Are Your Doctors Addicted to UpToDate?
Recently there has been some discussion on MEDLIB-L regarding the cost of providing institutional access to UpToDate. This discussion along with UpToDate's heavy handed tactics always seems to crop up every couple of months. Currently the discussion seems to be centered around two things. Their heavy handed license agreements and the cost.
Apparently there are some institutions starting to consider eliminating institutional access leaving their physicians to pay for the product on their own. UpToDate bases their prices on the institution's total number of outpatient and inpatients. No wonder some very big and successful institutions are rethinking the cost of UpToDate. It is not unheard of for small community hospitals to pay $10,000 -$15,000 for online access. I have heard of larger institutions paying $80,000 - $100,000 for access (which of course can't be used at home).
Coincidentally three recent physician blog posts have commented about UpToDate dependency among doctors. (Thanks to Halyna on MEDLIB-L for finding the posts.)
While I think UpToDate is a useful tool, it is not the best tool for every situation. Their business tactics in my opinion are questionable. Any company that does not address the positives of their competitors is bound for problems eventually. UpToDate's competitors (FirstConsult, DynaMed, eMedicine, etc.) all provide home access to institutional users at no additional cost. Both DynaMed and FirstConsult can easily integrated into a hospital's EMR. Talk about true point of care resources.
Full Text Osteopathic Literature
was recently released to provide access to all of the content within OSTMED
.DR is full text and is endorsed by the AOA
and is funded by VCOM
through the Harvey W. Peters Foundation. The goal is to "promote and facilitate research and scholarly activity in the ostepathic
profession by providing ready access to the current osteopathic literature and hard to find resources including historical documents." In addition to books and journals, videos and images are to be included in the database.OSTMED
.DR is free for the first six months (July - December 2007) Afterwards it will only be availble
through a subscription (personal or institutional).
So far accessing OSTMED
is glacial at best, most of the time I am timed out and can't even get onto the front page. I have repeatedly tried to get through but I guess they did not plan for this amount of traffic.
My biggest question regarding OSTMED
.DR is currency.OSTMED
.DR is the full text access to the content of OSTMED
, right? If so then how can it provide ready access to the "current osteopathic literature
" when OSTMED
ceased in 2004 and has not added any new information since December 2003?! Has OSTMED
started back up? This should have been addressed in the information they sent out about OSTMED
Of course I have other questions and I will write more about this resource if/when I am able to access it anytime soon.
What Becomes of a Hospital After it Closes the Library?
We all have heard of EPA library closures
and other hospital and medical libraries closing
, and many of us work very hard to try to prevent these situations from happening in our libraries. However, despite our best work and intentions the powers that be sometimes close the library. I remember at the HLS meeting in Philadelphia Mary Fran Prottsman mentioned that Joann Marshall was updating the Rochester Study
. I think that is wonderful and helps arm us with more information to show administrators our impact on patient care.
However, I am also curious as to what happens to a hospital that loses their librarian. How does it affect patient care? How does it affect doctor and employee information services? I know of an instance where a librarian retired and the hospital chose not to replace her. The library is essentially gone, they have five journals and haven’t bought a book since the librarian left a few years ago. Online resources are nonexistent, the two people who “manage” the defunct library were not even aware of PubMed until recently. The hospital is a part of a larger regional hospital system and it has an agreement with another hospital library to provide literature searches and article requests for a fee. The regional system is trying to become a more cohesive unit and negotiate system wide online resources to all of the hospitals within that group. Who negotiates for that hospital? Who pays for the resources for that hospital? Who educates the employees of that hospital about all of the resources they will be getting? With the defunct library’s budget close to nil will the hospital even agree to by the online resources the others within the system are buying? What happens if that hospital balks at the cost of its share of the resources and decides to opt out of the system wide consortia?
I realize many of us have similar stories about hospital closures. However does anybody have more than just anecdotes, does anybody have any other evidence of what becomes of a hospital that closes the library? All I can think is that patients as well as employees suffer as a result, but I don’t have any “real” proof. Yet, if the people “running” a hospital library don’t even know what PubMed is, I have got to believe that hospital has some serious problems finding evidence based care.
