Month: September 2009

According to Neil Versel’s Healthcare IT Blog, Apple looks to make a push into healthcare.  

It seems inevitable, given the success of the iPhone in healthcare, but I’m hearing that Apple is getting ready to make a full-scale push into healthcare. I understand that the company invited several vendors to a meeting at an Apple office in Chicago this week. I have no further details on what was said or who was present, but I know that there are a couple of EMR vendors out there who have tailored their products for Macintosh, even if it’s just optimizing the view over the Internet for the Safari browser.

I don’t doubt Neil’s information that Apple is interested in jumping into the healthcare market where there are “billions of dollars in federal money funneled into health IT over the next eight years.”  But it is not a question of Apple getting into healthcare but more of a question of whether healthcare (read hospital IT departments) will allow Apple in. 

I am not talking about research departments or academic medical centers who seem to have a few more Macs on campus than average and where your IT departments are somewhat used to dealing with them.  I am talking about the regular hospital institution where finding a Mac is about as rare as finding a vegetarian at Outback Steakhouse.  They are there, but not always, and don’t count on them to work within the system. 

Neil specifically mentions the success of the iPhone in healthcare as perhaps the basis for this move.  It is true iPhone is a very popular in medicine, but it’s popularity is usually a personal choice that is not supported by the average hospital IT department.  Again the only areas where I have seen institutions adopt the iPhone as a supported mobile device have been in the academic medial area.  Many regular hospitals still don’t support the iPhone.  In these institutions doctors, nurses, and hospital employees who have iPhones cannot access their own hospital email using the iPhone much less get on to the EMR (if the hospital even has an EMR up and running, there are still a lot out there that don’t). 

Earlier this year when Citrix released an app for the iPhone I asked our IT department if they had any plans to finally allow iPhone users access to institutional email.  I was told by my IT department, “The iPhone is a great personal device, but is not suitable for our institution at this time.” (Yes they did use itallics for personal device.)  The email went on to say that only approved Blackberry devices were allowed access to institutional email.  The IT department either were unaware or completely ignored the fact that many people use this so called personal device in the professional lives.  People use the medical applications on the iPhone to help treat patients or do consult medical references.  Yet it is still considered a personal device by hospital IT departments.  I see more and more doctors using iPhones.  I think their numbers are beginning to rival those of the Blackberry devices, but until the iPhone is accepted as an approved device within the hospital IT department, you will still have medical professional who will forgo the iPhone. 

While Neil sees the popularity and success of the iPhone in medicine illustrating the potential growth for the Mac in the healthcare, I see the the lack of iPhone adoption among hospital IT departments as an indicator of just how hard it will be for Steve Jobs to break into the healthcare industry.  Am I saying it is impossible?  No, and if anybody can do it, Jobs would be that person.  I just see it as a very large uphill battle to convince an institutional IT department so dependent on PCs to accept Apple on a large scale.

The sleek new 2010 MeSH line is here with new trees and vocabulary changes to keep the librarian database fashionistas busy. 

According to NLM, “In biomedicine and related areas, new concepts are constantly emerging, old concepts are in a state of flux and terminology and usage are modified accordingly. To accommodate these changes, descriptors must be added to, changed or deleted from MeSH with adjustments in the related hierarchies, the Tree Structures.”  To me, NLM  sounds a lot like Heidi Klum on Project Runway, “In fashion, one day you’re in, the next day you’re out.”

So let’s start the show.

What’s In:
Not content with just attending the show through keyword searching, 422 new descriptorsgrace the runway as full fledge MeSH terms.  Welcome Biofuels, Beekeeping, Blogging, Masculinity, Off-label use, and Vital Signs, Karl Lagerfeld NLM has deemed to you worthy to include in the collection.

The hem line of the MeSH world, changed descriptors, strut their stuff with the ever moody term Cyclones evolving to Cyclonic Storms and the stunningly popular Mass Immunization becoming Mass Vaccination.

What’s Out:
Liked crimped hair, neon colors, and bad prom dresses, these deleted descriptors have seen better days and are asked to leave the runway.  Goodbye Fungal Components (2002 MeSH born on date) your time has ended, now you are replaced with the younger model, Fungal Structures (2010 MeSH born on date). The many different styles of Eumycetozea, Mastigophora, Phytomastigophorea, Protozoa, Sarcodina, Sarcomastigophora, and Zoomastogophora are gone and replaced with the singular style, Eukaryota.  Following the same trend the specific term Specialties, Medical has been bumped by the broader more wearable term Medicine.

The 2010 MeSH collection is not yet available to the masses, I do not have a date as to when it will hit the shelves and go live.  But we should take this time and go through our closets of saved searches and take note of which strategies contain outdated terms and which could be better enhanced with the new terms.  That way when the time comes for us to update them and refresh them we can easily like Heidi say “Hallo” to the new and “Auf Wiedersehen” to the out.

