Krafty Librarian – Page 44 – Things of interest to a medical librarian.

Letter to the Editor or Respond With a Blog Post

Many people have lamented on how long it often takes to get an article, comment or letter published in a journal. The time delay is most often seen when the author is writing about a new technology that was new a year ago or when somebody is responding to an article by writing a letter or brief comment. The letter or brief comment shows up several months after the original article, creating what I feel is a bit of a disconnect.

Travis Saunders wrote an interesting post about his experience writing a Letter to the Editor and blog post discussing the conclusions of an article in the International Journal of Behavioural Nutritional and Physical Activity. No surprise the Letter to the Editor took considerably longer to get published. The blog post while quicker to post probably had the same reach as the Letter to the Editor. While the Letter was not the quickest nor maybe the most effective method, it is still the most important for career.

As Travis mentions, “Publications are the currency of research. These are what people (scholarship and grant committees, performance review committees, etc) focus on when determining your productivity, and having a few extra publications can make a huge difference for a young researcher.” As a result there is no way a blog post will compare with a Letter to the Editor. Travis mentions that a hybrid model using the best of both communication methods would be ideal, and points out that BMJ already does this sort of with has eLetters.

Given that the methods of assessment and professional communication still have to catch up to the way we communicate professionally via social media outlets, one would think it is pointless to even bother. Why write two “letters?” (The actual Letter to the Editor and the blog post) Why not? With some simple edits, adding of URLs (if need be) somebody can kill two birds with one stone and quite possibly reach others they would never have otherwise reached with a traditional Letter to the Editor. Compared to a traditional Letter to the Editor, a blog post has the ability to go viral much more easily thereby having a greater impact. Given how easy and little time it takes a blog post

Friday Diary: Moving from iPhone to Android

I am briefly suspending my Friday Fun posts so that I can report on my move from my iPhone to my new Motorola Triumph Android phone on VirginMobile.

I was a big iPhone user. I even had the phone plugged into the wall socket next to my bed. I originally had it there in response to a scary movie I had seen. But it stayed there long after the effects of the scary movie. My husband would say that we sometimes would wake up thinking there was a light on in the room only to realize it was the glow of the iPhone as I browsed. I tried to stay on the WiFi because it was faster most of the time, but when it wasn’t I used 3G. I averaged about 1G of data each month.

So why did I decide to dump my iPhone? Well it wasn’t the phone itself it was the cost of the plan on AT&T. Actually I can’t blame AT&T completely, Verizon’s iPhone plan isn’t much better. At one point in time I was paying $170/month for two iPhones on AT&T. My husband recently jumped ship to VirginMobile with an LG Optimus V and I followed him this past Wednesday. Now we pay VirginMobile $70/month for two smartphones. What do we get for $70? Well we have two plans. Mike pays $25 for 300 minutes of talk, unlimited data, and unlimited texting. I talk a lot more than Mike so I pay $45 for 1200 minutes of talk, unlimited data, and unlimited texting. (I have mentioned VirginMobile’s rates in prior posts, they have since changed their prices on their plans. People like Mike who were with them before the rate change were grandfathered in. People like me who just joined go with the new rates.)

I will be saving over $100/month or $1200/year. In my budget concious life, that is monster savings. Now you could argue that we aren’t exactly saving that much in our first year because we had to buy our phones outright. Well it depends. If we upgraded our iPhones we would have had to at least pay $200 for each iPhone and be locked into AT&T for another 2 years. Mike’s phone was fairly inexpensive, he got it at Target for $125. But Target wanted to buy his old 3G iPhone back from him for $50. So his phone only cost $75. Compared with buying the iPhone, Mike actually came out ahead by $125. My phone was a lot pricier at $300. Unfortunately I had a small crack at the volume rocker on my iPhone, so they wouldn’t take it as a trade in. The Triumph was more expensive to buy than an iPhone. But it was only $100 more expensive and after 2 months I will have made that money back on the plan savings.

While I am excited about the money I am saving, some things such as time, user experience, performance, etc. are worth almost as much as money. So, I am approaching this whole thing as a one year experiment to see whether saving the money using an Android on VirginMobile is worth it compared to an iPhone on AT&T.

