The prolonged use of PAT in elective surgical cases increases the risk of developing CDT positivity. The appropriate use of PAT could significantly reduce health costs by eliminating unnecessary doses of antibiotics, by decreasing the rate of CDT positivity, and by shortening the hospital stay. Restrictive policies may need to be implemented to prevent further antibiotic misuse.

Historically in public health surveillance systems have been designed and operated as registries targeting specific health issues. These systems included data from specifically targeted segments of the population, with data elements designed to answer specific programmatic questions. The result has been a collection of silo information systems that rarely can be used to address new needs without extensive revision, rework, or redesign.This decreases the opportunities for cross communication between programmatic areas, and limits the ability of public health professionals to examine issues that cross traditional programmatic boundaries.Emerging public health threats often require the coordination of stakeholders from different areas of public health practice. 2009 H1N1 influenza provided a similar challenge. In order to avoid the problems of silo information systems, the US Centers for Disease Control and Prevention's (CDC's) National Center for Public Health Informatics (NCPHI) and its partners began exploring and developing research for de-centralized information architecture through a Public Health Grid (PHGrid). Through systems research and the exploration of PHGrid capabilities, the CDC was able to develop a pilot project that enabled secure and timely exchange of information across multiple programmatic areas. This paper describes the process and results for the pilot project.

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Methods: The application was designed leveraging an agile methodology, and best practices in user experience (UX) design and mobile application development.Results: As it is an open-source project, the code to PTT Advisor was made available to the public under the Apache Software License. On July 6, 2012, the free app was approved by Apple, and was published to their App Store.Conclusions: Regardless of the complexity of the mobile application, the level of effort required in the development process should not be underestimated. There are several issues that make designing the UI for a mobile phone challenging (not just small screen size): the touchscreen, users' mobile mindset (tasks need to be quick and focused), and the fact that mobile UI conventions/expectations are still being defined and refined (due to the maturity level of the field of mobile application development).

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