InTOCicated by eTOCs

As you might gather from the post title, I love journal alerts (aka eTOCs) and here’s why:

  • They increase use of our expensive ejournals
  • They help keep clinicians up to date in their specialty
  • They repeatedly remind clinicians that the medical library exists; no small thing in these Googlesque days
  • They can be used to cross promote other library resources, services and news

We are a relatively small hospital library (two staff) which services around 5000 clients. Over the years, our ejournal alert service has grown to around 700 journal alerts, and is probably our most popular service.

The way it works is that all journal eTOCs come through one email and are forwarded to alert groups automatically via rules.

Our organisation used to have Groupwise for its email system and rules worked well with it. However on switching to Outlook, we quickly found that we could only create half a dozen or so rules before memory limitations were reached. After some searching, we found an Outlook add-in called Auto-Mate from Pergenex which came to the rescue. It’s an easy to use but powerful add-in, and it’s strangely gratifying to watch it automatically forward dozens of eTOCs each morning.

While signing up for eTOCs is a one off task, and forwarding of emails is automatic once rules have been set up, creating and modifying ejournal email groups is the most labor intensive part of the service. If I was to start the service again, I’d probably do it at the subject level (eg cardiology) rather than the title level (eg BMJ) as this would reduce the workload involved in adding and removing users from groups.

With a previous post – exporting Google Scholar citations to reference managers – I Kraftily used it as a Trojan horse to seek an answer to issue. Thanks to responders Farhad, Christine and especially Karen who provided the solution.

In a similar vein, I’m hoping a clever commenter out there can shed light on the following question:

Is there a way to have an online web form such that a user can make multiple selections (for the various eTOCs they are interested in) and which on submission updates multiple email groups (corresponding to the eTOCs they have selected/deselected). The email system doesn’t necessarily need to be Outlook. I thought this would be relatively straightforward process but as yet haven’t been able to find any offerings like this, despite playing around with the likes of MailChimp.

The JournalTOCs service has something like this available but our resolver wouldn’t work with their system alas alack alay

In any case, I remain a big fan of eTOCs and would be interested to hear if any other libraries have any comments, are using them in interesting ways or have any technology (not RSS ) that streamlines the process and so on

Thanks Rob

Designing Resources for Optimal Usage

Last week Clinical Key changed their interface and there was a big discussion about Clinical Key and how it works (or doesn’t) with Internet Explorer 8 & 9 on the Medlib-l listserv.  Basically the conversation fell into three categories.

  1. There was a general feeling that Elsevier did little to no testing of their website with hospital and other users.
    • Lack of functionality with IE 8 & 9 seem to indicate they didn’t test it very well using those browsers.
    • No A-Z alphabet listed for e-books and e-journals, so users have to wait for the entire list of e-books or e-journals to load and then scroll down to their title. Annoying, but not a big deal if your title begins with a C. But if you are J or another middle of the alphabet letter, it is worse than annoying.
    • Changing the way e-journals display a title.  In the past they displayed the title, current issue and then listed past issues on the page.  This is no longer the case and it makes finding the past issues very difficult. (update 10/2/14: ejournals now display current and past issues.)
  2. Most hospitals are stuck using Internet Explorer and often old versions of the software.
    • Many hospitals have legacy systems and are stuck on older operating systems which often dictate their browser software.  I know of one major hospital that has a goal of finally migrating to Windows 7 by Fall 2015.
    • If hospitals are a part of your clientele then it is a business imperative to know what the majority operating systems, browsers, and platforms your product will be used on.  Failure to do so means your product fails or is not used effectively. This leads to poor usage and will lead to non-renewal.
    • In general most hospital librarians CANNOT get their IT department to upgrade the hospital’s browsers.  At best they can get the computers in their library to have an upgraded or different browser, but they have no influence to have browsers upgraded elsewhere in the hospital.  It is naive to think otherwise.
  3. Academics have more flexibility and options regarding software and their IT departments are more open to other resources.
    • As a result they are often good places to try new things and experiment. However if the product will be offered to hospitals, vendors must be aware that what works at an academic institution may not work at a hospital.
    • While academic institution are concerned about privacy, in general they do not have to deal with HIPPA regulations.  This adds a layer of complexity to security that must be married to multiple hospital systems.