Review of the Triumph in general:
It is a little wider and longer than the iPhone but it is thinner and it seems to me to be a little lighter. It is basically a thin black rectangle, nothing funky. I am going to want to buy a cover/case for it because even though it isn’t as slippery as an iPhone I want something a little more grippy. Unlike my iPhone you can record HD video or watch HD movies and then play them on the phone or on a TV using an HDMI cable. Personally I think the HDMI output jack and the mini USB charging jack are way too close to each other. The size of the holes are very similar and I know there will be some day when I am trying plug the USB into the HDMI or vice versa. The Triumph has both a front and rear facing camera with an LED flash (other iPhones have this but the 3G didn’t). It does not come with a music player so you have to download an app for that. But the Triumph can play Flash! This makes me very happy, I want to see how well this works on a phone.

Activation and Porting My Number:
I bought my phone at BestBuy because they were running a deal where if you bought it and activated it with them you got a $50 BestBuy gift card (which I used to buy a car charger and screen protector). Porting a number is a pain in the butt. I have done it every great once in a while and every time I do it I am reminded why I don’t hop around to different phone companies all that often. Porting a number to a pay as you go carrier is a little more difficult than regular porting. Since I let BestBuy do it, it was easy for me (not necessarily fot he BestBuy guy). One current drawback of VirginMobile is their tech support call center, it is located overseas and you kind of are at the luck of the draw as to who you speak to and their English skills. BestBuy had to call them twice and during the first call my BestBuy guy had to spell the word “BAY” four times. I am sure if I had to do all of this on my own I would have been frustrated, but I just browsed the cell phone accessories to pass the time while BestBuy guy did all the work. Once everything was set through BestBuy, it still took a few hours (which is normal) for my number to move over. Once it did, I went online to VirginMobile and added money to my account. The online process was pretty easy.

Email:
I don’t have permission/rights to access my work email from my smartphone, so I can’t tell you how to set it up or how it works. But I do have other multiple email accounts (2 gmail, 2 yahoo, 1 att.net). The Triumph has a generic email app and a Google email app preloaded. The generic email app is finicky and you have to manually set up each email with the correct POP or IMAP settings for each system. (Finding that information took a lot of Internet sleuthing.) If you only have email from Gmail you may want to use the Google email app and ignore the other generic email app. If you have Yahoo email you might want to consider downloading the Yahoo email app. If you don’t mind having your various email systems under different apps then it is MUCH easier to use the Google email app, the Yahoo email app, or other downloadable email apps. My husband does this and he has no problem. It doesn’t bother him to have multiple email accounts under different apps. However, I wanted all of my email under one app (like the iPhone) to make it easier to access. This was a huge pain in the butt. Syncing email using the generic email app on the Triumph was ugly. Two beers and several swear words later, I synced all of my email. I don’t remember having that much difficulty setting up my email on my iPhone. Now that it is done, it works just fine.

That is about as far as I have gotten so far, aside from the email thing I am pleased so far with device.

Things I am starting to play with but haven’t really gotten into quite yet:

How do I get music? What to do with iTunes library? Is doubleTwist the answer?
General phone apps (clock, maps, calendar, etc.) how good are they or do you need to go Android market to get better ones?
Apps in general, what is available on the Android and how is the experience.

My plan is to write about my experiences with these things and other things I encounter next Friday if people are interested.

Doctor’s Going Digital

My husband fowarded me this interesting graphic.

++ Click to Enlarge Image ++

The Doctor's Tech Toolbox | Infographic |

Image Source: Spina Bifida Info.com

Some of my thoughts on the graphic:

63% of doctors are using mobile devices that aren’t connected to their practice! 79% prefer the iPad and 75% have purchased an Apple device. Another 38% plan to purchase an iPad in the coming year. Finally with 86% of physicians wanting to use their mobile devices to EMRs, hospital IT departments Needto get on the ball and deal with iPads and iPhones in their institutions. Clearly they make think it is a personal device, but the graphic clearly shows that doctors think it is more than a personal device, are using it in their medical practice.

