The #medlibs chat group will be hosting a five week series presented by the University of Massachusetts Medical School Lamar Soutter Library.
Here are the weekly chats:
- August 15th: Host: Donna Kafel Topic: e-Science portal
- August 22nd: Host: Kevin Read Topic:e-Science thesaurus
- August 29th: Host: Andrew Creamer Topic: New England Collaborative Data Management Curriculum
- Sept. 5: Host: Sally Gore Topic: Role of the informationist on research teams
- Sept. 12: Hosts: Lisa Palmer & Kate Thornhill Topic: Institutional repositoriesand open access
Discussing e-science issues on #medlibs is a great way to learn more about the topic, but the icing on the cake is that these chats have been approved for free (or near free at $5) MLA CE!
While this is a cool opportunity, there are rules for getting the CE.
- No partial CE hours will be awarded.
- Participation is measured by at least 3 tweets during each #medlibs chat session as shown by the chat transcript discussion AND/OR a reflective summary paragraph about the chat transcript discussion posted as a comment to each week’s blog post at http://medlibschat.blogspot.com/
In her post Nikki says that MLA pre-approved this e-science series for CE. If there are costs they would go directly MLA according to their Discussion Group Program. Nikki has graciously volunteered her time to be the convener for the program, verify participation, administer evaluations, and issue the CE.
The CE may or may not be free. If it is not free, it will be extremely cheap. It will only cost $5! Whether the CE is free or $5 will be clarified soon by MLA and announced when known.
If there is a fee for the CE, please note the following:
- Participation will not be tracked or awarded to those who indicate they will only take it for free if a cost is required.
- PayPal will be used to collect funds if there is a cost for CE. The convener (Nikki Dettmar) will email all participants who have indicated they will pay a cost for CE with further instructions.
- If there is a cost for CE and you have not paid by the end of the series, no CE will be awarded. There will not be followup/reminder emails.
What a great opportunity. Kudos to Nikki for all of her hard work coordinating this. Thank you to the weekly hosts. I have a lot to learn about e-science and I am going to sign up.Share on Facebook
Below is a guest post from my husband about his Windows Phone. A while back ago I asked him to write a post comparing the different phones he has had. He the only person I know who has had an iPhone, Blackberry, Android and Windows phone and is not working for CNET or another technology review company. He has used and lived with each of these phones at some period of time. He started with the iPhone 3G then moved to the Android. He had a Blackberry for work and now has a Galaxy S4 for his work phone. He currently has a Windows Phone as his personal phone.
He started out writing a big ol’ post comparing all of the platforms but realized lots of people have already done that, so why reinvent the wheel. It was after some good natured teasing I gave him about his Windows phone that he decided to write his post about his phone.
So enjoy your Friday Fun guest post and maybe it might get you thinking about a Windows phone. I have to admit, as much as I tease him, he is right about the Office capabilities being a big plus.
My name is Mike and I am a Windows Phone user.
Yes, I know. There are actually some of us out there and believe it or not, we really do like it. Alot.
It was a long winding path to get here, over the iOS river and through the Android woods. I won’t bore you with the details but I have had plenty of exposure to both of the major platforms through personal and work devices.
Using Apple products has always felt to me like I’m living in a subdivision with an overzealous homeowners’ assocation. It’s very clean and everything works but God help me if I want to put up non-sactioned Christmas lights or change the flag on my mailbox.
I won’t even mention iTunes. I’m still seeing a therapist over that.
When I went to Android it was for the promise of the exact opposite of the iPhone experience. Open, free, do whatever you want. It was the Summer of Love all over again.
But the more time I spent within that user interface, the jarring transitions from one app to another and the inconsistent overall delivery of the experience, it began to feel more and more that I had taken the brown acid and was in for a bad trip: http://www.youtube.com/watch?v=hKoLlKmQSHU
The app quality and overall safety itself wasn’t exactly what I had in mind either. Downloading something from the Google app store felt like the smartphone version of the Russian roulette scene from The Deerhunter.
It was at my moment of greatest smartphone despair that I found myself at an AT&T store and face to face with a Nokia Lumia. What do I have to lose? I told my then five year old son to stand still and try and be quiet while I tried something. While he went and did the total opposite of that I took the phone for a test drive.
I work for a software company so I have used countless numbers of different programs on different platforms over the course of my career. The Windows Phone UI was one of the simplist, most intuitive I had ever used.