While the medlib-l discussion on Clinical Key could be boiled down into one of these three themes, it does impact more than just Clinical Key.  They are just the most recent example, but others have failed to understand the market they sell to.

Before a vendor decides to upgrade, they would do well to have beta testers from both hospitals and academic institutions (large and small) and make sure the company or programmers they are using to upgrade their product know design to the lowest common browser.  That won’t make things perfect, but it will help.


NEJM Publishes Erratum After Social Media Peer Review

I stumbled across this blog post a week ago and thought it was a wonderful example of the way social media can be used to better biomedical science.

The New England Journal of Medicine published an article in June on the prevention of MRSA in the ICU.  The study was very large, 74,256 patients, and the results looked impressive, BUT nobody could get the stats didn’t add up.  The numbers given in the published paper didn’t correlate with the Number-Needed to Treat (NNT)

A blog post on Intensive Care Network posted the following about the stats in the NEJM article:


We were hashing this out in our journal club, but could not get the stats to add up.


The NNT’s of 54 and 181 seem impossibly small, with huge clinical implications.

Please try it yourself; look at Table 3. Frequency and Rates of Outcomes during the Baseline and Intervention Periods, According to Study Group

With bloodstream infection from any pathogen, the Group 1 (standard care) number of events per 1000 patient days is 4.1. With Group 3, the number of events is 3.6 per 1000 patients days. Even taking change from baseline into account and assuming these NNTs have been calcuated AFTER randomization, between Group 1 and Group 3, we get nowhere close to their NNT’s.

PLEASE have a go and see if you can match their NNT’s.

IF you can’t there is a serious problem, with practice changing implications.

It’s too late to write letters to the NEJM, so a robust discussion in a peer reviewed forum seems a good way to go.


The authors of blog post intention was to discuss the problem in “a peer reviewed forum” and according to them “there was lots of insightful commentary from around the globe.”

The fact that they were able to discuss problem with others around world is big but not unheard of, more and more scientists are discussing issues online.  To me the biggest thing is that the paper’s lead author, Susan Huang engaged in a discussion with the social media reviewers with a “prompt and gracious reply” agreed the published calculation was an error and showed “true scientific and academic integrity by contacting the NEJM as soon as there was a suggestion that the stats were incorrect.” NEJM responded by publishing an correction to the paper.

It is very cool how scientists discussed online a paper’s validity and work together to essentially provide world wide peer review.  However, what I find even cooler is that the author was engaged with the social media process AND a respected journal addressed and responded to the findings.  This is an example of everything that is right with social media and professional communication.  It will be interesting to see if we will see more of this type of world peer review in the future especially now that  PubMed Commons can also foster this kind of scientific inquiry and discussion.

NEJM is a big journal with lots of very smart authors contributing papers that are subjected to very peer reviewers, but still there can be mistakes.  World peer review via social media could help improve the process.  One question I keep wondering is, if we have this type of world peer review, could this cut down on the academic fraud that sometimes eludes the careful eyes of publishers’ peer reviewers?  What would have happened had Wakefield’s fraudulent study linking vaccines and autism (published in 1998) been published today?  Would that paper have had a chance to make it the general public’s consciousness and be as unfortunately influential as it still is today?


Plagiarism of Medical Text in Medical Apps

In a recent post, Timothy Aungst from sheds more light on the trend of copying established medical textbooks and repurposing it in a medical app that they sell on iTunes.  Aungst cites a recent report in BMJ, where three doctors, “Afroze Khan, Zishan Sheikh, and Shahnawaz Khan face charges of dishonesty in knowingly copying structure, contents, and material from the Doctor’s Guide to Critical Appraisal, by Narinder Gosall and Gurpal Gosall, when developing the app, representing it as their own work and seeking to make a gain from the plagiarised material.” Not only did the doctors plagiarize the text, but according to Aungst and BMJ the doctors also sought to increase their ratings within iTunes by writing reviews of their own apps without disclosing an conflict of interest.

