Evaluation of Firstline’s Antimicrobial Stewardship App

User Experience and Usability Testing for a Smartphone App Designed to Combat Antimicrobial Resistance by Providing Clinical Decision Support

About the Project

The prevention of overuse of (broad spectrum) antibiotics through antimicrobial stewardship (AMS) programs is increasingly regarded as indispensable, both to optimize therapy for individual patients, as well as to reduce the emergence of resistance. The Firstline AMS (formerly Spectrum) iOS and Android-based smart phone application (SApp) and Content Management System web-based application have been developed in response to this. Their overarching goal is to become a digital steward for use worldwide in order to increase adherence to prescription guidelines and reduce antimicrobial resistance.

A heuristic evaluation and qualitative interviews based on two unique interview guides were performed to evaluate the usability of the application. Results indicate that the Canadian-developed tool has been received very favourably. The lack of identifiable pain-points and negative user reviews reflects the well-structured content and easy navigation of the interface, and the SApp has been determined to meet well-established user interface design guidelines that optimize usability.

Currently, summative usability testing for the SApp is underway and aims to quantitatively assess the usability and user experience of the SApp.

Investigator: Dr. John Conly, MD


The tool, which has now been used in hundreds of hospitals around the world, is customizable to local guidelines and is updated frequently – for instance, Firstline in Canada was quickly updated to include very relevant COVID-19 support pages. Ensuring that these systems are user-friendly (effective, efficient, and satisfying to use) may be a key factor in encouraging widespread use of the Spectrum tools and assisting in antimicrobial stewardship.

Services Provided

• Ethics Development and Management
• Expert Reviews
• Stakeholder Engagement 
• Usability Testing
• User Experience Research and Design

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