10 but in a different graphic method). Hovering the mouse over the circle for the region of interest will provide more detail on: total visits for the syndrome, total ED visits, and the percent of total visits for that are for the selected syndrome. Figure 11: Example of Proportional Symbols mapping style with legend
Classifiers The classifiers drop down menu offers 5 options previously described in the Epicurves section. Classification This option allows users to classify the data being displayed by either the older classification system which was used in the previous EDSS/RODS system (by choosing S2006) or by the new ACES classifications system (by choosing S2014). Syndromes Under this tab, users can choose which syndrome will be displayed on the map. There are over 80 syndromes to choose from under classification S2014 and 8 syndromes under classification S2006. Level of Geography ACES can display ED visit and admission information by different levels of geography: FSA, Public Health Unit, and LHIN. ACES User Interface March 2015 Data Classifications When using the Chloropleth mapping style, there are three different ways in which the data can be classified. These include: Equal Interval, Quantile, and Standard Deviation. Equal Interval will map the data in equally spaced out gradients based the normalized values (Percentages) for that syndrome in the chosen geography. The number of gradients is determined by the user when they specify how many Classifications they desire and the size of those gradients is determined by the user when they specify the Percentage Range. For example, if a user chooses ‘6’ under Classifications and a Percent Range between ‘0‐24’ the legend will have 6 equal gradients of 4% each. Quantile is a more simplistic method to map the data and all the user needs to define are the number of quantiles they desire. If 4 quantiles are chosen, then Q1 will show 25% of the data making up the least number of visits under that syndrome and Q4 will show 25% of the data making up the most number of visits (with Q3 and Q4 making up the other 50% of the data). Standard Deviation will map the data based on a range of standard deviations below and above the mean for the syndrome chosen and based on the geography type selected. The legend will show gradients between +/‐ 3 standard deviations in 1 standard deviation categories. No further classification definitions are needed under this category. Number of Classifications This menu option is only valid when using the ‘Chloropleth’ mapping style and either the Equal Interval and Quantile Data Classifications. Users have the option between choosing 4, 5, 6 or 10 under this menu option. Percentage Range This menu option is only valid when using the ‘Proportional Symbols’ Mapping Style, or when using the ‘Chloropleth’ Mapping Style along with the ‘Equal Interval’ Data Classification. This option allows the user to choose the percent range for their legend under the above stipulations. With this option the user needs to be aware that for each syndrome the percent range can vary and therefore a good knowledge of how the syndrome in question behanves is needed. For instance, when mapping the Respiratory syndrome in the summer months, a basic guideline would be to choose a percent range between 0 and 20%. However, in the winter months the upper extreme needs to be increased because if a given HU has a higher percentage than what was chosen, it will not be included in the legend. Date Range, Gender, Age Group, Age Range With these categories the user can customize the map to display hospital data by gender, age, and desired time period. ACES User Interface March 2015 Once all desired parameters are entered, clicking the ‘Request Data’ button will generate the map. Pressing ‘Clear Data’ will clear the map created and revert back to the default settings. NOTE: While the user can in fact choose as wide a date range as they like, it is advised to use windows of a month or less. A request for large time periods of data can cause the system to time out and crash. Map Features – ‘Layers’ The second tab in the box on the right side of the map screen, named ‘Layers’, allows users to add additional information to their maps that could be useful for public health purposes. Checking the desired layer, for example Daycares, will add all daycare facilities on the map. Clicking ‘Clear Layers’ will clear all layers added. NOTE: Users can click on