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:

docphin1
And here’s how it looks in the iPhone app:

docphin2
 

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:

docphin3

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: http://techcrunch.com/2012/05/11/docphins-dashboard-for-doctors-expands-nationwide/

 An interview with Docphin co-founderMitesh Patel: http://www.imedicalapps.com/2012/08/questions-mitesh-patel-docphin-medical-journal-tool/

 Another Q&A with Mitesh Patel: http://www.healthtechinsights.com/emerging-health-technology-spotlight-qa-with-mitesh-patel-of-docphin/

 

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).

signin

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.

institution;

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.

specialties

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

collections

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.
help

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.

subject

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.

tagging

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.

 zinio

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.)

 oalib

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.)

 mylib

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.

toc

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

output

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?

Confusion on NLM’s Policies for PMC, PubMed, and MEDLINE Inclusion

Over at the Scholarly Kitchen, Kent Anderson writes of his frustrations regarding PMC, PubMed and MEDLINE and non indexed journals (particularly the start up journal eLife) in his post, “Something’s Rotten in Bethesda — The Troubling Tale of PubMed Central, PubMed, and eLife.”

I find myself both agreeing and disagreeing with Anderson. 

I agree there is a big problem with the blurring of the lines in the minds of most people (mainly doctors and researchers) regarding PMC, PubMed and MEDLINE.  PubMed houses the citations for PMC articles as well as the citations to articles in journals indexed within MEDLINE.  The problem is that to most normal people PubMed = MEDLINE.  I mention the blurring of the lines between PubMed and MEDLINE in post “Back Door Method to Getting Articles in PubMed: Is Indexing so Important?”  In my post I mention that doctors and researchers think of PubMed and MEDLINE as the same. I likened it to ordering a cola.  “PubMed and MEDLINE have become the Coke/Pepsi of medical databases.  Two different products but people use the terms interchangeably when ordering a cola soft drink.”  I even posted the email of a researcher friend further illustrating how they don’t distinguish between PubMed and MEDLINE and if the article is PMC it is in PubMed and that in their minds it is in MEDLINE.  At the time of my orginal post I questioned the point of actually indexing journal articles since researchers don’t search by index terms and they erroneously think PubMed is Medline.  All they have to do is get into PMC and it can be found in PubMed via keywords (which is how everybody searches these days).

Anderson’s main argument is NLM is acting as competitor to publishers and technology companies, by allowing certain journal publishers to bypass rules for inclusion into PMC and PubMed.  In his argument he brings up the journal eLife a “fledgling funder-backed journal” that was allowed include articles in PMC despite not having published the required 15 articles, not being indexed in MEDLINE, and PMC acting as the sole provider of the articles.  Not only is NLM circumventing the rules for inclusion to its databases but he believes that NLM is acting as the primary publisher to eLife because their articles can only be found on PMC.  Anderson uses JMLA and Journal of Biomolecular Techniques as other examples of journals that NLM acts as the primary publisher.  I don’t know anything about the Journal of Biomolecular Techniques but I disagree with JMLA serving as an example similar to eLife.  As I mention in my comment to his post on Scholarly Kitchen, JMLA has been around since 1911 so it has fulfilled the 15 article requirement and is published by a publisher (who is not PMC) and sends me the print 4 times a year. The journal is indexed in MEDLINE (since 2002).  Additionally the printed edition clearly states that the digital archives of JMLA are on PMC.  I went to PMC today (October 22, 2012) and the October 2012 issue is not available.  So the most recent issue is not online and PMC is acting as the a digital archive. Therefore NLM is not acting as the publisher of JMLA in the way he describes. In the case of JMLA NLM’s PMC is the secondary publisher that he describes, which is the case of many indexed MEDLINE journals. 

Unfortunatley I think Anderson’s argument misses a bigger issue.  The question of quality within the PubMed database.  As I mentioned there is confusion among PMC, PubMed, and MEDLINE.  People searching PubMed will find an article from the PMC that is in a journal that is not indexed in MEDLINE.  However people will erroneously think the article and and journal are in MEDLINE when in fact they are just in PMC.  By allowing non indexed journals into PMC, NLM is basically allowing a back door into PubMed, and by default into MEDLINE.  Of course NLM doesn’t see it as that, because they are one of the few people who can still see a distinction between PubMed and MEDLINE.  Their users (doctors and researchers) do not see the distinction.  To them PubMed is MEDLINE.  This calls into question the quality of the articles in PMC in journals that are not indexed in MEDLINE.   If the journal isn’t good enought to get into Medline then why is the article good enough to be found in PubMed? 