All of that information also means that librairans and library vendors need to make sure their electronic resources are accessible on the iPad. That means no Flash. It also might mean other formatting issues like reduce the need to scroll. It is a lot easier to scroll with a mouse than to flick scroll with your fingers. Even if publishers/vendors adhere to the no Flash rule, there are still ways to build interactivity into the material and have high resolution pictures, videos, sounds, etc. I know a doctor who used his iPad to access a video on WebMD to show at the patient’s bedside what their surgical procedure would be. Give electronic resources dimension, but make sure it can be accessible on the dominant platform, which appears to be the iPad (if this graphic is correct).

Interesting that despite the growth and popularity of the Android phone in the consumer market, it seems their tablet is much less popular because only 9% of physicians would want an Android model. Like I said interesting the difference between the phone and tablet market.

Librarians interested in medical apps should take note of the four relatively inexpensive (if you don’t count the camera attachment) medical apps that doctors are using on their devices.

Finally, I find it very interesting that with all the press that Sermo and other closed social networking sites have gotten that “physicians prefer open forums over physician only online communities.” So it looks like closed sites are not the answer. Perhaps something like Google+ which allows people to share in an open forum but also selectively restrict things to specific people/circles might become more popular among medical professionals.

One statistic I find suspect is the one stating 2/3 of the doctors are using social media for professional purposes. What social media and how? I find it hard to believe that 2/3 of the doctors are on FB (Sermo, LinkedIn, etc.) for professional purposes. If it means that 2/3 of the doctors are using some form of social media for professional purposes such as reading blogs and wikis, then I totally can see that statistic. I would like to see how that question was worded because if it asked them what of the following things have you done professionally and it listed read a blog, read a wiki page, use FB professionally, tweet a conference, tweet professionally, etc. I can totally seeing that kind of question skewing things. They may be using it professionally, i.e. reading a blog post, but they may not be participating for professional reasons i.e. tweeting a conference.

I hope you find the graphic as interesting as I do. Thanks Mike for passing it along to me.

E-Books

It seems a lot is being discussed about e-books and e-readers lately. Sigh… e-books what a tangle web you weave.

I think Mark Funk said it best in the recent 2011 Medical eBook Publishing Trends Webcast, ebooks are at the beginning stages of their evolution, somewhat similar to what ejournals were like when they started. There are differences between ebooks and ejournals but in general ebooks are in their infancy. Just like with human infants there is a lot of rapid growth, communication isn’t always clear, and stress and confusion can always pop up.

There was brief discussion on MEDLIB-l about the worry/feeling the publishers are cutting libraries out of the process of lending ebooks. This seems to have stemmed from Amazon.com recent announcementthat it allows you to rent ebooks from them for a fee. Sony (Reader) and Barnes and Noble (Nook) allow people with their ereaders to borrow books, but they have partnered through public libraries. From what I can tell Amazon.com currently doesn’t allow people to borrow ebooks through libraries. However an article from The New York Times from April 20, 2011, mentions that Amazon will allow Kindle users to borrow books from libraries later this year. I don’t know if Amazon is still planning to do that.

However, I am still unmoved by the goings on with Amazon, Barnes and Noble, and Sony and their ereaders. Why? Because their readers are really just one trick ponies, you read books on it. Yes you can get the web on B&N’s Nook color, but who (besides my husband) is looking at the Nook color as a cheap alternative to an iPad? The Nook color has apps. (It has Angry Birds what other apps are needed!?) What I see are more and more doctors carrying iPads. Specifically because the iPad is multi functional device. You can load Kindle and Nook apps on your iPad to read Amazon and B&N ebooks. There are a lot of great medical apps available for the iPad and depending on the hospital IT department, the EMR can be accessible through the iPad. Hospital IT departments are resistant enough to change, I think I have a better chance of winning the lottery than the likelihood that a lot of hospital IT departments will allow Nooks to access the EMR.

