Medical data collection on UK Military Exercise Saif Sareea 3: the EpiNATO-2 surveillance system.

INTRODUCTION: Epidemiological data from military exercises are important to identify trends in medical presentations and treatment requirements to aid planning for future operations. UK Military exercises use the EpiNATO-2 surveillance system for this purpose, however it has some limitations in the spectrum of data it can collect. An enhanced reporting system titled EpiNATO-2 PLUS was developed and introduced in all LAND (Army) Role 1 Medical Treatment Facilities (MTFs) as part of Exercise Saif Sareea 3 (SS3). It was assessed as part of a Quality Improvement Project for its utility in terms of spectrum and validity of data capture. METHOD: Epidemiological data were collected over a 2-month period from medical consultations in Camp Shafa during SS3 by EpiNATO-2 or EpiNATO-2 PLUS. This involved categorisation of symptoms into a coding system which represents a spectrum of clinical presentations, as well as collecting data on the effect of medical issues on personnel productivity. Halfway through the collection period, an EpiNATO-2 PLUS education session and Summary Guide were introduced. Data were audited for the period before and after these introductions. RESULTS: Of the 1163 consultations conducted in the 2-month period, the use of EpiNATO-2 PLUS captured an additional 169 patient contacts not collected by EpiNATO-2. The provision of a summary guide and teaching session decreased coding errors in the second audit period from 12.9% to 6.8% for EpiNATO-2 and from 19.4% to 6.6% for EpiNATO-2 PLUS, respectively. CONCLUSIONS: The use of EpiNATO-2 PLUS collected a broader spectrum of medical activity in the Role 1 MTF, by capturing an additional 10% of the clinical workload compared with EpiNATO-2. The increase in coding accuracy correlates with the introduction of the education session and EpiNATO-2 PLUS Summary Guide. It is recommended that EpiNATO-2 PLUS is used in future deployments.