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.


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.

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?

Read QxMD: Another Journal App for Your iPad

Recently I have been more atune to medical apps because I am in the process creating a libguide featuring medical apps.  From what I can tell, there are three main apps out there that try and provide full text access to institutional journals subscriptions via the iPad.  They are Browzine, Read, and Docphin.

Last week I reviewed Browzine, today I am going to review Read by QxMD.  Next week Alison Aldrich, will provide a guest post about Docphin.  (I usually try to use all of the products reviewed on my blog, but in this instance Docphin doesn’t work with the way my library provides off campus access and they don’t provide access to free journals.  So, I can’t try it. Alison has graciously agreed to try and write a guest post about it. -Thank you Alison!)  If possible, I will take the reviews and try and compare the three apps against each other.

Read is produced by QxMD which makes several medical apps. It is founded by “medical professionals” and is dedicated to “creating high quality, point of care tools for practicing health care professionals.”  They are partners with Cardio Exchange, Society for Vascular Surgery, Vascular Study Group of New England, American Academy of Family Physicians, and the Canadian Society of Nephrology.

It is also important to note their app is free and is available for the iPad as well as the iPhone (did not see an Android version). Their site promotes “seamless automatic one-tap access to full text PDFs available” for a lot of universities (full list scroll to bottom) including Johns Hopkins, Harvard, Washington University, and Yale. Despite advertising the institutions using Read, they do not include information on their website for librarians to add their institution. You have email them to add your institution, according to a tweet from QxMD .

After you download the app you are asked to create an account by adding information about your profession, specialty and institution.  I find asking for profession and specialty to be annoying but I realize this is for their usage stats. If your institution is not listed you can still use the app but you will get a warning that you will only be shown free papers (Take note because this will be confusing later on).


Since my institution isn’t listed (it wasn’t listed for Browzine either, so we have a pretty equal comparison) I proceeded anyway without adding my it.


Next you are asked to select the specialties you would like to follow.  I chose Family Medicine because I know a few titles off the top of my head that are Open Access and would have free PDFs.


Once you select a specialty you are then asked to select journals to follow.  The first set of journals are ones within the specialty then you are presented with an A-Z list of all journals.  After selecting the journals you are also presented with a list of “collections” to follow. It appears they only have NEJM collections (which are subscription based and NOT free).

journals to pick


If you are paying attention to my screen shots and with the fact that my institution is NOT subscribed you will notice that there are an awful lot of listings for non-open access titles.  For example: Almost all of NEJM’s stuff is available to only to paid subscribers. While Annals of Family Medicine  and the journal Family Medicine are free and have no embargo period on their most recent issues, that is not the case with the rest of the journals.  American Family Physician and Family Practice are not free and have an embargo on the current 12 months.

Personally I find this to be an area that has great potential to be very confusing to users.  If the first screen says “By not selecting an institution you will be shown only free papers,” then as normal average person (not somebody who understands nuances institutional subscriptions, free Open Access articles, and embargo periods, which most doctors don’t) I would expect that everything I see from the first screen forward would be free.  In other words since I told the app I don’t have an institution AND it told me I will only be shown free papers, then I would expect the app to be smart enough to only show free journals or papers.  Instead, I am able to see free papers and subscription papers side by side, only when I click on them do I realize whether they are available. (If it isn’t available I get message indicating I can’t download the PDF)

Now you might be saying, well this whole mess is pointless if your institution subscribed to Read. No it isn’t pointless. In fact, I think it gets even messier, because no institution subscribes to every journal.  There will be occasions where a user is logged in as your institution and selects a journal that your library doesn’t subscribe to (but is available on Read’s list).  The average user doesn’t know what the library subscribes to and will become frustrated when they tap to read the full text of an article and it can’t download the PDF.  Who do you think they will call when that happens? The following discussion plays in my head even now, “But it is listed on Read and your library is listed Read, so why isn’t it available?”

A listing of all possible journal titles that isn’t synced to a library’s holding list nor has the ability to only show free article for those not affiliated with an institution is confusing.  Doctors don’t know what articles are free and what aren’t without trying to first get the PDF.

 After you are done selecting the journals you are presented with a very helpful guide explaining your screen lay out.  This is necessary because there is a lot going on.