Steal This Book? Don't Bother
There are two interesting articles on CNET
about libraries and online resources.Steal this book? Don't bother
. by Candace Lombardi
Talks about libraries are offering more and more free search services, access to databases, articles, photo, ebooks
, audio books, etc. The problem is that most people don't know that these things are available. Gary Price from ResourceShelf
states in the article, "The bottom line is people can't use what they don't know about. It's not just search. It's everything. Libraries need to do a better job of promoting themselves. Unfortunately, it's been a challenge for the library world to get anyone's
Tell me about it Gary. As I mentioned in my previous post "Look at the Library
" I mention how I am constantly amazed that I run into a lot of people who are unaware about what services my library has. I am not a hide in the office kind of gal, I am out there talking to people and trying to promote my stuff. Obviously judging from the reactions of my patrons about our resources, I need to do a better job. Free information for the taking
. by Candace Lombardi
This article mentions all of the "free" resources available to people. Unfortunately I find this article a little misleading. It implies that all of the resources listed are free for anybody. "There's a wealth of free resources out there - online databases, audiobooks
, museum passes, and help so that you can find even more resources. You just need to know where to look:" Candace then lists a bunch of online resources such as Factiva
(which she misspells), JStor
, etc. which are NOT free! Libraries have paid for these resources and licensed them to be used by their patrons for free, but they aren't just hanging out on the Internet free to use by anyone who happens upon them. Equally frustrating is that she completely ignored major free resources like PubMed
, etc. I just listed a few of the free medical resources, I am sure there are some great free websites out there that other librarians use and know about.
I think the first article was a good article about how library's have a lot of resources available online that patrons can access for free through their library, but are unaware of them because we (librarians) haven't figured out a good way to market our resources. However, the second article
is just so frustrating. The whole article implies that people can access these resources for free if they just "know where to look." Yeah they are free if they look at the library. Personally, I think this article just reinforces the idea that everything is available online for free, and defeats the entire purpose of the "Steal this book? Don't Bother" article. Perhaps I am off base, what do you think?
Look at the Library
These last few weeks have been busy for me. I have been happily doing a lot of library demonstrations to various groups of hospital users and departments. While they are brief little hour presentations, I think they have been extremely helpful.
Most of the comments I have heard from the people who attend my presentations:
- I didn't know we had online journals let alone access to 6,000.
- I can use that?
- Can you come to my department and tell the rest of colleagues about what you have?
- We can get access from home now?!
While many people still think of libraries as a book and journal repository, these educational classes help them see that while we still have the traditional books and journals, we also have a lot more things that can bring information to them on the floors.
As much as I think I tell people about what the library has to offer, I am still amazed that there are people in my small community hospital who have no idea about us and our service. That makes me think about all of the possible ways I can inform people about the library and our services. I have done flyers, sent out group emails, posted on the Intranet, written articles in employee newsletters, and spoken to people. Any other ideas? I am open to almost anything other than walking around with a sandwich board advertising the library. If you have some good ideas, please share because I would like to know what other people are doing out there.
Young See Tech as Organic Part of Life
The interesting article on MSNBC.com "Young see 'tech' as organic part of life
," is about how only a handful of 8-24 year olds think of technology as a concept or use terms like social networking. It doesn't mean they aren't using technology or social networking tools. Quite the opposite, it means they use it so much that it is ingrained in their lives and they have ceased to think of these things as "technology."
The article likens talking to kids about technology and their lifestyle today as to talking to kids in 1980 about the role the telephone played in their social lives. It has always been there since they were born, they don't know a world without it.
I have already begun to see this on a personal level.
One day my 4 year old son hopped on to my desktop computer when I wasn't looking. I turned around and asked him what he was doing it and he responded very sincerely, "Checking my email. I have to check my email." Of course he doesn't have an email account and he can only spell his name, but he has grown up in a time where checking one's email is as common as getting on the phone and calling somebody. To him email isn't technology, it is just something you do on the computer.
This mind set isn't necessarily limited to the youth. While on a recent vacation to Boulder, CO my husband and I used GoogleMap
s and the Internet to navigate and plan our itinerary. The hotel had a free business center for guests and each night we printed off the various maps to our destinations. We lamented that we didn't have TomTom
or some other portable GPS to help us out when we decided to stray from the map and the itinerary. It wasn't until we were reminiscing about past family trips did I remember everything my mom used to do to plan our great excursions. My mom used to spend months planning family trips by getting AAA TripTiks
and lots of visitor bureau pamphlets. There was no checking out web sites or getting reviews on local restaurants. We had become so accustomed to using GoogleMaps and the Internet, that we ceased to think of it as technology and were actually wishing we had a newer technology.
