The ILS and the Future Needs of Libraries

ALL current ILS products suck.

There are several reasons why they suck, but the bottom line is that they fail to serve the modern needs of library which have drastically evolved.

OhioLINK and Ithaka S+R just released the white paper, “It’s Not What Libraries Hold; It’s Who Libraries Serve: Seeking a User-Centered Future for Academic Libraries” detailing the needs of libraries for systems going forward. *note* I served on the committee that helped formulate this paper.

Please note, we originally struggled with using the word ILS. Because the ILS we need now and in the future cannot be the ILS as we know it. But coming up with a name is difficult because what we really need is a true integrated library system, so what else do you call it? Think of the current ILS as Model T and the future ILS is a Tesla. The original Model T didn’t have windshield wipers and you had to crank to turn it on. The Tesla plots your course and will self park. They are both cars. They both served the needs of the population at the time. Can you imagine a Tesla on the unpaved roads of past? Likewise can you imagine commuting in a Model T every morning on the highway (in the winter in Ohio)?

The problem is the current ILS products fail to serve the needs of the current population. ILS products over prioritize the print collection (what the library owns) and fail to deliver on serving the needs of the user which has shifted beyond just the print collection. Since I am a medical librarian I see this most prominently in the medical library world. Librarians have used outside vendor products (link resolvers, discovery platforms, LMS, aggregators, etc.) to duct tape together a system to solve the needs that a true Integrated Library System should.

I encourage everyone, especially medical librarians, to read the white paper and think about the 4 main points we present that are necessary in the ILS of the future (near future IMHO).

  1. Libraries have shifted their raison d’etre from being the keeper of information to a user centered services. Unfortunately, every ILS I know of is centered around the keeping of the collections. The collections are important but they are not primary focus of libraries or users now. ILS products have not full understood that because it requires a complete reframing of the entire system. Too many ILS products are built on legacy coding and legacy structures and new versions and features are glued on. It is like taking a Model T and adding keyless entry.
  2. ILS products are still overly focused on print or physical in house collections. While we still need to keep track of that stuff, we need more help dealing with the external collections like online journals, image databanks, ebooks, music, databases, etc. Having a link in the catalog is not the answer, nor are any of the electronic resource manager modules that the ILS vendors provide. The ERMs do poor job of pulling in that information. Its as if you stuck turn signal lights on the Model T without any electricity to make them blink.
  3. Libraries are more than just where you read a book or study. Library resources are more integrated with their institution’s research, teaching, and learning. ILS products must be able to work with LMS platforms, research platforms and be able to handle the decentralized world that we live in. The report gives an awesome example of this type of unmet need that is NOW (not the future).
    “A medical researcher at the University of Cincinnati is collaborating with a colleague at Case Western Reserve University (both in OhioLINK) and with a third colleague at Oxford University, funded by a grant from the NIH. They are able to set up access and journal alerts for their joint work in three labs with multiple potential authors by seamlessly merging their respective e-resource entitlements and are able to integrate library materials and citations, their own data, and their draft publications in a common online working platform. When lab members are ready to publish, they are able to track where articles have been submitted, accepted, and where and how the Open Access provisions required by the NIH have been satisfied. The library maps seamlessly to the researchers’ workflows.”
  4. Gone are the days of reporting just your circulation stats. Librarians need data to analyze and communicate their value to their institution. Currently ILS products cannot do this in any meaningful way. “Library systems must be completely re-architected for the modern business intelligence needs of libraries & consortia.” If I reported just circ stats that just tells my administration how many times people are borrowing books. Why do they need a librarian to loan books? I need to report on ways we are involved in interprofessional education and how that impacts the educational and research needs of employees and the care and treatment of patients. Reporting on that requires a lot of work gathering data from multiple systems that don’t talk to each other. It is like asking somebody to monitor the gas consumption of their Model T to see if they can make it to the next gas station on their trip. It requires a lot of guessing and math. Hint: The gas gauge is a paint stick. You open the gas cap and look in the tank and stick a stick in to see how full your tank is.