Even using one hand and half my brain to try and corral a kid who was going Dennis the Menace inside the store, I effortlessly moved through the interface. I read (fake) e-mail and text messages, did a quick Google search and was even able to take a photo of my son hiding behind the Samsung Galaxy Note display (thanks to the dedicated camera button on the side).
The more I used it and the more I read about it, it was like having the best of both worlds. The live tiles and the Metro (Modern UI) interface gave every app a uniform sameness but yet there was a freedom to change and different ways to view and do things. It was like the hippies had grown up, moved into the subdivision, and gotten rid of the rules but still kept their lawns mowed at a reasonable height.
The first time I emailed myself a couple of Word documents and an Excel spreadsheet for a meeting and they opened without so much as a single glitch I almost cried.
Even the physical qualities were to my taste. I like a little heft to my phone, something that doesn’t feel like it will fly out of my hand as soon as I pull it out of my pocket. For example, my two year old daughter’s pink barrettes feel sturdier than the Galaxy S4 I use for work.
I could go on and on (and maybe I will if the Krafty Librarian gets lazy and needs me to fill up more space). If you find yourself in the smartphone doldrums like I was, I highly recommend you at least pick one up and give it a try.
Or you might just be happier like this:
The app Figure 1 has been getting a lot of press recently. I learned about it a few weeks ago but I am just now getting around to mentioning it here.
Figure 1 is being called the Instagram for doctors. It is a crowdsourced images database app. The crowd happens to be doctors, and the images happen to be medical images. The app is a collection of medical images submitted by doctors to share, collaborate and learn from. Doctors are verified using their institutional email address. The app takes patient privacy very seriously. It has a face detection program that automatically blocks out the face in a submitted photo and it includes other editing tools to remove other identifying features. A HIPPA authorization digital consent form is also included. Patients click the agree button then sign screen/form.
You don’t have submit any images to benefit from the app according to their site. “First of all, you can still access the images that others are posting so that you can learn from them, use them as a reference for your own practice, or comment on them so that others can learn from you.”
David Ahn at iMedicalApps posted a great review describing the positives and negatives of this novel app. He notes some of the limitations of the app are the indexing of the images and lack of identifying information. Ahn discovered upon doing a search for heliotrope rash that the first seven results were “clearly not a heliotrope rash.” As librarians know, indexing images is tricky. Ahn noted Figure 1 also pulls images from outside medical websites (non-user submitted images) and a link to the website instead of the submitter’s name is listed. However the outside images have “no captions, markings, or even any clear diagnosis listed.” Besides the obvious problems with lack of identifying information, Figure 1 displays user submitted images before web scraped images. As Ahn illustrated with the heliotrope rash, this can cause problems because the correct image (scraped from the web) was buried below the 7 incorrect ones (user submitted ones).
Additionally, I find doctors not only want to see and share images, but they often want to include them in presentations and slides for teaching purposes. Right now you can only share the images through the app. Emailing a colleague an image gives them a simple email (below) requiring them to use Figure 1 to see the image. Making it so Figure 1 images can be used in presentations would make this Instagram like app even more useful to doctors and medical professionals.
This is a very new app. It appears they launched in May 2013, so it isn’t surprising that there is some room for improvement. I don’t know of any products or apps that are perfect 3 months from their launch. Yet as of today, it is the 5th most downloaded app in the Medical category of iTunes and according the MedicalApps post, the app is outpacing Landy’s projections. So, given its popularity I expect to see some improvements relatively soon.
What I found to be interesting was Dr. Landy describing to Ahn his reason for creating this app.
Dr. Landy wondered how he could quickly access a medical image database to assist in identifying new clinical pathologies. This question eventually led him to create Figure 1. Like many physicians, he was not satisfied with the paywalls of private medical image libraries or with Google Images’ lack of medical selectivity.
Furthermore, when it came to sharing medical images with his peers, he found e-mail inefficient, as images would often get drowned out amidst ballooning inboxes. As a result, he helped create Figure 1, a free, crowdsourced medical image sharing resource that is quickly and easily accessible for health care practitioners.
Finding good medical images has always been a booger, and Dr. Landy is right about the frustrations of pay walls. I would extend it a bit further to say that not only is the paywall part is a barrier to finding medical images, but the siloed nature of these medical image sites is a massive barrier as well. Even if somebody has paid for these medical image sites, there is no repository or online catalog of all the image packages bought from different companies. That makes searching for images difficult even if you paid for them.
