Interested in learning more about how mobile technologies can be used in the medical library? If so, register for the Medical Library Association (MLA) continuing education webcast Leveraging Mobile Technologies for Health Sciences Libraries on Wednesday, April 18, 2012 1:00-2:30 (central time)
More information about the webcast (from MLA.net)
The goal of this webcast is to familiarize information professionals with current practical applications of mobile technologies in clinical and curricular support settings. Topics will highlight innovative uses of mobile technologies, address technology challenges, and provide best practice guidance for applying in viewers local environments.
- Define how mobile technologies can be used in clinical settings
- Define how mobile technologies can be integrated into curricula
- Identify challenges faced when using mobile technologies in different settings
- Explain challenges faced in clinical and curricular settings that mobile technologies can help solve
- Demonstrate how mobile technologies can be used in your own setting
- Plan how to work with vendors and IT support to enable use of mobile technologies
- Identify opportunities for library resources via mobile technologies in multiple settings
- Compare different mobile technologies and choose which might be appropriate for your own setting
Go to the MLA Webcast site to learn more about presenters Colleen Cuddy, Heather Holmes, Molly Knapp, Kimberley Barker, and Alisha Miles.
There are two ways to register for this webcast, individual or site. Individual Earlybird Registration Fee: $75 (nonmember, $150.00). Earlybird Site Registration is $395 (nonmember $495).
Keep your eyes and ears open for sites near you that have registered for the program.
- Pacific Northwest Region (PNR) will host the webcast at two sites.
- GMR has several sites sponsored in states through out their region.
- The Middle Atlantic Region is sponsoring it at the University of Pittsburgh.
For more information about the webinar or to register go to:
I think we all can agree that something like fire, tornado, flood, earthquake are all disasters and hopefully libraries have some sort of contingency plans when those events happen. But what about those “other” disasters. I say other because they may not meet the standard definition of a disaster, but when they happen all work stops or something majorly impacts your productivity.
Marie Kennedy posted “Disaster planning for e-resources” on Organization Monkey about her library’s recent problems when EBSCO’s databases went down earlier this month. “From a library perspective, when a major content provider goes down, it is a legitimate disaster. For electronic resources librarians, all the usual work stops and crisis management mode takes over.” This is true for us as well. Even if a major journal goes down we start getting calls right away from doctor’s wondering what happened. If our linking system goes down or a major database goes down, then all *blank* hits the fan.
Our operations are so dependent on certain programs that when they go down our access to information also goes down. It may not be a disaster in the traditional sense of the word, but it is still a disaster for information retrieval.
Marie describes the procedures her library use to inform library personnel and library users of situation. She also mentions how frustrating it was for her and her library’s staff to go through this “without the help of EBSCO.” In fact most librarians were reaching out through MEDLIB-L, Twitter, and other local listservs, to try and figure out why CINAHL, Discovery, and other resources were DOA.
EBSCO is just the latest resource, but this sort of things has happened with Ovid, PubMed and other databases or online journals. It also won’t be the last resource to experience a “temporary outage.” So what are your library procedures for dealing with these events? How do you notify your customers and does that vary according to the resource?
I think by now everyone has heard of the term phishing as the gathering information online on an individual or group of people. But today I read of a new type of phishing, spear phishing. Spear phishing is using information for pinpoint attacks.
It is apparently pretty successful because recent spear phishing attacks have ”ensnared” several top U.S. government officials and RSA (you know the company that makes those SecurID tokens) and defense contractor Lockheed Martin (using information from hacked from RSA). According to a CNNMoney article, the attackers were able to trick people into opening email attachments that appeared to come from trusted sources or colleagues.
While we don’t know exactly how hackers were able to hack the government officials and RSA, we do know that many believe that social media sites, especially LinkedIn, serve as a hacker’s gold mine. According to the article, at a DefCon security conference where they staged a hacker game, Google and LinkedIn were the most widely used resources.
All it takes is getting the name of one of your coworkers and a well created email to get you to click on a link.
Everything is on the Internet, while I don’t want to discourage people from connecting to family, friends, colleagues and coworkers, but you may want to use some discretion when connecting. Obviously on Facebook you want to lock down your site. On LinkedIn, maybe you might not want to put down everything about your current job.
This project was to increase awareness our patron’s awareness of our e-book collection and I am worried I am going to going to become Sisyphus in the process.
E-books are hard for patrons to know about. We still have a large group of users who peruse the stacks for books on a topic.
Put the subject list of e-books within eyesight of those who browse the shelves. Create a brightly colored message to be displayed on the shelves informing people of our ebooks and how to access them.
Users will see the QR code and scan them with their smartphone to view a list of ebooks within that subject. We are using http://www.delivr.com to create the codes and track their usage. Users without smartphones will see the note and check the catalog for ebooks.
Used bright yellow paper and old unbound journal holders.
Made multiple notices for each subject area depending on the size of print collection (area it spans on the shelves).
Distributed the notices through out the stacks within each subject area and spaced for maximum viewing opportunity.
We haven’t invested anything into this project other bright yellow paper and my time. We used the many unbound journal holders that we had left over from our print journal days to post the yellow paper and as place holder in the stacks. Even the QR code generator and tracker is free. The only thing that really wasn’t free was our e-books but we bought them long ago before QR codes were known to geeks.
So while we haven’t invested anything in the project. We have a vested interest that our e-books get more usage. This project is just another way to drive attention to them.
Still, I am plagued by a persistent little voice in my head asking whether people will even bother to scan these codes. Because according to the CNN Tech article, Why QR Codes Aren’t Catching On, “many people don’t understand what QR codes are or what to do with them.” The article cites a study by Archival which found that while ”80% of students owned a smartphone and had previously seen a QR code, only about 20% were able to successfully scan the example QR code they were shown. Furthermore, about 75% said they were unlikely to scan a QR code in the future.” Even if people know what a QR code is and know how to scan it this Market Plan post says, Consumers Still Don’t Know What to do With QR Codes.
I really want this project to work, but these articles suggest I have an uphill battle. It is going to take a lot of promoting and educating to get this QR code thing moving.
I have begun to post signs through out the library and strategically next to QR codes in the stacks (see the yellow code below the sign) promoting our e-books and the QR codes.
I finally got all of the yellow QR code signs in the stacks and the advertising signs up on Friday. It is Monday and while I know I have a long way to go before I know if this project is boom or bust, I need to come up with some more educational and promotional ideas to get it off to the best possible start. So I am asking you all in the library world to throw me some suggestions via your comments. The suggestions won’t only help me, they will help others who are thinking of doing the same thing.
The iMedicalApps team compared Harrison’s Principles of Internal Medicine on Inkling vs. AccessMedicine. I feel I am at a bit of a conflict of interest here. I have recently begun to work with iMedicalApps to write some posts (I am currently working on a post right now) and I agreed to moderate the Medical Librarian’s Corner of their Medical Apps Forum.
My problem is that I see at least one error in the review, another area where the author needed to be clearer in their evaluation, omissions regarding updates, and a slight bias toward student use. As a result it makes it difficult for me to read the comparison without talking back to the computer. Now I don’t have an iPad (saving up for an iPad 3 when they come out) and I don’t have a subscription to Inkling, but I have worked with Harrison’s Online through AccessMedicine extensively so I am extremely familiar with it. Since I don’t have Inkling’s Harrion’s I can’t do a comparison of the two products, but I feel the need to point out the error in the review and provide some criticisms about the review itself.
While I may be struggling with how to do this appropriately given my new relationship with iMedicalApps, I don’t have any conflict of interest with AccessMedicine, McGraw Hill or any of the Access databases. In fact I have recently been kind of critical of them for having difficult mobile access policies (require personal login even while on campus) that do more to hinder the use of their ebooks.
Update 2/22/12 Ooops…I am wrong, I do have a conflict of interest with McGraw Hill that I should report. I am on the Library Board for Silverchair and Silverchair actually built McGraw Hill’s AccessMedicine product. I want to thank those who reminded me of that. It was never my intention to hide that information, I just was more focused on the actual product and the review and honestly forgot about Silverchair’s involvement. So I guess with ties to iMedicalApps and AccessMedicine, you could say I am equally(?) conflicted?
Despite the various possible conflicts of interest, I really just tried to expand on the orginal review of the two platforms and correct an error.
First, let me address the obvious error within the review. The author of the review compared the search features of the Inkling platform and the AccessMedicine platform.
“Both AM and Inkling have search capacities, but Inkling’s is far superior. First, Inkling confines its search only to Harrison’s and it retrieves every table, figure, and text finding. AM, on the other hand, has a website-wide search function that doesn’t just give Harrison’s results but also the results from other titles in the AM library.”
This is incorrect. AccessMedicine’s Harrison’s can search only within the book. The author of this review failed to notice the drop down arrow next to the search box that allows one to search only within Harrison’s. See image below.
This a pretty obvious error. Now I admit the default for the search box is AccessMedcine (as you can see) but just clicking the arrow you can easily limit your search to Harrison’s. Perhaps AccessMedcine might want to consider making the default for the Search dependent on where the user is on the site. If the user is within Harrison’s then the default is Harrison’s. If the user is in Goodman and Gilman’s then the default is Goodman and Gilman’s. If this is possible, this would help people out.
Second, I feel the reviewer needs to be a little clearer regarding the search results within Inkling and AccessMedicine. The reviewer takes issue with the number of times the term heparin was found within AccessMedicine’s Harrison’s vs Inkling.
“Moreover, the power of the Inkling search is greater than AM’s. I retrieved 50 matches when I searched Heparin on Inkling. In AM, I only retrieved 13 matches, most of which were tables, rather than mentions of heparin within text chapters. Harrison’s is such a mammoth text that a powerful search function is essential, which Inkling provides and AM does not.
This statement implies that the reviewer only looked at the search results screen from Harrison’s and counted on the number of retrieved results. They are correct that most of the retrieved results were tables where heparin was mentioned, and only one result was where heparin was mentioned within the text of Harrison’s. However, this is kind of misleading. This implies that the term heparin was only mention once in the entire book of Harrison’s on AccessMedicine, which is not the case. When you do a search for heparin in AccessMedicine’s Harrison’s, the top result (see image below) is a whole chapter on antiplatelets and anticoagulants (Chapter 118). Yet in the reviewers own screen shots, a search on heparin in Inkling also lists mostly tables AND the most relevant information (the chapter that heparin is mentioned) is listed far down on the retrieved results. I would have thought the chapter is more relevant than the tables (and given the tone of the review, so does the reviewer) but it would seem from the Inkling screen shots that it isn’t because listing for the chapter burried below the results for tables.
The whole chapter in AccessMedicine’s Harrison’s has over 100 mentions of the term heparin (as shown in bright red circle below)
So my question for the reviewer is whether Inkling retrieved more hits because it was counting the multiple times the term heparin was mentioned in the chapter on anticoagulants OR did it find more instances of the term heparin within OTHER chapters of Harrison’s. This is kind of an important nuance when you are looking at search results. Because if Inkling’s 50 hits were all within the same anticoagulant chapter then the search feature is similar to AccessMedicine’s and the results are just presented differently. (Here is a whole chapter on heparin vs. here is where it is mentioned every single time in the chapter.) But if Inking’s search found more instances of the term heparin within other chapters of the whole book then the search features on Inkling are picking up something that AccessMedicine isn’t. Is this good or bad? It really depends. Is it picking up relevant results like the paragraph on heparin in Chapter 370 Cerebrovascular Diseases (ischemic stroke section) or is it just picking up the term where it is used briefly in a sentence and really has little relevance if you truly searching the subject heparin? It is also important to remember that Inkling’s results for heparin were not as relevant because the chapter was listed the tables.
When looking at the strength of search engines more than a mere word count needs to be discussed if we are to really understand which platform has the best search features. Relevancy is way more important than sheer number of results, look how much junk floats to the surface of some Google searches. Unfortunately this was not discussed in detail enough for us to determine whether Inkling’s search engine is really better (retrieves more relevant results).
The reviewer does correctly mention that AccessMedicine has the most updated information from Harrison’s. Updates are made continuously online through AccessMedicine, therefore a reader doesn’t have to wait for a new printing of the book. ”It is uncertain whether Inkling will enable the same kind of updates.” The reviewer surmises that Inkling will update their version when the next edition of Harrison’s is available (much like a print edition schedule). However, the reviewer omitted to discuss the e-chapters within AccessMedicine’s Harrisons and whether they were available on Inkling.
There are over 50 e-chapters that according to AccessMedicine are only available online (image below just captures the last chapters with the note about the e-chapter logo).
Some chapters that are e-content only:
- Primary Care in Low and Middle Income Countries
- Complementary, Alternative & Integrative Medicine
- Ethical Issues in Clinical Medicine
- Approach to the Patient with a Heart Murmur
- Mitochondrial DNA and Heritable Traits and Diseases
It is imporant to know whether Inkling’s text has these same chapters as AccessMedicine or whether it is missing chapters.
Finally, the reviewer seems to have a slight bias toward student use. The reviewer seems to dismiss the charts, tables, and PowerPoint lecture slides.
“There is also some ancillary material that the AM version gives that Inkling does not. Nearly every chapter in AM’s Harrison’s has powerpoint lecture slides that have figures and tables from the book. This is not of great importance to most students I suspect, but instructors may care.”
Maybe some students may not care about slides, figures, and PowerPoint slides, but if you have to give a presentation you probably care a lot. As a librarian at a large research medical center I can tell you this type of “ancillary material” is asked for and used more than the reviewer would think. For example I can’t tell you how many times I used to get asked about NEJM’s PowerPoint slides and how they could download them. (I am not unique, other librarians have been asked this too.) So I would say that Harrison’s slides, charts and tables are more than just mere ancillary material that only instructors may care about. I think if you are doing any research, publishing, and presenting you will be very happy to have another resource for your papers and presentations.
Now that I have pointed out the things I found to be lacking in the review, I do want to mention some of things that I feel the reviewer correctly hit on.
Note taking within AccessMedicine’s Harrison’s is not helpful and all types of users, including students, take notes. If you have created your own personal MyAccessMedcine account you can “Bookmark” chapters and items, but you really can’t take notes.
The reviewer is also correct that if you want a version of Harrison’s that is not dependent on an Internet connection then Inkling is for you. However, as hospital networks improve I see this locally loaded feature (of any product not just Inkling) to be less of an issue. The cloud is the future for information storage and retrieval. But I do recognize this is a personal taste issue, some people just like having content loaded locally.
The way AccessMedicine limits readers to view only sections at a time is frustrating and a barrier. As a result AccessMedicine’s Harrison’s Online is not an easy book to read online. Inkling’s version appears to be very easy to read online based ont he review. The reviewer correctly mentioned the reason for divvying up the book into sections was to prevent online piracy. Unfortunatly, this does little to prevent piracy and more to inhibit real usage. (People are scanning entire books and making them available online. AccessMedicine does little to prevent guests from creating a MyAccessMedicine password at a subscribing institution and using it well after they are an authorized user.) It appears from the review, Inkling’s book is much more user friendly to read in a sitting rather than the AccessMedicine version. AccessMedicine’s presentation is limits its use.
Personally, I think the decision to use AccessMedicine’s Harrison’s vs Inkling breaks down into 2 parts.
1. If you want to stay current and have the most recent information then you need to use AccessMedicine’s version. Inkling has not indicated their update schedule and AccessMedicine always updates Harrison’s. The reviewer did not mention if e-chapters are in Inkling’s version, if they aren’t then you are missing chapters.
2. If you are not as concerned about the timeliness of the information (or the possiblity of missing e-chapters) and you want an easy to read experience with the ability to take notes and read offline then Inkling’s version is what you want.
I had a great idea. Or at least I thought it was a great idea. However making it a reality makes me think that maybe my idea might just stay in the realm of ideas.
I have mentioned in previous posts that I swear a boat load of people got iPads or smartphones for Christmas because the calls for help about resources, ebooks, network access, etc. have really taken off. Some things like network access or knowing how much data they might consume if they are doing 3G are a little bit out of our control. But ebooks and library resources, well hell, I thought I could help with that in a relatively easy way. (Just hit me over the head if I ever think something is going to be easy.)
We are in process of re-designing our website so we did a survey of our users. We learned that 53% surveyed agreed or strongly agreed that a website for mobile use of library resources is important. We learned that our users want a website with; better organization, streamlined function, easy for tech un-savvy, and fewer clicks to get to resources. They want a simple way to find books and ebooks. (Clearly the catalog isn’t what they consider simple.) They want an easier way to login to resources from home, and to login once. Not only do our users want simple easy ways to access online resources from the website and their mobile devices but they want simple (few clicks, easy one login) to ebooks from home.
Ok, now we’re cooking. We know what our users want, so let’s get going. Somebody is working on the regular website and I thought I could help get things mobile. I approached it on two fronts, the mobile resources and easier access to ebooks.
Lots of librarians shared their lists on iMedicalApps.com Medical Librarian Forum and we have been compiling a list of mobile friendly resources. Not only would we have a list of mobile friendly sites and apps the library subscribed to but we would have our own mobile site linking to the mobile friendly library resources. Additionally we came up with a few ideas on how to increase the visibility (and hopefully the usage) of our ebooks.
I was feeling pretty confident that these things could make finding ebooks easier and also help current and future mobile users get to our resources. Remember, I said I thought it would be easy? Just start hitting me on the head now…
The problem is the mobile site of vendors. Many vendors like Elsevier (MDConsult and First Consult), McGraw Hill (Access database) direct smartphones immediately to their mobile site. While this is nice, their mobile sites require users to login using their personal login they created. So a library user would have to have a personal login to each database: MDConsult, First Consult, and all of the Access databases we subscribe to. If somebody is accessing our resources off campus these personal logins are needed in addition to our proxy login that our users already use to access library resources from home.
See the problem? People who are just browsing our resources on their smartphone on campus have to create multiple logins in order to use our online resources from their phone. We link to our ebooks through the catalog and we are thinking about adding QR code browsing of ebooks in the stacks, but this won’t work on smartphones. Why? Because when the person scans on the code or clicks the link in our catalog the vendor’s mobile site demands a personal login. So there is no direct link to the ebook, they have to have a personal login. Most users don’t think of our ebooks according to vendors, they just click on the title and they EXPECT the book to show up, they don’t expect to be asked for another login. This method assumes our users have created a personal login with that vendor prior to clicking on the book. Most people aren’t thinking, “Oh I want to look in Harrison’s Online, I should get a MyAccess login before I click on the title.”
The problem gets even more compounded when our users are off campus. Our users have been trained to login to our resources using our proxy server. This is what they have been doing for years, it is a standard for accessing resources remotely, and this is what most users want. In fact respondents to our recent user survey said they want one login! Well, we can’t provide that if the vendors are creating an extra login!
So even if I want to provide easy access to ebooks, I can’t. I have remind people that they have to create a personal login with each vendor. How do I do that? That is a heck of mess to write in the online catalog record for each title. “Click here for access. If you are using a smartphone you must login with your personal login.” Great then I get more calls about how to create a personal login, to reset their personal login, or that they are using their personal login and can’t get in (but they are using their proxy login).
Not only do I have the problem in the catalog, I would have the same communication problem on the mobile library site. As anybody who has a smartphone knows, mobile optimized sites are easier to view than the full website. So the design is a little different than a regular website. For example if you are linking to resources, you probably don’t want a whole lot words explaining things. People on a mobile library website really kind of want the links to go to the resources they need not a whole bunch of instructions about unique login procedures for each resource.
As somebody mentioned to me users don’t have to have a personal login they just tap on the link to Full Site and they can access the resources. Um doesn’t that kill the whole point of having mobile optimized resources? Searching th full site of MDConsult or AccessMedicine on a smartphone involves a lot of screen expanding and pinching. Aren’t we trying to get our users to use our ebooks? Aren’t we asking/demanding vendors that our ebooks also become mobile optimized?!
Locking ebooks behind personal logins or forcing people to use the Full Site is not getting people to use the ebooks or online resources. It is a barrier! Why have vendors created this artificial barrier?! Why can’t an institutional user access an online resource or ebook without having a personal login?!
In addition to the user access problems I have with personal logins, I have two other questions/problems…
- Usage stats – Are we getting usage stats each time somebody from our institution is using their personal login? If no, that is very bad. If yes, that is good but we can get without personal logins. You already have our IP ranges and proxy info.
- Concurrent users – If you don’t have an site license then people can easily come as visitors create a personal login and then use that personal login to access your material looooong after they have left your institution. These unauthorized unaffiliated users are taking up your concurrent user license spot(s). We maintain our authorized users list. We enter the expiration date of visitors, students, contractors, techs, etc. into our system. When their badge expires they can’t access our resources via proxy. Therefore we are in agreement with our license agreements AND they are taking up a concurrent user spot.
It is possible to have the mobile site work using institutional proxy, Thompson Reuters Web of Science is mobile optimized. I click on the link to WoS and I am directed to the mobile site. I am not asked for a personal login. Off campus I am asked to login to my library account then I am directed to mobile site. Easy squeazey and MAKES SENSE!
What started out as an easy (yes keep hitting me on the head) project of providing a simple list of mobile optimized resources and linking directly to the books turned into a giant mess. How can I recommend these mobile resources to smartphone users or the ebooks when I know it will confuse them and frustrate them. Hell, it confused and frustrated me and I am a librarian who is FAMILIAR with this stuff. Our users aren’t going to use this stuff the way it is set up right now and unfortunately I can’t make it easier for them because this personal login thing is out of my control. Why should I bother setting up links to mobile resources and ebooks when it is going to cause more problems and questions then it is worth and serve as another reason to bypass the library for stuff. No wonder people get their ebooks from Amazon….it is EASY! Easy is what the users want, medical library ebooks in their current state are not easy, they are a royal pain.
Why bother?! We try to make things easily available and barriers keep getting thrown up. It is enough to drive you batty. According to ReadWriteWeb, mobile Internet usage has doubled every year since 2009….so this problem isn’t going away. Hopefully in the near future I won’t be asking why bother with the mess of ebooks.
As a medical librarian with limited time and money I can’t really attend the ALA annual meeting or the midwinter one. So I was quite excited to see that they were going to have a technology wrap up webinar. The webinar was yesterday and while I watched it I tried to tweet some of the things that might have been of interest to medical librarians.
I tried to keep up but I got a little side tracked when they started talking about new things with ILS companies and while I was able to follow ebook discussion, the concept of what 3M was doing with ebooks went right by me too. Thankfully, we don’t have to rely on my faulty memory or tweets. The archive of the ALA Midwinter Tech Wrap Up is available at http://bit.ly/zFic6Q, it is about 1 hour long. For those of you who are interested in the slides only you can view them at http://bit.ly/wD9xeg (scroll down and click on each presenter to view their slides).
The things I found the most interesting…
I did find the MediaSurfer to be a really cool and interesting way to distribute library loaded iPads. Of course that was until I learned that the basic tower was $25,000, and that price DIDN’T include the iPads. Yea. Cheers. Thanks a lot. Moving on.
Big discussion about ebooks and lending and distributing them. Most discussions on vendors were geared towards public and some academic library companies, which is natural. I learned that EBSCO will not be charging any fees for their ebooks. According to Sue Polanka of No Shelf Required, EBSCO will not charge markups, set up fees, annual hosting, platform, access or maintenance fees, no Adobe Content Server subscription fees, no download fees and no fee for MARC records.
What was disconcerting as well as interesting was Sue’s discussion about ebook statistics. OverDrive reported in 2011 that they had 99 million visitors, 35 million check outs and 17 million holds. Ok at first glance you see impressive statistics for ebooks. But what Sue pointed out is that out of the 99 million visitors on 35 million and 17 million found books they wanted. Basically only about half of their visitors found the ebooks they wanted to either check them out or put a hold on them. Technically that number is probably less than half because some of those 17 million holds are also checkouts. When you look at the fact that only one half to one third of visitors found an ebook they were looking for (AND they are ebook distributor…these people are coming looking for ebooks) then that is kind of crummy.
That leads us right into Library Journal’s Patron Profiles from January 2012 which found that while ebook usage increased from 18% to 25% a whopping 23% were unsuccessfull download the book (so they didn’t check it out) and another 44% were unsuccessfull because the content was unavailable. There has got to be more availabe titles for these people and it has to get much easier for them to use.
The lack of ebook titles and ease of downloading is not a surprise and I think it is even worse in the medical library field. It seems that medical textbook publishers were once the innovators of ebooks, getting content online way before Kindle was a glimmer in Amazon’s eye. The books could be accessed online from a laptop or desktop and were nice to use when you were too far away from the library or the library was closed. However, medical text publishered were slow to move on from that distribution method and now are playing catch up.
It was a very good webinar to learn about new and emerging things in libraries even if it was a little slanted to the public and academic side of things. I highly recommend watching the archive to see if anything they mention might be of interest in your medical library.
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Apple announced today the release of iBooks 2 which is supposed to revolutionize the etextbook market.
The area of ebooks is very tumultuous in general but then add specialty books like medical texts, volume usage (libraries buy one book for many to use), license agreements, platforms, and easy discoverability and accessibility and it becomes a giant quagmire. Additionally, I think major medical publishers have been v-e-r-y slow to get into the ebook market. Oh yeah they had ebooks for a while, but those were produced similar to ejournals. They were available online and accessible usually by desk top or laptop. The Kindle started the movement but the iPad just turn things on its ear.
Many of the ebooks medical libraries have bought are from established publishers like the AccessMedicine books through McGraw Hill, Lippincott Williams and Wilkins books through Ovid, or multiple different publisher titles through Rittenhouse or STATRef. The one problem is that while most of these books are online, they are really only accessible via regular computer. The vast majority have not been formatted for the iPad or other platforms. (Interesting since Apple just announced they are partnering with McGraw Hill to make textbooks on the iPad, but it seems like they haven’t really done that with the Access textbooks.) Now for some books not being optimized isn’t a big deal because they display alright using the iPad browser. However even if they display correctly the publishers’ sites make it MISERABLE to access the book. This was a major problem BEFORE mobile readers. Librarians world wide for years bemoaned the difficulty their users had at finding and accessing their ebook packages. The silos that publishers host their ebooks makes it difficult for library users to access titles. The problem hasn’t changed now that we have tablets, it has just gotten worse.
The one saving grace prior to tablets was that many accepted that ebooks were accessible by traditional computers. But when smartphones came out people starting accessing the web using their phones. They were beginning to access online resources via the phone when they weren’t near a computer. Instead of walking down the hall they whipped out their phone. The iPad just continued to ween people off traditional computers. Instead of using smartphones doctors were using iPads and they were using them so much at work that the traditional lab coat got a make over to include an iPad size pocket. People not walking to a computer to access the web, they have the web with them and they want their online texts.
In the past when I would talk to various publishers and library vendors about accessing their texts via mobile device (pre iPad and Kindle) they would smile and gently say that nobody wants to read a book on a phone. Well I disagreed. What do you think Unbound Medicine or Skyscape did? They made texts (and other medical programs) available for handheld devices. Originally they did that with PDAs now they have transitioned to smartphones. Heck they have some of the major publishers, McGraw Hill, Elsevier, LWW, etc. on their site all ready to be used on a smartphone or the iPad (they don’t have Kindle or Nook stuff). Yet the publishers, while trying to push their own silo suite of online books, have been slow to adapt to technology and user demands. The writing was on the wall folks.
Medical librarians are left trying to figure things out. We have the silos of ebooks that were difficult to find and access prior to mobile devices and now we are getting more users asking us for ebooks. What do we say or do? Do we tell them we have ebooks…sort of? Yeah you can access it online but no it isn’t optimized for the tablet or smartphone so it may or may not be readable. We have quickly moved from ebooks as simply online books on the computer to a portable information resource that can be accessed anywhere without lugging around a computer.
The SCR CONNECTions webinar, Unwrapping Mobile Technology Trends for the New Year is now available in the SCR CONNECTions archives http://nnlm.gov/scr/training/webmeeting.html#Archives. The PowerPoint presentation which has a lot of great links to the references she mentions is also available on the website.
The webinar is very good for librarians new to the area of mobile devices. Emily Hurst, the presenter, discusses smartphones, tablets and e-readers. Mobile devices in libraries is still fairly new. According to Emily’s survey most of the people attending the webinar use them for education and instruction, but there were still those who don’t use it in the library. What was interesting was LSU mentioned in the chat that they use mobile devices to check off campus access. That is how the systems librarian and I use our personal mobile devices at work too. Often we are told a resource is unavailable off campus, but of course we are told this while we are work (on campus). Now when we are notified of problems either the systems librarian or I turn off wifi on our smartphone and use 3G to access the off campus server and then try and access the problem resource for troubleshooting.
Emily also described the differences between mobile sites and mobile apps. There was a brief discussion about the pros and cons for each. Emily asked the question, “Providing direct access to a specific type of data, program, or information on a mobile device is best archived with a… mobile site or mobile app?” While most of the people in the webinar answered mobile app, I feel the question was kind of a loaded one. I think the real answer is, “it depends.” It depends on how you want to use the resource, does it need to be loaded and “on” all the time regardless of 3G or wifi connectivity? If so then you need an app. How often does the information change and how robust is your computer programming skills? If your information changes quite often and you don’t have a cadre of computer programmers then you need to go with an mobile website. Finally you need to think cross platform. If all of your users have iPhones then that is great you only need to develop one app. But if your users have a variety of devices and you don’t have variety of programmers, you might consider a mobile site which can be read by any mobile device.
Two valuable resources Emily mentions are CNET’s Updates Tablets Test Results and Yale’s Mobile Device Options for Healthcare Professional. CNET’s is a listing comparing LOTS of tablet devices with each other so that people can make an informed decision as to which one they would like. The nice thing is this list is updated regularly. Yale’s is a listing of various resources (phone and tablet) and healthcare things to consider prior to purchasing a device.
The last technology discussed was the e-reader. The nice thing about Kindle is you DON’T have to have a Kindle, you can download the free Kindle app on your Android, iPhone or iPad. It is important to remember that e-readers aren’t just for books. Librarians might want to consider creating or selecting PDFs, Word docs, audio files, or collection of works for specific users or groups. This works especially well in outreach and education endeavors. Suzanne Shurtz and Megan von Isenburg describe using e-readers in medical education (Shurtz, S., & von Isenburg, M. (2011). Exploring e-readers to support clinical medical education: two case studies Journal of the Medical Library Association : JMLA, 99 (2), 110-117 DOI: 10.3163/1536-5050.99.2.002) and although medical students did use them at the bedside they said they were very helpful in their studies.
Mobile devices are a part of our daily lives. The largest growth in smartphones was from women and older individuals, as Emily notes this really indicates that smartphones have gone mainstream. This is a great webinar for those new to the technology in medical libraries.
I saw this article, “Hospitals slow on tablet implementation,” last week and posted it right away on my Facebook account with the intention of blogging about it the next day. Sigh… that was before round two (or is it three now) of sick kids.
Several things flitted through my mind when I first read the title:
- Wow, Apple’s Tim Cook was a little off on his estimate that 80% of top hospitals were testing the iPad.
- Ok, looks like my hospital and I are not in the minority as it sometimes felt.
- Yep, same ol’ same ol’. By the time we adopt the new technology it is out of date
But after those thoughts and others left I began to wonder what is the real hold up. It can’t be that 99% of all hospitals have the same draconian IT policies. (Although my conspiracy theory friends might disagree.) Why does it seem that U.S. hospital have such wonderful advance cutting edge technologies for diagnosing and treating diseases, but when it comes to computer infrastructure, hospitals cannot keep up with technology.
So I began to look around the web to find out if anybody commented on Sarah Jackson’s post at Fierce Mobile Healthcare as to why so few hospital have done fully functional tablet systems.
Both Jenny Gold of Kaiser Health News and iMedicalApps approach the problem from the app side of things. Gold’s article blames the EMR companies that often don’t have apps for their software, thereby forcing hospitals to use third party apps like Citrix or VMware which can be clunky and slow. Satish Misra at iMedicalApps points out that even apps created by EMR companies like Epic, Centricity, and Allscripts require make their EMR apps read only making it a necessity for doctors to log on to a separate computer to make notes in the chart. To add to the “fun” many of these EMR companies like Epic and Allscripts require separate licensing for their mobile platforms. (Hmm that little caveat sounds familiar to librarians.) So what you have is all these hospitals who have spend LOTS of time and money getting themselves and EMR product and now enters a game changing product that was never envisioned 5 years ago when many hospitals were well into their EMR planning and implementation.
While EMR integration is important there are many doctors who are using the iPad without that ability. They are using them in the exam room, ER, Surgery, and especially in radiology. According to Robert McMillan of Wired, Apple has a secret plan to steal your doctor’s heart. His name is Afshad Mistri. (Although I am not sure how secret he can be when Wired does a big article on him and he is organizing invitation only conferences for medical professionals.) His goal (and Apple’s) is to get the iPad in the hands doctors. McMillan reports that it was Mistri who launched the special iTunes room for healthcare in September, and promoted it to a select group of healthcare app developers. Apple has to be careful promoting the iPad in hospitals. Step too far one way and the FDA will want to regulate it as a medical device, but don’t step at all and you don’t get it in the hands of doctors. The Wired article is a very interesting read and highly recommend it because it does a good job of illustrating just how Apple, a consumer oriented company not a company usually interested in businesses, is delicately trying to work its way into healthcare, specifically hospitals.
As much as Apple has secret fingers in the pie, trying to hook docs to the iPad, don’t forget that there are still signal issues within most hospitals. This is a big barrier to implementation. You can have all the best apps and EMR integration but if you are in a deadzone, you have an expensive brick. Ravi Nerella posted in the iMedicalApps forum, “We had issues with reception throughout our hospital (the ED was a dead zone) until one of the major cellphone carriers was allowed to place a tower or repeater (whatever it is they needed) and now we have great reception (for the specific carrier only of course) that also forced us to go with the specific carrier to provide us service.”
Just from a quick look through the Internet it seems that there is a host of reasons why 99% of the hospitals don’t have fully functional tablet systems. But from my perspective it seems to basically comes down to money (doesn’t everything). It takes some serious cash to license the app (3rd party or from the EMR company), some apps aren’t even fully functional so you aren’t saving on hardware costs by chucking the PCs. It also costs a lot of money to support the product and write hospital specific apps. Additionally they have to spend money on the infrastructure, making dead zones viable. If something wasn’t put in the budget and it is that costly to implement, it is going to take quite a while (years maybe?) to implement. The iPad is less than 2 years old. It wasn’t even a glimmer in budget lines back then. The speed of personal day to day technology has outpaced hospital budget planning processes. Quite simply, hospitals are giant cruise ships that can’t turn on a dime when the iceberg of new technology comes into sight. Let’s just hope most hospitals are not the Titanic.