The display is set up similar to a Flipboard style of browsing, showing “Featured” articles by default.  There is no clear explanation as to what determines an article to be “Featured.”  As I mentioned I selected these specific journals:  Annals of Family Medicine, Family Medicine, American Family Physician and Family Practice.  However, the bottom right article is from the European Heart Journal which I didn’t pick.  (Sorry it is the journal is very faint, I couldn’t get it any darker.) I am not opposed to having featured articles, I like the idea because it allows people to become aware of articles outside of their normal journals.  But, I would like to know where they get featured articles from. Is it based on a rating system or something else? (My guess is it based on their algorithm they mention in a comment on iMedicalApps.)

flipboard 1

Tapping Journals at the top bar allows you to flip through the articles within your selected journals.  The Collections tab just allows you to view the NEJM Collections (which currently are the only collections available and are not free).  The outline icon (underlined in yellow on image below, next to the star) is the Topic Reviews button.  It allows you to browse through “1000’s of outstanding topic reviews” which are organized from broad to narrow subjects  Again it is important to note that not all of the articles listed as topic reviews are free.


Tapping the star allows you to select articles as your favorites which you can tag with your own words or from a pre-selected list for easier retrieval. Below tagged an article Family Medicine, and while I was starting to type another word the auto suggest popped up.  The auto suggest while dynamic is a bit limited and I’m not sure where they are getting the rather long terms/descriptions.  It appears they are either journal article titles and/or topic review subjects.


IF you have a subscription, downloading the article is very easy, you just tap on the title and it tries to download the PDF.  You can email the PDF (if you have access), tweet it, share it on Facebook, add a comment, star it (which saves it as a favorite), or rate it with a thumbs up or down. If you can’t download the article you get the message “Paper could not be downloaded” and you are encouraged to either view the citation in PubMed or Add Proxy.  If you don’t have access to the full text you can still email the citation, tweet, Facebook it, comment, star it, or rate it.

no pdf

Finally users have the ability to directly search PubMed while within Read.  This would be useful if you read an article on a specific topic and you wanted to quickly search PubMed to see if there were other articles on the same topic.  However the search is so limited, it would just be better to use PubMed app you already have on your iPad or go to PubMed using your iPad browser.  I did a quick and dirty search on heart attack.  I have no idea what algorithems it uses when searching the text word heart attack but I get completely different results when searching PubMed directly. (I looked both within relevance and publish date, neither of which seemed to be close the the PubMed results.)  I searched using the MeSH term myocardial infarction and got similar puzzling results.

Finally, there is an issue regarding timeliness.  While Read displays the current issue for some journals, that is not the case with all journals.  For example the current issue for the Annals of Family Medicine (a free Open Access Journal) is January/February 2013, yet the most recent issue displayed on Read is the November 2012 issue. The same is the case for Family Medicine, and The Journal of Family Practice.  This is a problem within what I call the core journals as well. While BMJ, JAMA, JACC, and NEJM have the current issue available Lancet is two issues behind. Since many of the journals are current this could be an issue as to when their software hit the journal sites, perhaps it just needs tweaking with certain journals.  When many of the journals have the most current issue, it can be difficult to try and discover the ones that don’t. Kind of like find an needle in a haystack but the need moves, because the software does eventually get the most recent issue.

(I don’t remember noticing this within Browzine because their display was slightly different so I wasn’t as aware of the timeliness of the citation as I am within Read.  I will have to double check how timely Browzine is.) 

The good news is this app is free to users and free to libraries who want to make their journals available.  However, those libraries without straight forward proxy servers might have difficulty registering with Read. They would really need to contact QxMD to see if the two systems work together.  Doctors who like the idea of Flipboard for their medical journals will be happy with the display and function of Read. 

According to the comments made by Read on an iMedicalApps review, they feel their algorithmic curation of the literature is perhaps the greatest strength of Read. “Rather than simply relying on our users to tell us which journals they want to read, we use a combination of machine learning, semantic analysis, crowd-sourcing and proprietary algorithms to figure out which articles our users should likely be reviewing.”  I think it is  matter of personality as to whether doctors end up liking Read’s selections based on their algorithms or whether they prefer a different method of selecting/reading their articles.  However if Read’s algorithm determines what users should likely be reviewing then I have to wonder why their algorithms chose editorials, not articles, to display on the first Read page for JAMA. Are JAMA editorials more important that articles?

I think Read has a lot going on with it and a lot of potential but I am concerned about the fact that it only contains a few of the BioMed Central and PLoS titles which are Open Access and possible confusion regarding what is available full text and what isn’t.  In theory I know doctors shouldn’t care whether an article is full text, if it is relevant they should find a way to get it.  However, theory doesn’t always work in reality.  I have seen more doctors ignore relevant articles because they weren’t full text or they couldn’t figure out how to get the full text.  I have doctors who won’t click an order it button to order an article (FOR FREE) from our library because they don’t want to deal with it. I think there needs to be a better way for Read to work with institutions so that doctors clearly know what journals are available to them and what aren’t. Doctors assume that if they input their institution then what they see is what the institution gets, which is not always the case.