Eric Schnell writes an interesting post  regarding the precarious future of QuickDoc now that its creater and maintainer, Jay Daly, passed away this Spring. Unfortunately even the National Library of Medicine is uncertain of the future of QuickDoc since they were not the producers of the program. 

Eric brings up a very good point, “As a community, libraries should not have to reply on innovative people like Jay develop systems that bridge the functionality gaps we expect from our systems.”  Eric is completely right.  Unfortunately this seems to be the case within the library community as well individual libraries.  Why are we still treating technology and programming as a add on feature?  These improvements and programs are valuable services and features.  We don’t treat cataloging or document delivery as whole like this, so why do we do this with the tools that help make these services possible?

This little article and video popped up earlier this weekend and I couldn’t help but post it for a little fun reading/viewing before the weekend.  Fellow Ohioan, Beth Hollis is a librarian at Akron-Summit County library by day, but outside of the library in roller rink she is MegaBeth with the Ruber City Rollergirls. 

Beth, looking for a hobby tried knitting first, but was kicked out of knitting class.  So she took up Roller Derby instead.  This has me thinking about all of the medical librarians I see knitting at meetings.  Will the next thing I see be the knitting impared strapping on some wheels and helmets at the next MLA Annual Meeting?  It would make for an interesting Sunrise Seminar.

Just in case there is interest for 2010, try the Roller Derby Name Generator.  -Rumble Kitty.

What does the future hold for libraries?  CNN.com believes it will be one without books.  The CNN.com article primarily focuses on public libraries and the young hip library-chic librarians embracing technology.  (By the way I hate how CNN has sort of split librarians into the young hip techie librarians vs. the old out of style bookish librarians.  It irks me.  Tech savvy has nothing to do with being young, old, hip, boring, chic, or dowdy.  Both types of librarians have tech savvy and non-tech.)

The article, “Welcome to the Library. Say goodbye to the books.” on Boston.com (posted by Cynthia on Medlib-l) is about one prep school’s idea of the future library.  The school eliminated the 20,000 volume collection and will be spending $500,000 for a “learning center.”  Laptop friendly study carrels ($20,000) and three large flat screen TVs ($43,000) projecting data from the Internet will occupy the space where the book stacks once stood.  So what will students read?  Where are the English lit. books that they might read for class?  Ah so glad you asked.  The school bought 18 electronic readers ($10,000) which will be loaded with these tomes.  My first thought, only 18 readers for a whole school to loan out?  My second thought, what a licensing nightmare.  Maybe I am overly sensitive to that because science and technology materials tend to have more licensing hoops to jump through than high school resources. 

Just take a look at our medical libraries today.  There a lot more library re-design projects happening to make room for group study rooms, conference areas, digital resources like smart boards, TVs, etc.  Librarians are dumping the print journal subscriptions in lieu of online access.  And the area of online textbooks has begun to expand and offer different opportunities for librarians and patrons. 

It would be silly to say we aren’t getting more wired and digital, because people are finding information more online these days.  But I think it is slightly premature to do what Cushing Academy has done and eliminate all of the books from the library.  People (especially students) use what is convenient and frankly right now it isn’t always convenient to get and use everything online.  If it were then why are we still printing out the PDFs of the online journal article?  You can still read a book if you drop it or fail to charge it, the same can’t be said of an e-reader.  However that isn’t an excuse to hide your head in the sand and ignore online access and technology.  If your library doesn’t have any online journals, books, or an online catalog, you are no better than those who have abandoned all printed material.  Both types of libraries are extremes and living on the extreme you will find your information access limited. 

While I am tech minded person and I am the first to start a weeding party in the stacks, I am not ready to say that libraries will be void of all books.  There will be less books of course, and online access makes it easier for more people to use the material, I just don’t think the death of the paper printed book is here. Yet.

There is a email circulating around the medical and scientific community with titles like, “Manuscript Submission,” “Call for Papers,” or “European-Elsevier Scholarships”  that are sent under email accounts from free email providers (Gmail, Hotmail, etc.).  These emails are aimed at would be authors and often involve a request to send “handling fees” to cover the article submission process.  Another scam is aimed at people interested in being an editor or reviewer, these “Editorial/Review Appointment” emails usually ask people to pay a fee to be a review. 

Elsevier is aware of this phishing scam and have posted a web page to try to inform and warn people about it.  I don’t know how long this scam has been going on but I first heard of this scam from Mark Funk who sent an email out to MEDLIB-L today (Sept. 2, 2009).  Others have been posting about the phishing scam as well, a post on the blog Leaves a Mark, has an example of one emails and it is clear from the picture that they are trying to look like communication from Elsevier. 

Not satisfied with pretending to be banking and financial institutions, it looks like the scammers have locked on to the scientific publishing arena where there are sometimes legitimate fees associated with publishing research articles, i.e. some open access journal publishers.  Currently Elsevier is the spoofed agency, but there is nothing stopping these people from adapting and picking another STM publisher.  As with all things I would use caution if anybody is asking for money.  In the STM publishing world it is not unusual to pay open access author fees to publish an article, just make sure the publisher is an open access publisher and it doesn’t hurt to do extra leg work to ensure everything is on the up and up.

If online technology was in the fashion world, social media would be considered the new black.  It is the latest little must have article of clothing that you can mix and match with other things in your wardrobe.  However, just because it is can be easily used and applied to a lot of things, doesn’t mean it should be used for every occasion. 

So how do you know if social media applications like Facebook, LinkedIn, Twitter, etc. are for you or your organization?  Well what do you plan on using it for?  In other words why would use it, what are your goals?  You don’t want to be using any application (including social applications) just for the sake of using them.  The folks over at TechSoup have an interesting webinar on Understanding the ROI of Social Networking in which they not only discuss the idea of setting specific goals, but also how you can measure your success and the return of investment of the project. 

Hospitals, medical organizations, and academic medical centers are jumping into the social media arena.  I am a part of the social media group at my institution where our hospital is actively using social media and planning social media technology, goals, and events.  We meet every month and people from various departments are at the meeting, everybody from the Executive Board, IT, marketing, education, alumni relations, etc.  We are on Facebook and have a Twitter feed. 

So why would this be important to hospitals?  Well there is the marketing and public relations side of things.  Hospitals love getting their name out there, love driving interest to their facilities.  But there might be other areas that we have not considered, for example, do social hospitals have better HCAHPS scores?  HCAHPS is the Hospital Consumer Assessment of Healthcare Providers and Systemsthat surveys patients’ persepectives of hospital care and their hospital experience.    In the post on the Social Hospital, John Domansky a hospital CFO, believes a “hospital that has adopted social media tools to better communicate with their patients, employees, medical staff, and community reflects an organization culture of superior communication.”  Because the many of the publicly reported HCAHPS questions focused on communication, it would stand to reason that institution that prides itself on good communication would have good HCAHPS scores.  Domansky says, “These very same characteristics mirror the basic principles of social media, ‘communicate well, listen, and explain.”  He continues to investigate this idea by looking at and comparing the HCAHPS scores of hospitals that use social media and ones that don’t use it. 

I wouldn’t say that getting on Twitter will improve your HCAHPS scores.  I don’t think you can take an organization with poor communication procedures and have them slap up a Twitter feed or Facebook page and expect good scores or good patient experience.  But I think institutions who are already good at communicating are already looking at ways to communicate better and social media is one of those was of improving  communication, thus would have good HCAHPS scores. 

Communication is a great thing, but new methods and new ways to contact people and organizations or communicate feelings and thoughts about people and organizations can be tricky until one learns their appropriate boundaries and creates the appropriate social media persona.  For a regular person it can be tricky.  I have only recently begun to find my social media persona.  years ago when I started this blog I made a conscious decision that it would be primarily professional not personal.  Well lines began to blur when I got on Facebook and started using Twitter.  Personal updates that my friends and family would be interested it, were co-mingling with professional things.  Only recently did I sort my social persona out.  I post personal information on Facebook and mainly professional posts go on Twitter (those feeds are also re-posted on Facebook).  The blog, which will always be my more professional side, will post a link both on Twitter and Facebook (believe it or not I have some family that are interest in my blog posts).  So I guess if you look at it for my social persona, Facebook is the most personal, Twitter is more professional with a smattering of personal, and the blog is the most profession with little personal.  All three areas link upon each other but I think I have set up distinct areas.

For those in certain professions like a doctor, nurse, lawyer, teacher, etc. it can be even more tricky.  A recent article in NEJM, “Practicing Medicine in the Age of Facebook,” recounts one physician’s experience where the blurring of the lines of professional and personal communication. 

Organizations such as hospitals or libraries don’t have to worry as much about their personal/professional image, but they still have to worry about the communication and what they are going to say and how they are going to do it.  The Internet and the social media sites are rife with examples of how not to do something.  Unfortunately many of these examples were made live, and some of the companies suffered for their blunders.  Not doing one’s homework on how a organization should operate with social media is a big blunder, but second to that is not having a clear goal on what the social media technology will help accomplish.  Just slapping up a Twitter feed and Facebook page without know why is bad.  That is why it would be a good idea to not only investigate the hows of doing it, but the whys.  Once you have the whys you can then measure whether it was successful and whether you should continue by looking at its return on investment.