Here is what I think might be an interesting article for everyone who is interested in the EMR and how the library fits in.

Integrating Knowledge-Based Resources into the Electronic Health Record: History, Current Status, and Role of Librarians. Albert, Karen. Medical Reference Services Quarterly 26(3) 2007 1-19. (subscription required for full text)

Abstract:
Satisfying clinical information needs remains a major challenge in medicine, underscored by recent studies showing high medical error rates and suboptimal physician adherence to evidence-based practice guidelines. Advanced clinical decision support systems can improve practitioner performance and patient outcomes. Similarly, integrating online information resources into electronic health records (EHRs) shows great potential for positively impacting health care quality. This paper explores the evolution and current status of knowledge-based resource linkages within EHRs, including the benefits and drawbacks, as well as the important role librarians can play in this process.

Oooh I have got to get my hands on this article. I really think the next step for librarians is to expand their services by providing point of care resources that can be integrated in the EMR. Unfortunately, I think many librarians are spinning their wheels trying to figure out how to get involved.

Labels: EMR, Technology

Well if you aren't into the whole Social Networking craze then take heart because according to Lance Ulanoff of PCMag.com, "My Space, Second Life, and Twitter Are Doomed." He believes the hype and the fate of these programs is similar to the same fate of the millions of personal web pages created in the 1990's.

His theory is that My Space, Second Life, Twitter are "huge, ugly, unmonitored, unrestrained, and pointless." I am sure there are other's out there in the library community and elsewhere who are thinking the same thing. I am not sure if they feel exactly the same or they are just suffering from what I call Burnout 2.0.

If it is true, and all of these and other programs are doomed for failure, I have to ask the question, "Is that necessarily a bad thing?" The Discovery Channel is the most popular television channel in my house. My four year old son and I love watching Dinosaur Planet. His eyes are riveted to the screen as he watches dinosaurs, eat, hunt, migrate, hatch and die. He has learned that birds and dinosaurs are closely related and on some level he has learned about evolution.

So, I have to say that Lance is probably right. These programs are doomed, they will die off. When, who knows. He believes sooner rather than later. Me? I don't know. What I find more interesting is what will take their take their place. What will evolve from these social networking tools? What will these "dinosaurs" of the Internet become?

Labels: Social Software, Technology

John Sharp, eHealth mentions his presentation on Web 2.0 and Healthcare to the Northern Ohio Healthcare Information Management and Systems Society (HIMSS) in Cleveland.

The main themes to John's presentation are:

• What you need to know about Web 2.0
• Why you should worry about Web 2.0
• Why you should use Web 2.0

Because the hospital's network and security is IT's job they are going to come down on the conservative side of things. After all you aren't the one who will be getting paged at 2:30 in the morning if something bad happens. Our job as librarians is to connect people to information freely, and the some of the ways we connect or want to connect people to that information can be understandably scary for the IT people. They aren't the only ones who get freaky with the ideas of access to everything, information control by the masses, and perpetual beta....Just ask a cataloger about social bookmarking and tagging within "their" catalog.

Even though IT people are worried about some Web 2.0 applications, there are reasons to use them as John mentions. The trick is to do so without comprimising the hospital system's network or security. The trick is to come out somewhere in between. Where that is? I am not sure. I am not an IT person I don't know about all of their issues and concerns. However, the IT people are not librarians either, and they don't know or understand all of our issues and concerns.

This presentation is from perspective of the hospital IT people, the very people some of us librarians are trying to reach out to and collaborate with. (Or at the very least get on their email/call list when IP ranges change.) The IT people know about Web 2.0, some are proactive and some aren't. By looking through this presentation and others like it you begin to get some insights into their perspectives. You may not agree with everything, but you at least know a little bit more about what they are thinking. That way when you approach your IT person about chat ref, blogs, wikis, etc. you might be able to address some of their concerns and hopefully get their approval.

That is of course if you can actually get a hold of a friendly face within IT to build a work relationship with. It always seems that once we find "that person" they end up getting transfered to a different area in the hospital system or they leave for another IT company's greener pastures and we are left seeking out another victim...uh I mean friend to educate about the library's IT needs.

