Do you know what library resources your doctors are accessing through your hospital's electronic medical record? Most librarians do not. Unfortunately most librarians have been shut out of the electronic medical record roll out. There are numerous reasons why this is unfortunate, one of which is the library's license agreements. The license agreements for electronic resources vary. Some are extremely complicated. Some prohibit off campus access and ILL. Some have strict definitions of what is an authorized user.


Why should you be concerned about your hospital's electronic medical record system and the library's electronic resources? Because there are some electronic medical record systems that allow doctors to add their own links to information resources. You got it, doctors can add links to your resources and access them within the medical record, making these electronic resources available off campus. Depending on your hospital, this could also mean that private practice doctors (i.e. for profit entity) could be accessing resources as well as other unauthorized users (according to the license agreement). Simply put, these doctors may be authorized to access the medical record, but they may not be authorized to access the library resources within the medical record.


Believe it or not this is already happening. Depending on the electronic medical record system, doctors can add links to library resources within the medical record. Online journals, textbooks, drug guides, society websites, and point of care databases (such as UpToDate) all can be added as information resources accessible within the electronic medical record. A doctor (and anybody else with electronic medical record access) can use these resources from his home and his medical office building. Depending on the resource this may be a violation of the library's license agreement.


Librarians not only need to be aware of what resources their doctors find helpful to answer clinical questions but they also need to know the licensing implications. Your hospital IT personnel are going to be concerned about the security of patient data, and rightfully so. Most likely they will be completely unaware of the software and vendor license agreements the library has and the implications for use within the electronic medical record. After all, imagine what would happen if one of your doctors added a link to UpToDate to use within the electronic medical record thereby enabling UpToDate to be available from off campus? I can probably speak for many librarians in saying that would be very bad.

***Update***
I know not everybody reads comments in blog posts and Marie made a comment that made me realize that I left off something VERY important.

It may not matter if you restrict your resources to a specific IP range! The doctor viewing the electronic medical record is already virtually sitting on your IP range, and your resources are available to him off site. I know of instances where libraries have tunred off proxy access and limited access to specific IP ranges to certain resources not licensed for off campus access, yet the doctor was able to use them off campus while he was within ERM.