1. How Did Information Technology Boost the Dissemination of Community-wide Antibiogram to Healthcare Providers? Lei Chen, PhD, Sr. Epidemiologist Steve B. Fisher, B.S., Department Computer Application Specialist Washoe County Health District, Reno, Nevada 2011 CSTE Conference, Pittsburgh, PA June 13, 2011

2. 2 Objectives Brief description of antibiogram Demo of online antibiogram How online antibiogram was developed How well received by local medical community

3. 3 Background What is Antibiogram? An overall profile of antimicrobial susceptibility of a microbial species to a battery of antimicrobial agents. A tool for healthcare providers to use local antibiotic susceptibility data as recommended by the CDC to provide guidance in their prescribing practice. Collaborating with hospitals Yearly product between 2002 and present Dissemination to the medical community Between 2002 and 2004: pocket size Survey among healthcare providers Between 2007 and present: online, pocket size, wall-chart Demo of online antibiogram http://www.washoecounty.us/health/ephp/antibiogram.php

4. 4 Methods (1) Programming Languages PHP:Hypertext Preprocessor (PHP) Cascading Style Sheets (CSS) JavaScript

5. 5 Methods (2) Monthly web statistics report Effective in August 2005 Web visits for online format, pocket size format, and wall-chart One web visit definition One web visit is counted if the visit comes from one IP address within 15 minutes regardless of the number of hits. One month’s IP address April 2011, look at unique IP address Google analysis of Operating Systems

6. 6 PHP:Hypertext Preprocessor (PHP) Screenshot

7. 7 Cascading Style Sheets (CSS) - Screenshot

8. 8 JavaScript - Screenshot

9. 9 Results Total 15,510 web visits between 2008 and 2010, of which 13,527 visits (87%) electronic formats Average monthly visit for the online format (See following graph) Total web visits between 2005 (August – December) and 2007 was 2,359. Unique IP address analysis: April 2011: 227 unique IP addresses visited the website.

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11. 11 Why increased? Online format became available Increased usage of SmartPhone, for example, Google analysis of OS 2008: iPhone 0.16% 2009: iPhone 0.45% 2010: iPhone 1.4% 2011: iPhone 1.65% EpiNews distribution

12. 12 Conclusions Online antibiogram using computer programming languages definitely assist increase the popularity of the antibiogram Easy to prepare, easy to disseminate, easy to use, and well received by the end users The limitation is lack of trend graph presentation

13. 13 Thank you! Dr. Lei Chen Lchen@WashoeCounty.usLchen@WashoeCounty.us Steve B. Fisher sbfisher@washoecounty.ussbfisher@washoecounty.us www.WashoeCounty.us/health 775.328.3735