 

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: http://bit.ly/O7yrh4 

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 [email protected] 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.

Organizing eBooks

I feel like I am beating a dead horse when I mention the topic of ebooks, but it is one of those topics that I just can’t put to rest.  The reason I can’t put it to rest is because ebooks are wanted by our users but they are pain in the neck for librarians, users, and probably publishers too.  Users want downloadable books and unless a library subscribes to something like UnboundMedicine (which can be very costly) there aren’t a lot of options.  Most of our ebook providers still provide ebooks only via the web (you need a Internet connection either via WiFi or cell tower) to view them and they certainly aren’t downloadable. In addition to these physical barriers of ebooks, just finding them can be a challenge. 

 

Finding ebooks is like wandering through a maze but without the cool pattern.

Finding an ebook is like wandering through a maze but without the cool pattern.  In order to find an ebook medical library patrons must navigate the catalog or the web page or know the silo their specific title is hosted.  They run into more dead ends and switchbacks that it is frustrating and deafeating. Why?

The catalog is dead (but that is another blog post).  Users just really don’t search it.  They search Google or they will slog through the library website looking for ebooks to magically be listed.  We have so many ebooks from different vendor packages (McGraw Hill Access databases, StatRef, Ovid, Wiley, Springer, MDConsult, etc.) and it is pretty much impossible to create and maintain an accurate web list of the ebooks.We used to keep up  a web page on a title and subject basis  but with hundreds of titles (thousands once you add in OhioLink) the web list was impossible to maintain.  We also used to list our ebooks providers. We had a web page detailing that ebooks could be found at the following sites (then lsited all of the vendors like AccessMedicine, Ovid, StatRefe, etc.)   That wan’t helpful.  Users have no clue where each title is housed, so they don’t know to “just click on AccessMedicine to view the online version of Harrison’s.”  The big web page with links to AccessMedicine, AccessSurgery, OvidBooks, StatRef, Wiley, MDConsult, Safari Tech Books, was not helpful. 

Unfortunately we learned that we were thinking too much like a librarian when we tried to direct people to our ebooks.  What do I mean by this?  If you aren’t a cataloger think back to library school cataloging, and if you are a cataloger I appologize for my crude cataloging example.  We librarians have been ingrained to provide as many discover points to a resource that we can.  When we catalog a book we do it to the exact specific subjects (thus making a general subject search difficult) and we add all sorts of added titles, authors, subjects, etc. to make it more findable.  The idea is sound for cataloging, but it is VERY bad for web design and discoverability.  

We recently conducted a user survey of our website.  We knew it needed to be redesigned but we wanted to know how our users were trying to find things in order to create a better site.  The one thing that was stated repeatedly was that users did NOT want multiple ways for finding things.  They wanted one straight shot way and that was it.  As librarians we were brought up to try and think of all the ways people might try to find something and make it findable in those ways.  We designed our web pages that way.  It turns out our users viewed the multiple ways just like navigating a giant maze.  The added paths did not aid in discoverablity they just served as switchbacks causing user navigation confusion.

Because ebooks are in different silos and our users have abandoned the catalog, it is difficult to provide one single easy way of searching and accessing anything beyond a very small collection of ebooks.  EBSCO A-Z does now keep track of ebooks.  But that is such a new feature (released in 2011 or 2012) it is still really too new to be effective.  Batch uploading doesn’t keep author or subject changes/additions.  Information from the publishers is sometimes missing making the author search a crap shoot. We have consolidated the various ways users can find our ebooks down to two ways; search the catalog or search EBSCO A-Z.  Neither method is exactly ideal, somethings are in the catalog that aren’t in A-Z and somethings are in A-Z that aren’t in the catalog.  It isn’t the best method for finding ebooks, but it is an improvement over the multitude of ways we provided.  Still because I know my users are looking for ONE way to find ebooks, I am always trying to find out how other libraries best to do that. 

So how do patrons find your ebooks?  What methods are working?  What isn’t working?  Do they use your catalog?  If so how did you get them to use it and how do you keep up with the ebook changes?  Let me know your thoughts because I can’t be the only one banging my head against a wall when looking at ebook discoverablity.

ClinicalKey Brief Review

Over on iMedicalApps.com I wrote a brief review on ClinicalKey.  The post is direct more towards doctors rather than librarians but it is worth a read through for librarians. 