multiple layers but keep in mind that the more that are added the more ‘messy’ the map may become. The ACES team is also considering adding more layers as we continue the systems’ development. Map Features – ‘Map’ The ‘Map’ Tab provides different viewing options for the base map. For instance, the default setting is Topo, however the other display options include: Street, Satellite, Hybrid, Gray, Oceans, National Geographic, and OSM. Choosing the desired option and clicking ‘Update’ will change the base map. Under this tab, the user can also change the Layer Color and Border Color as desired. ACES User Interface March 2015 VI. ALERTS Figure 12: ACES alert page The Alerts page (Figure 12) lists all alerts being generated by the ACES system. The table that lists the alerts includes columns with information for Date/Time of alert, Alert Class (CUSUM, SPC or NRC), Alert Type (numerous), Syndrome, Geog Type, Geog Name, and the Alert ID. Clicking on the grey arrow at the top right corner of the table prompts a menu that allows the user to customize which columns will be displayed. Clicking on one of these columns will list the alerts by that column. NOTE: Further detail on Alert Class and Alert Type will be made available in the near future. ACES User Interface March 2015 The box on the right side of the table can be used to specify whether the list will display all alerts being generated in the health unit or whether only alerts at a specific hospital will be listed. This is done by selecting the desired hospital in the drop‐down menu. The options available to each user are dependent on their level of access In this box, the user can also specify the date range for the alerts being listed. Clicking on the alert of interest will bring up a window with a graph that displays the hospital visit data for the two weeks leading up to the event (Figure 13). Figure 13: Graphical representation of alert
ACES User Interface March 2015 Choosing the ‘Data’ tab within this window (Figure 13) will list aggregate details pertaining to the alert for more in‐depth analysis (Figure 14). Figure 14: Alert specifics under Data tab ACES User Interface March 2015 APPENDIX APPENDIX A ‐ Health Unit (Key to Table Below) APH CKPHU DRHD EOHU GBHU HKPRDHU List of Public Health Units and Hospitals within those Health Units Participating in EDSS/ACES Hospitals within Health Unit Blind River District Health Centre (BRH) Lady Dunn Health Centre (WAW) Sault Area Hospital (SAH) St. Joseph’s General Hospital (QEL) Chatham‐Kent Health Alliance – Chatham (CKHA) Chatham‐Kent Health Alliance – Wallaceburg (CKHAW) Lakeridge Health – Bowmanville (LHB) Lakeridge Health – Oshawa (LHO) Lakeridge Health – Port Perry (LHP) Rouge Valley Health System – Ajax and Pickering (APG) Cornwall Community Hospital Glengarry Memorial Hospital (HGMH) Hawkesbury and District General Hospital Winchester District Memorial Hospital Grey Bruce Health Services – Lion’s Head (LHSH) Grey Bruce Health Services – Markdale (MDSH) Grey Bruce Health Services – Meaford (MFSH) Grey Bruce Health Services – Owen Sound (OSSH) Grey Bruce Health Services – Southampton (SSH) Grey Bruce Health Services – Tobermory (TSH) Grey Bruce Health Services – Wiarton (WSH) Hanover and District Hospital (HADH) South Bruce Grey Health Centre – Chesley (CSH) South Bruce Grey Health Centre – Durham (DSH) South Bruce Grey Health Centre – Kincardine (KSH) South Bruce Grey Health Centre – Walkerton (SWH) Campbellford Memorial Hospital Haliburton Highlands Health Services ACES User Interface March 2015 Date linked to ACES Feb‐2013 Jul‐2011 Sept‐2014 Jul‐2011 Jun‐2013 Jun‐2013 Sep‐2013 Sep‐2013 Sep‐2013 Sep‐2013 TBD Apr‐2010 TBD TBD Nov‐2011 Nov‐2011 Nov‐2011 Nov‐2011 Nov‐2011 Nov‐2011 Nov‐2011 Nov‐2011 Nov‐2011 Nov‐2011 Nov‐2011 Nov‐2011 TBD TBD Health Unit (Key to Table Below) HRHD HPH HPECHU KFLA LAMBTON – CHSD LGLDHU NRPH NBPH Hospitals within Health Unit Northumberland Hills Hospital Ross Memorial Hospital Halton Healthcare Services – Georgetown (GEO) Halton Healthcare Services – Milton (MIL) Halton Healthcare Services – Oakville (OAK) Joseph Brant Memorial Hospital (JBMH) Hamilton Health Sciences Corporation – Hamilton General Hospital and Urgent Care Centre (HAH) Hamilton Health Sciences Corporation – Juravinski Hospital and Cancer Centre (HEN) Hamilton Health Sciences Corporation – McMaster Children's Hospital (MCM) St. Joseph’s Healthcare Hamilton (ST01) Quinte Healthcare Corporation – Belleville (BGH) Quinte Healthcare Corporation – North Hastings (NHH) Quinte Healthcare Corporation – Prince Edward County (PEC) Quinte Healthcare Corporation – Trenton (TMH) Hotel Dieu Hospital (HDH) Kingston General Hospital (KGH) Lennox & Addington County General Hospital (LACGH) Bluewater Health ‐ Sarnia (BWH) Charlotte Eleanor Englehart Hospital of Bluewater Health –Petrolia (BWHP) Brockville General Hospital (BRGH) Carleton Place and District Memorial Hospital (CCC) Perth & Smiths Falls District Hospital – Great War Memorial Site – Perth (GWMH) Perth & Smiths Falls District Hospital ‐ Smiths Falls Site (SFH) Niagara Health System – Douglas Memorial Hospital Site (DMH) Niagara Health System – Greater Niagara General Site (GNG) Niagara Health System – Port Colborne General Site (PCG) Niagara Health System – St. Catharine's General Site (SCG) Niagara Health System – Welland Hospital Site (WHS) West Nipissing General Hospital (WNGH & WNG) North Bay General Hospital (NBGH) ACES User Interface March 2015 Date linked to ACES TBD TBD Oct‐2011 Oct‐2011 Oct‐2011 Oct‐2011 Sep‐2011 Sep‐2011 Sep‐2011 Sep‐2011 Sep‐2005 Sep‐2005 Sep‐2005 Sep‐2005 Sep‐2005 Sep‐2005 Sep‐2005 Jun‐2013 Jun‐2013 Jul‐2009 Oct‐2014 Nov‐2008 Jul‐2008 Feb‐2010 Feb‐2010 Feb‐2010 Feb‐2010 Feb‐2010 Apr‐2010 Apr‐2010 Health Unit (Key to Table Below) NWHU OPH PEEL PCCHU PHU SMDHU SDHU Hospitals within Health Unit Mattawa General Hospital (MH & MGH) Atikokan General Hospital (ATGH) Lake‐Of‐The‐Woods District Hospital (LWDH) Riverside Health Care Facilities Inc. (RHF) Sioux Lookout Meno Ya Win Health Centre (SLH) Queensway Carleton Hospital (QOQ) Trillium Health Partners ‐ Credit Valley Hospital (CVH) Trillium Health Partners ‐ Mississauga Hospital (MISS) William Osler Health System ‐ Brampton Civic Hospital (BCH) Peterborough Regional Health Centre (PRH) MICs Group of Health Services – Anson General Hospital (AGH) MICs Group of Health Services – Bingham Memorial Hospital (BMH) MICs Group of Health Services – Lady Minto Hospital (LMH) Hôpital de Smooth Rock Falls Hospital (FSR) Hôpital Notre‐Dame Hospital (NDH) Hornepayne Community Hospital (HPH) Sensenbrenner Hospital (SBH) Timmins & District General Hospital (TDH) Georgian Bay General Hospital ‐ Midland Site (GBGH) Muskoka Algonquin Healthcare – Huntsville & Bracebridge (MAH) North Simcoe Hospital Alliance – Huronia District Hospital Orillia Soldiers' Memorial Hospital (OSMH) Royal Victoria Hospital (RVH) Stevenson Memorial Hospital Chapleau General Hospital (CHS) Espanola Regional Hospital and Health Centre (EGH) Date linked to ACES Apr‐2010 Sep‐2010 Aug‐2010 Sep‐2010 Sep‐2010 Oct‐2014 Nov‐2011 Feb‐2013 Jan‐2011 Apr‐2009 Jul‐2011 Jul‐2011 Jul‐2011 Jul‐2011 Feb‐2013 Feb‐2013 Feb‐2013 Jul‐2011 Feb‐2010 Feb‐2010 TBD Feb‐2010 May‐2010 TBD Jul‐2011 Feb‐2013 Manitoulin Health Centre (MHC) Feb‐2013 TBDHU Sudbury Regional Hospital (SRH) Dryden Regional Health Centre (DRH) Geraldton District Hospital (GDHO) Manitouwadge General Hospital (MGHO) McCausland Hospital (MCCA) Nipigon District Memorial Hospital (NDMH) Thunder Bay Regional Hlth Sciences Centre (TBRH) Feb‐2011 Sep‐2010 Sep‐2010 Sep‐2010 Sep‐2010 Sep‐2010 May‐2010 ACES User Interface March 2015 Health Unit (Key to Table Below) THU TPH WECHU Hospitals within Health Unit Wilson Memorial General Hospital (WMGH) Englehart And District Hospital (EDH) Kirkland And District Hospital (KDH) Temiskaming Hospital (TEM) The Hospital for Sick Children Mount Sinai Hospital (MSH) North York General Hospital Rouge Valley Health System – Centenary (RVC) The Scarborough Hospital – General Site (TSH) The Scarborough Hospital – Birchmount Site (TSHB) St. Joseph's Health Centre (STJOE) St. Michael's Hospital (SMH) Sunnybrook Health Sciences Centre Toronto East General Hospital University Health Network – General Site (TGH) University Health Network – Princess Margaret (PMH) University Health Network – Western Site (TWH) William Osler Health System ‐ Etobicoke General Hospital (EHC) Hôtel‐Dieu Grace Hospital (HDGH) Leamington District Memorial Hospital (LDMH) Windsor Regional Hospital (WRH) Key to Table Above: APH: Algoma Public Health CKPHU: Chatham‐Kent Public Health Unit DRHD: Durham Region Health Department EOHU: Eastern Ontario Health Unit GBHU: Grey Bruce Health Unit HKPRDHU: Haliburton, Kawartha, Pine Ridge District Health Unit HRHD: Halton Region Health Department HPH: Hamilton Public Health HPECHU: Hastings and Prince Edward County Health Unit KFLA: KFL&A Public Health LAMBTON – CHSD: Lambton – Community Health Services Dept. LGLDHU: Leeds, Grenville and Lanark District Health Unit NRPH: Niagara Region Public Health ACES User Interface March 2015 Date linked to ACES Sep‐2010 Jul‐2011 Jul‐2011 Jul‐2011 TBD Oct‐2013 TBD Sept‐2013 Jan‐2014 Jan‐2014 Jun‐2010 Mar‐2013 TBD Oct‐2014 July‐2013 July‐2013 July‐2013 Jan‐2011 Jun‐2013 Jun‐2013 Jun‐2013 NBPH: North Bay Public Health NWHU: Northwestern Health Unit OPH: Ottawa Public Health PEEL: Peel Public Health PCCHU: Peterborough County City Health Unit PHU: Porcupine Health Unit SMDHU: Simcoe Muskoka District Health Unit SDHU: Sudbury & District Health Unit TBDHU: Thunder Bay District Health Unit THU: Timiskaming Health Unit TPH: Toronto Public Health WECHU: Windsor‐Essex County Health Unit YORK: York Region Community & Health Services Dept. APPENDIX B – ACES Syndromes Syndrome Code Syndrome Description ALLERG AST BITE BRONCH BURN CAD CARD CDIFF CELL CHF CO CONC COPD CROUP CV DEHY DENT DERM DM ELECT ENT EOH FALL FBI FEB GASTRO GB GI GMED GNSURG GYN HEAD ENVIRO HEM HEP ILI INF INJ INS allergic reaction, angioedema (not bee sting) asthma, wheeze, difficulty breathing, SOB human, animal, bug (not tick related) bronchiolitis, RSV burns –chemical and thermal, electrical shock coronary artery disease, chest pain pericarditis, effusion, myocarditis, endocarditis c difficile cellulitis, non wound infection, non abscess congestive heart failure carbon monoxide exposure or other gases‐sulphur etc concussion, head injury, chronic obstructive lung disease, croup‐PIV cardiovascular (excludes MI and strokes; includes peripheral vascular disease) dehydration dental pain, infection, trauma to tooth etc rash, undifferentiated, lesion, wart diabetes and its complications electrolyte imbalance, hyperkalemia, hypomagnesium, hyponatremia related to ears nose throat‐surgery, non infectious, tinnitus (not in GNSURG) alcohol and complications‐intoxication, addiction, withdrawal or end organ damage falls undifferentiated foreign body ingestion‐nose to anus febrile neutropenia gastroenteritis Guillain Barre syndrome, flaccid paralysis GI bleed‐upper and lower, epistaxis, hemoptysis general medical admission‐other‐unconscious weakness, unwell, chronic diseases general surgical admission‐appendicitis, cholecystitis, bowel obstruction gynecological, bleed, hysterectomy, PID undifferentiated headache, non traumatic heat stroke, heat syncope, heat exhaustion, cold‐frost bite, hypothermia hematological condition, anemia, thrombocytopenia, not oncological hepatitis, undifferentiated and A,B,C fever, myalgia, undifferentiated flu non specific infections‐potential interest to public health, epiglotitis, tonsil abscess sprain, strain, laceration, dislocation, bruise, swelling insomnia, sleep disorder ACES User Interface March 2015 INT LAC MEDREN MEDSE MEN MH MHS MIGR NEC NEURO NEUS NEWB OBS ONC OPI OPTH ORTHF ORTHH ORTHO OTHER PAIN PE PHYSC PN PO REN REPORT RESP SEP SI SOC TEST THOR TICKS TOX TRMVC TRO TRW TRS URO VOM intussecption lacerations medication renewal, request medication side effect‐not OD meningitis and encephalitis mental health suicidal ideation, attempt or overdose migraine necrotizing fasciitis, severe cellulitis, gangrene dementia, Alzheimer’s, stroke, seizure, vertigo, syncope, fainting neurosurgery‐aneurysm, bleed etc, subdural , SAH newborn related to obstetrics oncology opioid intoxication, addiction overdose, withdrawal general ophthalmological condition fracture, non hip fracture of the femur or hip orthopedic elective surgery, cast change or assessment null, missing, other pain, undifferentiated, non cancer, radiculopathy, back pain, sciatica pulmonary embolism, DHT, VTE physician consultation pneumonia post op infection or complication renal failure, dialysis, renal disease and its complications reportable diseases respiratory infection non croup, non bronchiolitis bacteremia, SEPSIS smoke inhalation, chemical, gases social admission test results, blood or diagnostic imaging, xray, US, biopsy,transfusion, tube change thoracic, pneumothorax ticks toxicology‐not alcohol or opioids, withdrawal, substance abuse, chemical exposure trauma from a MVC/ATV trauma from another means, fall etc. gunshot or stab, violence, assault sexual assault, rape urological ‐stones, prostate, UTI vomiting‐alone‐NORO like illness, not secondary to chemo or with other symptoms ACES User Interface March 2015