The acute-care pathway (from the emergency department (ED) through acute medical units or ambulatory care and on to wards) is the most visible aspect of the hospital health-care system to most patients. Acute hospital admissions are increasing yearly and overcrowded emergency departments and high bed occupancy rates are associated with a range of adverse patient outcomes. Predicted growth in demand for acute care driven by an ageing population and increasing multimorbidity is likely to exacerbate these problems in the absence of innovation to improve the processes of care.

Key targets for Emergency Medicine services are changing, moving away from previous 4-hour targets. This will likely impact the assessment of patients admitted to hospital through Emergency Departments.

This data set provides highly granular patient level information, showing the day-to-day variation in case mix and acuity. The data includes detailed demography, co-morbidity, symptoms, longitudinal acuity scores, physiology and laboratory results, all investigations, prescriptions, diagnoses and outcomes. It could be used to develop new pathways or understand the prevalence or severity of specific disease presentations.

PIONEER geography: The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix.

Electronic Health Record: University Hospital Birmingham is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.

Scope: All patients with a medical emergency admitted to hospital, flowing through the acute medical unit. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes patient demographics, co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to process of care (timings, admissions, wards and readmissions), physiology readings (NEWS2 score and clinical frailty scale), Charlson comorbidity index and time dimensions.

Available supplementary data: Matched controls; ambulance data, OMOP data, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.