I think the same can be said of library technology. There was day when I had to go to the card catalog or the big microfilm reader to find a book. I had to look in the volumes of the Readers’ Guide to Periodical Literature to find a few articles on a topic. Now a lot of things are online and we have come to expect it. I once had a librarian tell me that he didn't see why he should convert his card catalog to an online catalog because none of his users were asking for an online one. (This was only 2 years ago.) My gut response was to squeal, "They aren't asking for one because they probably expect that you have one!"
Someday some of the very social networking tools we are looking at will be ingrained in ourselves and our profession that we will forget that they were ever considered technology. We will be obsessing about some other new technology.
Calling All Medical Library Leaders
(forwarded from the HLS-list)
The Association of Academic Health Sciences Libraries is pleased to announce the 2007-2008 year of the leadership program jointly sponsored by the National Library of Medicine and AAHSL. The NLM/AAHSL Leadership Fellows Program, focused on preparing emerging leaders for the position of library director in academic health center libraries, offers the opportunity to work closely with a mentor and to work collaboratively with other fellows and mentors.
Applicants with leadership experience in academic health center libraries, hospital libraries, or other library-related settings are encouraged. The multi-faceted program takes advantage of flexible scheduling and an online learning community.
Fifty fellows and mentors have participated in the program since its inauguration in 2002. To date, five former fellows have assumed director positions.
"The program helped sharpen my focus and convinced me that becoming a director was a worthwhile ambition," noted Jett McCann, fellow, class of 2004-2005. "It exposed me to what a variety of directors actually do and how they work. The comradeship forged with my cohort colleagues continues; we are each others' best critics, advisers, and champions."
The deadline for applications for fellows and mentors for the 2007-2008 class is August 17, 2007.
For more information, see http://aahsl.org/document/NLM_AAHSL_Leadership_Fellows_2008.pdf
MLA President's Blog
MLA President, Mark Funk has his own blog. Mark hopes that Only Connect
will be more than just a presidential report. He would like to develop a dialog, saying he wants to hear from the MLA membership and asking what you would like to see in blog from the MLA president.
Check it and his presidential priorities
If you didn't get a chance to see his presidential inaugural address in Philadelphia this year, It is available to MLA members to download in the members-only meeting content area
of MLANET. I highly recommend it, to borrow my four year old's new phrase, "It Rocked Dude!"
Social Survey for Medical Librarians
In line with Mark Funnk's Only Connect presidential theme the MLA's Task Force on Social Networking Software is investigating issues surrounding the implementation of blogs, wikis, RSS feeds, and other social networking tools. The task force is looking to create guidelines for the technologies and their use by MLA members and units. Web 2.0 technologies offer new opportunities for MLA members in MLA business, knowledge sharing, and collegial connections.
The task force wants to hear from you! Please take a few minutes to fill out a short online survey
by Augus 10, 2007. The data will be reviewed carefully and the task force will base their recommendations on results.
As a member of the task force, I want to invite all flavor of medical librarians (academic, hospital, consumer, corporate) to take this survey. We want to know what you want not just what a small subsection of medical librarians wants.
Joint Commission Update
Yesterday I received an email from HLS-list regarding the Joint Commission proposed changes. So I have reposted the email sent by Katherine Stemmer Frumento for all you who might be interested.
"At the 15th Annual Invitational Liaison Forum, which was held last week, Carla Funk and I had the opportunity to meet on Wednesday, 7/11 with Dr. Robert Wise, the Joint Commission's Vice President, Standards and Survey Methods. Dr. Wise acknowledged our concerns, thanked us for all of the input that we, other health sciences librarians, and members of the medical community had provided on the Management of Information Standards. He assured us that none of the proposed changes to the Standards would go into effect, if at all, until the entire standards review process was completed and additional input was requested from the field. There will be another comment period in mid-2008 concerning the entire document, with the revised standards going into effect in January 2009. Our meeting was very positive. Dr. Wise agreed with us about the importance of retaining the concept of evidence-based information in the Standards. Carla and
I stressed the importance of staff and patients having access to evidence-based information and to the services of a qualified health sciences librarian in obtaining that information. Dr. Wise was very cordial, gave us his card, and urged us to contact him with any future concerns. We also talked informally with Dr. Paul Schyve, Senior Vice President and honorary MLA member. Dr. Schyve also expressed his concern about the importance of retaining the evidence-based
information standard. Carla and I will continue to monitor the situation and send out an alert to the membership when the next comment period begins. Thanks again to all of you who responded to the survey."
Who Names These Things?
