Other Medical Library Stuff

Australian Healthcare Orgs Gain $9 for Every $1 Spent on Their Health Libraries

(Special thanks for Julia Esparza for her email directing me to this.)

Check out this cool infographic from the Australian Library and Information Association and Health Libraries Inc.  Basically it states that despite having budgets, staff and space cuts health science libraries provide $9 of benefit to their healthcare orgs for every $1 spent on them.

This infographic is part of a study conducted by Health Libraries Inc (HLInc) and Health Libraries Australia (ALIA HLA, a national group of the Australian Library and Information Association).

“The partners commissioned award-winning firm SGS Economics and Planning to survey health libraries across the nation and from this to assess the return on the annual investment in these services to their organisations.

The results provide a snapshot of the continued outstanding value of health libraries against a backdrop of significantly greater usage but declining investment. Patient and medical staff numbers and hospital expenditure are increasing, while health library budgets, space and staffing levels are decreasing.”

To view the full report, please click here. You can also find the SGS report here.

There are lots of very cool things in the infographic but the one that really stands out to me is at the bottom (unfortunately). It says, “The investment in these services (library) is just 0.1% of the recurrent expenditure in Australian hospitals.”

IMHO that information is HUGE.  Why are hospitals cutting such a SMALL percentage of their recurrent budget when it provides a healthy return on investment!?

One of the reasons I think this is happening is because we need to do this kind of study on a local level.  Hospital librarians need to figure out how we can show this information to our administration and also show how we are helping with their bottom line DESPITE our cuts.

While I think this is information is important, I don’t think running up to your administrator showing him this infographic (or emailing it to him/her) is going to help.  Administration has the mind set of, “What have YOU done for me lately?”  They will see this infographic and think “how nice for Australia, but what about our hospital?”  How are you helping your specific hospital with costs and patient care?  Please don’t answer them with the phrase, “I provide doctors and nurses with information.”

That is all fine and dandy but that answer doesn’t specifically detail how you are helping the hospital with costs and patient care.  Numbers matter to them.  Hospital librarians need to do these studies on a much smaller level in their own institutions. We need our own local numbers telling administration that we helped our OWN caregivers change their thinking and improve their diagnosis or treatment plan X%.

That is what matters to our administration.

Hospital librarians…we need to do our own research studies to survive. The research doesn’t have to publishable in a library journal but it has to be given to administration and make sense to them.  Heather Homes calls it the “small r research.”  It is research that doesn’t take a year or more to complete, it is specific to your department and institution, and it is what administration finds important.  All of these things run contrary to big R research. Big R research takes several years to complete, applies to libraries as whole, and is of interest to other librarians.  The little r research is about your job, the big R research is about the career of librarianship.

So lets start to deconstruct these great big R research projects like the Marshall study and this one from Australia so we can see how we can apply them for our own small r research in our institutions and in our jobs.

Who’s with me?!

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3 comments - What do you think?  Posted by KraftyLibrarian - November 7, 2013 at 12:42 pm

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MLA’s Rising Star Program: Apply Now to be a Star or Mentor/Host

(reposted from MLA-LMS)

The MLA Rising Star program has been developed for MLA members who are interested in attaining leadership roles in MLA but who have not yet become active at a national level. The one-year leadership development program matches each Rising Star with a mentor in a curriculum that includes:

  • learning how MLA succeeds through the volunteer efforts of its members;
  • the roles of the MLA Board and staff; and
  • project management skills applied to an actual MLA project.

Application and information can be found online at: http://www.mlanet.org/pdf/awards/20130827_rising_star_app.doc

Applications are due November 1, 2013. 

Also, if your chapter, section, or committee is interested in submitting a project for the program, the host/mentor application can be found online at: http://www.mlanet.org/pdf/awards/20130827_rising_star_host_app.doc

Host/Mentor applications are also due November 1, 2013.  

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Be the first to comment - What do you think?  Posted by KraftyLibrarian - October 17, 2013 at 10:36 am

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Cutting Muscle and Bone

One of our favorite movies is Raising Arizona.  We can sit back and watch it any time and we often quote movie lines to each other when it fits a situation.