The Future of ePub Browsing

Sunday I got an email from my county library, Cuyahoga County Public Library, about their new online journal platform called Zinio.  Zinio is a company that allows my public library to provide access to many of their magazine subscriptions on to my iPad (as well as other devices) in an easy to read format. 

Here is a screen shot of the magazines that I selected to have on my iPad to read, all courtsey of my Cuyahoga County Public Library card.


I was also in the process of finding apps for our medical library’s libguide.  I sent a tweet out asking for suggestions and some people including Third Iron responded.  Third Iron is a company that produces the product Browzine.  Their company which is has many executives with library degrees or significant library experience, works to make online journals available in an easy browsing experience for the online user.

Tuesday I spoke with Kendall Bartsch about Browzine, what it does and how it might work for our library.  Browzine is very similar to Zinio.  Where Zinio is magazines, Browzine is scholary publications and with its share, email, download, features, (not available in Zinio) it quite frankly blows Zinio out of the water. 

Browzine allows people to browse scholarly publications and read the table of contents to the recent issues of journals.  It works with various publishers such as Springer, Wiley, AMA, Nature, etc.  It also works with Open Access publications.  Users download the free Browzine app (currently iPad only but they are working on Android).  When they login to Browzine it asks them to select their library.  If their library has a subscription to Browzine they can login and access their library’s subscriptions via the iPad. 

Browzine is a very new company, they have quite an impressive list of libraries who are either trialing the product or have a subscription, including Welch Medical Library, Medical University of South Carolina, Northwestern, and Washington University.  If your library doesn’t have a subscription to Browzine, or if you want to try it out and play with it you can still download the free app and select Open Access titles which enables you to view the table of contents and PDFs of the open access publications and journal articles. 

There are a ton of Open Access titles and if your library subscribes to Browzine then there are a ton of publisher titles that users can access.  With that large of a number of journals it would get tedious to scroll through or search for your favorite journals that you like to keep up with.  That is why you are able to save those journals in your own personal library shelf.  So when you access Browzine you can go directly to that shelf instead of searching through a bunch of other journals.

Here is a screen shot of Open Access titles in Biomedical and Health Sciences -Medical Science. If your library has a subscription your library’s name is where Your Library Identity is and your list of journals will be more than just the OA titles.  (Note: there are MANY OA journals, the picture below is just a small slice from the OA Biomedical & Health Sciences -Medical Sciences category.)


Here is a screen shot of my “favorite” journals that I like to read.  (Pretend I am doctor or researcher who likes to read these scholarly publications.)


Here is a screen shot of the table of contents for one of my favorite journals. The yellow inbox indicates I have saved that article on my iPad.


Here is a screen shot of the PDF of an article from the TOC and the options for emailing, saving, sharing, etc.


Browzine is compatible with iAnnotate (a popular PDF annotating app) and DropBox and Box as well as other programs. 

To say I was blown away was an understatement.  Finally now after all these years, people will be able to browse the table of contents easily AND connect to the article via the library’s subscription in an extremely easy way.  The concept of my own personal bookshelf is great.  The ability to export the articles is essential and thankfully is easy to do with Browzine.  Currently Browzine does not provide notifications when a new issue is available, however that is a feature that they are adding shortly.  When that does happen, users will see a little red bubble with a number next to their journals. 

As cool as Browzine is, they don’t work with every publisher yet.  (Publisher availablity list here.)  Also Browzine won’t work with database provided journals.  So for example, journals you get full text through CINAHL aren’t going to be available through Browzine. Perhaps that may be why LWW is not on Browzine? (LWW requires institutions to access journals through Ovid.)  However, for databases like ClinicalKey, which is an Elsevier product and has all Elsevier journals, one has to wonder if that will be in Browzine or if it will be considered a CINAHL (ClinicalKey and Browzine are both so new who knows).  If it is considered a CINAHL then that would be a shame since some libraries may look at ClinicKey as their Elsevier journal provider. 

While Browzine currently only does journals, I can see where this type of easy access can be applied to ebooks.  eBooks suffer from much of the same silo content problems as ejournals.  Each publisher has their own way of displaying and providing access.  You have to bounce around from provider to provider to view the ebook on your iPad (or even your laptop).  There is no easy way to find and access ebooks for medical libraries.  Most of our users don’t know how to find ebooks.  They sometimes check the catalog, but even then that is only a brief snapshot of some of the titles available.  PMC titles and other ebook collections aren’t always in the catalog because you are either waiting for the MARC records from the provider (in the case of large aggregators like Clinical Key with hundreds of titles) or you are simply unaware of the latest title that was added to the online collection. 

