Stewardship in your pocket: launching Colorado's free antimicrobial mobile application

Area of Science:

• Healthcare technology
• Infectious disease management
• Public health

Background:

• Antimicrobial stewardship programs (ASPs) face barriers in implementation within hospitals.
• Mobile applications offer a potential solution to extend ASP support.
• The Firstline app was developed to address these challenges in Colorado.

Purpose of the Study:

• To describe the development and implementation of the Firstline mobile application.
• To assess the reach, effectiveness, adoption, implementation, and maintenance of the Firstline app using the RE-AIM framework.

Main Methods:

• A mixed-methods pragmatic implementation study.
• Utilized the RE-AIM framework for evaluation.
• Collected data through geocoded user data, cross-sectional surveys, utilization pattern analysis, and monthly active user tracking.

Main Results:

• Firstline app downloaded by 4,409 unique Colorado users within the first year (15% of state clinicians).
• High user satisfaction reported (e.g., 72.9% found it very easy to use, 83.2% reported enhanced antibiotic selection knowledge).
• Sustained monthly active users (average 871) and emerging institutional adoption (10% of respondents).

Conclusions:

• The Firstline app demonstrated widespread use across Colorado, with increasing rural engagement.
• High satisfaction, sustained use, and adoption indicate a scalable model for ASP support.
• The mobile app effectively extends ASP resources beyond academic medical centers.