Over here I thought I would include a few things that librarians might find interesting about ClinicalKey.

I have to say that the front page of ClinicalKey where it has two large squares “For Institutions” and “For Individuals” kind of confusing.  While testing the product we had a couple of librarians who kept clicking the “For Institutions” square to try and search the product.  But they were confused because they kept getting into information about ClinicalKey for Institutions.  They thought they were supposed to click the “For Insitutions” button to search because they were in an institution.  We had to explain to them you just type in the box and hit the search button.  As a a librarian who often fields questions from users, I have a feeling this will be confusing for our users.  I am not sure which blue box they will click on but the boxes are just so large and so close to the search box it implies there are different accounts for different users.  I understand Elsevier wants to market ClinicalKey to both groups, perhaps they can find a less confusing design to do that.

Access to PDFs currently is a two step process for users.  Recently (just after I submit my write up to iMedicalApps) Elsevier required an additional login to access the PDFs.  Basically users must create a personal login and password to access the PDFs even while on the insitutional account.  If you have read my blog or followed me on Twitter for any amount of time you will know that requiring additional logins to common (not customized) content is a barrier to usage.  Patrons understand if they want to save articles, images, or customize the content they have to create a personal login.  Patrons do NOT understand the need to create a personal login to access regular content just to read. 

They are often dissatisfied with this additional login and they do one if not several of these things:

  1. Don’t use it. They quit, they don’t bother trying to get the PDF.
  2. Yell at the library because “we don’t have the PDFs” because it is asking for additional login.
  3. Get confused and try using every other login under the sun that they know.
  4. Repeatedly call the library for the special login (which we don’t have because it is a personal login).

The big thing is though, users won’t use it.  Plain and simple.  Plenty of librarians have usage data to back this statement up.  Creating a login to view the PDFs is a barrier. 

Now it is also a barrier for copyright piracy, which is one of the main reasons Elsevier has instituted the PDF personal login requirement.  They are also using the login information to generate usage statistics. They said that this information could help us understand usage but I am unsure as to what usage statistics we as librarians really care about that are the personal login level.  Really all I care about is overall usage, resource usage (which books & journals are being used), etc. 

There have been some librarians who have expressed their displeasure over the PDF personal login requirement.  As a result Elsevier has said they are investigating other alternatives.  I look forward to them making alternative adjustments so that they can eliminate the personal login requirement.

Librarians are going to have really look at their needs and what they want.  ClincalKey is a very nice (almost) all inclusive Elsevier product.  Subscribers get 900 book titles, almost all of the Elsevier journals (Nursing is not in ClinicalKey) and a ton of videos and images from the Elsevier books.  However as I mentioned in the iMedicalApps article, ClinicalKey is a bit like trying to take a drink of water from fire hydrant, there is that much Elsevier information.  As a result, institutions barely using MDConsult or find MDConsult to a lot of information, might be ovewhelmed by not only the price but amount of content.  Institutions looking to subscribe to ClinicalKey really should have ways to manage the amount of information because it would be silly or downright negligent to not have an link resolver to handle finding all of the ejournals, an established method to handle finding the ebooks (whether it is your catalog, home grown system, or a link resolver that does ebooks).  If you don’t have an easy way to manage the fire hydrant of information then you shouldn’t be getting ClinicalKey in its present form. 

Other things that I think need to be addressed are downloading (for appropriate use) of ebooks and how they are dealing with the FirstConsult app. 

The writing is on the wall, the horse has left the stable, use whatever metaphor you want but users are now expecting to download ebooks to their iPads to read offline.  This needs to be build into the system.  FirstConsult isn’t the only product that hasn’t done this, McGraw Hill’s Access databases, Ovid, etc. have not figured out how to create a ebook product that will check out books for download to users.  I am not sure how they do that while still keeping it within the larger product like ClinicalKey or AccessMedicine, but this is something that must be addressed now because users expect this. 

I realize ClinicalKey is too new to really have an idea as to what they are doing regarding apps.  But there should be some sort of statement or direction as to whether the FirstConsult app will continue on as is, or whether they will change things and make it more of a ClinicalKey app with FirstConsult.  Like the downloadable ebook market this is an area where our uses have specific expectations. 

Those of you who have tried or bought ClinicalKey what are your thoughts?  Those of you who don’t have it and don’t plan to get it what are your thoughts and reasons? Write a comment either here or on iMedicalApps
Thoughts on extra login for PDF and Librarian’s thoughts on ClinicalKey.