If we could get our ebooks to display like Browzine displays ejournals, I will jump for joy and quite possibly stop my ranting on the inaccessibilty of ebooks in the medical library. 



Should You Get Medical Books Via iBooks?

Sigh…. I hate ebooks.  I really do.  Dealing with ebooks is worse than refinancing your home loan.  Yeah the home loan has a ton of paperwork and dives into your private financial life, but the hoops you have jump through for ebooks makes me want to repeatedly bang my head on my desk.  (I’d bang it against my iPad but that cost too much to replace from repeated bangings.)

The article “Why you should avoid iBooks for your medical ebooks” on iMedicalApps is just another example of the frustration having to do with ebooks.  My major criticism about the post is that it isn’t news.  I mean really, is it a shocker that you can’t get your iBook somewhere other than your Apple device?  Does music and iTunes ring a bell to anyone?  This problem really isn’t unique to Apple and iBooks. What makes iBooks unique is that it doesn’t have an app that pretends to allow it to be read on another device.  You can’t download an iBook to an Android, Kindle, or Nook.  While that may be frustrating, at least most people should know that going in, which isn’t always the case with Kindle or Nook books.

First off… Downloadable ebooks are device dependent.  Don’t tell me that you can get a Kindle book on an iPad so Kindle books aren’t device dependent.  Pthbb.  I have the Kindle app on my iPad and there have been several times where I have wanted to read a Kindle book only to learn that certain Kindle book requires me to download it first to a USB or to my Kindle device.  Gee thanks, for making it a pain to get it on my iPad. 

All (with the exception of iBook) ebook platforms have free apps for reading their books on your “different” device.  But it isn’t always a simple to download and read the book as the cool television commercials or the apps claim.  It is a pain in the butt. 

If you get ebooks through your local public library the process can still be confusing.  Overdrive, a “leading full-service digital distributor of eBooks, audiobooks, and other digital content,”  enables libraries and schools to provide downloadable books to their clients.  They have an app for downloading and reading books.  Supposedly this app makes it easier for people to download and read an ebook regardless of the ebook format and their device.  All I have to say about the Overdrive app is that it is still confusing to the average user.  I am a librarian for God’s sake and I find it  confusing at times. 

If you aren’t a public library, you might consider Mathews ebrary to offer downloadable ebooks.  However their platform is confusing and clunky, it is difficult to even find the title you want to download.  It doesn’t matter what titles they have if they are difficult to find.  I don’t know how easy it is to download the ebooks to your device because we never made it that far. 

See where I am going here?  I don’t care if you have a Kindle, Nook, iPad, etc. I guarantee you that there will be a time when the title you want is only available in a format different from your device.  If you buy direct from Amazon, Barnes and Noble or Apple, you run the risk that the book won’t work on your “different” device despite having the app.  Equally frustrating is that the “all in one” ebook reader services such as Overdrive and ebrary are confusing from the design side of things and confusing from the download side of things because they are dealing with ALL ebook types and devices. 

Next…. Institutional subscriptions to ebooks, specifically medical, may not be device dependent but they aren’t the answer either.  This is somewhat related to ebook format and platform problems but like all things bought at an institutional level, the problems are different. 

UnBound Medicine and Inkling are companies that provide access to download ebooks to institutional users.  While it is fairly easy, their titles are limited and can be quite expensive as some charge as if you are buying an individual copy for every person.  

Other ways institutions get their ebooks are through publisher electronic site packages.  These aren’t downloadable ebooks.  You can’t highlight a paragraph or take notes on the ebook because they all live on the web and you are accessing them through your wifi or cellular connection.  These are books within MDConsult/ClinicalKey, AccessMedicine, Ovid/LWW, Wiley, Springer, Rittenhouse, EBSCO etc.  While these books aren’t device dependent they are just as much of  pain, but for different reasons. 

They are all in their own publisher created silos so searching their full text is difficult if your library doesn’t have a discovery tool.  Even if your library has a discovery tool, ease of searching depends on the discovery tool’s set up and your resources’ set up. 

Users are unable to take notes on these book “pages” and at the same users are looking at these sites trying to find the downloadable version.  They now are expecting books to be downloadable.  They see it online and that is nice but then they ask how they can get that same book downloaded to their iPad or Kindle.  Short answer, you can’t.  Long answer…publishers either don’t want to do it or don’t have infrastructure to do it.  Theoretically Ovid or Springer could partner with Overdrive to get their books downloadable. But I’m sure there is more to it than just partnering like that.  I’m not sure if they are only interested in creating their own site for downloadable books or if they just aren’t interested.  ClinicalKey/MDConsult and AccessMedicine probably won’t do downloadable because their books are within their larger information database site.  In other words those sites have more than just the ebooks, they offer videos, patient information, images, etc. 