The paper provide several key pieces of evidence supporting these 4 main points. For example:

The Primacy of Print is Past
A snapshot of OhioLINK’s resources clearly illustrates that print is smallest collection component of current libraries. In state wide consortia of 34 libraries, there are 12.6M ejournals, 9M etheses and dissertations, 7.5 ebooks, 6.3M database resources, and only .3M print that were lent within the cosorita*. Why are ILS products focused on print? *1/27 clarification as someone on Twitter mentioned the print number appears low and off. It is low, but to provide more context, that number reflects the stats for the consortial activity, ie interlibrary print lending and consortial digitally provided access. We did not go into each individual institution’s local print circ stats for this specific report.

Users Start Outside of the Library
Google, Google Scholar, and direct (going to the source like JAMA directly) are the first stop for finding information the greatest amount of time. Despite some OhioLINK libraries that have implemented discovery systems, only a teeny tiny amount of people who start their search using the library’s discovery system. Interesting for my medlib people, of the 117 OhioLINK libraries there are only 5 medical libraries. Yet, more people start their search for information on NCBI than on discovery platforms.

I hope you all read the white paper. I know several ILS vendors have been irritated with me in the past as I have critiqued their products. However, this white paper just articulates the needs that we librarians have been saying for years, about your products. We are all riding the information highway in our Model Ts covered in duct tape with modern day accessories (which are more necessity than accessory) as Google, Amazon, and other companies and library competitors speed by us in their Teslas.

Hospital Acquistions: Problem with Libraries

According to Modern Healthcare, “Hospital megamergers continue to drive near-historic M&A activity,” the actual number of hospital mergers and acquisitions have been similar to 2018 and the numbers seem to be pretty consistent from when the merger and acquisitions “trend” hit in 2010. What is different according to the article is the amount of revenue that is part of the process. The money involved was “nearly four times higher in the second quarter of 2019 compared with the prior-year period.” No longer content with serving a specific locale (city, county, etc.) hospital systems are expanding to larger regions and into different states to diversify and expand market share.

What this article doesn’t talk about is everything that happens once these hospitals are acquired and merge. Everything from HR, GME, billing, etc. gets assimilated to the buying entity’s system. As librarians we see this every time our hospitals merge, doctors, nurses, and some administrators assume that they automatically have access to the library resources “now that we are part of your hospital.” That is not the case. Like many other librarians, I am forever explaining that our license agreements only extend to the current facilities and do not automatically allow for newly acquired institutions to be added. If the newly acquired institution wants to be added to the licenses, they must agree to pay the costs of the library resources. This blows their minds. I don’t know why, because that is same deal with EMR systems. You just don’t get EPIC for free now that your hospital was bought by a hospital using EPIC.

Nursing, Pharmacy, IT have programs and resources that they license for the institution to be used by their people. Why is it that they seem to get those added to the new institutions faster than library resources when some of resources are drug databases and nursing information tools and are often sold by the same companies that sell to libraries? It was only a few weeks ago when I was once again reciting my license speech when it hit me. Every hospital (buyer and acquired) has a CNO, Chief Pharmacy Officer, CTO, etc. Yet, due to an increase in layoffs and “retires but no rehires” (see Hospital Library Association benchmarking survey) there are very few “Chief Librarians” or any librarians at many of the hospitals. So while the two CNO’s work together to discuss address issues, costs, etc. of their two hospitals merging, the librarian rarely has a peer at the other hospital to do the same thing. Not only that, but there is no hierarchy for the librarian of the buying hospital to consult at the acquired hospital to address the issues, costs etc. of merging. Because there is no librarian, there is nobody supervising the librarian, buying/budgeting library resources, licensing them, etc. It is basically a black hole.

Can you think of this happening within any other hospital department? I’m trying… help me out.

Without my counter part at the other hospital to discuss the merger and to discuss the costs, logistics, onboarding, etc. with their boss, I am left to talk to the wall. Nobody in the newly acquired hospital knows how to handle it and plays hot potato passing along the “library stuff” to the next administrator who also doesn’t know…. all before I drop the cost bomb. So, I am left giving my license speech to doctors and nurses explaining why I can’t give them access. I become the big bad librarian, alienating potential customers.

If a tree falls in the woods and nobody is there, did it make a sound? If a hospital librarian asks about resources and services and nobody is there, do we even exist? How can hospital librarians navigate this situation? Where do you find the support for resources in a hospital system that never supported it and doesn’t have the infrastructure to create it?

The Predatory Journals: The Dandelion of Biomedical Research

For years I have complained about predatory publishers found in PubMed. The publishers entry point is through PMC. Articles submitted to PMC are searchable and findable using the PubMed interface DESPITE being from a journal that is NOT indexed in MEDLINE.

Librarians and very savvy researchers might know the distinction, but the vast majority of the people using PubMed do not know or care. If it is found in PubMed then it they believe it has passed some sort of litmus test. Librarians, ask yourself, how many times have you done a long complicated search in PubMed and then looked at the journals to try and weed out predatory journals. Several different people have questioned, criticized or stated concerns about the PMC backdoor to PubMed. However, a recent post on Scholarly Kitchen reveals things have gotten worse. Predatory journals can now be found in other biomedical databases such as Science Direct and WoS via cited references. Where PMC was the backdoor for predatory publishers to be findable in PubMed, the cited reference has become the backdoor for these publishers to be findable in other biomedical databases.

Citation Contamination: References to Predatory Journals in the Legitimate Scientific Literature by Rick Anderson identified seven journal titles that fell victim to publishing junk articles or fake editor approval. He then looked for any published articles that cited and article published in these seven journals. What he found was articles published in predatory journals are indeed being cited by authors who are writing in non-predatory journals and thereby are findable in WoS and Science Direct and DOAJ.

Rick Anderson isn’t the only person to have discovered this problem. Authors of the article, Citations of articles in predatory nursing journals, in Nursing Outlook found “814 citations to articles published in predatory nursing journals. These articles were cited in 141 nonpredatory nursing journals.” The authors correctly noted that CINAHL and MEDLINE do not index predatory journals and that the prevalence of predatory journals in other databases is still small. Yet these journals are findable in PubMed (through the PMC backdoor) and other databases through the cited references backdoor, I feel it inadvertently and falsely gives these journals some legitimacy to authors.

Unfortunately, NLM has yet to adequately address the PMC problem. NLM employees responded to the CMAJ article “How predatory journals leak into PubMed” stating, “journals that apply to be in PMC undergo a rigorous assessment of scientific and editorial quality.” Really? Then why are there articles from predatory publishers even in PMC? IMHO, rigorous assessment of scientific and editorial quality means that no article published in a predatory journal should be allowed, regardless of whether NIH grants were used for the research.

Rick Anderson’s post is very recent (published Oct. 28, 2019), as of today (Nov. 5, 2019) I have not found any responses from the databases he mentioned regarding infiltration of predatory journals via cited references. Several databases have stated they have taken steps to help prevent the indexing of predatory publishers’ journals, but I couldn’t find anything dealing with the issue of cited references.

Predatory publishers have become the dandelion weed in the garden of biomedical literature. While they have not completely infested the landscape, their seeds distributed on the winds of Google, PMC, and other databases have invaded legitimate biomedical databases that researchers, clinicians and others use to share knowledge and treat patients. It will take a concerted effort by librarians, legitimate publishers, editors, and researchers to eliminate the predatory journal seeds from spreading further into the biomedical databases and invading the literature. If not, our biomedical databases will be like this.

Everyone Wants to do a Systematic Review

It isn’t your imagination, more and more people are writing and publishing systematic reviews. In a recent research letter from JAMA Internal Medicine, Assessment of Publication Trends of Systematic Reviews and Randomized Clinical Trials, 1995 to 2017, the authors noted the rate of growth in published systematic reviews was ginormous. I know ginormous is not a technical term and the authors would not use it in a publication like JAMA Internal Medicine, but when the rate of growth is 4676% I think the word ginormous is appropriate.

The systematic review is the new little black dress on the publishing runway, everybody must have one dahling.

But not all systematic reviews are created equal. The JAMA Internal Medicine study did not look at the quality of these systematic reviews. It just looked at the number of publications across 18 medical and surgical areas that made it into PubMed and were indexed as systematic reviews. Many systematic reviews do not meet basic standards. (Why are we calling them systematic reviews then?!) Melissa Rethlefsen reports in the Journal of Clinical Epidemiology. 2015 Jun;68(6):17-26, systematic reviews that included librarians or an information specialist as a part of the process were more likely to be reproducible and meet specific search standards.