I am curious to see how Figure 1 evolves and what impact it will have on doctors finding images. I am also curious to see how/if subscription companies with medical image silos might adapt as a result of apps like Figure 1.Share on Facebook
Google is letting several people “play” with Google Glass. I know of two people at my institution who are trying it out. Since I don’t have Google Glass(es) and I don’t have a real need for them right now other than playing with them and obsessively worrying about breaking them (there is a reason I buy cheap sunglasses). I thought I would summarize some of things the medical/technical people testing Glass have said.
John Sharp at eHealth
John works at the Cleveland Clinic. He had three days with Google Glass and his thoughts are:
- Voice command takes some getting used to
- Menu gets some getting used to
- Nice to be hands free browsing, taking videos/photos -camera quality excellent
- Possiblity for healthcare – Physicians receive alert on patients lab results via Glass
- Network access for surfing is currently problematic. Need an available wireless network or an open network that does not require authentication. Alternative is to connect using your phone’s bluetooth (wifi) or enable your phone as a wireless hotspot (dataplan!)
- Messages are alerts are short and limited text to fit on tiny screen/glass
- Permissions/privacy concerns because you don’t know somebody is filming using Glass
John Halamka at Life As a CIO
Chief Information Officer of Beth Israel Deaconess Medical Center briefly describes Google Glass and how it works and lists 5 potential uses.
- Google Glass basics: (He calls it basically an Android cell phone without the cellular transmitter.)
- Can run Android apps (Krafty thought: Candy Crush andyone?)
- Videos displayed at half HD resolution
- Sound uses bone conduction only wearer can hear it (Krafty note: I am very familiar with this method, there is an underwater MP3 player that uses the same technology.)
- Has motion sensitive accelerometer for gestural commands
- Right temple is touch pad but also has microphone for voice commands
- Battery lasts about a day
- Meaningful Use Stage 2 for hospitals- Screen shows picture of patient and medication on Glass to nurse who is about to administer the drug to ensure that she has correct patient and medication. (Krafty thought: The movie Terminator is coming to mind and I can imagine the the nurse “scanning the room” and it flashes on patient and does face recognition with ID bracelet confirmation then scans the barcode of the medication and gives a green screen if it is right or red screen if it is wrong. But according to this post facial recognition apps are currently banned.)
- Clinical documentation – provide real time video of the patient/doctor encounter.
- Emergency Department Dashboards – ER doc puts on Google Glass and looks at patient and it does a “tricorder” like scan of patient providing vital signs, triage details, nurse documentation, lab results, etc. John states “At BIDMC, we hope to pilot such an application this year.” (Krafty thought: Dude that is the Terminator screen up display that I am thinking of.)
- Decision Support – Google glass would retrieve the appropriate decision support for the patient in question and visually sees a decision tree that incorporates optimal doses of medications, the EKG of the patient, and vital signs.
- Alerts and Reminders – Communication, emails, phone calls, calendar, etc.
Timothy Aungst and Iltifat Husain at iMedicalApps
I can’t tell from the post whether they tried one out or whether they were just coming up with usage scenarios. They provides a lot of scenarios (too many to list here) so I just thought I would mention a few that I think stand out. There is also a lively discussion in the comments section.
- EMS Responder at an accident has Google Glass on and transmits live stream to ER department status of patients and the traumas for each patient enabling the ER to better prepare for the patients upon arrival.
- A cardiologist in a cath lab overlays the fluoroscopy as they perform a femoral catheterization for a patient with a recent myocardial infarct.
- A physical therapist can see past sessions with a patient from previous recordings, overlaying their current range of motion, identifying changes as well as progression.
- Any healthcare professional could walk up to a patient’s bed and instantly see all their vitals such as pulse, BP, O2 Sats, etc.
Dr. Rafael Grossmann @ZGJR Blog
Has several very interesting posts on his current use of Google Glass treatpatients. He is not only using it in medical scenarios but also with real patients.
- CPRGLASS, THE AUGMENTED REALITY APP THAT CAN HELP YOU SAVE A LIFE Creating apps such as a CPR app or other medical education videos and procedures.
- “OK GLASS:..TEACH ME MEDICINE!” -Used a medical simulator mannequin for emergency and medical treatment scenarios, to show the potential of Google Glass in Medical Education.
