Monday, April 28, 2008

Your License Agreements and Your Electronic Medical Record

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.

Wednesday, April 23, 2008

Twittering a Conference?

Twitter is a micro-blogging application. Micro-blogging is a form of blogging that allows users to write and publish brief text updates (in Twitter, 140 characters or less). These updates can be viewed by anyone or by a restricted group. People can update and post these messages by text messaging, instant messaging, email, or a variety of other methods. I have been playing off and on with Twitter and other micro-bloggers such as Pownce to see what uses they might have (if any) in the medical library world.

I was intrigued when I read the Travelin' Librarian's post, How to create a Twitter conference feed. He has micro-blogged three conferences and created a Twitter RSS feed so people who are not at the conference could read posts from attendees. He shares how to twitter a conference based off of his previous experiences. While he admits his system may not perfect he thinks that the major bugs have been worked out.

It is an interesting concept. However, it seems a majority of us are just getting a handle on managing regular blog reading and RSS feeds, plus I am not sure how interested most people would be in a play by play sort of information that micro-blogging gives. Still it is an interesting perspective and there are some very active twittering medical librarians. There is already an MLA2008 account on Twitter for people attending the conference. Some industrious librarians have started a pubmedbootcamp which is an experiment teaching advanced PubMed searching skills via a twitter group.

Other than it being fun and another quick way of connecting with peers, I am not yet convinced micro-blogging is ready for prime time in the medical library world. It will be interesting to see how MLA2008 and pubmedbootcamp turn out. If they are successful, it offers new opportunities for some librarians to share information.

Tuesday, April 22, 2008

Traveling

I am going to be out of town Wednesday-Friday. I may or may not post, it all depends on Internet availability and how busy I am.

Google Starting in on the Invisible Web

The Google Webmaster blog announced that, Google is starting to crawl through HTML forms to get data. "In the past few months we have been exploring some HTML forms to try to discover new web pages and URLs that we otherwise couldn't find and index for users who search on Google."
Why is this important or interesting? Google crawling through HTML means that it is starting to harvest some of the stuff that is available on the "invisible web." The invisible web, is a term used to describe websites are not registered with any search engine. According a 2000 white paper, there are approximately 550 billion individual documents hanging around not found by search engines (invisible).

This step will make more information searchable online. It will be interesting to see how this effects searching and what kind of information Google will find.

For more indepth information on this from Google, go to the Official Google Webmaster Central Blog.

Monday, April 21, 2008

ISI Web of Knowledge Enhancements

ISI Web of Knowledge has made some changes to help you and your users search more precisely, share material, create a complete publication history, retrieve web content, and export more easily.

Precise Searching

  • Exclude results while refining or analyzing search results
  • Sort alphabetically or numerically while refining results
  • Refine faster, with standardized and simplified document type options when searching across all databases.

Share material and collaborate easier

  • Designate read/write access for shared EndNote Web folders
  • Link to the full text of articles directly from EndNote Web records

Increase the visibility of your research efforts

  • Users can search for all of their ISI Web of Knowledge content from within ResearcherID, making it easier to create a complete publication history
  • Upload publication histories from outside of the ISI Web of Knowledge authenticated environment into ResearcherID in RIS format, allowing for easier creation of publication lists
  • Showcase and visualize your contributions to global research with ResearcherID Labs. Use this interactive and collaborative workspace to discover and display who is citing your work and where your collaborators work and live.
  • Access ResearcherID Labs from ResearcherID.com
  • Easily create a "badge", which can be placed on a user’s website, blog, or e-signature to reference a registered author’s profile and publication history

Retrieve context-sensitive scientific results from the open Web

  • Search the open Web for scientifically relevant results with Thomson Scientific WebPlus through BIOSIS Previews, Biological Abstracts, Zoological Records, and Current Contents Connect, in addition to Web of Science
  • Get context-sensitive results, depending on the database used

Export from the Web of Science easier

  • Output Web of Science results in the BibTeX format

For more information go check out their FAQs, training materials, or attend an online training seminar.

Wednesday, April 16, 2008

Sharpening Up Our Search Skills

The Journal of the Medical Library Association features a series of case studies. These cases provide "narrative and insight from expert commentators drawn from librarianship, informatics, medicine, research and other areas." The JMLA Case Studies Blog serves as an online forum for further discussion of the scenarios (within the journal) and the facets of the search strategies addressing these cases.

The blog lists the cases presented in the journal (free full text) and then posts the search challenges and strategies for each post. Readers are encouraged to read the case and then suggest (through blog comments) a search strategy addressing the Search Challenge post. Search Challenge 6 looks at pediatric literature. What are the causes of pediatric ischemic stroke?

I have this blog in my feed reader and I always find something interesting when I see the Search Challenge results. I can always benefit from seeing how somebody else approaches a search and their strategies.