So, it would behoove people who want to do a systematic review to contact a librarian to help. That is a good thing. Unfortunately, it seems too many people don’t understand what is really needed to do a proper systematic review. They just want that little black dress, and they want it now.

Librarians are not only drowning in the requests for systematic reviews, but the pool is continually filling with people who refuse to understand the requirements for a systematic review, or they are delusional about the commitment in time and effort needed to do one. Librarians are continually trying to lower the water level through education, but those educational methods are not hitting home with the right people.

I have seen librarians post information sheets online detailing the process. I know some librarians require forms and “contracts” to be fully filled out prior to discussions. Yet there still are those who are surprised by search results in the thousands (even though they were informed this is typical and they need to go through them) and ask for fewer results. There are systematic review searches that the librarians spend days creating that are languishing in systems like Covidence or DistillerSR never to be revisited by the requestor.

It isn’t that librarians don’t want to do systematic reviews, they don’t want to waste their time (often several days) on something that goes nowhere or is of such poor quality they need to ask that their name be removed from the paper. So they continue with their education efforts, guiding researchers to on how to do a proper systematic review or suggesting different types of searches as appropriate.

However, I feel this approach is a little bit like the librarian sticking their finger in the leaking damn. It isn’t until somebody repairs the damn will the leak actually stop and prevent the flooding of poor systematic reviews.

Publishers, faculty, researchers, and authors need to step up and help repair the leak.

  1. Publishers need to make it very clear to authors the criteria needed for a systematic review and anything that doesn’t meet the criteria will be immediately rejected. Some publishers are good at this, many are not. We have over a 4000% increase in published systematic reviews, clearly some publishers are not that strict.
  2. Faculty need to stop assigning systematic reviews as a summer project to their students. Assigning how to learn the methods or requirements to conduct a systematic review is entirely achievable for the summer. Telling students, residents, and other junior researchers to do a systematic review over the summer is not.
  3. Researchers and authors need to have a reality self check. We are not lying when we say a proper systematic review typically takes 12-24 months. You will not be the one who is “different” and can get it done in 4-6 months. You will also need at least 3 colleagues who have same time, opportunity, and dedication as you do because you need at least 3 reviewers (including yourself) to minimalize reviewer bias.

A quality little black dress is something that you will come back to and use as often as the need arises. A good systematic review is something that people can utilize to form policies, treat patients, and base recommendations. Unfortunately, a poorly done systematic review is worse than ill fitted, poorly stitched, little black dress made out of cheap material. Poorly done systematic reviews not only waste time but it flood the databases and do little to improve policy or treat patients. But hey, you got that little black dress published and it is now on your CV, so who cares if we pull a thread and it all falls apart. You don’t need to be the Ralph Lauren of systematic reviews, but you also shouldn’t be Amazon version either.

**Quick edit/update**
After posting this, I started thinking we librarians need to start being more assertive when somebody wants a “systematic review” without knowing or wanting to put in all of the work of actually conducting a systematic review. In addition to educating them, we have to remember to say No. It is hard to say no, librarians don’t like to say no. Perhaps we should also say no.

*Disclaimer* The authors in the JAMA Internal Medicine cited above are from my institution and one of them is my librarian co-worker.

I’m a Different Librarian Now

I first became a medical librarian 20 years ago. I was bright eyed and bushy tailed ready to learn everything I could about medical librarianship. Naturally over the 20 years I changed as a librarian, I became more confident, specialized in certain aspects of medical librarianship…essentially evolved.

However, I think the biggest change that I have experienced is the change in my librarian-ness when I became director of my library. I remember when I was hired I was told I will need to learn to let go of some things because the things I needed to do as director would fill those spots. Intellectually I understood this, but I don’t think I realized how much I would have to let go until I attended MLA and the whole slew of other librarian meetings that happened in Cleveland this year

As I walked the exhibit floor talking to vendors, I spoke to some great people at companies telling me how their product does this or how they’ve improved things. As I talked with these people I started to really realize that I was not the right person for them to be talking to. Yes, I make the final decisions with purchasing, but I have found that I am just not using these products as I once did.

I still do searches. We get a lot of search requests so every librarian on staff steps up and does a lot of searches. But I don’t do systematic reviews. Five years ago I would have jumped at the chance to do them and learn everything I could about doing them. Now, I just don’t have time to do them and I give them to one of the librarians who do them. I don’t edit web pages or test products as much as I would like to. Honestly, I had to go to one of my LibGuide librarians to remind me how to a certain thing in our guides.

As I look back, the transition has been a little weird to me. I don’t have the time I once had to investigate things. It is no longer my job to be the expert on library things. My job is to make it so my co-workers can be the expert in library things. That means I do everything I can to make it so they can do their jobs. My job is to be the expert at running the library. That is a big switch.

You can take all of the leadership and management classes from MLA and AAHSL (and I encourage everyone to do so) but until it happens, you really don’t understand how things change. I am forever grateful to my library friends and peers for sharing their knowledge and letting me pick their brains. Without that camaraderie, the switch to library director would have been more difficult. Librarians a great group of people who share. I hope as I continue to grow and change and be a different librarian that I am able to share with others and give back as much as others have given to me.

Don’t be afraid of change, of moving to a different job, role, or path. It will be different, but that isn’t necessarily bad, it can be quite good.

We Don’t Understand How Our Users Find Information

I had the unique pleasure to be the moderator for the McGovern Lecture at this year’s Medical Library Association Meeting. You must login w/ your paid meeting registration to watch. If you didn’t go to the meeting you can get a virtual registration to watch (scroll down to econference rates)

The McGovern Lecture traditionally is one person who give a lecture on a topic of importance to health sciences librarianship. This year the lecture featured 4 speakers (an Academic Hospitalist, a Professor of Physical Therapy, a Family Medicine doctor, and a Director of Nursing Research) all speaking about how they find information to stay up to date in their areas of specialty.

Each one of them used the library. Each one of them loved their librarians. Each one of them professed that they get the most up to date information in their specialty from Twitter. This was mind blowing to almost every librarian in the audience. These professionals use Twitter to connect across the globe with others (mentors, friends, experts in the field). They have a very curated list of people they follow on Twitter, so that they receive tweets specifically targeted on topics of interest in their field. If somebody they follow tweets about a good article, they get it. Its a bit like the old commercial when EF Hutton talks they listen.

We have all known that caregivers consult each other when faced with questions or staying up to date. In the past these people were usually in the same place of employment or geographical area. Now, with Twitter there are no boundaries for professional networking and consulting.

What also shouldn’t come as a surprise is these people mentioned that they get the articles in the easiest way possible. Sometimes that is the library, sometimes that is not. One person said if they can’t find it easily at the library, “there are other methods to get the article” implying less kosher methods. As I mentioned this should come as a no surprise, we (librarians and publishers) suck at getting people hooked up to their entitled articles and professionals don’t have the time nor patience to deal with our sucky methods. RA21 is not the answer either. RA21’s proposed method is still more complicated and more clicks than getting something from SciHub or ICanHazPDF.

If you are a librarian or somebody who works for a publisher or information provider, I highly recommend watching this lecture. It really illuminates what our patrons do in real life to get information, and it isn’t what we think they do. I also think people at NIH and NLM need to really watch this to see that front line caregivers never mentioned MedlinePlus as a resource to give their patients information until librarians in the audience asked. The speakers listed every CHI resource BUT MedlinePlus. Perhaps NLM may need to re-focus on hospitals and providers as the people who provide CHI information in addition to NLM’s efforts to connect to public libraries.

RA21 Hospitals Library Working Group & Survey

When RA21 was brought to my attention I was concerned because it was coming from a lot of publishers and vendors familiar with their world and the world of large academia but completely unfamiliar with the medical and hospital world.

In my post Medlibs Needs RA21 on Their RADAR, I briefly described RA21 and some of the concerns I had with moving towards this method of authentication and I was extremely concerned that the people talking about it hadn’t the faintest clue about library resources, usage, and IT in the hospital and academic medical world.

While I still have a lot of concerns about RA21 I am pleased to announce the creation of the RA21 Hospital/Clinical Access Working Group.  Their objectives are to “survey, identify and define the use cases/problems for accessing licensed resources from within a hospital/healthcare system that are involved with RA21 adoption and are related to RA21’s authentication use cases.”

In an effort to understand hospital and medical library authentication issues and needs they have created a survey of 20 questions that they would like any librarian serving in a hospital or health care institution or academic health care institution to take. (If you participate you can also enter into a raffle for an Amazon gift card.) *The survey closes March 1, 2019!!

I encourage every qualifying librarian to take this survey so that the working group has a clearer picture of the issues and needs regarding access to information.

The working group was started in July 2018 and the website says it will complete its work by the end of February 2019. Hmm…. I hope they plan to continue their work.  If they continue, I hope they will include some non-vendor people on the working group from medical libraries familiar with IT issues. The co-chairs are from the vendor community and while I am sure they are lovely people, they are not in the library dealing with IT and hospital policies and restrictions.  The RA21 team does have some people from large academic institutions, but is still very vendor heavy and has no representation from the medical or hospital community.

Librarians and Publishers Working Together: MLA InSight Summit 2

The second MLA InSight Summit was held in Chicago in September.  I am on the Insight committee, the group that is working to put on a good program and produce deliverables to both librarians and publishers.  I also was the moderator for the September summit. (Gabe Rios moderated the first one and Jerry Perry is going to moderate the third summit.)

The summits are intended to be a space where librarians and key figures in the publishing and vendor world work together to try understand users (researchers, clinicians, students, nurses, etc.).  It is not a place to talk about pricing, sales, or budget blaming. It is a place to discuss the issues of our users impacting all of us and how we can take steps to improve things.  Because let’s face it, if our users stop using us (either of us) we are out of business.  The librarians who attend are a diverse group of librarians who represent different perspectives and health sciences libraries.  The publishers who attend represent small and big STEM publishers and vendors.

I wanted to wait until Elizabeth Ketterman (Library Director of the William E. Laupus Health Sciences Library at East Carolina University) and Sean Pidgeon (Publishing Director for Science and Medicine and Oxford University Press)published their summary of the of second session.  Guest Post: MLA InSight – How to Buy Whisky is a very good post that describes some of the issues we discussed.

Ketterman and Pidgeon list the most prevalent concerns and challenges we (librarians and publishers) are facing and that were discussed and explored.

They were:

  1. Patrons do not understand the value of the services provided by the library. (and I would say by natural extension publishers)
  2. We (librarians and publishers) have a poor understanding of how our users find content and interact with one another online.
  3. We seem to be helpless targets for pirates.
  4. Predatory publishers are taking advantage of a shifting Open Access Landscape.
  5. It is challenging to conduct rigorous and reproducible research in the biomedical sciences.

No surprise, I have several thoughts on those 5 issues and I plan to write about those things at future date.  The main thing I want to convey with today’s post is that both librarians and publishers came together to work their way through some of these problems. Did we solve them all on that day back in September? No, but we all certainly learned a lot more about those things than before the summit.

For example, after hearing from several different users (researchers, doctors, physical therapists, etc.) we learned that many of them just don’t give a damn about all of the special unique customization features that publishers (and some libraries) provide to people who create accounts and login to their sites.  I was sitting at a table with a person from a major publisher who actually said to everyone at the table, “We have spent all this time, effort, and man power on customized and personalized features that we just rolled out. Now I am thinking we wasted a lot of time and should have been looking at ways to better direct people to the content without logging in.”

That kind of information along with the collaborative effort to work together on things impacting both of us made the summit worth attending.  This was just the second summit, there are more good things to come that we can learn from.

At the annual meeting I will be helping to moderate, the Innovation & Research Practice Immersion Session 4, “Disorienting Dilemmas: Transforming the Librarian’s Understanding of How Today’s Health Professionals Discover and Use Information Resources Outside the Library Setting,” by Jeff Williams and Martin Wood. Monday May 5, 2019 from 4:30-5:55pm. Jeff’s presentation at the second summit was so revealing that I highly encourage librarians and vendors at MLA to attend his and Martin’s presentation on Monday.

I am also looking forward to the 3rd Insight Summit.  I hope that we can take the knowledge and information from Summits 1 and 2 and continue to build upon them other and create change together.  That is why I feel it is important that we get as much representation from librarians AND publishers for the next summit.

Publishers who have sent somebody please talk to Dan Doody to get an understanding of what is involved.  Publishers who sent somebody but didn’t feel it was worth attending again, ask yourself this question, “Did I send the right person?” Most likely you didn’t. Those publishers who are forward thinking and sent the right people (those high enough up in the company who are leaders in change) seem to have gotten the most value out of the summit.  Those who sent the local sales rep really missed out, and didn’t see the value because the information and message didn’t to the change agent.