Because of the iPad and a few simple reader apps, the ereader wars between Amazon, B&N, and Sony are just background noise to me. I also don’t think much about the idea of checking out ebooks. Perhaps it is because we have a site license for almost all of our ebooks, we don’t have many ebooks that you “check out” for a period of time. So it is difficult for me to think of “checking out” ebooks. In my mind you just hop on the Intranet and click on the link to the book and read it. Perhaps if I was a public librarian dealing more with NetLibrary my mind would be thinking more in the manner of checking out an ebook.

People on Medlib-l mentioned the frustration they were having with the bundling of titles and how it makes the prices of said bundles cost prohibitive causing them to go buy the print of the book. Well that just stinks for anyone in that situation, kind of counter productive to the whole electronic movement. However, bundling isn’t new, it happened with journals and it is probably no surprise that it is happening with books. I can understand the pros and cons to bundling from both the publisher and the librarian perspective. Bundling can be very good if done well by the publisher. Nobody benefits from bad bundling. Hopefully as ebooks grow in demand and in popularity, more of the titles in the bundles will be more relevant to the purchasing librarians.

What seems to be a more pressing issue is lack of medical books available electronically, the inconsistencies between ebooks and the printed books, and digital rights/licensing.

I think more and more titles will eventually become ebooks. We had the same problem with ejournals. We got new carpeting in the library so we had to empty everything out of our desks and file cabinets so they could move furniture to put the carpet down. My co-worker ran across a 1999 memo exclaiming that we had over 100 journals available online. We have access to more than 100 times that amount. In time we will probably say the same of ebooks.

I recently got an email from somebody telling me that since their ebooks were web based they work very well on the iPad and other tablet devices. I got one word for you, Flash. Guess what is not on the iPad? Flash….AHHHH (Sorry still hearing Freddy Mercury singing the Flash Gordon theme song, damn you Blackberry for making sure I can’t forget your commerical.) Even though some of the texts on their site say download to handheld, McGraw Hill’s Access books don’t seem to work for iPads. We had a doctor try and access a McGraw Hill book on one of their Access sites and it didn’t work. When we called their help desk (even though this book is readable on the web with computers) we were told it wasn’t available and wouldn’t work on the iPad. I know that many things in McGraw Hill’s Access sites use Flash, I don’t know if this was a factor with their books. Optimizing ebooks so that more than just people on desktops or laptops can use them needs to be a priority of publishers.

One of the biggest pet peeves I have with both ejournals and ebooks are the inconsistencies between print and electronic. Maybe it is just me but it appears that ejournals are getting better with dealing with the inconsistencies, although the damn epub ahead of print still causes me to pull out my hair. Of course maybe I just expect the unexpected a big more with ejournals and I am more savvy to their inconsistencies and don’t see them as inconsistencies anymore. However, ebooks are still messy. There are some books that have more information in the ebook than the print. There are some publishers like Elsevier who sell printed books but only allow access to the online book and extra material through StudentConsult which isn’t for libraires. I know there were several times where we bought a printed book and whole chapters were missing and we were told it was available online but we couldn’t access the online because it was on StudentConsult or it was tied to an individual code. That is maddening.

Of course that leads me to the digital rights and licensing. Academic librarians must deal with issue of ebooks and Blakboard and course reserves. All librarians must deal with ILL issues and ebooks. We are so used to copying a page or chapter for ILL or sending a whole book to another library, but with ebooks ILL becomes a mess. Basically, you can’t ILL a whole book which I understand. But a library should be able to ILL some pages or chapters to the ebook. Just look at the example where the necessary chapter of a library books is available online but the library doesn’t have online access. The student or researcher needs that information but is it available through ILL? Depends on the publisher. That is just a basic (but big) example of how digital rights and licensing is maddening to librarians, patrons, and normal people. There is a lot of work to be done in this area. Unfortunately I think this might take a fairly long time to shake out, because only recently are journal publishers beginning to really work in ILL agreements into electronic journal license agreements.

Are ebooks perfect? Oh far from it, but ejournals aren’t perfect either yet look how far we have come with them. Perhaps when ten years from now when we will trip across another memo about our ebooks and sit back and laugh at how far we have come.