So you have these major barriers to using ebooks but you also have a group of people who despite the complications are interested in getting them.  What I find most misleading about the iMedicalApps post is that it is directed only at Apple’s iBooks when the problems with ebooks is pervasive and really a pain across all devices.  Quite frankly it is a miracle that users have stuck with trying to get ebooks this long.  We are a society that finds waiting more than 20 seconds for an elevator too long, how long are we going to wait for publishers to get their act together on ebooks?

Notes from the #Medlibs Chat

Last Thursday (August 30, 2012) the #medlibs chat on Twitter discussed issues around ebooks.  The full transcript can be found here: 

We had a few new people join us in the discussion and some lurked, and we were glad to have them.  I want to thank everyone who participated, not only was it a great chat but you all made my job as moderator easy.

So what was discussed about ebooks?

  1. Findability – Most people reported this to be a big problem.  Some are using libguides to direct people to subject books. Some are cataloging them.  Others are doing web lists (either home grown or through EBSCO or Serials Solutions).  It seems that many are doing a combination of approaches that are sort of piecemeal and as @mscully66 mentioned “it’s inefficient as all get out!”
  2. Usability – There was a bit of a disagreement whether findability impacted usability or whether usability was its own issue.  Some said if they can’t find it they can’t use it, while others like @RyloLH think “usability is it’s own issues.” Regardless of whether findability is a part of usability, everybody could agree that ebooks are not user friendly.  Many mentioned the confusing packages like Dynamed/Skyscape, user confusion over single user licensing vs unlimited access, and inability to download.  @CarolinaFan1982 believes  the download process as usage barrier, he thinks the “download process needs to be more like it is for books I get from the pub. library, relatively easy”
  3. Portability and Devices -CarolinaFan1982’s tweet segued nice to ebook portability and devices.  It seems the biggest issue was multiple platforms causing the problems.  Patrons don’t know what book is on what platform and if it can be downloaded from that platform and if so in what format.
  4. PDA (Patron Demand Acquisition) – I erroneously labeled PDA as Purchase on Demand Access (what can I say it was 9:40pm and the Cleveland Browns were playing in the background.) Lots of people mentioned they were experimenting or beginning to start trials on PDA.  I think the best tweet during this discussion was changing the name PDA to DDA. @jannabeth tweeted “DDA = demand driven acquisition. We decided PDA had too many alternate meanings!” Many of us like using DDA instead of PDA.
  5. Usage – We finally discussed usage of ebooks.  A few discussed getting the usage stats on packages but not individual titles.  There was some interest in knowing the usage stats for individual titles within the larger packages.  

All in all it was a very interesting discussion.  I want to thank @eagledawg for giving me the opportunity to moderate, it wasn’t as scary as I thought it would be.  I was just more nervous that I would forget so I set every reminder and alert possible so I could remember.   In fact I became so engrossed in the discussion that I lost my husband for a brief period of time.  Long story, but I found him again.

If participating in the #medlibs chats sounds interesting, we will be doing it again next Thursday 9/6 (and every Thursday) at 9pm est.  Join us!

Medlibs Twitter Chat: Everything eBooks

This week I will be moderating the medlibs Twitter discussion that will happen Thursday 8/30 at 9pm Eastern for 1 hour.  (I hope I do as well as Nikki!)

Last week, we discussed and shared a link to the book, Rethinking the Reference Collection: Exploring Benchmarks and E-Book Availability.  This week will look at ebooks a little more in depth and their use in general, not just the reference collection.

Some ideas for discussion can be:

  • Findability -What are the best ways for patrons to find stuff? The catalog, A-Z lists, other?
  • Usability – How easy are they for patrons to use?
  • Usage – Are they getting used?  What is appropriate usage stats?
  • Portability and Devices – Where are people using them and on what devices?
  • Patron Driven Acquisition (PDA) – Who is doing this and what are your results?
  • Anything else that might be interesting

Anybody can join a medlibs chat, you don’t have to be a librarian, you just have to have an interest in the topic.  For more information on how to join a Twitter chat using hashtags check out this guide created by the usual moderator Nikki Dettmar.

I look forward to see you online this Thursday.  Even if you plan to lurk, please at least tweet us your name and where you are from (on Thursday at 9pm est.) so we can officially welcome you and answer any questions you might have.