Librarians who would like to attend talk to previous attendees or Gabe, Jerry and myself. We can tell you what it was like. We aren’t looking for any specific librarian position (director, collection development, systems, etc.). We are looking for a diverse group that are engaged, making changes, and willing to take that information and disperse to the library community.

We have only just begun. I think of the Summit 1 as a small little snowball rolling down the mountain. My hope is that with each summit the snow ball grows producing an avalanche of change.

*Here are more articles about the previous InSight summits:


Your Cell Phone and Searching PubMed: Full Text May Not Work

Wow time flies when you are having fun, or staring at the screen of your cell phone.  Did you know it has been over 10 years since the first iPhone was released?

According to an article in Computerworld “Nine of 10 healthcare systems plan significant investments in smartphones and secure unified communications over the next 12-18 months.”  (April 4, 2018) More and more hospitals systems are providing cell phones to their care givers and integrating their usage into their workflow (access the EHR, lab results, pharmacy orders, etc.) The cell phone is the individual’s portable computer. An older (2013) report stated 74% of their surveyed physicians used a smartphone for professional purposes which included using diagnostic tools, drug information, and reading articles. Back in 2013 they stated the most often used app on a tablet was an app for medical journals/newspapers/magazines followed by diagnostic apps. In 2017 the Physicians Practice 2017 Tech Report, shows that reading journals on a mobile device is still very popular. In this survey it was the second most reported activity physicians did when using their smartphone at work.  Looking up drug information was first, reading articles was second and looking up diagnosis and treatment information was third. Of the responding physicians, 64% reported using mobile technologies for reading journals online (slide 12). The need to read articles on a mobile device has remained important to physicians over the years.

Not surprisingly medical libraries have been adapting to this for some time. Many libraries have optimized their websites to be more mobile friendly. Lots of libraries have web pages or libguides dedicated to mobile apps (just a few examples: HSLS University of Pittsburgh, Becker Medical Library Washington University, Health Sciences Library UNC) The demand for reading journal articles on mobile devices is big. Browzine and Read by QxMD are the two main apps for reading journal articles online.

Our patrons rely upon full text information being available. They want to access the full text of an article quickly and easily. Why do you think Sci-Hub got so popular? Science reported “many users can access the same papers through their libraries but turn to Sci-Hub instead – for convenience rather than necessity.” Given this information, it is important that access to the library’s full text article be easy to access when searching the literature databases, regardless of the device used. So it surprised me the other day when I was struggling to help a physician access the full text of an article when they were using PubMed on their cell phone. We tried everything, but it always resolved out to the publisher (not always the way we own the article). It did not use not our Outside Tool that we set up.  I even tried finding a way tap the link that says go to full website. No dice.  We could not access the library’s subscribed journal article in PubMed on the cell phone. Surely I was missing something obvious.  Surely NLM has figured out away in 2019 to connect physicians to their library’s full text collection while searching PubMed on their cell phone.

Well I was wrong. I reached out to NLM and a person from the MEDLARS Management Section responded they “don’t currently offer a way to populate library links (via Outside Tool or LinkOut for Libraries) on the mobile PubMed site. If the URL to the publisher happens to activate IP authentication on the publisher end, your users will get access via your subscription.” Basically that means IF your user is ON your IP range AND you get the article from the publisher (not via consortia, full text database, or other means) THEN your user can get access. That is not good. Even on campus, a lot of articles are inaccessible. Off campus…well nothing is available.

So what are other librarians suggesting to their patrons?  Our patrons use Browzine to keep current with their favorite journals and they love it. But what do you suggest for people who search for articles on a topic? Are you still encouraging them to use PubMed from the cell phone even though access to full text articles will be difficult and frustrating for them? Are you suggesting other sites or apps for searching MEDLINE? What about Ovid MEDLINE? Or is this question pointless because everyone searches Google, gets frustrated accessing the full text  and runs to Sci-Hub?

I am very interested in hearing other librarians’ thoughts on what mobile apps or mobile friendly sites they use to search MEDLINE that preserves the library full text linking. Leave a comment.