This type of plagiarism is not new. In fact as Aungst states Editor, Tom Lewis, discovered several apps in iTunes that plagiarized other works.  (I wrote a brief post about Tom’s finding while I was on vacation last year.) I can see from Tom’s comment that while he never heard directly from Elsevier regarding the issue, YoDev apps LLC had all of their apps pulled from the App Store.

Copying and re-posting a book online or through bit torrents for free is so 2005.  Welcome to the new world where plagiarizing can make you money. All you have to do is steal the content and sell it in an app.  They are also sneakier than they were in 2005.  They aren’t selling the app under the original book title, they are changing the name and trying to market it as something totally different.   Hmm it seems requiring users to use personal logins to view the PDF is really working to curb copyright violations.


According to an updated BMJ article, the doctors accused of plagiarizing The Doctor’s Guide to Critical Appraisal to use in their app Critical APPraisal, have been cleared of plagiarism by the Medical Practitioners Tribunal Service.

“A regulatory panel rejected charges by the General Medical Council (GMC) that Afroze Khan, Shahnawaz Khan, and Zishan Sheikh acted dishonestly in knowingly copying structure, contents, and material from a book, The Doctor’s Guide to Critical Appraisal, when developing their Critical APPraisal app, representing it as their own work, and seeking to make a gain from the material.”

Shahnawaz Khan and Afroze Khan were also accused of dishonestly posting positive reviews of the app on the Apple iTunes Store without disclosing that they were co-developers and had a financial interest in the app.  The GMC found that Shahnawaz Khan  no evidence that he knew that the app, which was initiallly free, would later sold for a fee. His case was concluded without any findings.  However, the GMC panel found that “Afroze Khan’s conduct in posting the review was misleading and dishonest.” Yet they considered this type of dishonesty to be “below the level that would constitute impairment of this fitness to practise.”  The GMC panel said it was an isolated incident and did not believe it would be repeated in which they “considered his good character and testimonials attesting to his general probity and honesty and decided not to issue a formal warning.”

The Journal App Wars

I have doctors asking about all four journal browsing apps; Docwise, Docphin, Read, and Browzine (click links for reviews on each app. The reviews were either done by me or guest librarians who had access to the app).  A few of the requesting doctors have used one of the above products, but it seems the vast majority of the doctors haven’t used any of the apps and are asking based on word of mouth. 

The four apps are very similar.  To me it is a bit like comparing PubMed vs Ovid Medline, both do the job well but differently.  You also have people who prefer one over the other.  One is free while the other is not. 

The biggest difference is that three of the apps show the abstracts and tables of contents to almost every medical journal known to man (I over exaggerate of course).  The full text is provided if the library/institution as a subscription to that journal.  However, there is no clear branding or explannation of what journals the library/instituion owns because Docwise, Docphin, and Read don’t know.   If a doctor views the table of contents for the Journal of Big Toe Science in Docwise, Docphin, or Read  (which is not owned by the library), the doctor is denied the full text.  Last time I checked, there was no clear message as to why they can’t get the full text. Docwise, Docphin, or Read didn’t say soemthing like, “Your library doesn’t subscribe to this journal therefore you can’t access the full text.” Docwise, Docphin, and Read do not know the library/institutions holding or access methods.

Browzine does know what the library/institution owns.  Because the library submits the list (with access methods) to Third Iron (the company that owns Browzine).  Browzine only shows those journals to doctors. There is no guessing as to whether it is available full text to the doctor.  If it is in Browzine, it should be available full text.

Let’s pretend that my hospital library provided proxy access to resources. (Most hospital libraries don’t have proxy servers to provide access to journals or other resources.)  I could have my pick of these apps to provide to my users.  My question for librarians is: Do I list all four apps and let them decide what they want?  I have a very strong feeling (based on 15 years of answering doctor’s library questions) that doctors are going to be complaining about Docwise, Docphin, or  Read not providing the full text.  After all, if the library recommended a product that connects users to the full text, shouldn’t everything be full text?