Labels: Social Software, Technology

If you have been following the AskDrWiki threads around the blogosphere (David Rothman, Doctor Wiki, AMA News, etc.) you will know that the creators of AskDrWiki have instituted a detailed editorial policy to help ensure that accurate and quality medical information is posted.

Unlike many wiki and blog pages, editors on AskDrWiki are not anonymous and are identified with their name and degree. Now the Who is Dr Wiki Page not only lists the editors but it will also link to their resume or curriculum vitae. Examples: Kenny Civello MPH, MD and Brian Jefferson MD.

AskDrWiki is still a little subject heavy in Cardiology, however they are looking for editors in every specialty. For example the Biomedical Informatics section is currently empty, so if there are any librarians, physicians, medical information systems people who specialize in Biomedical Informatics, you might want to drop them an email and help contribute.

Labels: Social Software, Technology, Wiki

Hardin Medical Library has recently begun applying tags to images from UIHC (University of Iowa Hospitals and Clinics) -example images from the Dermatology Department and the College of Dentistry.

Sometimes I feel like I have been accidently recruited into a large team building scavenger hunt exercise when I am asked to look for a good medical image online. I have previously mentioned how I think tagging medical images online would be one way to possibly help organize and retrieve good medical pictures. However, I have seen little development in this area, which is a little surprising to me. The only reason I can think is that many medical images are located in pay databases such as images.MD which wouldn't take too kindly to having there images tagged, displayed, and freely. But what also is a little surprising is that images.MD doesn't allow people to tag images. You can save images to your account but you can't tag them with your own words or notes. I personally think that would be a helpful feature.

Why should we stop at tagging only our personal and fun photos on sites like flickr? Tagging could make finding medical images much easier. What would be cool is if there was a site similar to flickr only dedicated to medical images.

Labels: Social Software, Tagging, Technology

Judy Burnham gave a presenation to the Medical Association of the State of Alabama on Web 2.0 tools in Clinical Practice.

Her handout http://southmed.usouthal.edu/library/masasite/class.htm and PowerPoint presentation http://southmed.usouthal.edu/library/masasite/Web2.0.htm are available. She mentioned that during the meeting her library hosted a CyberCafe where attendees could check their e-mail and/or confer with librarians on accessing knowledge based information. The web site developed for the CyberCafe is at http://southmed.usouthal.edu/library/masasite/.

Labels: Social Software, Technology

This article, "A Wikipedia-style site for medical information?" appeared in yesterday's (March 29, 2007) Cleveland Plain Dealer. I have been busy with a couple of projects so I am just now getting to blog about it.

David Rothman, was interviewed as a librarian opposed to AskDrWiki and that actually shocked me a little. Even though David has criticized the wiki on his blog in the past, he has also discussed the positives of AskDrWiki as well as other wikis. It wasn't until I read David's blog this morning did I get the full picture. In his post, Cleveland Plain Dealer on Medical Wikis he revealed his frustration of being quoted out of context and his decision to publish his interview with the reporter.

I am very familiar with AskDrWiki and I have been watching it with great interest as one the better examples as to how wikis could work in the medical field. It offers a lot of promise as a learning site that can be used in conjunction with other medical information resources. While I share David's concerns about authority control and errors with medical wikis I am not as jittery as many would think.

Perhaps it is just in my mind but I kind of think of wikis, specifically specialty wikis like AskDrWiki, as a virtual discussion room for individuals. As librarians we look at various resources that our patrons use for information. However one resource we often forget about because we often don't see it, is doctor to doctor personal communication. Doctors (as well as other professionals) often consult each other formally or informally. At the basic level what is the difference between the sharing of information face to face vs. online through a wiki? Both methods are a means of exchanging information. Aah.. but there is a chance that the information posted on AskDrWiki is wrong. Yes. But isn't there also a chance the individual you are consulting in person is wrong? People are infallible, including doctors.