MedlinePlus Connect Webcast: Linking Patient Portals & EHRs to Consumer Health Information

Mark your calendars, carve out a bit of time on Wednesday July 27 at 2:00pm (EST) to attend the UMLS Webcast on MedlinePlus Connect: Linking Patient Portals and EHRs to Consumer Health Information.

“MedlinePlus Connect allws patient portals, EHRs and other health IT systems to link to relevant and authorative consumer health information from MedlinePlus.gov.” The webcast will give an overview of MedlinePlus Connect, how to implement it, and explain NLM’s behind the scenes support.

Webcast Information:
When: Tuesday July 27, 2011 2:00pm US Eastern Time
Where: https://webmeeting.nih.gov/medlineplusconnect_essentials
What you need to participate:
Adobe FlashT enabled web browser
Speakers or headphones (audio will be broadcast over the internet)
Captioning will be provided for this Webcast

If you are on vacation, busy, or just plain forget, the webcast will be recorded and made available at:
http://www.nlm.nih.gov/research/umls/user_education/webcasts.html.

Friday Fun: Medical Library Helping At Risk Youth

The A.R. Dykes Library of the Health Sciences serves at the University of Kansas Medical Center is open to the public and within walking distance from a neighborhood middle school. Students would often come to the library to use the 4 public PCs after school. As students were sometimes disruptive and disrespectufl to staff tensions rose among them. There were no other appropriate and safe places within walking distances for at-risk youth to go besides the library.

They describe the situation at A.R. Dykes Library of Health Science as unique yet I personally think it is more common of situation that we don’t hear about as often or with positive approaches. I am assuming (and please let me know if I am wrong) since they are open to the public, they cannot just kick out or prevent a large portion of the public such as middle school students from the library. They probably can only ask them to leave as individual(s) presented problems.

The librarians decided to create a positive and safe environment (instead of just a hagnout with free computers) where the students could learn vocational skills and “expand socially, emotionally, intellectionally, and physically.” As a medical library they were not for a lack of resources but a lack of experience as to how to apply these resources effectively with teenagers. Through partnerships with various organizations they created a “community within a community at the Medical Center.” Students participated in hospital department tours, tutoring sessions, activity days, and guest speakers.

For more information on their program or contact information go to:

http://www.libsuccess.org/index.php?title=39th_Street_Crew

More on G+

I am on Google+ and I am not sure if I like it. I am sporadically kicking the tires, testing it out.

Here are some reasons I like it:

I like having everything Google together. Iam not sure if I like how it brings up another window when I click the links to my email, calendar, docs, etc. on the Google bar, but I am not sure what work better.
I like the idea of Hangout, but I can only use it at home because it requires me to install a Google plugin and I don’t have a microphone or camera on my work computer. I can see it being used for web conferencing and other professional things. I tried Hangout one weekend but nobody in my Circles were hanging out so I really couldn’t test it. I think I would Hangout more if I could do it on my phone. I would also like to know if I could Hangout with people outside of my circle. For example, I would like to attend topical Hangouts but I may not want to add those people to my circles.
Setting up your circles is much more intuitive and easier than setting up friend lists in Facebook. It is really easy to do, you can click multiple people, drag and drop and easily create new circles. The Facebook friends lists were always something sort of hidden.
Posts, it automatically and easily asks you who (which circles) you want your wall posts to be seen by. In Facebook you have to play around with the post defaults and friend lists and remember to hit the arrow to change things when you don’t want a wall post to be seen by your default group.

Some of the things I don’t like:

Not enough people. Yeah all of my geek friends are on it, but nobody else. One family member is on it but he is always playing with cutting edge stuff. So in order to share things online with family and friends, I still have to go onto Facebook since the majority of my non-geek friends are not on G+. I don’t like going to different places to share information (one reason I am rarely on LinkedIn), so I don’t see myself using it until/unless more of my regular friends join.
+1 button is confusing, until you know it is just Google’s version of Like. After that it is just as boring as the Like button. I would have liked it if you could hit the +1 button and then comment on the item or person’s comment.
Blog integration? Since you are reading this you already know I write a blog. A few sentences of the post and its link go up on my Krafty Librarian FB page (not my personal FB site) directing people (primarily librarians) to my latest blog post. If I can’t integrate blog feeds into my G+ wall then it is pointless for me to use G+. However, it is still too early to tell if this will be possible in the future. I am sure there are WordPress geeks working all types of widgets for G+.
Twitter integration? Every wall post (including blog posts) on my Krafty Librarian FB page is then sent out via Twitter. This increases the abilty to share information. Again without this ability G+ is not worth it. I am told you can integrate Twitter and G+ if you use Google’s Chrome browser. Yeah, I don’t use Chrome at all. I really hope Google doesn’t limit innovation specifically to Chrome because that will kill G+.
RSS feeds. I still need to got to at least two sites to stay on top and share information. I grab all of my feeds using Netvibes. Netvibes allows me to follow ANYTHING that has an RSS feed. That means I can follow Twitter feeds, blog posts, news feeds, flickr, search feeds (web and database), etc. Basically Netvibes is my one stop shop for finding information. It is my morning newspaper. I can also share things on Twitter, FB, and email through Netvibes. However, to get the whole picture I really have to jump back and forth between Netvibes and FB or Twitter. If G+ could somehow incorporate RSS feeds so I don’t have to bounce between sites, that would be a huge help. I know Google Reader is accessible from the top tool bar when I am logged in and I when I went into it, I tried to share a story. It looked like it worked but nothing showed up on G+ so I have no idea if I shared that story and if so where. Perhaps I something is wrong with my settings.

As I said, I am still playing around with G+ bit by bit. In the mean time I thought I would share two other people’s opinions on G+. John Halamka likes G+ better than Facebook, he finds FB’s interface to be cumbersome. Daniel Hooker shares a funny cartoon about G+ and FB and also describes his surprise at re-sharing through G+ and how you might want to disable re-shares.

They are saying G+ is the Twitter or Facebook killer. But right now it is all about people. While G+ has grown quite quickly, the people still aren’t there yet. If you don’t get a critical mass of people, then FB is going to remain the place to be. In the mean time, I am continuing to play with G+ and will write more as I learn more. If you have any ideas about it or if I am missing something or doing something wrong please comment or leave a post on G+ or FB.

Internet Librarian Conference: Discount Available

The 2011 Internet Librarian Conference will be held October 17-19 in Monterey, California. Uusally the cost for the 3 day event is usually $499 but you can get a group discounted admission of $299 (a savings of $200) if you register through Marty Magee, NNLM MidContinental Region. You must register no later than September 1, 2011. For more information on how to register for the conference at a discount and contact information go to the MidContinental Region News blog post, Internet Librarian 2011 – Conference discount available at $299.

Even at a discounted registration price, you may want your institution to help fund some of the conference. Check out the, “Why I Must Go To Monterey” document on the Internet Librarian 2011 site. As they say, “Sometimes all it takes to get permission is using the right words.” They have created a draft memo for you to use to try and sell your administration on paying for you to attend. (I am sure also explaining how you are able to secure a $200 registration discount can’t hurt either.) The draft memo is a bit long for memo to your boss, it is definitely a draft. You will need to edit it so that it takes on the proper tone of your administration yet still convey the importance of attending the meeting. Personally, I would also edit it so that it is no more than 1 page. In my experience, memos longer than 1 page don’t get read. But I applaud the Internet Librarian conference for providing a sample memo, and I would rather that sample be longer with as much information so that potential attendees can edit it as necessary. Better to have more information and cut down than not enough information.

Finally, since I am talking about discounted registration and justifying your presence at the Internet Librarian Conference, I am going to make a shameless plug promoting MLA 2012 Fund Your Meeting Contest. Two $400 awards will be given out to help pay for registration or travel expenses to the 2012 meeting in Seattle. All you have to do to win is submit the most original, funny, interesting, or beth method you used to get funding from your institution to attend a meeting. Go to http://www.surveymonkey.com/s/2T8K9LJ to enter before November 1, 2011. To read other people’s submissions to get ideas as to how you can try and convince your administration to pay or help pay for you to go to MLA, go to http://mla2012contest.wikispaces.com/.