Tuesday, April 15, 2008

Hospitals With Libraries vs. Hospitals Without Libraries

About a year ago I asked the question, "What becomes of a hospital after it closes library?" I posed this question in response to the EPA library closures and other hospital and medical libraries closing. We all have horror stories about a hospital library that was closed or hospital that chose to replace the departing librarian with an overworked secretary who had never heard of PubMed. I was curious as to what happens to a hospital that loses their librarian or library. How does it affect patient care? How does it affect doctor and employee information services?

In the comments section of my post, T. Scott Plutchak said, "My hypothesis is that hospitals that either don't have a library or have closed their library do 'okay.' That is, there's nothing dramatically bad about the quality of care they deliver that would lead to an investigation resulting in a finding that the lack of up-to-date information resources was a determining factor. I suspect that we operate in the nebulous region between okay care and excellent care."

That is probably the case. However, given the choice of having your cancer treated at top hospital providing excellent care or a good hospital with okay care, what do you think most people are going to choose? In the past, it was little more difficult to know what was a top hospital and what was an okay hospital. Things are changing. Recently there has been a lot of chatter with rating doctors and hospitals. Even Angie's List is adding physicians, dentists, chiropractors, and other healthcare providers to their ratings list. Angie's list and others like HealthGrades, offer the average consumer to look at and rank their healthcare.

Recently I read the Medical Librarian Maven's blog post about her concerns regarding a transition (layoffs) that her hospital and her health system are dealing with. She is afraid there will be cuts to the library staff. Two of the hospitals in the system were recently ranked in the top 15 for major teaching hospitals. Both hospitals have larger libraries with more than one professional librarian on staff. She believes, "in order to be an excellent center for clinical practice and education you need an excellent knowledge-based information center (aka - library) with excellent professional librarians to help clinicians find the best, most appropriate information in the time the need it."

Her post got me thinking again about the value of the library within the hospital and whether there is a correlation between hospital libraries (or lack of) and the hospital's quality of care. How could one study that? Wouldn't information like that go hand in hand with an updated Rochester Study to show our value? I wonder if you could compare hospital rankings within selected states of hospitals with and without libraries. I think you might have to adjust for size and revenue. You could also compare hospitals according to the outcomes of various common standard procedures.

Being new to research and writing, I am not sure if a study like this is even feasible or how I would go about doing it. But, I think in addition to an updated Rochester Study we need to start looking at the quality of hospitals and whether it correlates with having a library. I think if we were to have that type of research it could go a long way in justifying our existence to administration and the medical community.

Monday, April 14, 2008

MLA Annual Meetings Scheduled Through 2013

As you all know by now, MLA's 2008 Annual Meeting will be held in Chicago, IL
May 16-21.

Here are the other cities chosen for the meeting.


May 15-20, 2009 Honolulu, HI - Break out the sun screen and flip flops.
May 21-26, 2010 Washington, DC - See where all your money comes from and eventually goes.
May 13-18, 2011 Minneapolis, MN - Why not combine it with a trip to the Mall of America?
May 18-23, 2012 Seattle, WA - Catch the view from the Space Needle.
May 17-22, 2013 Baltimore, MD - Great crabs and Edgar Allen Poe.


Looks like a lot of neat places and I am sure MLA members in those cities are excited. I am just patiently waiting for MLA to choose St. Louis (Arch, Westward expansion, St. Louis Cardinals, Ted Drews) or Cleveland (Rock and Roll Hall of Fame, Cleveland Indians, the Christmas Story House, and Great Lakes Brewery). Of course I am slightly biased.

Friday, April 11, 2008

MLA Seeks Conference Bloggers

This year MLA will sponsor 15 "Official MLA Conference Bloggers," who will blog about the conference speakers, sessions, committees, and social events. If you are going to MLA and you blog this is your opportunity to officially share your thoughts and experiences. Official Bloggers will provided with wireless Internet access for the duration of the Annual Conference and MLA will acknowledge your contribution to the membership on the MLA Conference pages. All Official Conference Blogs will be listed on the Blog Roll at the MLA Conference Wiki.

If you are interested you need to apply using the online entry form. Entry Deadline is May 1 and official notification will be by May 9.

Thursday, April 10, 2008

Pushing Tag Items Usings RSS Feeds to Our Users...Why and How

I have read David Rothman’s blog and listened to him talk about RSS feeds often. In the back of my mind I knew what he was saying about tagging and RSS feeds was important but my brain was always a half step behind his message. But finally, I have to say, I get it! I think I understand some of the possible outreach opportunities tagging RSS feeds can do. Sorry David, I am a little slow at times.