Now that AskDrWiki has instituted a credential review policy, it ensures that at least medical professionals are posting and sharing information which does help with some quality control. However, it does not totally eliminate the chance of errors and I don't know of anything that eliminates that chance completely. Textbooks have been recalled for errors, journal articles have been amended or retracted, and treatments medical society once thought to be the gold standard have been replaced. I tend to think of wikis like other information resources (articles, textbooks, personal discussions, etc.) where the onus is still on the user to verify the information. We do it all the time with print resources or through subtleties in conversation.

The medium is not what should be questioned, it is the information within. Learning is all about asking questions. Wikis offer that opportunity to learn.

Labels: Social Software, Technology, Wiki

Many hospital librarians complain about the inability to create and implement certain technology projects because of their hospital IT departments policies. Some libraries just want an web page while others would like to do some more involved things such as hosting a few instructional multimedia files. Personally, I think this is one of the biggest areas where hospital librarians see big difference between their work environment and the work environment of academic medical librarians. We see a lot of the cool technology and we can envision how it would work in our hospital if only we got approval from our IT department.

As many of you know I have been working on using Athens for providing off site authentication for my users. I love it. However it has led to a new problem. Now that I have all these products available off campus to my users, how are they going to be aware of these products to actually use them? Most public libraries and academic libraries have web pages on the Internet so that patrons can browse through resources and use them. However, all of my library web pages are hidden to the outside world because they are on the Intranet. My users can't see the hospital's Intranet when they are off campus. So I need an Internet web page.

It took me a while to find the right person to contact for this specific request, but color me surprised that he was open to the idea. We had a great conversation as to how we could do it in the easiest, most logical way. Whoa. I had to double check the phone number to make sure I was indeed calling the IT department.

I was so prepared for failure that I had begun to look at other solutions. Like many other hospital libraries we do not have the budget or time to buy and maintain our own server. So that wasn't an option. One option I was looking at was getting a third party hosting service. There are a lot of companies out there that offer hosting services. You need to do your homework to determine necessary account features like disk storage size, bandwidth, support, programming, etc. You also want to see what kind of technology platform they provide i.e. Windows, Unix/Linux servers, or both, because that can impact what type of applications you can run.

Two hosting services that come to mind are LISHost.org and DreamHost. LISHost started by Blake Carver is librarian focused and already hosts several small public libraries. Cost is a major concern for many small hospital libraries and these services can be actually quite reasonable. For example, DreamHost has multiple package levels ranging from $10/month to $80/month depending on your needs

You also need to start talking to the appropriate people in your hospital. Start first with IT. They may have some ideas and solutions that might work without the need to go to an outside company. If they don't they might be able to give you an idea on technical requirements that you might need. You also want to make sure they are kosher with the library getting services from an outside hosting company. Some IT people I have talked to were fine with it because it is one less thing they had to worry about. You will also probably need to talk to somebody in administration and quite possibly legal. After all, you are putting up a web site with the hospital name on it. They will want to make sure you are not including medical advice or slandering the hospital in any way. You need to stress that you are not going to be dealing with patient information and dispensing medical advice in any way. Try to get them to see it as something similar as university's medical library on the web. They don't provide patient or medical information.

It is second nature for librarians to look outside of the institution to provide articles, books and "library stuff." However, many of us have been so locked into the tunnel vision of what we can't do because of IT policies, that we me have forgotten to look outside of the institution for technology solutions. Perhaps outsourcing and using a third party hosting service offers us a way to provide better electronic services to our patrons.

Labels: Social Software, Technology

A while back ago I mentioned giving an article on listening to heart sounds using iPods to the curriculum development coordinator. Yesterday, Newsweek also wrote an article on Dr. Michael Barrett and his iPod and heart sounds idea.

What I found most interesting in this article was the statement, "What's amazing isn't necessarily that doctors are using iPods as teaching tools - it's that they've taken so long to catch on. In 2005, Duke University gave all incoming undergraduates their own iPods, and many other schools have signed up for Apple's "iTunes U," which allows them to download podcasts of lectures and other course materials. But medicine, particularly cardiology, has lagged behind, says Barrett."