What do other libraries do?  Do you list all of the apps and let the users decide?  Do you worry that there might be confusion among the apps because they are so similar but slightly different? Do you worry that doctors might feel frustrated when they can’t get the full text? Would doctors even bother ordering the unavailable article (going outside of the app to do this) through the library? 

I appreciate your thoughts and comments. Because sometimes I feel with these journal apps I am being asked to pick between Coke and Pepsi, Ovid and PubMed.  I know the difference between them, but my users don’t. Does it matter?

Medical Library eBooks: Five Years Behind

When Fergie sang, “I’m so 3008. Your so 2000 and late”  I am 100% sure she was not singing about medical libraries and ebooks, but whenever I think of ebooks, libraries and publishers Fergie’s lyrics repeatedly ring through my head.

Public libraries and Amazon are ahead of medical libraries regarding ebooks.  Providers of medical library ebooks such as McGraw Hill Access databases, Ovid, Elsevier’s ClinicalKey, and others methods of providing ebooks are from the digital dinosaur age when a portable device was considered a laptop.

Not much has changed on how we provide our ebooks with these vendors.  Our users go to their website and view the book online like they are viewing a web page.  They do it the same way they did before the Kindle or iPad.  Not only is some of the content STILL in Flash (AccessSurgery) making those videos completely useless, but they treat viewing the ebooks on the iPad and Kindle as mini laptops which is limiting.  Kindles have been around since 2007 and the iPad has been around since 2010.  People have had between 3-6 years worth of downloading expectations that have been fostered by Amazon, Apple, and public libraries.

People’s concepts of an ebook have drastically changed.  The term ebook no longer refers to a book that is available online in HTML or  PDF.  Users now define an ebook as something DOWNLOADABLE to their device.  They are disappointed when they aren’t.  When I am asked if we have any ebooks and I say yes, the next question I am asked is how do they download them to their device.  When I tell them they can’t, they are immediately turned off.  They aren’t interested. 

I understand that these providers don’t want people downloading their books for free and keeping them forever.  However,  public libraries have already done a pretty good job at training our users for us and they have figured out methods to curb copyright and theft.  While users expect to download the book to their device, they also expect that the book will be returned or disappear from their device after a set period of time.  This is the way public libraries have done things.  This is the way iTunes and Amazon “rent” movies.   Amazon has been renting etextbooks and renting to ebooks to Prime members for a while.  It is cheaper to rent the Amazon book than to buy it, and Amazon customers can set their own expiration date (more expensive for longer terms).  Overdrive was founded in 1986 and has been working to provide public libraries with ebooks and materials since 2002 with their Digital Library Reserve, a digital download platform. People are well versed in the concep downloading an ebook to their device for a limited time.

Yet many medical ebook vendors are still plodding away with their ebooks that can only be viewed online, the same way they always had when all we had were laptops.  They have not evolved.  We are still looking at HTML or PDF versions of the print.  Yeah some ebooks have video content or interactive tests, but that isn’t any different than what was available in 2000.  As a result, when it comes to non-downloadable ebooks, we are losing our users. 

Have big publishers become too big to be agile to adapt to current technology?  Are their online publishing platforms too entrenched to be able to provide downloadable ebooks that can disappear (be “returned”) on a device?  Other companies do it.  Why don’t they?  Are they over invested in the way they used to do things that it is inhibiting the way things have evolved?  Or are they operating as usual and don’t really realize the demand to download the books? Only they know.  But one thing is for sure, their online ebook platforms days are limited.  I can’t say whether it is today or tomorrow but it is coming. The consumer demand for downloadable content is not waning, and the use of iPads within hospitals is growing.  According to EHR Intelligence a study conducted at Columbia University Medical Center in New York determined that “iPads were used frequently by residents attending rounds: 90% of residents reported referring to their iPads, since they are unable to leave their attending physician to use a PC elsewhere.” 

If they can’t use a PC to find information and are using their iPad instead, then the old way of offering ebooks via a web page  or PDF is like the Dodo bird. It is stuck on an electronic island with no means of leaving or evolving and being preyed upon by users expectations.