So here is what I finally discovered (with the help of David).
One of coolest things is that del.icio.us tags can be made into RSS feeds that you can monitor. Why on earth would I or my users want to monitor a specific de.licio.us tag?
As the librarian I can create a del.icio.us account for my library. I can then create tags for various departments within the hospital (cardiology, OBGYN, pediatrics, nursing).
Then as I run across news items, web sites and articles I can tag them according to the appropriate department.
Library users can subscribe to the tag feed and will be notified whenever I tag an item that falls within their discipline.

How do you do this?
It is really easy.... Let's say your are a library user at UBHSL (which has a del.icio.us account) you can go to http://del.icio.us/UBHSL
Let’s say you are interested in all articles with the tag medicine (I know this is broad but it works as an example), click on the tag medicine and you will see every item they tagged with the term medicine.
If you want to subscribe to that medicine feed, go to the URL http://del.icio.us/UBHSL/medicine and copy it. Go to your feed reader (I use Bloglines) and click add a feed, and paste the URL http://del.icio.us/UBHSL/medicine into the box and click subscribe.

Every time the librarian tags an article with medicine you will get an update in your feed reader account.

As I mentioned the term medicine is probably too general, but it served as a nice example here. It probably would be more beneficial if you created tags for specific hospital departments or research interests. Then you could create a page listing the feeds that library users could subscribe too.

You can create user monitored feeds with CiteULike as well. However, I think CiteULike can be a little picky if you don’t use one of their “supported” sites. You have to manually enter the information, blah. For example PubMed and NEJM work great on CiteULike (because they are supported sites) but JAMA doesn’t work and you get an error message. Yuck.

You can monitor user feeds using Connotea, but I am not sure if you can if you can drill it down to the specific user feed and a specific tag like you can with del.icio.us or CiteULike.

I am sure David has figured this all out before and knows way more than I do, but like I said the light bulb finally went on in my brain and I thought I would share it with everybody. If you have other ways tagging and RSS feeds can be helpful or if you have more to add on to my “ah ha” moment, please leave a comment.

Wednesday, April 09, 2008

Instant Messaging Applications Reviewed

If you are interested in instant messaging you might want to take a look at the post, 5 Best Instant Messengers Compared & Analyzed.

Digsby, Pidgin, Meebo, Adium, and Trillian are all reviewed.

Illiad in the Medical Library World

If you have heard about Illiad but don't know much about it you might want to check out a nice post on The Cornflower, Illiad and the Medical Library World. Many of you in academic medical libraries are probably familiar with Illiad, but those of you in hospital libraries or other medical (non academic) libraries might not be as familiar with it.

Illiad was created to manage OCLC requests, but with some tweaking it can work well within Docline. If you are a library that does a lot of Loansome Doc, you will want to know that it can be a little tricky. "Managing Loansome Doc traffic in ILLiad allows for some creativity. New Loansome Doc requests are imported into ILLiad’s borrowing module. They can be handled there or transferred to ILLiad’s document delivery module, depending on how you define your Loansome Doc service. When Loansome Doc requests transferred into DOCLINE are indicated as filled on the Activity and Status page, those requests need to be updated in ILLiad."

If you are in a one person hospital library, you may not need Illiad. But it is nice to know about it. Who knows you may not always be at a one person hospital library.

Tuesday, April 08, 2008

Risk is a Four Letter Word That Isn't Always Bad

Recently I gave a talk to 10 library students taking a special libraries class. The topic was career and professional development. When I started to prepare for the talk, I wondered what on earth do I know about professional development and career development? I still think of myself as young librarian just starting to dip my toes in the professional development pool. So, I began to think of what I had done within my library career to develop and grow professionally. It was only when I began to reflect on some of my developmental milestones as a librarian did I realize something. Developing one's career requires some risk taking.

I am not a big risk taker by nature. Everything I know about crab fishing is from watching Deadliest Catch on the Discovery Channel, and there is no way on God's green earth that you would be able to get me on one of those boats. Noo thank you. While I drive a mean Honda Civic stick shift in Cleveland traffic, I am certainly not a NASCAR driver. I like to do fun things and I don't think I am boring, but Risk is not my middle name...it is Aileen. But I have come to realize that risk is not always a bad thing. There is a big difference between working in one of the world's deadliest jobs and librarian professional development.

Measured and calculated risk can actually be good. Don't get me wrong it is scary, but it can be good for you. Sometimes after weighing the options you need to take the professional risks to grow. Sometimes those risks are small like writing a blog, journal article, review, etc. Sometimes those risks can be larger like speaking at conference or being watched live via a webconference by your peers. You haven't seen scary until you realize what you look like on TV. I think some of the hardest and scariest risks can involve changing jobs. Can you move cross country for a job, uprooting your spouse's profession and children's school? Can you accept a new position with more responsibilities, duties and growth but still get paid the same (even after negoitations) as your previous position? While some of these decisions may be easier to make than others, they all involve a certain amount of risk.