We often see this with technology. There can be a lag between the emergence of that technology and effective educational (or business) uses for it. When I was in grade school there was the push to have computers in the school and have us using them. (Remember those big Apple IIe's?) What did I do with those expensive, large, tan boxes? I learned how to plot graphs. That was big stuff back then, but I am not sure how much I learned about computers and math from that experience.

It can take some time for innovative people to discover practical uses for technology. Often it is after an "aha" moment. As podcasting, wikis, chat ref, mashups etc. become more mainstream and more people begin to have that "aha" moment, new applications will emerge. The process is cyclical. It will get to a point where those "new" things will be integrated into our lives (education, work and leisure) and we will be wresting with how to adapt other new technologies to work in our world. Just look at computers and the Internet. Twenty or so years ago I was staring at a graph on a green and black screen. Now, I am lobbying for a second computer in my house because everybody but the dog and the 3 month old "need" to use the computer.

So if you are like me and sometimes lack a little in creativity to always know what exactly to do with all of this new stuff, don't worry. There are other people out there who are testing the waters. The key is to keep an open mind and take notes. You may not be a creative innovator but that doesn't give you the excuse to ignore technology and become "that guy." You know, the one who only has 8 track tapes, and not for nostalgic reasons.

Labels: Podcasting, Technology

All of you catalogers out there might want to take a look at this article (free online) "Catalog/Cataloging Changes and Web 2.0 Funtionality: New Directions for Serials," by Rebecca Kemp.

Abstract:
This article presents an overview of some of the important recent developments in cataloging theory and practice and online catalog design. Changes in cataloging theory and practice include the incorporation of the Functional Requirements for Bibliographic Records principles into catalogs, the new Resource Description and Access cataloging manual, and the new CONSER Standard Record. Web 2.0 functionalities and advances in search technology and results displays are influencing online catalog design. The paper ends with hypothetical scenarios in which a catalog, enhanced by the developments described, fulfills the task of find serials articles and titles.

Kemp mentions that many features of modern day catalogs are still based off of the old card catalog. She says the OPAC is now at a critical juncture in time where there are major conceptual and technological developments occurring. This article will give you an idea of the directions catalogs are heading and their continual evolution.

Labels: Social Software, Technology

Check out the Medical Library Trends blog and read what I and other librarians think will be the top technology trends that medical librarians will encounter. Read and see whether you agree or disagree then add your .02 cents. It is intended to be an open discussion.

(courtesy of Bart Ragon on Medlib-l)

ALA's technology arm LITA has been watching trends for years
(http://litablog.org/category/top-technology-trends/)
and there are numerous trade magazines that annually produce technology watch
lists.

These lists, while useful, do not always speak to the needs or concerns
of medical librarianship. Recently I began to wonder, what do medical librarians
think are the top technologies confronting our profession and how might this
differ from other lists . My primary intent is expose emerging technologies and
to hopefully start a conversation within the medical library community about
these technologies, our future, and the impact on the profession.

I asked three technology minded professionals try a little experiment with
me. Wallace McLendon, Gabe Rios, and Michelle Kraft are medical librarians who
do great things with technology. I asked each to come up with a list
technologies that are impacting our profession. I asked for around ten items,
there were no constraints, and each person worked independently.
You can
comment, disagree, or post your technology list on the site!
http://medlibtechtrends.wordpress.com/

Labels: Technology

The 5 Weeks to a Social Library course is a completely free and completely online course devoted to teaching librarians about social software and its use in libraries. Eventhough the course is limited to 40 participants (already chosen), everybody may access the course content.

The course will cover Blogs, RSS, Wikis, Social Networking Software and SecondLife, Flickr, Social Bookmarking, and Selling Social Software at your Library.

Week 1: Blogs and Week 2: RSS and Social Bookmarking are available already. In David Rothman's blog he mentions Melissa L. Rethlefsen's screencast to demonstrating some of the cool things that can be done with RSS on a Library’s Web site. *small note* You might have to watch the screencast from home if your institution blocks blip.tv.

For anybody who is interested in how these technologies can be used in libraries, I would recommend checking out 5 Weeks to a Social Library to get some ideas.

Labels: RSS feeds, Social Software, Technology