There is a role for technological innovations, but they are no substitute for having good, astute clinicians

Dr Angus Nicol, PHLS

The UK has a system where clinicians notify experts in communicable diseases, who log reports, but also check diagnoses.

The US system, the Lightweight Epidemiology Advanced Detection and Emergency Response System (LEADERS), was developed as part of a Defense Advanced Research Projects Agency project for the US Air Force.

It is currently used at 79 military hospitals, but just a couple of dozen civilian hospitals.

Early warning

It can extract details from patient records via a secure Internet connection, no matter what software a hospital uses.

This means hospital staff won't have to do any extra work, according to Brigadier General Klaus Schafer, assistant surgeon general for medical readiness, science and technology for the US Air Force.

Nurses don't have time to enter stuff into a computer

Brigadier General Klaus Schafer,, US Air Force

"Nurses don't have time to enter stuff into a computer," he said.

Brigadier Schafer said the system should spot outbreaks of infectious diseases before doctors are even aware of a problem.

He said it would pick up similar symptoms found at hospitals in the same area, where a doctor finding a patient with a rash and fever might not immediately think of smallpox.

LEADERS, he said would spot the similarities and alert hospitals and government agencies.

And if a case of something like smallpox had already been identified, any cases with similar symptoms would be logged without waiting for a diagnosis.

The company which developed the system believe it may be possible to roll the system out to the US's 6,000 hospitals within 60 days.

Brian Jones of computer company Oracle, who co-developed the system with Idaho Technology, EYT and ScenPro said it was easy to set up because the software runs off a central server accessed via the Net, so the hospitals do not have to install additional hardware or software.

The difficulty, he said, was persuading hospitals to share their data.

System failures

Dr Angus Nichol, director of the Communicable Disease Surveillance Centre (CDSC) at the Public Health Laboratory Service said: "There is a role for technological innovations, but they are no substitute for having good, astute clinicians."

He asked how systems like the US one would pick up notes which said 'we don't think this is anthrax'.

"Certainly if you suspect anthrax, this is a way of detecting these problems.

"But nine times out of 10, once you go back and look, then you find it isn't anthrax."