There are rewards to taking risks. Everything builds upon each other. For example the poster presentation you gave at MLA led to a nice article published in a library journal. Somebody read that article and thought you would be the perfect person to speak to their group about that topic. Even when things don't go as planned and the move you make turns out to be riskier than you intended, it is how you learn from that experience that can make it better. I am not saying that you will always be able to turn lemons into lemonade. But you can make some things work. For example, if you start out in libraries as a cataloger only to later learn that it wasn't your life's calling (as you originally thought), you can take that experience and perhaps work it to fit another job that you might like.

Life is full of risks, and what we do and how we handle it makes us who we are personally and professionally.

MLANet Down

MLANet is currently having some server issues and has been sporadically up and down. Rest assured the MLA staff know about this problem and they are working on the problem.

If you still need to register for MLA before the Early Bird deadline expires go to:

http://www.xpressreg.net/register/medl058/lookup.asp

Please note that MLA email lists and email have NOT been affected by this outage. MLA section, chapter, and committee sites hosted by MLA are also not affected.

Thursday, April 03, 2008

Connotea: Review

This week MLA's Web 2.0 101 class is looking social bookmarking. Coincidentaly Melissa Rethlefsen's review of Connotea (Nature Publishing Group's answer to del.icio.us) was just published in the J Med Libr Assoc. 2008 April; 96(2): 175–176. You can read the full text or the PDF for free.

Unlike del.icio.us, Connotea automatically captures and parses the bibliographic metadata (complete citation information for articles, books, blogs, etc.). Librarians who are responsible for author databases might be interested in Connotea to help them with their work.

Standards for Hospital Libraries 2007

The 2007 standards for hospital libraries is out and available online (free) from the Journal of the Medical Library Association.

For those of you who forgot to grab your daily dose of caffeine (like myself), don't forget to look on the left side of the web page (just left of the blue stripe down the side) and you can easily click and view each standard individually. The PDF is also available as well.

Tuesday, April 01, 2008

Hospital Library Blog Example

Hospital librarians face some unique challenges that academic or other medical librarians may not have to deal with. Often hospital librarians are solo librarians and often their hospitals have some strict Internet and Intranet protocols. This can make creating and maintaining a hospital library page difficult and it can make having a hospital library blog down right frustrating.

However, there are some hospital librarians out there who are looking around the corners and doing things just a little bit differently to get their information out there to users. One example is the St. Louis Children's Hospital Medical Library.

I was out trolling the Internet trying to find good hospital library blog examples and ran accross SLCH Medical Library. Being a native St. Louisian, it caught my eye immediately. St. Louis Children's Hospital Medical Library is affiliated with Washington University Bernard Becker Medical Library and serves the faculty, staff and students at St. Louis Children's Hospital.

Right away I noticed the site was very new and the domain was registered in December 2007. So after a bit more poking around I emailed the librarian contact to find out more information.

This is what I learned:

  • The SLCH Medical Library blog was an easy way to have a website for the library that was under the librarian's control and could act as the centralized access and service point for users.
  • While the library has a web page on the hospital's Intranet, the librarian had no control over it or its content and despite several requests, information was not being updated on it.
  • Technically the librarian is using a blog format, but she refers to it as the library's website. The concept of a "blog" is kind of new to the majority of the user population and she suspects the term might put them off to the idea.
  • Washington University's Becker Library bought the domain for the blog (notice the SLCH's URL is different from SLCH Medical Library and Becker Medical Library).
  • The librarian got permission from hospital adminstration to start the blog and use the SLCH Medical Library name. In addition they provided a link to it on their clinical services portal. However, the hospital does not provide server space or any help to manage, maintain, or fund it.
  • In addition to regular links and contact information on the site. The librarian included an RSS PubMed feed for SLCH affiliated publications.
  • The librarian mentioned two thoughts for the future. One is to get the library page as a desktop icon on all of the hospital computers (she is collaborating with hospital tech folks on that). Two, while her user population might not be hip to term "blog" she knows that her residents are interested in an online journal club and she believes this would be the perfect format for it.

I think this is a really neat example of how a hospital librarian was able to work around and within the system at the same time. I applaud Becker Medical Library for funding the domain name registration and hosting. That amount of money may not have been a large sum for Becker, but it allowed the librarian to have a site. There happens to be many sites that will register domain names and host sites for a very nominal fee (as little as $7-10/month). So for $120/year (less than the price of many medical texts) a library could get a domain name and hosting.

So you see, it can be done, you can have an online site. It may take some time, but when more and more business is done online, having a usable site is extremely important.

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The Krafty Librarian has been a medical librarian since 1998. She is currently the medical librarian for a hospital system in Ohio. You can email her at: