Emergency Medical Associates is a medical group with more than 190 board-certified emergency physicians who staff the emergency rooms at 16 hospitals in the New York City area. And while the company's No. 1 mission is providing bedside emergency care, its use of data warehousing and data analysis might one day help health officials in New York and New Jersey detect a bioterrorism attack or the breakout of an infectious disease like severe acute respiratory syndrome.

While many physician groups in the United States are just beginning to roll out electronic patient record systems, EMA has been electronically collecting patient data for years. EMA in 1988 developed its first Emergency Department Information Manager system, which included patient tracking and electronic medical chart software. Over the years, the company added physician-billing software and developed an Oracle-based data warehouse called Emergency Medicine Analysis & Reporting System, or eMARs.

The company also uses business-intelligence tools from Business Objects SA to provide monthly reports to hospital administrators and EMA doctors analyzing nitty-gritty details such as how long emergency room patients with heart problems had to wait for treatment and how long after treatment were they discharged.

EMA is in talks with state and city health departments about providing historical data that might help officials detect a bioterrorist attack, SARS, or other possible public health emergencies. Having the ability to analyze historical data from the more than 600,000 patients that EMA physicians treat each year in hospital emergency departments in northern New Jersey and Westchester County, New York, might help health officials spot trouble.

New York public health departments currently gather "syndromic" information from New York-area hospitals--the symptoms that patients present when they seek treatment in an emergency room. But they lack the ability to effectively analyze symptoms for unusual patterns in real time, something that having historical data to compare it to would help, says Jonathan Rothman, EMA's director of data management.

For instance, EMA's data could help determine if the number of ER patients complaining of gastrointestinal problems is unusually high and if it's consistent with rotavirus gastroinfection outbreaks in past seasons, Rothman says. "We're working on projects with the state and city health departments and the Centers for Disease Control and Prevention to use our data for those surveillance purposes."