Our hospital is replacing it's horribly complicated and clunky purchase ordering system. They are replacing it with a product called, Requisition Self Service (RSS). A lot of the communication sent via email keep referring to it as RSS. Now am I the only geek in the hospital who keeps getting confused when I read RSS in the subject line of the email? Why can't we have a name like R Self Service or Req SS, anything but RSS.
If I get confused, I wonder how many of my users are going to start asking me about RSS feeds and how that ties into the hospital ordering system.
I know there are hospital librarians out there whose IT departments prevent them from downloading videos. However, librarians all know there are some good online medical/health videos out there that our users want to watch. I just read on Blogadillo
that a survey by Jupiter Research that forty six percent of online users are interested in watching health videos online. Of those online users 52% already go online for health reasons. Most of the respondents find the videos through search engines (62%) while 47% go to a health web site and 11% go their health insurer's web site.
People learn and retain things in different ways. Many people find writing information down as a helpful method of retaining knowledge while others find observation (watching health videos) as helpful. Systematically preventing hospital employees and patients from downloading medical and health videos is hurting the education interests of a large group of online users. I have heard some librarians say that IT rationale for blocking videos is limited bandwidth. None of us want the hospital's internet
to slow down to a glacial creep, but perhaps there could a better solution rather than blocking all videos. One idea is to allow the library computers to watch videos.
Perhaps hospital librarians out there can use some of the statistics to help bolster their case to IT to allow video downloading. If you have had success with this, please comment and share your knowledge so that we all can benefit from your experience.
Service Oriented Library Systems
What is SOA?
SOA stands for Service Oriented Architecture. According to wikipedia it is architecture system that relies on service orientation as its design. SOA is not dependent on a specific technology and may implemented using a wide range of technologies.
That is as much as my non-programming brain can absorb. Thankfully, Eric Schnell at the Medium is the Message helpfully uses twentieth century automobile assembly lines to explain SOA. The machines in Ford's assembly plant were fixed in place for the Model T. Due to the expense of re-tooling the Model T's design remained the same for twenty years. General Motors was able to make changes to its car models because they utilized a flexible manufacturing approach. Japanese automakers went further by having parts that could be interchanged between model lines.
In the computer world, "service oriented architecture (SOA), the data, application, and interface are separated so that each can be implemented using the best technologies for the task. The pieces can be interchanged or repurposed."
Many library tech people are looking and moving towards SOA library systems. To get a better idea of what SOA is and what it means for libraries check out these sites:
If you are really interested in SOA and Libraries you might want to subscribe to Planet Library SOA (created by Peter Murray) an aggregation of blog postings and resources related to SOA and library systems.
Librarians aren't the only ones exploring SOA. Here are some links to SOA and healthcare:
SOA is definitely an emerging trend. It is probably a good idea to be aware of it and keep your ear to the ground as new information pops up.
Hospital Library Blogs
library blogs (not academic medical library blogs) can be tricky to say the least. Many hospital library web pages are behind a firewall, so if they have a blog it is usually internal to the hospital system and cannot be seen by the outside.
Mary Fran Prottsman
has been working at creating a list of hospital library blogs and you can see the results of her sleuthing
on the Hospital Library Section (HLS
)'s Wiki http://mla-hls.wikispaces.com/Blogs
. Now others can view the list and may continue to add to it as new blogs are created and discovered.
is a health information site offering "distinctive, in-depth, physician-reviewed guides" to over 60 chronic and life-threatening medical conditions. By December 2007 40 more conditions will be added. The guides are updated quarterly and reviewed by its advisory board of leading specialists throughout the country.
The guides include information on:
- treatment options and research advances
- links to relevant medical article abstracts from leading journals (supposedly provides abstract for free, but when I clicked on the link I got the "Page Cannot Be Displayed" message)
- contact information for clinical trial sites, and leading researchers and their institutions (Poor navigation, you have to click through each state to get to your state. Email addresses are not active and word wrap poorly. When you click on Centers for Research you only get authors and their institutional affiliation, you DO NOT get a listing of specific centers)
- links to top associations relevant to the condition (So far all I found were links to Complementary and Alternative Medicine associations)
- complementary and alternative medicine resources
- physician-locator information (doesn't give you physician information, it gives you TIPS on finding a physician)
- important questions to ask your doctor
In my opinion the number of topics is few and the website design is awful. I was constantly battling with advertisement expanding and jumping around the page. The line in the middle of the page makes it look like information is falling off the screen. Several times I tried to click on a link to an article and got Circuit City because the ad moved over the article URL. While I like the concept of this site, I am less than impressed.
