Milwaukee hospitals established a Regional Emergency Medicine Internet (EMSystem®) to securely share real-time ambulance diversion information. Participating in the governance and use of REMI allows the Milwaukee Health Department (MHD) to issue 24/7 alerts to all area emergency departments and ambulances (e.g., for heat waves, an E. coli outbreak, West Nile, Homeland Security level, SARS); monitor diversion to detect and respond to health system crowding; provide ready access to reference materials (heat wave plan, bioterrorism agent recognition, West Nile tests); and perform syndromic surveillance (e.g., heat-related morbidity, bioterrorism sentinel syndromes, SARS).

The goal of this program is to provide real-time information about fast-breaking environmental hazards, communicable outbreaks, or terrorist events.

All county hospital and EMS providers are connected to the system and can be reached 24 hours a day, seven days a week. Voluntary SARS syndromic surveillance now involves 11 hospitals.