Acute Care Enhanced Surveillance (ACES) provides real-time epidemiological surveillance for Ontario. ACES monitors triage (emergency department visits) and inpatient (admissions to hospital) records from over 95% of Ontario’s acute care hospitals. Records are monitored as the patients are being treated, giving real-time situational awareness for disease outbreak and other potential health risks. Hospital visits are monitored with a sliding scale of specificity, from a province-wide assessment to our smallest level of geography, the FSA (forward sortation area, the first three characters of Canadian postal codes). ACES has built-in temporal and spatial capabilities to enable public health to be better informed on the health of the community to improve public health protection and prevention initiatives.