PTT Advisor: A CDC-supported initiative to develop a mobile clinical laboratory decision support application for the iOS platform.

OBJECTIVES: This manuscript describes the development of PTT (Partial Thromboplastin Time) Advisor, one of the first of a handful of iOS-based mobile applications to be released by the US Centers for Disease Control and Prevention (CDC). PTT Advisor has been a collaboration between two groups at CDC (Informatics R&D and Laboratory Science), and one partner team (Clinical Laboratory Integration into Healthcare Collaborative - CLIHC). The application offers clinicians a resource to quickly select the appropriate follow-up tests to evaluate patients with a prolonged PTT and a normal Prothrombin Time (PT) laboratory result. 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).

The role of public health informatics in enhancing public health surveillance.

Public health surveillance has benefitted from, and has often pioneered, informatics analyses and solutions. However, the field of informatics also serves other facets of public health including emergency response, environmental health, nursing, and administration. Public health informatics has been defined as the systematic application of information and computer science and technology to public health practice, research, and learning. It is an interdisciplinary profession that applies mathematics, engineering, information science, and related social sciences (e.g., decision analysis) to important public health problems and processes. Public health informatics is a subdomain of the larger field known as biomedical or health informatics. Health informatics is not synonymous with the term health information technology (IT). Although the concept of health IT encompasses the use of technology in the field of health care, one can think of health informatics as defining the science, the how and why, behind health IT. For example, health IT professionals should be able to resolve infrastructure problems with a network connection, whereas trained public health informaticians should be able to support public health decisions by facilitating the availability of timely, relevant, and high-quality information. In other words, they should always be able to provide advice on methods for achieving a public health goal faster, better, or at a lower cost by leveraging computer science, information science, or technology.

Using secure web services to visualize poison center data for nationwide biosurveillance: a case study.

OBJECTIVES: Real-time surveillance systems are valuable for timely response to public health emergencies. It has been challenging to leverage existing surveillance systems in state and local communities, and, using a centralized architecture, add new data sources and analytical capacity. Because this centralized model has proven to be difficult to maintain and enhance, the US Centers for Disease Control and Prevention (CDC) has been examining the ability to use a federated model based on secure web services architecture, with data stewardship remaining with the data provider. METHODS: As a case study for this approach, the American Association of Poison Control Centers and the CDC extended an existing data warehouse via a secure web service, and shared aggregate clinical effects and case counts data by geographic region and time period. To visualize these data, CDC developed a web browser-based interface, Quicksilver, which leveraged the Google Maps API and Flot, a javascript plotting library. RESULTS: Two iterations of the NPDS web service were completed in 12 weeks. The visualization client, Quicksilver, was developed in four months. DISCUSSION: This implementation of web services combined with a visualization client represents incremental positive progress in transitioning national data sources like BioSense and NPDS to a federated data exchange model. CONCLUSION: Quicksilver effectively demonstrates how the use of secure web services in conjunction with a lightweight, rapidly deployed visualization client can easily integrate isolated data sources for biosurveillance.

Communications and Web services: What do CDC users desire in partner relationship management and does CDC's PHIN Directory meet the need?

The National Center on Birth Defects and Developmental Disabilities (NCBDDD) at the Centers for Disease Control and Prevention (CDC) sought to establish a database to proactively manage their partner relationships with external organizations. A user needs analysis was conducted, and CDC's Public Health Information Network Directory (PHINDIR) was evaluated as a possible solution. PHINDIR could sufficiently maintain contact information but did not address customer relationships; however, its flexible architecture allows add-on applications via web services. Thus, NCBDDD's needs could be met via PHINDIR.

Developing metadata to organize public health datasets.

The Centers for Disease Control and Prevention (CDC) has available a large number of datasets from previous and current surveillance and research.1 Until now, these datasets have not been catalogued. Metadata would organize these datasets and enhance CDC's ability to efficiently use this data to quickly gain the broader view of the nation's health status to effectively carry out public health activities. This project was to develop metadata for cataloguing CDC datasets and a system that would allow researchers to search at least 95% of databases within CDC based on the most relevant criteria for research. It also explored the need to involve stakeholders and users in the project. The resulting metadata and system are available only to CDC researchers on the CDC intranet.