Updates on Edwin Mellen Press lawsuits

Another layer has been added to the issues surrounding the Edwin Mellen Press lawsuits.  Last week Scholarly Kitchen published a post explaining they removed two posts (and comments) by Rick Anderson discussing Edwin Mellen Press because they received letters from EMP threatening legal action. The letter tells Scholarly Kitchen, “We are putting you on notice that the moment Mr. Anderson publishes or provokes any statement about our company or authors that is the slightest bit defamatory, we will pursue legal action only against him, but your organization as well.”

Here is the full letter to Scholary Kitchen about Rick Anderson.  It also appears that Edwin Mellen Press is also holding Scholarly Kitchen liable for libelous comments made by the general readership.  Because in their Rick Anderson letter they also mention they enclosed a copy of a letter  to Kristine Hunt, who they claim posted libelous statements in response to Anderson’s blog.  EMP’s Anderson letter says, “We are bringing this information to your attention because you are the publishers of both Ms. Hunt’s statement and Mr. Anderson’s blog. As such, you have a legal obligation to monitor these types of comments. In order to limit any damage from such events, we request the immediate removal of Ms. Hunt’s comments from your blog.”

The letter to Kristin Hunt specifically states that EMP takes issue with two comments she made on Anderson’s post that they believe are harmful and untrue.  Their letter ends, “You have the right to seek legal counsel pertaining to this matter and, if you do so, your attorney should contact me directly.  If you do not consult an attorney, you are welcome to contact me yourself.  If I do not hear from you or your attorney by April 15, 2013, the Press will take legal action as it sees fit.”

Yikes! But there is more.

Roy Tennant with The Digital Shift published on Friday that Edwin Mellen Press registered domain names using Dale Askey’s name (Askey, to my knowledge, is still battling one of the two lawsuits brought by EMP).  Roy has the registration record  as an in the post showing DALEASKEY.COM registered to Edwin Mellen Press Ltd. address and has Iona Williams with an EMP email address as the administrative contact.

Dave Pattern mentions in the comments, that many sites (besides the Dale Askey ones) were registered by “pseudonymous  ‘Arthur Scholar’ (pen name of the blogger on the EMP site & also the EMP tweeter) has been used to register around 100 domains over the years.”  He says Iona (Margaret) Williams registered some other mellenpress domains and is listed as a contact on Mellen’s website and as a Secretary for the company at these two places



I agree with Dave, in which I have no idea why anyone or any company would want to buy domain names that aren’t related to themselves.  Weird, and just to let my readers know. This is not an April Fool’s post.

(Total side note and apology to Rick Anderson, I can’t help it but every time I read the EMP letter all I can hear is Agent Smith (Hugo Weaving) in the Matrix saying “Mr Anderson.” I bet there are times Rick and Dale wish they took the blue pill.)


JLA Editorial Board Resigns Due To Taylor Francis Copyright Issue

According to The Chronicle of Higher Education, Wired Campus,  the editor and entire editorial board of the Journal of Library Administration resigned in response to a conflict with the Taylor & Francis author agreement that the board believed was “too restrictive and out fo step with the expectation of authors.”

Damon Jaggers told The Chronicle that the Taylor Francis author agreement and licensing terms scared potential authors away making it difficult to attract quality authors.  Not only was this a problem for potential authors but even a member of the editorial board who was was concerned about publishing and licensing. 

In the blog post, The Journal of Library Administration, Jason Griffey describes his concerns in detail after reading the Taylor & Francis author agreeement sent to him by Brian Mathews (guest editor for special issue of the journal).

I’ll be blunt: there is no situation in which I’d sign copyright over the T&F…or, frankly, anyone. I’m very happy to sign a license of limited exclusivity (say, 30-90 days) for publication, or license the work generally under a CC license and give T&F a specific exemption on NC so they can publish it. But their language about “Our belief is that the assignment of copyright in an article by the author to us or to the proprietor of a journal on whose behalf we publish remains the best course of action for proprietor and author alike, as assignment allows Taylor & Francis, without ambiguity, to assure the integrity of the Version of Scholarly Record, founded on rigorous and independent peer review. ” is just…well, bollocks.