MIT Libraries Using Del.icio.us
has recreated their Virtual Reference
site so Del.icio.us users can add the library to their network and stay informed of new resources added. MIT is using FeedDigest
to send links from their (MIT Library’s) del.icio.us account via RSS
into their web page.
I would love to hear how this endeavor pans out.
Medical Images Available
The Wellcome Library
has made the their Wellcome Images
available under the Creative Commons License. Users are allowed to copy, distribute, and display images, as long as they are used for non commercial purposes and the source is fully attributed.
I keep thinking there has got to be a good way to organize and search all of these images from all over the internet. Is del.icio.us or other tagging applications a viable option. There doesn't
seem to be a good database that keeps track of all them (like a Medline for images) and that is a shame because there are a lot of good images that can be used, if they can be found.
Free Conference Calls?
Do you need to get a group of people together to discuss a few things? Check out Freeconference.com
. On The Cornflower, Tammy Mays explains
how easy it is activate an account and use. The Standard service is free, participants only pay for the long distance charges incured for calling the Las Vegas area.
I can't help but think this is not only helpful for small business, hospitals, libraries, etc. but also for nonprofit groups.
JMLA Looking for Electronic Resource Reviews
The Journal of the Medical Library Association is seeking authors for electronic resource reviews for upcoming issues. The purpose of the electronic resources reviews in the JMLA is to provide critical appraisals of electronic products that can assist staff in health sciences libraries as they make collection development and technology implementation decisions. Reviewers can evaluate any relevant type of resource, such as databases and catalogs, electronic collections, research and reference tools, library management systems, and educational instruments. Health sciences resources are the primary focus of reviews. To be reviewed, resources must be readily accessible for use in health sciences libraries.
Electronic resource reviews are short pieces, generally 2-3 double-spaced pages in length. Reviewers are not required to be members of MLA. Additional guidelines for electronic resource reviewers are online at http://www.mlanet.org/publications/jmla/jmla_eresource.html
For more information or to propose a topic contact Rachel Walden, MLIS at jmlaeditor [AT] vanderbilt [DOT] edu.
Here is a little article that you can read to start your work week off on fun note. A Hipper Crowd of Shushers
, looks at the younger generation of librarians and mentions how libraries are more tech. oriented now.
My completely un
-hip self enjoyed reading about others in the profession and why they like being librarians. Some people enjoy connecting users to information, but for me it is the thrill of the hunt. I always love trying to find that one bit of information that is eluding me and my patron. I sometimes joke that the missing info bit is deliberately mocking me as it hides.
iPhone and Medical Applications?
The UBC Health Library Wiki has a page on Apple's new iPhone - Applications in medicine
. People lined up around the block for hours for that little booger (my sister and her husband included) just a week ago and Dean already has information about its use in medicine. Wow!
According to the wiki page, Unbound Medicine
is eyeing up to offer medical products for the iPhone. Emphasis will be placed on already well known references. Of course with the release of every new technology come the bugs and the iPhone isn’t immune to them. For example, if your iPhone’s battery goes kaput, it could be a costly and frustrating fix
leaving you without a cell phone for a while.
MLA Letter to the Joint Commission
For those of you who are interested, MLA's letter protesting the Joint Commission's hospital accreditation standards is available at http://www.mlanet.org/resources/vital/letterjc.html
Are Hospital Libraryians on the Endangered Species List?
David Rothman has a post on the Future of the Hospital Librarian
. I have been kicking around this topic for a while and haven't posted anything on it because I think it is a hot but timely topic and I wanted to really think about it before I just whipped up a post. David's brain is ahead of mine because his thoughts are very interesting and well thought out.
July Resource of the Month
I hope those of you living in the United States had a nice Fourth of July holiday. Unfortunatley, it is time to get back to work. Hopefully July's resource of the month will be of help.
Disaster Medicine & Public Health Preparedness
A joint publication with the American Medical Association (AMA), this journal is aimed at all health care and public health professionals, the emergency management community and others who are essential to effective planning and response. The journal translates science into practice and integrate medical and public health perspectives to bridge all health care communities and constituents. The journal covers a wide range of relevant topics, including applied epidemiology, health care services and systems research, clinical management issues, population-based triage, educational curriculum development, and testing and evaluation.Try it now at OvidLearn more about Disaster Medicine & Public Health Preparedness from Ovid