- “OK GLASS: HAND ME THE SCALPEL, PLEASE…” GOOGLEGLASS DURING SURGERY! -Using Glass during surgery with a real patient and streamed of non-identifying patient information thru a Google Glass Hang-Out.
There are a lot of people in library land writing posts about Google Glass and its potential impact on libraries. I don’t know of a librarian who has tried them (if there is one let me know) and asside from iMedicalApps I chose to focus on those who have actually tried them. A future post will look at the potential of Google Glass in libraries.
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Tomorrow I will be moderating the #medlibs chat and we will discuss the use of social media for patient education and consumer health. 72% of adults seek medical information online, and between 26-34% (depending on various reports) of people use social media to find health information. The thought is the trend will continue to grow.
I will be asking these questions (I’m giving them to you ahead of time so you can think about them):
- How are librarians using social media to provide consumer health information or patient education?
- How do you measure the effectiveness of a social media health information campaign?
- What are some barriers to providing patient education/consumer health information via social media?
#medlibs is a active group with lots of ideas and opinions so I am sure we will have more questions as we discuss things, but this is these are the main ones to get us started.
See you all online Thursday July 11, 2013 at 6pm PST and 9pm EST.
I am writing a book chapter on this topic and this #medlibs discussion will help me with it. I may use some tweets or reference parts of the #medlibs chat in the chapter. I don’t want to squelch the overall fun chattiness of the group. If I use anything I will only refer to tweets that are specifically related to the discussion topic and I will make every effort to let you know I am using your tweet.
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People who have been using Google Reader have been scrambling to find an adequate solution to replace their beloved feed reader. Back in March, I wrote post on reader options for those looking to migrate before the end of Google Reader. I never really got into the Google Reader. I was a Bloglines girl who threw all of her feeds to Google Reader in a panic just before Bloglines disappeared. In months following the Bloglines blow up, I settled on Netvibes. At the time, I liked Netvibes integration with my social media and feeds. As I mentioned in my post in March, I haven’t been reading my Netvibes as much as I used to. While I liked Netvibes, something was missing. I suspected it was because it didn’t have an app, but now I think it was a combination of things.
When Google decided to pull the plug on its reader I decided to investigate different feed readers again to determine if I found one better than Netvibes or if I really even needed a reader now. These days I get a lot of my information from Twitter and to a lesser extent Facebook. People are tweeting their blog posts, or interesting questions, topics, issues, etc. and I wondered whether my social media feeds caused me to move beyond a feed reader. This is kind of the same thing Marcela De Vivo at Search Engine Journal wondered with her post, “Google Reader Is Almost Gone, But Do You Really NEED An RSS Reader Replacement?”
Could it be that Google is transitioning away from the RSS Reader format entirely? They’re switching over to Google Plus, and they want you to come with them.
Consuming social media as part of an RSS feed is not exactly new—that’s exactly what Digg is doing when it launches its own reader, the same day Reader shuts down. But to do away with readers entirely, relying solely on a social platform? When we’re looking at large-scale data consumption, is it a viable transition?
The answer is yes—if Google can pull it off. With the latest Google Plus redesign, this social platform is now much more social, making it easier to stream and share information. It could be possible to amass “feeds” of information… if you’re following the right people. And in order to make sure the right people are on Plus, Google got rid of it’s eminently popular Reader.
It could also be said that Google is simply following on the heels of a major trend in how we access information. RSS readers were designed for people to sit down and browse their collected feeds. But with the increasing number of those who use smartphones and tablets as their primary internet checkpoint, it’s more common to see people who are accessing information all day long, checking the latest news on a constant basis—which makes an integrated social media/reader platform much more probable option.
It is an interesting concept. Right now I only use Google Plus for work at my institution. (The Department of Education is exploring its use for connecting and sharing within the department and increasing synergy.) I play on it a bit for personal and library stuff, but I just haven’t gotten into it yet. Maybe Google knows me better than I do, and Google Plus will be attached to my hip in a year’s time. I remember saying years ago that Twitter was fun but I couldn’t think of using it professionally. Doh!
In the meantime I have not yet given up my feeds. I decided to explore Feedly. I don’t like the fact that Feedly doesn’t work with IE. I know everybody talks about IE’s decline in the browser wars but the problem is that many major hospitals and larger companies use only IE. Academia and the open natured technology industry have the flexibility to shun IE in favor of other browsers, but there is a large group of the working population that can’t. I am not the only one who reads feeds at work, Feedly’s suggestions page has many comments on the IE issue. Apparently the new Feedly Cloud feature might help IE users, but there are those on the suggestions page that seem to have problems with Cloud.
Now I am lucky in that I am able to use Firefox and Chrome on my work computer. However, because there are a lot of hospital resources and other web resources that were created specifically for IE, it tends to be my browser of habit at work. I noticed I am breaking that habit slowly. I have Chrome up almost all the time for two reasons. 1. Our the Department of Education is exploring the use of Google Plus. 2. My life is on Google Calendar and I need to consult it often.
One of the nice things about Feedly is that it integrates very well with Chrome. As soon as I launch Chrome the Feedly tab launches with my feeds. This is actually is quite helpful to me and works perfectly with my morning current awareness reading habit. When I login to my computer each morning the first thing I do is bring up Chrome for my calendar, so the Feedly tab with my feeds is right there too. This has gotten me back into the habit of reading my feeds.
Feedly has an app and it is on my iPhone, but like Marcela mentioned, it is a bit clunky. I don’t use Feedly on my phone as much as I thought. I still use it more than I used Netvibes, mainly because it is an app on my phone. I have found that on my phone Feedly has to compete for my attention among my other apps. I tend to use apps that have the alert icons on more than the ones that don’t. Because Feedly doesn’t have alerts showing up on the icon, it often gets ignored for other apps like Facebook, Hootsuite, mail, Words with Friends, news apps, etc. that all have alerts. I see a little red number next to those apps and my brain says, “Ooh what’s new that I need to know about?” I know I am easily distracted.
I have pretty much left Netvibes, it just didn’t fit into my work flow anymore. I have moved to Feedly and while I am using it more than I used Netvibes, the jury is still out as to whether I keep it or move to only get information through Twitter. Intellectually I am not ready for that kind of switch, but we’ll see if my daily life’s actions tell me otherwise.
For those that don’t like any of the options I mentioned in March, Digg is creating a reader that might interest you. They are certainly cutting it close, as they mentioned on their blog, their public release of version 1 will come just before Google shuts Reader down. Currently they sent out their first batch of invites to the survey participants who helped with their development process. “Over the next few hours”, they’ll open Digg Reader to the rest of the users signed up for early access. If you want to try Digg you can sign up here: digg.com/reader. As they scale up over the next day or so, they’ll be adding users in increasingly larger batches. According to Digg, “this beta version is aimed first and foremost at Google Reader users looking for a new home in advance of its imminent shutdown.” They have instructions on how to migrate from Google to Digg.
As they mentioned the beta version is very basic but they have plans to really improve it in updates.
Things Digg will be rolling out in the next few months include:
- Android app (before end of July)
- Additional options like “View Only Unread” and “Mark As Unread”
- Useful ways to rank and sort your posts and stories, such as (1) by popularity within your social networks, (2) by interestingness to you, and (3) by article length
- Better tools for organizing feeds and folders, as well as support for tagging
- More options for sharing and sending (e.g., to LinkedIn, Google+, WordPress, Tumblr, Squarespace, Evernote, Dropbox, Buffer), and integration of IFTTT functions
- Browser extension and/or bookmarklet
- Ability to import and export your data
- Uber for cronuts
After reading more about Digg, it looks like I am going to have to check it out. However, I am going to wait a bit. I don’t need to jump Feedly’s ship just yet and the things I am interested in are not in the product yet. Still it is interesting.Share on Facebook
A colleague tweeted this article, “Are Physicians Truly Engaging with their Patients? by Nancy Finn” about physicians, EMRs and meaningful use. According to the article, “as of March, 2013, 160,890 eligible professionals had received Medicare incentive payments and 83,765 professionals had received Medicaid incentive payments” for achieving stage 1 one meaningful use. While they were able to achieve stage 1, are they ready for stage 2? How are they changing their practice patterns to achieve stage 2?
The article states stage 2 requirements are:
- Provide patients with their health information (via a web portal) on 50% of occasions and have at least 5% of these patients actually download, view or transmit that data to a third party.
- Provide a summary of the care record for 50% of transitions of care during referral or transfer of patient care settings.
- Provide patient-specific education resources identified by Certified EHR technology to more than 10% of patients with an office visit.
- Engage in secure messaging to communicate with patients on relevant health information.
- Make available all imaging results through certified EHR technology.
- Provide clinical summaries to more than 50% of patients within one business day.
Finn wonders if “a majority of physicians remain steadfast in dominating the physician/patient relationship, convinced that engaging patients in their care is a burden? Or are many of them beginning to realize that engaging the patient in their health care decisions will make health care more efficient and cost effective, and improve patient outcomes?”
The librarian in me wonders if there are ways we can help physicians meet stage 2 requirements. I know with EPIC a physician can send a request for a librarian to provide patient education information to the patient through their portal. I know specifically of one librarian who got a message in Epic to do that. She logged in, provide links and contact information to appropriate free patient ed resources to the patient. The patient got the information through My Chart and was so happy that she emailed the librarian thanking her for the information. Another nice thing about this patient ed transaction, EPIC noted that patient education information was sent to the patient and included that in her chart for the doctor to see.
I’m not trying to say that doctors shouldn’t help provide patient education information, but I also know that in a hospital environment things can be hectic, confusing, scary, etc. for the patient. They may have gotten information from the doctor but not understood it or wanted more detailed information. Using the librarian to provide patient education material through EPIC (and EPIC notes that it was provided) has got to help both doctors and patients.
Are there other ways that librarians can help doctors and their institutions meet stage 2 requirements? Please comment with your ideas.
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I know I am a bit late with the news that Google is killing Google Reader. I know lots of people who are upset about this. For me the sky started falling back when Bloglines died. Back then I migrated all of my feeds to Netvibes. I could have gone the Google Reader route, but I just didn’t quite like Reader as much as Netvibes. So while my feeds were both in Reader and Netvibes, I used Netvibes more.
For all of you Readers, you are probably wondering what you are going to do with your feeds. First, let me tell you this is a really good time to evaluate and weed your feeds. You also might want to evaluate if you still need a reader. I have noticed that I have been using my reader less and less. I don’t know if it is because of my personal and professional life changes and time constraints have made reading my feeds more difficult or if it is because I am getting my more of my news from Twitter. I have noticed with my adoption of TweetDeck (and Hootsuite iPhone) for monitoring tweets, my reader use has dropped. I have debated about dropping my feeds altogether. But old habits die hard.
So if you still need a reader then you might want to check out a few of these sites to see if they suit you.
Netvibes – It has a free and premium version. Free is all you need and has plenty of features Has very good social media integration. Makes tweeting or facebooking blog posts and other feed items very easy. I still recommend using TweetDeck or Hootsuite for monitoring Twitter overall. It doesn’t have an app, but is mobile optimized but that has limited features. Perhaps that is why I don’t use it as much. As my husband will tell you, if it isn’t on my phone, it isn’t on my mind.
The Old Reader - Is free. Is designed to look and feel like old Google Reader, so if you liked that style, it might be the perfect option for you. You can also follow other Old Reader users and share with them, similar to Google Reader. They don’t have a mobile app but are supposedly working on one. It is looks fine on a mobile device.
Feedly – Is free and has been around for quite a while. Bad news for IE controlled institutions, Feedly doesn’t work with IE. It only works with Firefox and Chrome. It also requires you to install a plug in and if you have a locked down computer, it won’t work for you. It too is a social media tool that easily lets you share things with your social network friends. There are several layouts that are available for you to choose from. They have the straight top to bottom feed style , full articles, or the Flipboard style. Easy to transfer feeds from Reader, in fact I signed in using my Google ID and everything migrated seamlessly. Feedly does have an app for iOS and Android. With demise of Reader there are quite a few upset people posting to the Feedly board about the lack of IE use. There are many more people with companies that force IE use than just hospitals.
NewsBlur – Premium version costs $24/yr. They have a free version but it caps the number of blogs, stories and public sharing options. The blog and stories cap is the deal killer for me. It caps you at 64 blogs and 10 stories at a time. Additionally they have temporarily stopped free users from signing up. Ptthhbbb. I normally wouldn’t even mention them (I didn’t link them) but since other sites are recommending them, I felt obligated to at least mention them with their fees and stopping free user registration. Stupid considering this the time to grab users leaving Reader. Once they find a reader they won’t magically switch unless forced to. Very short sighted of them and makes me thing even less of them.
While I wasn’t using Reader, I also dialed back my Netvibes reading considerably. So instead of worrying about my Reader feeds from Google, I am going to take this time to investigate whether I even need a reader anymore by investigating Feedly. I am not a big fan of the Flipboard style of things but that is no big deal because I can use the plain ol’ reader style. While I like Netvibes, clearly I evolved beyond it for some reason. My guess is because it doesn’t have an app. That is why I am giving Feedly a try. I am going to see if having my feeds synced to an app on my phone increases my use of them. I am lucky to be able to have Firefox on my computer, but I rarely use it since much of our hospital stuff is IE. So the whole Feedly experiment will be interesting to me.Share on Facebook
Back in the olden days a library bought a subscription to a journal and they paid the institutional price which was often listed on the inside cover of the printed issue. It was always more expensive than the personal subscription, but there wasn’t tiered pricing, FTE pricing, or pricing based on inpatient admissions and number of specialists. For the most part the price you saw on the inside cover was the price you paid.
Then came the electronic journal. At first journals weren’t quite sure how they were going to have their articles online. Some gave it away free, others were free with a print subscription, some charged a nominal upcharge, while some charged a specific online journal price. Ejournals grew in usage and with tightening budgets librarians began dumping the duplicate print. During that time institutional prices evolved to a Ladon of possibilities.
Additionally, the concept of eresources has moved beyond journals. It extends to books, databases, integrated EMR and patient education products, image databases, etc. As librarians we demand to know our usage statistics for our eresources. We need to know what our patrons are using so we can get the most bang for our buck. However, we aren’t the only ones who see our usage statistics. The vendors that sell us our products run the reports and it isn’t in their best interest for us to get the biggest bang out of our buck. I am not trying to imply that all of the vendors are nefarious. I am just saying that if they see that your cost per use stats are so phenomenal that they may be looking how to get more money from you. For example you are paying $50,000 for a product that you use so often that you have $.05 per use but the average library in your tier pays about $.10 per use, the vendors think you are getting their product for a $50,000 discount compared to others in your tier.
Prior to eresources, vendors knew very little about the usage of their product in the institution. The usage of printed journals and books were often only known by the librarian through shelving studies or circulation statistics. I remember when we had CD Plus and had to load the MEDLINE CDs on a CD tower for people to search. Despite not having the type of usage data we have to today, librarians still looked at how their databases were used (Volkers AC. Bull Med Libr Assoc. 1995 Oct’ 83(4):436-9.) and even tried to determine journal needs through the database (Dunn, K. Medinfo. 1995;8 Pt 2: 1428-32.) The usage stats were all in house. So while you might have known what your cost per use was for a journal, book, or database there was no way that a vendor knew, unless you published it in a journal article that they read.
It seems that with wide scale use of eresources, usage stats have become a double edge sword. Not only do we still need to know what is being used but vendors now also know what we are using. They can use this information to their advantage as well. While neither party wants to have a resource that is a dud, I’ve got to wonder if we are now also victims of our own success. Many of us have already cut the chaff from the wheat years ago. All of our eresources are high performers. Yet because they are high performers are they costing us more than if they were less utilized? If so isn’t that the exact opposite of what a librarian needs to be thinking about?
Betsy Kelly, Claire Hamasu, and Barbara Jones wrote an interesting article, “Applying Return on Investment (ROI) Libraries. (Journal of Library Administration. 2012;52(8):656-71.) Determining the ROI is necessary to measure the value of the library resources to the institution. Many medical librarians use the NN/LM MCR ROI Calculator to determine the replacement value of services provide by the library. In addition to quantifying the number of classes, room use, photocopies, and ILL’s the calculator can also factor in the cost of ejournals, databases, ebooks and their usage. So in order to get a good ROI we want high usage for these electronic resources.
ROI is what hospital administrators are looking at when it comes to everything. Hospital administrators are focused on controlling costs and demanding the biggest savings possible. According to an article from the Daily Beast about the Cleveland Clinic , CEO Dr. Cosgrove is described as something of a “fanatic” regarding controlling costs.
“Our physicians are so engaged in our supply chain that they help negotiate the price down for the things we use,” Cosgrove told me (Daily Beast), and reeled off a list of examples:
- When I was the head of surgery, we needed a new heart-lung machine, and we decided there were three models that could work, so we did a reverse auction to get the lowest price.
- We put price tags on things in the operating room: before you open that $250 set of new sutures, make sure you actually need it.
- We found out that there’s a lot of redundant tests that are done, or tests that won’t be vital to the patient’s care. We know that there are some things that don’t change. For example, the reticulocyte count can’t change but week to week. So if someone’s ordered a reticulocyte count, you can’t ordered another for a week.”
I might be going out on a limb here, but I have to think that all administrators are pretty fanatical about costs and keeping them low. So how does the idea of keeping costs low factor in with eresources? Are we at a point with some resources that good usage is actually hurting us, costing us more come negotiation time (if we can even negotiate)? In the spirit of the $250 suture kit, do we start adding a price tag to our eresources before users click on them? That would be kind of absurd and certainly would drive down our usage stats which in turn would drive up our cost per use.
In this day and age where we use our usage statistics to drop resources and vendors use them to determine pricing, how are we to come to a even playing field when our budget is shrinking and our administrator wants to see increase cost savings? We struggle to show our ROI on a smaller and smaller budget as our resources increase in price. We explain to administration that if they didn’t have us to do what we do it would actually end up costing them a lot more in time and money to provide the same resources and services. But as Kelly et al mention, the “problem with ROI calculations based on cost avoidance is the underlying assumption that users will look elsewhere to purchase the same services and resources they receive from the library. It is not realistic to assume that users could afford or would make the effort to personally pay for all of the services they receive.” Hospital administrators are essentially already doing this. By cutting the library’s budgets to the bone they are forcing librarians to not pay for all of the same services and resources. When a hospital library closes, the budget for those electronic journals, books, and databases (as well as everything else) is gone. Almost none of the resources are kept by the institution. When administration closes a hospital library, they are not replacing the same services and resources.
Usage statistics help librarians determine ROI to hospital administration, but what are we to do when administration wants to see usage and ROI go up but vendors increase the price (thus decreasing our ROI) as a result of our usage stats? It seems as if librarians are between a rock and hard place. Do we need to look at another method of valuing our services and resources? If so, what?Share on Facebook
Tomorrow (Thursday 3/7/13) at 9:00pm est, I will be hosting the #medlibs chat on apps and tablets. What are you doing with apps? Are you creating a library specific app, catalog app, etc? Or do you have a good app guide that you want to share with others? Is there a push for tablets within your institution, if so which one? Can tablets access the EMR so that your docs & nurses can treat patients and do research with one device?
What other trends do you see or want discussed about apps and tablets? Let me know?
Here are some sites you might be interested prior to the #medlibs chat.
- Nova Southeaster University Health Professions Division Library http://bit.ly/HApZqW – tips, resources
- University of Groningen Central Medical Library http://bit.ly/15vCVqE -finding medical apps, information on adding bookmarks, (side bar has a lot of info)
- Setting up a library iPad program: Guidelines for Success – http://crln.acrl.org/content/72/4/212.full Full text article in ACRL News by Sara Thompson at Briar Cliff University
- Continuing the conversation: Integrating iPads and tablet computers into library services http://bit.ly/wgnMRS -ALA Tech Source article by Daniel Freeman
Policies and Procedures
- Duke http://bit.ly/kcRLCz
- KOC University http://bit.ly/YU7mCZ
- University of California Irvine http://bit.ly/cqwAuk
- University of Chicago http://bit.ly/XUoB5K
- University of Utah (iPad, Xoom, Kindle, Nook) http://bit.ly/wuIW2s
- Virginia Tech http://bit.ly/99151e
- Wake Forest http://bit.ly/Zm1JNS
- ZweigBibliothek Medizin in Münster, Germany, What to consider when borrowing English Translation http://bit.ly/15vDOjd
- iMedicalApps.com -One of the best review sites. Are there other good ones?
- Journal Reading Apps
- Browzine, ReadQx, Docphin, DocWise
- Other medical libraries –See what they have & how they organize them
- University of Michigan http://guides.lib.umich.edu/healthmobile
- University of Washington http://bit.ly/Nbzc9y
- University of Iowa http://guides.lib.uiowa.edu/mobile
- Weill Cornell Medical College http://bit.ly/13EJUQ4
- Norris Medical Library http://bit.ly/eaPRxO
- Dahlgren Memorial Library http://bit.ly/u7mbHH
- Florida International University http://bit.ly/102A45z
Hope to see you on the chat tomorrow! If you haven’t participated in a chat before, the easiest way to do it is use the cite TweetChat, login with your Twitter password and the follow #medlibs.Share on Facebook