According to a post from Chris Bourg (an editor for JLA), Jaggers tried to work with Taylor & Francis on their licensing terms and try and make a change from within.  Unfortunately he was not successful.

Damon continued to try to convince Taylor & Francis (on behalf of the entire Editorial Board, and with our full support), that their licensing terms were too confusing and too restrictive. A big part of the argument is that the Taylor & Francis author agreement is a real turn-off for authors and was handicapping the Editorial Board’s ability to attract quality content to the journal. The best Taylor & Francis could come up with was a less restrictive license that would cost authors nearly $3000 per article. The Board agreed that this alternative was simply not tenable, so we collectively resigned. In a sense, the decision was as much a practical one as a political one.

On Friday the board resigned and the resignations were announced Satruday in a email sent to JLA contributors.  Jaggers told to The Chronicle, “the editor and the board memebers have not heard back from Taylor & Francis since their resignations.”

Other articles or posts on the JLA issue:

Please let me know if there are new articles or any updated information.




Usage Stats: Are They a Double Edged Sword?

Back in the olden days a library bought a subscription to a journal and they paid the institutional price which was often listed on the inside cover of the printed issue.  It was always more expensive than the personal subscription, but there wasn’t tiered pricing, FTE pricing, or pricing based on inpatient admissions and number of specialists.  For the most part the price you saw on the inside cover was the price you paid.

Then came the electronic journal.  At first journals weren’t quite sure how they were going to have their articles online.  Some gave it away free, others were free with a print subscription, some charged a nominal upcharge, while some charged a specific online journal price. Ejournals grew in usage and with tightening budgets librarians began dumping the duplicate print. During that time institutional prices evolved to a Ladon of possibilities.

Additionally, the concept of eresources has moved beyond journals. It extends to books, databases, integrated EMR and patient education products, image databases, etc.  As librarians we demand to know our usage statistics for our eresources.  We need to know what our patrons are using so we can get the most bang for our buck.  However, we aren’t the only ones who see our usage statistics.  The vendors that sell us our products run the reports and it isn’t in their best interest for us to get the biggest bang out of our buck.  I am not trying to imply that all of the vendors are nefarious. I am just saying that if they see that your cost per use stats are so phenomenal that they may be looking how to get more money from you.  For example you are paying $50,000 for a product that you use so often that you have $.05 per use but the average library in your tier pays about $.10 per use,  the vendors think you are getting their product for a $50,000 discount compared to others in your tier. 

Prior to eresources, vendors knew very little about the usage of their product in the institution.  The usage of printed journals and books were often only known by the librarian through shelving studies or circulation statistics.  I remember when we had CD Plus and had to load the MEDLINE CDs on a CD tower for people to search.  Despite not having the type of usage data we have to today, librarians still looked at how their databases were used (Volkers AC. Bull Med Libr Assoc. 1995 Oct’ 83(4):436-9.) and even tried to determine journal needs through the database (Dunn, K. Medinfo. 1995;8 Pt 2: 1428-32.) The usage stats were all in house.  So while you might have known what your cost per use was for a journal, book, or database there was no way that a vendor knew, unless you published it in a journal article that they read. 

It seems that with wide scale use of eresources, usage stats have become a double edge sword.  Not only do we still need to know what is being used but vendors now also know what we are using.  They can use this information to their advantage as well.   While neither party wants to have a resource that is a dud, I’ve got to wonder if we are now also victims of our own success.  Many of us have already cut the chaff from the wheat years ago.  All of our eresources are high performers.  Yet because they are high performers are they costing us more than if they were less utilized?  If so isn’t that the exact opposite of what a librarian needs to be thinking about? 

Betsy Kelly, Claire Hamasu, and Barbara Jones wrote an interesting article, “Applying Return on Investment (ROI) Libraries. (Journal of Library Administration. 2012;52(8):656-71.)  Determining the ROI is necessary to measure the value of the library resources to the institution.  Many medical librarians use the NN/LM MCR ROI Calculator to determine the replacement value of services provide by the library.  In addition to quantifying the number of classes, room use, photocopies, and ILL’s the calculator can also factor in the cost of ejournals, databases, ebooks and their usage.  So in order to get a good ROI we want high usage for these electronic resources. 