In Raising Arizona, Nicolas Cage plays  H.I. “Hi” McDunnough and has quite a few interesting expressions and quips. One has been on a loop in my brain lately.  It one that in the first few minutes of the film. “These were the happy days, the salad days as they say, and Ed felt that having a critter was the next logical step. It was all she thought about.” A few moments later, Hi’s voice says, “Our love for each other was stronger than ever, but I ‘preminisced’ no return of the salad days.”

Sometimes I wonder if there were ever a salad days in medical libraries.  I know medical libraries had budgets, the money just wasn’t falling from the sky.  However, it seems these last few years medical librarians have seen their budgets continually cut.  Even “lucky” libraries who have had a flat budget for the past few years, are being told to cut their budget by a percentage.  Those are the lucky ones. They have weathered the storm well until now. Hospital reimbursement from the ACA are impacting the hospital budget, they are seeing less reimbursement.  Less reimbursement means less money, less money means they are cutting budgets.

Yet as hospital library budgets have been cut, the cost of resources have continually increased.  Depending on the vendor it could be anywhere from the rate of inflation to a 75% increase.  Librarians have done their best to watch all of their resources and cut anything that is under performing.  Journals that cost more per use than ILL fees…gone. Databases that don’t have a certain cost per use…gone.  Resources that up their prices to align with competitors because the competitor is more expensive…gone  If medical libraries were a steak, they would be the leanest toughest piece of leather on the plate. There is no fat left.  There is no chef’s steak sauce to compliment the “unique” flavor.

So what happens when you have trimmed the fat?  You trim the muscle and the bone.  The cuts in medical libraries have caused librarians to cut things we would never have cut 1-2 yrs ago. Guess what…We have now cut all of our under performing resources. We are now cutting products based on price alone.

Of course, what else can you do when you don’t have the money?  Donors like to fund projects they could put their name on, not operating budgets or resources that are annual.  A bake sale ain’t going to work. Yet the prices of resources continues to rise. Vendors have told me about the “VALUE” of their product and how important it is.  Big flipping deal.  I know it is valuable, I wouldn’t be talking to them if it wasn’t. Don’t talk to me about value.  But they persist, as if hammering me about the “VALUE”  will magically cause me to find money to pay for their 30% increase.  My answer: My car is a value to my job and my life.  But, if it breaks down and my family budget cannot pay for repairs or a new one, I have to take the bus.  Do I want to commute 1 1/2 hours each way via public transportation every day? Hell no, but if that is all I can afford that is what I do.

If I can’t afford your “VALUED” product, I am going to make do without it.  Sorry, but it could be the most valuable thing on the face of the planet but if I can’t buy it, I can’t buy it.

I know of a few great medical librarians, who are looking for new jobs out of librarianship.  They aren’t looking because they were laid off (although there are those too).  They are looking because they see no future in medical libraries.  The shrinking budget (even in well funded institutions) and rising cost of resources makes them feel like they can’t do their job.  Some question whether the rise in costs will inevitably force libraries to shift the costs to the institution as a whole. Thus the shift of the product’s cost to another cost center.  What will happen when that happens for every resource, in the library?  Don’t laugh, at 15%, 20%, 30% price increases when faced with a 3%, 5% or 10% budget cut, the pot of resources gets smaller and smaller.

It would be interesting if there was a survey where librarians could anonymously mention what percent their budget was cut and list the resources they cut as a result.  They don’t have to list costs.  Just the percentage they lost in their budget and the products that were dropped as a result.  I know the resources cut will vary by institution, but it would be interesting to see if there was a pattern.  What things people are holding onto until the bitter end?  What type of vendor cannibalizing is happening within the library?  Not only will it be interesting to see what products are eating the other, but what two (or more) products from the same company are eating each other.  For example: Does a rise in the cost for UpToDate effect LWW titles purchased?  Does a rise in the cost of AccessMedicine effect AccessSurgery (or other Access database)?  It could be any resource or vendor.

The funding model is unsustainable for hospital libraries.  Time will tell whether the reduction in reimbursements from ACA will make shifting the library resources cost to another department in the hospital unsustainable.  Who wants to take on another department’s cost for a product when they are also rquired to cut a certain percentage out of their budget?

In my Sacred Cows and Heretical Librarians post I mentioned we need to think evaluate our sacred cows.  At the time I meant services or how we do librarianship, but we probably need to apply the same principle to our resources.

 

 

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1 comment - What do you think?  Posted by KraftyLibrarian - October 16, 2013 at 11:00 am

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Thomson Reuters Frank Bradway Rogers Information Advancement Award

(reprinted with permission)

Do you know someone who has developed an application, tool or interface to help deliver medical information to their clients?  Perhaps the technology fits the definition of meaningful use?   Maybe you know of an innovative way that a library or informatics center is using technology to better serve a specific group of people.  If so, consider nominating a colleague for the Thomson Reuters/Frank Bradway Rogers Information Advancement Award. Technological advances for this award are considered both on their merit, and the extent of their impact.

The award is presented annually in recognition of outstanding contributions in the application of technology to the delivery of health sciences information, to the science of information, or to the facilitation of the delivery of health sciences information. The award is sponsored by Thomson Reuters. The recipient receives a certificate and a cash award of $500.

 

Deadline for applications is November 1.
Complete information and nomination forms can be found at http://www.mlanet.org/awards/honors/

If you have questions, please contact Terrie Wheeler, Jury Chair, terriewheeler58[atsign]yahoo[dotcom]

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Be the first to comment - What do you think?  Posted by KraftyLibrarian - October 14, 2013 at 10:33 am

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Sacred Cows and Heretical Librarians

Last weekend I had the wonderful opportunity to be the keynote speaker for the Midwest MLA Chapter meeting.  It was a great meeting and I learned so much from so many people.  I LOVE Chapter meetings.  Ask me and I will tell you, the Chapter meeting is a great place to share and learn from other in a much more scaled back and doable scale than the large MLA meeting.  That is not to take anything away from MLA, I just think that a Chapter meeting is more intimate.

Some people at the meeting asked if I was going to post my slides from my presentation.  Yes, they are on SlideShare and I have re-posted them here.

Emerging Technologies & Evolving Library from Michelle Kraft
These slides don’t have a lot of text.  So I feel there needs to be a bit of outline of what I talked about to give them some context.  So here is a brief summary of what I talked about….
Technology is disruptive.  That doesn’t mean it is bad or good, it just changes everything we do.  It could change things for the good or the bad.  An example of a very disruptive technology is the light bulb.  It completely changed the way we as society do things.  Thinking of more recent technologies, the phone is another disruptive technology.  The telephone changed how we communicated to each other.  The cell phone disrupted things again.  Not only were are we able to communicate with each other over long distances, but we can do it wherever and whenever.  The smartphone just ramped things up even more by making our phones the necessary multi-purpose tool of our lives.  We use it to communicate (text, voice, email, Twitter, Instagram, etc). We use it as our own personal computers to find information online and store/create documents. It is our entertainment center for music, movies, books, online radio and podcasts.  The cell phone (among other technologies) have changed we as a society find and share information.  It is has changed the way people find and share information in libraries.  Think of what future technologies will be like and their impact on libraries.  Think of the latest technology, Google Glass, and library possiblities.
People access library websites through their phone… OR they are bypassing the library website all together and using an app (journal app, library database app, library catalog app, etc.) to find information.  They are accessing all of this information wherever and whenever….in the cafeteria, bathroom, in bed, etc.  This change in society’s behavior requires us to change the way we do things.  We must adapt to the changes in society or we face extinction.  Other professions that are dealing with changes in society as a result of technology: US postal service, newspapers, photo journalists, etc.
My presentation was not a doom and gloom thing.  On the contrary…. I said we needed to look at these disruptive technologies as opportunities.  They provide us the opportunity to shape our own destiny.  They allow us to take our services and resources and put them together in different ways to adapt to the changes.  Think of your resources and services as Legos, each one can be put together in different positions.  If something changes or doesn’t work, change the Lego’s position or swap it out.
Swapping out Lego pieces sounds easy but it may not be as easy as you think.  Libraries need to look at the changes in society and start asking themselves some hard questions.  Are the services/resources we provide for ourselves or for our users.  We do a lot of fooling ourselves that some of our traditional services/resources are for our users when really they are for ourselves.  For example, why are we checking in print journals?  Why do we even have print journals?
We need to look at our sacred cows in our library.  We need to evaluate whether we should keep them or kill them.  We can’t just keep them because we have always kept them.  Cows (in real life and virtual) need to be fed and maintained.  If feeding and maintaining them serves a valid purpose to our users, then we should keep them.  If they don’t, then we need to kill them, or they will eat food and take up space of other resources.  I gave several examples of sacred cows.  The one that everybody seemed to latch on to was my cataloging example.  I asked the question, “Do you need a catalog or would an A-Z list suffice?”  Predictably a few catalogers freaked.  What I tried to convey…
  • If you are at a large academic medical institution or even NLM you need a catalog….BUT do you need to catalog the way you are doing right now? Could you be more agile?  Could you do something slightly different?  We are too entrenched in the way we catalog things.
  • If you are small hospital library with only a few shelves of books, you may not need a catalog.  I know it is crazy to think that, but you may not. Perhaps an A-Z list or *gasp* an Excel sheet posted online will do.  Maybe you could tag your holdings in Library Thing.
  • If you are a small hospital library with more than a few shelves of books, but nowhere near what an academic library has perhaps you need a catalog. But do you need to add anything to the catalog other than what our users care about?  Most users only care about title, author, year, edition, URL, and table of contents.  They don’t care if it is 24 inches tall, illustrated and has 246 pages.  Do you need to catalog using MeSH?
Evaluating these sacred cows may cause us to think some pretty heretical librarian thoughts.  The idea of not cataloging is pretty heretical. don’t get stuck on my catalog example.  One hospital librarian at the conference mentioned they did something pretty heretical, they stopped doing research and providing articles to people who were going back to school. She told them they needed to get their research help and articles from the library of the school they were attending.  She said it was a pretty heretical thought to her staff at the time.
Wikipedia’s definition of heresy: “Heresy is any belief or theory that is strongly at variance with established beliefs or customs.”  Long established customs may not be what we need now as our society changes with technology.  In order to evolve we need to look at our services and question our long established services and see if they are really needed or helping us go forward.  If not, why are we doing them?
In sum we need to look at the sacred cows and start thinking heretical librarian thoughts.  We need to always keep trying and never give up.  Let’s not be afraid of failure, failure just tells us what doesn’t work.  We need to know what doesn’t work, to know what does.
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2 comments - What do you think?  Posted by KraftyLibrarian - October 9, 2013 at 1:35 pm

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Government Shutdown and Hospital Libraries

Medical librarians were asking questions yesterday on Twitter and on Medlib-l about the impact the government shut down will have on medical library operations.  Will PubMed be up? What about Docline?

There was some uncertainty.  Alisha Miles has summed up the latest information (that we know of) in a blog post.  PubMed, NLM, Docline, and MedlinePlus websites all have notes (click on links to see the images of the notes) regarding their status during the government shutdown.

Of course being librarians we are focused on how it will impact library services, to get a perspective of how it will impact health care and hospitals check out the Forbes article, “Government Shutdown Hits Research, Teaching Hospitals, Residency Programs.”

As bad as it is, we might consider ourselves somewhat lucky.  At least the websites and backbone service programs (PubMed and Docline) we use are up.  There are other sites and industries that are not.

Alisha pointed out on her blog that ERIC (eric.edu.gov screen shot) is down. And while this tweet got a snort of laughter out of me, NASA’s website is down and redirecting to http://usa.gov (screen shot).
sarcasticrover

The White House website is down, but interestingly the Senate and the House of Representative‘s websites are up.  I am refraining from making a bevy of sarcastic comments about essential government services right now.

**Update**
Vanderbilt’s Eskind Medical Library has a REALLY good list of what is up and what isn’t.
http://www.mc.vanderbilt.edu/diglib/news/2013/10/federal-resources-affected-by-government-shutdown/

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4 comments - What do you think?  Posted by KraftyLibrarian - October 1, 2013 at 11:33 am

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Congrats to the New Leadership Program Fellows & Mentors

Congratulations to the fellows and mentors chosen for the 2013-2014 NLM/AAHSL Leadership Fellows Program.

According to the statement posted on the MLA-LMS listserv, “the NLM/AAHSL Leadership Fellows Program prepares emerging leaders for director positions in academic health sciences libraries. The program provides a combination of in-person and virtual learning experiences for fellows and offers the opportunity to work collaboratively with the cohort of participants. Fellows are paired with mentors who are academic health sciences library directors and will visit the libraries of their mentors.”

More information about the program is available at
http://www.aahsl.org/assets/documents/2013/2013-2014_nlm_aahsl_lfp.pdf.

Although I haven’t seen a non-academic librarian accepted in a while, the program isn’t limited to just academic librarians.  Hospital librarians and librarians from other library environments can and should apply if  they have a “strong interest in pursing a directorship in academic health sciences libraries.”

2013-2014 NLM/AAHSL LEADERSHIP FELLOWS PROGRAM

Debra R. Berlanstein

Associate Director, Hirsh Health Sciences Library
Tufts University

Mentor: Thomas G. Basler

Director, Libraries and Learning Resource Centers
Chair, Department of Library Science and Informatics
Medical University of South Carolina

Renée Bougard

National Network of Libraries of Medicine Outreach Librarian
National Library of Medicine

Mentor: Pamela S. Bradigan

Assistant Vice President, Health Sciences
Director, Health Sciences Library
Ohio State University

 Tara Douglas-Williams

Division Head for Information Services/Library Manager
Morehouse School of Medicine

Mentor: Barbara Bernoff Cavanaugh

Associate Director, Health Sciences Libraries, and Director, Biomedical Library
University of Pennsylvania

 Deborah L. Lauseng

Assistant Director, Academic and Clinical Engagement Taubman Health Sciences Library
University of Michigan

Mentor: Anne Linton

Director, Himmelfarb Health Sciences Library
George Washington University

 Alexa Mayo

Associate Director for Services
Health Sciences and Human Services Library
University of Maryland

Mentor: Christine D. Frank

Director, Library of Rush University Medical Center

Dongming Zhang

Associate Director for Advanced Technologies and Information Systems
Welch Medical Library
Johns Hopkins School of Medicine

Mentor: Gerald J. Perry

Director, Health Sciences Library
University of Colorado Denver

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2 comments - What do you think?  Posted by KraftyLibrarian - September 26, 2013 at 9:56 am

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What is the Biggest Thing in Medical Libraries

A few weeks ago over dinner and drinks my public librarian friend and I got into a very interesting and lively brainstorming discussion about the biggest “things” that have or will hit libraries. The conversation was all over the place.

Some of the things we discussed:

  • Budgets or Tax Proposals
  • Closing of libraries or space problems
  • Competition – Used to be book stores but who is it now?
  • Technology – 3D printers, Google Glass, ebooks, virtual reality
  • Outreach – embedded librarians, phone booth libraries, gas station out reach
  • Legislation – ACA, local issues, NIH, NSA spying
  • Staffing – Where is that giant hiring push?  Staff retire and aren’t replaced.

This discussion has been bouncing around in my head for a while and I keep thinking about the “things” (good or bad) that will affect specifically medical librarians and librarianship.

In your opinion what are the major things to to be hitting medical libraries in the near future?

Is it:

  • Afordable Care Act – Hospitals tightening budgets (and thus the library’s budget) in response to lower reimbursement
  • Meaningful Use – Promote the spread of EHRs to improve health care in the United States
  • Big Data – Its use in hospitals and biomedical research
  • Space – Change of library space from holding books to services? (Often means shrinking of library space)
  • Electronic resources- What isn’t available electronic these days!? Access and usage across devices and outside of the institution.
  • Employment – In response to some of the above instititutional issues, librarians are losing their jobs or are not being replaced as they retire or move to another position.
  • e-Science – Better known as just science within scientific community, but is heavy on the tech, data, and social side of things

I think all of those thing are going to make an impact on medical libraries. But if you had to narrow it down to one thing from the above list, or something I havne’t listed, what would be the biggest thing medical librarians must deal with on the horizon?

Please make it a discussion by commenting below and on Twitter #hittingmedlibs.

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8 comments - What do you think?  Posted by KraftyLibrarian - August 26, 2013 at 10:15 am

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#Medlibs Tomorrow: Using Social Media for Consumer Health

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.

*Disclosure Notice*
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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Be the first to comment - What do you think?  Posted by KraftyLibrarian - July 10, 2013 at 10:46 am

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Meaningful Use Stage 2: Can Librarians Help?

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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4 comments - What do you think?  Posted by KraftyLibrarian - June 13, 2013 at 11:30 am

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