When Good Enough Just Isn’t Good Enough

David Rothman wrote a very interesting post Thursday, “Voltaire & Information Services: ‘Good Enough’ – ‘Excellence’ – ‘Perfection”, saying while the quest for perfection may not be attainable, good enough might not be…well….good enough. He described how he once worked for a CIO who told him “never let ‘perfect’ get in the way of ‘good enough.” While he understood the CIO’s intent, he felt something just wasn’t quite right with using “good enough” as a good standard.

“On the other hand, I don’t think ‘good enough’ is an acceptably high bar. When we deliver services to our customers/patrons/clients, should’t we be shooting for ‘excellence’? Excellence is do-able.

It seems to me that, most of the time, the amount of effort that would bridge the difference between ‘good enough’ and ‘excellent’ is small and that ‘excellence’ pays dividends in extra-satisfied customers/patrons/clients that it is absolutely worth investing.

On the other side of that is that users/clients/customers/patrons are usually savvy enought to know ‘good enough’when they see it. It tells that that their needs really aren’t the priority. Rather than paying dividends, it costs.”

I recently went on cruise for vacation. Niether me nor my kids nor husband had ever been on a cruise. It was extended family cruise, and members of my extended family had previously been on cruises. Prior to the cruise they spoke on and on about how wonderful cruising was. The whole time they were telling me these things I kept thinking, “Yeah I get it, it is fun. What isn’t fun about being on vacation and relaxing.” It turns out I really didn’t get it. Yes, being on vacation was fun but what made the cruise different from a week at the beach, last year’s trip to Hershey Park, or going to Meramec Caverns? Service. The service on the cruise was excellent. It wasn’t just good enough, it was freaking phenomenal. You want a second helping of lobster on lobster dinner night, bam you get it. Three helpings? Bam my brother got it. Midway through the cruise while we were playing and lounging around the pool, our assistant waiter (who we really only saw at dinner) happened to be on the pool deck for something else and also happened to overhear my brother-in-law mention he would like to get an ice cream. Important to note, my brother-in-law did not ask the him to get it, he was merely telling us of his plans to go get ice cream. Not only did our assistant waiter overhear these plans, but he recognized my brother-in-law and told him to relax that he would get it for him. We were at one of the bars late at night chatting with the family and my husband ordered a beer. It turns out that bar was out of that specific beer and when the waiter returned with the rest of our drinks he appologized to my husband and told him it would be a few more minutes for his beer because he was going to go down to another bar to get his beer because they were out of it. We were on deck 14, the closest bar was on deck 11 on the pool deck (if it was open late at night). These are just a few examples, the entire week the service on the cruise cruise was excellent. It wasn’t perfect, but it was light years beyond good enough.

Hospitals aren’t perfect, but “good enough” isn’t good enough either. As the Cleveland Clinic’s Chief Experience Officer, Dr. James Merlino mentions in an interview with Beckers Hospital Review, hospitals must focus on providing a more patient-centric approach to provide a better patient experience. Soon part of Medicare reimbursement will be tied to HCAHPS scores, but that isn’t the only reason to be excellent. The amount of Medicare remibursement is small, the biggest ROI are repeat customers. Hospital administrators don’t want people to be sick or hurt, but if they are, the administrators want them to choose their hospital to receive treatment vs. a competing hospital.

“As healthcare continues to become increasingly competitive it is also experiencing greater consumerism. Patients start paying attention to how well they’re treated. Generally now if you go to a top medical center, you’re going to get good outcomes. Medical care is becoming very good, and people now want more than just outcomes. That’s why it’s critical to implement programs that drive service.”

I think librarians in general have been very good at providing excellent service. Perhaps I am biased because I am a librarian or maybe I am just surrounded by excellent librarians. But I would say one of the things I have noticed that drives us batty is when we are unable to provide excellent service. Perhaps it is because the only copy of a book a patron needs is missing, stolen, in repair, etc. Maybe there is a database that we know our patrons want and need but we can’t get it because it is too expensive, won’t work on the network, restrictive license agreement, etc. Providing excellent service can sometimes be difficult but it doesn’t mean we still can’t strive to be excellent. While we don’t have HCAHPS score, we do want repeat customers.