ROI is what hospital administrators are looking at when it comes to everything.  Hospital administrators are focused on controlling costs and demanding the biggest savings possible.  According to an article from the Daily Beast about the Cleveland Clinic , CEO Dr. Cosgrove is described as something of a “fanatic” regarding controlling costs.

“Our physicians are so engaged in our supply chain that they help negotiate the price down for the things we use,” Cosgrove told me (Daily Beast), and reeled off a list of examples:

  • When I was the head of surgery, we needed a new heart-lung machine, and we decided there were three models that could work, so we did a reverse auction to get the lowest price.
  • We put price tags on things in the operating room: before you open that $250 set of new sutures, make sure you actually need it.
  • We found out that there’s a lot of redundant tests that are done, or tests that won’t be vital to the patient’s care. We know that there are some things that don’t change. For example, the reticulocyte count can’t change but week to week. So if someone’s ordered a reticulocyte count, you can’t ordered another for a week.”


I might be going out on a limb here, but I have to think that all administrators are pretty fanatical about costs and keeping them low.  So how does the idea of keeping costs low factor in with eresources?  Are we at a point with some resources that good usage is actually hurting us, costing us more come negotiation time (if we can even negotiate)? In the spirit of the $250 suture kit, do we start adding a price tag to our eresources before users click on them?  That would be kind of absurd and certainly would drive down our usage stats which in turn would drive up our cost per use. 

In this day and age where we use our usage statistics to drop resources and vendors use them to determine pricing, how are we to come to a even playing field when our budget is shrinking and our administrator wants to see increase cost savings?  We struggle to show our ROI on a smaller and smaller budget as our resources increase in price.  We explain to administration that if they didn’t have us to do what we do it would actually end up costing them a lot more in time and money to provide the same resources and services.  But as Kelly et al mention, the “problem with ROI calculations based on cost avoidance is the underlying assumption that users will look elsewhere to purchase the same services and resources they receive from the library. It is not realistic to assume that users could afford or would make the effort to personally pay for all of the services they receive.”   Hospital administrators are essentially already doing this.  By cutting the library’s budgets to the bone they are forcing librarians to not pay for all of the same services and resources.  When a hospital library closes, the budget for those electronic journals, books, and databases (as well as everything else) is gone.  Almost none of the resources are kept by the institution. When administration closes a hospital library, they are not replacing the same services and resources. 

Usage statistics help librarians determine ROI to hospital administration, but what are we to do when administration wants to see usage and ROI go up but vendors increase the price (thus decreasing our ROI) as a result of our usage stats?  It seems as if librarians are between a rock and hard place. Do we need to look at another method of valuing our services and resources?  If so, what?

Review of Docphin: App to View & Read Journals on iPad

Previously I reviewed two apps (Browzine and Read)  that help users view and read journals on the iPad.  There are two additional apps that I will be profiling on this blog.  Docphin and DocWise are similar journal apps for the iPad.  Thankfully Alison Aldrich has agreed to test and review Docphin (below) and Joey Nicholson will be reviewing DocWise.  My hope is to get all of the reviews posted then later try and do a comparison chart of the products.

So without further ado, her is Alison’s review of Docphin.

Review of Docphin
by Alison Aldrich

Earlier this month, Krafty reviewed Browzine and Read, two journal reader applications for iPad. Today I’m writing about Docphin. Docphin is of similar ilk to Browzine and Read but with a few interesting differences. 

The “phin” in Docphin stands for personalized health information network. Docphin was founded in 2010 by some entrepreneurial physicians looking to address that all-too-familiar information overload problem. Docphin users customize their experience by choosing the journals and news sources from which they would like to receive updates.Sounds like an RSS reader, right? Docphin attempts to add value over something like Google Reader by suggesting sources based on specialty, simplifying access to full text, and making it easy to comment on and share sources via social media channels. 

Access to Docphin is restricted to those with email addresses at one of approximately 100 U.S. academic institutions that have requested activation. Activation is free and does not necessarily involve anyone from Docphin communicating with the library, so you may have access to Docphin without knowing it. Check by entering your university email address.

 Once your institution is on board, signing up for an account is straightforward. Enter your level of education (attending, fellow, resident, medical student, or other) and between one and three medical specialties of interest to you. Docphin suggests news feeds based on your selections, but you have the final say over the sources you choose.

An important note: Docphin does not cover every journal. It draws content from around 250 journals, so about 5% of the journal titles indexed in PubMed. A Docphin representative explained to me in an email message that journal titles were selected after consultation with hundreds of practicing physicians, including Docphin’s official team of Ambassadors, about what would be the highest impact titles in each specialty. 

In addition to journals, Docphin also draws content from about 250 twitter feeds, many from organizations (publishers, government organizations such as the CDC, AAMC, etc.) and a few from individual physicians. There are a handful of mainstream news media feeds available, too. 

I set up my profile to watch four internal medicine journals, two public health journals, and news feeds from ABC and the New York Times. My home screen looks like this in a regular web browser:

And here’s how it looks in the iPhone app:


Back to the regular web version, in the right column, I see articles that are trending among Docphin users right now. Clicking a journal title smoothly overlays this screen:


I have the option to view the article (this prompts me for my proxy server login), share the citation via social media, like it, comment on it, or mark it as a favorite. I have the option to create my own keyword tagging scheme to keep the articles I tag as favorites organized.

From my home screen, clicking to the Search tab allows me to search by keyword within all of Docphin’s Journals and News collections, practice guidelines from the National Guidelines Clearinghouse, UpToDate, News, Images, and Videos. The UpToDate search does not prompt me for a proxy server login.

Docphin sends regular email alerts about new content from the sources you chose. Email alerts can be turned on and off under Privacy Settings.

Things I Like

The interface is clean and navigation is smooth.

For the journals it covers, Docphin works quite well with my institution’s proxy server as long as our subscription access is direct from the publisher. The system breaks down when it comes to journal content we get through a third party vendor such as EBSCO or Ovid. Those articles were unavailable to me through Docphinfrom off campus. 

I like the integration of Twitter feeds and trends data. Docphin does well to acknowledge these alternative modes of information discovery.

I also like that mainstream media feeds are included. I don’t know many residents who have time to catch the evening news. Docphin could help them stay a step ahead of what their patients are hearing and reading.

Things I Would Like To See

Right now, Docphin can only be accessed through a web browser or an iPhone app. There is no iPad-optimized Docphin application yet, although one is coming. An iPad app will make it much easier to interact with Docphin PDFs on the go.

I would also like to see a collection development policy of some sort.It’s difficult to get a global sense of what Docphin covers because journal titles and Twitter feeds are siloed into lists by specialty. I would like to see a master list of journal titles somewhere.

Docphin does cover a number of open access journals, and of course abstracts are freely accessible. Why not open up this level of content to those outside of registered institutions? This seems like a strategic decision, I’m just not sure what’s behind it.

Other Thoughts

In many ways, Docphin reminds me of another social scholarship website making headlines lately: Mendeley. Both work with proxy servers to simplify full text access. Like Docphin, Mendeley attempts to encourage discussion around individual articles and to expose metrics about who’s reading what. Granted, the discussion part has not exactly caught on yet. There are many, many articles and few discussions. Still, I like the idea of a discussion platform that is independent of publishers—sort of a universal online journal club.

I have been impressed with Mendeley as a PDF and bibliographic citation management tool. These features combined withDocphin’s newsfeed personalization capabilities would make for a very unique product I think.

Bottom Line

Docphin is worth a look, and another look once the iPad app is released. The developers have been quite successful at growing the business through their networks of newer physicians and medical students. Your physicians and medical students need to understand, though, that while Docphin is an excellent current awareness tool, it is not the place to go for a comprehensive literature search due to its limited journal coverage and limited search functionality.

For further reading:

TechCrunch article:

 An interview with Docphin co-founderMitesh Patel:

 Another Q&A with Mitesh Patel: