Technology

Privacy is Dying Fast, Are We Slow to Respond

Privacy is dying or already dead. People (myself included) freely tell the world about our activities through Twitter, Facebook, Instagram, etc.  But we have given up our privacy in even more subtle ways than social media.  I currently have 3 loyalty cards on my key chain, my grocer, pharmacy, and pet store.  That doesn’t include the several loyalty cards I have in my wallet, hardware store, shoe store, sports store, and sandwich chain.  Additionally I have 2-3 apps that are loyalty cards like Shopkick and Cartwheel.  All of these cards and apps give me discounts (some very substantial).  In exchange these stores know exactly what I buy, how often, whether I use coupons, and probably a bunch of other things.

I know there are a lot privacy advocates in the library world.  Along with finding information and connecting people to resources, privacy is important to our profession, especially in the medical world.  Of my friend and colleagues make statements that they would never give out information to people or companies yet the post on social media and they shop at Costco.  We as society have been gradually giving up our privacy in return for convenience or money (discounts and cost savings).

This type of behavior is not going to change any time soon, in fact the next generation is even more willing to give up their privacy.  What is interesting (disturbing?) is that they don’t even think of it as privacy.  A few months ago I saw the Frontline report, “Generation Like.”  The report primarily looked teenagers and the complicated relationship between themselves and the big-name brands they like and actively promote on social media. Not only are the brands are constantly working to target them but the teenagers are actively trying to target their own peer group in the form of likes and comments to gain popularity and fame.  The teens told FRONTLINE that social media makes them feel empowered. The most successful or most popular social media teens are rewarded with all sorts of free products to the point a few have been able to make a living off of their social media posts just from the brands they mention.

I am by no means new to social media, and this was a huge eye opener to me. While I realized the brands mined the data and rewarded those who mentioned them on social media, I had no idea how extensive and deep the rewards went.  But the biggest eye opening moment wasn’t specifically a moment but the repeated sight of these teenagers who so completely bought into it all and didn’t think twice.  In fact after the Frontlined aired the show, most of the teenagers reportedly were excited about getting even more popularity online because of their presence on the show. None of the teenagers blinked twice about the fact that they were giving so much of their privacy away. One interviewer asked the kids about whether they felt like “sell outs” by promoting everything, and the kids didn’t even understand the question.  One even mentioned they didn’t know what a sell out was.

As disturbing and fascinating as this Frontline report was, it made me realize that the concept of privacy is either dead or it will be by the time the teenagers of today are in the workforce tomorrow.  So why is this important? Aren’t we librarians the champions of privacy?  Yes but should we?

I am not talking about disclosing financial data, medical information, or blabbing to the next patron about another’s circulation record.  I am talking about our own information systems working with data to provide a more customized and convenient experience.  Our ILS immediately clears the record of a book from a patron’s record once it has been returned.  That protects our patrons privacy.  But how many of our patrons want a record of what they borrowed for their own purposes?  I have been asked many times in my library career if I could “just look up the last book they checked out because they forgot the title” or a variant of that question.  Personally I love how Amazon knows what I was buying, looking at, and can link my purchases to what others have bought.

My question for librarians is whether our own information system’s restrictions on privacy will ultimately hurt us as the next generation comes to expect more connectivity and convenience.  Like the current teenagers now, will they be fine with giving up a certain amount of privacy so that their experience is better?  If so what kind of systems do we design (or should we) that can balance the privacy line of information that people are willing to give up (or no longer consider private) vs what we still consider private.

Don’t get me wrong, I am not advocating libraries drop their privacy stance, but I am wondering as society’s views on privacy change, how are we going to change.  Obviously education is key.  People don’t always know what they information they are giving up and how it is being used.  However, there things are changing where people don’t care about certain once private things.  So how are we to respond in the future and will that response help us or hurt us?

I’m just thinking out loud, what are your thoughts? (BTW if you leave a comment think about how you are relinquishing some of your privacy and how you are ok doing that now and whether there was a time when you weren’t….you don’t have to put that in your comment, just something to ponder.)  As I tell my kids anything you put online is there forever. Sometimes that is good, sometimes not.

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Be the first to comment - What do you think?  Posted by KraftyLibrarian - September 18, 2014 at 11:36 am

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Wanted: Librarians With Good IT Relationships and Knowledge

The Southeastern/Atlantic (SE/A) Technology Program Advisory Committee (PAC) has been outlining their goals for the coming year to try and best to meet the needs of their members. One of the Tech PAC’s multi-year goals (based on the results of the survey given in 2012), is to address technology issues some librarians face daily professional lives.  They are planning a series of webinars on the topic and they need your help.

The first webinar will address relationship-building between libraries and the technology departments which support them.They would like to feature the partnerships of one or more librarians and their tech people on the webinar.  So if you are BFF’s with your tech people or just merely have a good working relationship then they would like to use you to serve as models for the medical library community.  **Krafty Note** HOSPITAL LIBRARIANS….You are especially important in this area. Many hospital IT department have vastly different and considerably more strict policies than academic institutions which sometime make being a librarian’s job more difficult. So if you are a hospital librarian with a good working relationship with your IT people, then please, please, please consider contacting the Tech PAC.

The second webinar in the series is tentatively titled, “How to speak IT,” and will focus on defining and contextualizing basic IT terms. We know librarians have our own geek speak; ILL, PDA (not kissing), MeSH, etc. Well, IT has their own geek speak as well and if you two aren’t speaking the same geek it can make communicating a bit difficult at times. For example (not library related): A woman today told me my face look BEAT!  I was bummed. I was well rested (unusual when you have 3 kids) and I actually looked in the mirror and put on make up before I went to work. I thought I looked good.  The woman seeing my confusion said, “That’s a compliment. You look really good.”  She said that makeup artists and others use it to mean on how stunning somebody looks, especially their makeup.  I felt very happy…that is until I realized I am now so old that I don’t know what “kids” are saying these days.

The Tech PAC is looking for a good IT geek speak “explainer” who would be willing to participate as a speaker to help librarians out there speak a little IT geek speak. If your IT guy says to you, “A VLAN configuration issue has surfaced between our new Web app and the SQL back end,” and your brain translates it to, “The network configuration needs adjusting before we go live,” then Tech PAC wants you.

Finally, Tech Pac is also asking for ideas for future webinars and other programs based on librarian technology needs. So contact them via Twitter (@KR_Barker) or email (Grumpy_Cat [atsign] virginia.edu) if you have ideas or can help them with one of their two webinars.

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1 comment - What do you think?  Posted by KraftyLibrarian - July 31, 2014 at 11:20 am

Categories: Educational Opportunities, Other Medical Library Stuff, Technology   Tags:

Hospitals Still on Windows XP Could Mean Loss of HIPAA Compliance

Roughly two weeks ago MLA released a new version of its website.  Right away librarians stuck (due to institutional standards) on IE 8 started complaining that the new MLA site did not display properly on IE 8.  The good news is that the folks at MLA know of this problem and are working with the web developer to fix it and others.  The bad news….the number of librarians stuck on IE 8 might be indicate a bigger problem for hospitals as a whole.  My guess (and this is totally hypothetical) is that a many people who are stuck on IE 8 are stuck because they can’t upgrade to IE 9+ because they are on Windows XP.

My husband works for a company that creates an enterprise content management software system that is used by over 1,500 healthcare provider organizations representing more than 2,500 facilities.  Sometimes our jobs deal with similar issues, sometimes they do not.  This is one of those times that they did.  I happened to mention the whole IE 8 problem with my husband and I think I started to see smoke billow out of his ears.  Since the kids were already asleep for the night, I figured I touched on a hot topic.  He told me that this has been a big problem in healthcare and banking for several years.  Many of the hospitals running IE 8 are also the same organizations that are still running Windows XP.  (While IE 8 can run on Windows 7, IE 9+ cannot run on Windows XP.)  Not only did his company decide to stop supporting XP they recently decided to no longer support IE 8.

Windows XP is NOT supported by Microsoft. Being on Windows XP is a security risk.  Just yesterday the Wall Street Journal, reported on a newly discovered security hole in Internet Explorer versions 6-11 in the article “New Browser Hole Poses Extra Danger for XP Users.” According to the article the “coding flaw would allow hackers to have the same level access on a network computer as the official user.”  Yeah I echo the WSJ in saying “that’s really bad.”  Microsoft is working on a fix, but that fix will not be available to XP users.  The Forbes article title “Microsoft Races To Fix Massive Internet Explorer Hack: No Fix For Windows XP Leaves 1 In 4 PCs Exposed,” pretty much says it all.  A 13 year old operating system still represents 25% of the world’s PCs.  The cyber security software company, FireEye,  revealed a “hacker group has already been exploiting the flaw in a campaign dubbed  ‘Operation Clandestine Fox’, which targets US military and financial institutions.”  While the WSJ article says FireEye said attacks were mainly targeted at IE 9-11, this security flaw is still a major problem specifically because Microsoft will not offer a patch for XP.  Basically once Windows Vista, 7 and 8 machines are patched….what system is left to hack? One that doesn’t even have a patch and users refuse to upgrade.

It isn’t like the XP rug was pulled out from under users.  On the contrary, XP users have know for 2 yrs that XP would be unsupported.  According Forbes, Microsoft “repeatedly sent a pop-up dialog box to reachable Windows XP machines” with end of support information.  Software developers including my husband’s company have warned customers that XP will no longer be supported by Microsoft and as a result they will no longer write software for XP nor support software on XP machines.  My husband told me how they have contacted their hospital clients of regarding XP yet the clients haven’t upgraded nor have any real plans to upgrade immediately.

So we get the fact that have a operating system that is no longer support is bad and could lead to security problems.  But when your a hospital and the security of patient information is paramount to your existence, second only to treating patients, then you have a major problem. The HIPAA Security Rule section 164.308(a)(5)(ii)(B), organizations with sensitive personal health information are required to protect their systems from  malicious software.

Several articles have stated that failure to upgrade from Window XP is a violation of HIPAA.

Mike Semel’s article states, “Just having a Windows XP computer on your network will be an automatic HIPAA violation— which makes you non-compliant with Meaningful Use— and will be a time bomb that could easily cause a reportable and expensive breach of protected patient information. HIPAA fines and loss of Meaningful Use money can far outweigh the expense of replacing your old computers.”

Sound a little drastic?  It doesn’t seem so when you look at Laura Hamilton’s interview with HIPAA attorney James Wieland,

Additive Analytics: Let’s say that a hospital computer is still running Windows XP after the end-of-life (EOL) on April 8. Then a virus compromises the machine, and attackers steal personal health information (PHI). What are the legal ramifications for the healthcare provider?

James: On those facts, it would certainly appear to be a breach, reportable under the HIPAA breach notification rules to the individuals and to the Secretary. Breaches are subject to investigation and may result in penalties.

Hmmm we just found out that there is a major security flaw with Internet Explorer which could lead to a breach and machines running XP will NOT have a fix from Microsoft. What happens when the hacker group that FireEye discovered (or any hacker group) decided to exploit the healthcare side of things?

To me the IE 8 design problem for MLA.net opened my eyes to the greater XP problem within healthcare.

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6 comments - What do you think?  Posted by KraftyLibrarian - April 28, 2014 at 11:40 am

Categories: Other Medical Library Stuff, Technology   Tags:

Adding Value to EHRs: Librarians and Infobuttons: Free Webinar

Hospital librarians are asking how they can show their value to administration and how they can show that they are more than just the keepers of the books.  The answer is to branch out and get out of the library and do something that is related to the library but is not always thought of by others.  Participating with EHR team to provide information to caregivers is a great example.  This webinar not only will discuss librarians, EHRs and Infobuttons, but it will also highlight successful approaches for getting relevant information into the EHR and librarians can round with caregivers to help at the point of care.

Not only is this webinar interesting but it is also FREE! So you have little to lose by attending it.

Title: Adding Value to EHRs: Librarians and Infobuttons

Time: March 19, 2014, 10:00 – 11:30 am EDT.

Course length: 1.5 hours

 *Registration Required

http://nnlm.gov/ner/training/register.html?schedule_id=2751

(description from the NN/LM NER website)

This webinar is being planned as the first in a series sponsored by the NN/LM, NER on ways librarians can add value to electronic health records.
Additional webinars are in development.  The overall goal of this webinar is to give medical librarians an understanding of clinical decision support mechanisms in electronic health records (EHRs) and to increase awareness of the ways that librarians can contribute.  An understanding of the ways that library resources can be integrated into clinical decision support will empower librarians to pursue this in their own institutions.

Guilherme Del Fiol, MD, PhD, University of Utah, School of Medicine will present results of a systematic review on clinical questions raised by clinicians and tools that help answer these questions by integrating EHR systems with online knowledge resources.  He will also discuss how these tools are being disseminated via the “HL7 Context-Aware Knowledge Retrieval Standard” (a.k.a., Infobutton Standard) and the EHR Meaningful Use certification program.

Taneya Koonce, MSLS, MPH, Eskind Biomedical Library will share the Eskind Biomedical Library’s successful approaches for integrating highly relevant evidence into the institution’s electronic medical record, outpatient ordering systems, and online patient portal.

Lauren Yaeger, MA, MLIS, St. Louis Children’s Hospital Medical Library will talk about clinical librarianship/rounding with the patient care team, Evidence Based Medicine Quality Initiative Project with the residents, and integrating clinical decision support at the point of care.

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3 comments - What do you think?  Posted by KraftyLibrarian - March 11, 2014 at 9:32 am

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Call for Virtual Projects for JMLA Column

(cross posted in a lot of places)

Virtual Projects for JMLA Column by March 15, 2014

The Journal of the Medical Library Association (JMLA) Virtual Projects Committee is seeking innovative and notable projects for the upcoming JMLA Virtual Projects column. The annual column which was launched in October 2013 (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3794676/) focuses on library virtual spaces that extend the library “presence” outward to support users in their digital spaces, wherever and whenever needed.

The JMLA welcomes submissions of recent projects for the Virtual Projects column that will be published October 2014. To be considered for this column, please submit a 200 word abstract of your virtual project or a link to your project web page that describes the project and why it is innovative/notable. Send your submissions to Susan Lessick, AHIP, FMLA, [email protected], by MARCH 15, 2014.

Some examples of virtual library projects :

  • projects that demonstrate the integration of evidence and/or digital content and library services into the institution’s Electronic Health Record (EHR) as part of the treatment and care process
  • projects related to providing new technologies, such as libraries providing collections and tools to support 3D printing or offering 3D services (‘makerspaces’)
  • projects that improve the quality of the library’s web presence through the implementation of a new web design, feature, or tool, such as animation, user interactivity or webpage/site builders
  • projects that facilitate information discovery and content delivery (e.g, use of web-scale discovery or knowledge bases)

Please consider sharing your knowledge and experiences with implementing virtual projects in your library to inspire and encourage your peers, partners, and communities!

JMLA Virtual Projects Committee:

Kimberley Barker
Janis Brown, AHIP
Michelle Kraft, AHIP
Susan Lessick, AHIP, FMLA
Eric Schnell
Elizabeth Whipple, AHIP

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Be the first to comment - What do you think?  Posted by KraftyLibrarian - February 27, 2014 at 10:09 am

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NEJM Publishes Erratum After Social Media Peer Review

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

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

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

ARE THE STATS CORRECT?

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

If you can PLEASE COMMENT HERE!

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

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

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

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

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

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

 

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

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

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

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

 

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Be the first to comment - What do you think?  Posted by KraftyLibrarian - January 14, 2014 at 10:40 am

Categories: Journals and Books, Social Media, Technology   Tags:

The Future of Libraries: Free Discussion

American Libraries Live will be hosting a panel discussion on the challenges and changes within the libraries for the near and distant future.  It is Thursday January 9, 2014 at 2:00-3:00 Eastern.  It is FREE to register and “attend” the discussion.

David Lee King, digital branch and services manager at the Topeka & Shawnee County Public Library will lead the panel which also includes:

  • Marshall Breeding, Library Technology Consultant, Speaker and Author
  • Buffy Hamilton, Librarian at Norcross High School in metropolitan Atlanta, Library Technology Writer and Speaker
  • Bohyun Kim, Digital Access Librarian at Florida International University Medical Library
  • Joseph Murphy, Director of Library Futures, Innovative Interfaces

 

Register for this episode so you get email reminders at http://goo.gl/1p5dpV .

Preregistration is not required to attend. You can also attend by simply going to the site at the time of the event. If you’re unable to attend live, it will be recorded and available at http://www.americanlibrarieslive.org shortly afterwards.

Innovative Interfaces is sponsoring this episode. AL Live is the popular free streaming video broadcast from American Libraries, covering library issues and trends in real time as you interact with hosts via a live chat and get immediate answers to your questions. With the help of real-time technology, it’s like having your own experts on hand. Find out more, including how to catch upcoming episodes, at  http://www.americanlibrarieslive.org .

 

Future 2014 broadcasts will be:

  • February 13: The Library Website
  • March 13: E-Books: The Present and Future
  • April 10: Copyright Conundrum

 

Sounds interesting.  While they don’t have an medical librarians, I’m sure there will be something that will also apply to us.  Since our ILS is an Innovative Interfaces system, I am curious as to what Joseph Murphy of Innovative has to say.  I often think integrated library systems including Innovative’s are overly complicated and fail to address typical user needs. I am also interested in the March 13th E-Books discussion but I fear this will be more public library related and less related to the unique mess the medical publishers have created.

 

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Be the first to comment - What do you think?  Posted by KraftyLibrarian - January 6, 2014 at 10:27 am

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#Medlibs Killing Cows

Join us tomorrow for what is sure to be a lively discussion on killing sacred library cows on #medlibs this Thursday at 9pm Eastern.

As I mentioned in my post on the #medlibs blog

The library environment has changed drastically and is continuing to do so.  The library of 5 years ago is different from the library today.  For example, the iPhone had just been released, there were no iPads and the idea of a “downloadable” ebook had just been introduced by Amazon Kindle.  There were a very limited number of Kindle and certainly not intended for medicine. Yet many of us are doing the same things we did as librarians 5, 10, 15, 20 yrs ago.  We were stretched thin back then, so there is no way we can now add things to our repertoire without giving up something in return.  We must look at what we do in our own libraries and evaluate whether it is necessary, whether it helps our patrons or helps us.  To really evaluate our services we need to look at EVERYTHING including the sacred cows of the library.  We need to ask ourselves, do we need to check in journals, catalog books, make copies, eliminate the reference desk, fuss with circulation, etc.  The right answers will depend on the library. A large academic library might need to still do cataloging but does a small solo hospital library with 4 shelves (not ranges) really need a catalog system much less spend time cataloging books?  Some of these ideas are dangerous and even somewhat heretical librarian thinking, but I feel we need to discuss them.  For more background on sacred cows and heretical librarian thoughts check out my summary of my keynote address I gave at the Midwest Chapter annual meeting.

 

We need to look at, evaluate and slaughter some sacred library cows.  IT makes no sense for us to spend our time doing things that are no longer relevant or used by our patrons.  That isn’t to say that we should have never done them. Everything has its time and place.  It might be hard to give up, but we can’t just do things because we always have.  We need to think like our patrons and for many of us that means completely taking off our librarian hat and looking at ourselves from a patrons view point.  That may mean we come up with answers that are uncomfortable, that borderline on librarian heresy.  But that is what is needed.

This Thursday’s #medlibs discussion at 9pm Eastern will discuss the idea of thinning the herd of library services so that we can grow healthy new opportunities.

Molly Knapp (@dial_m), Amy Blevins (@blevinsa) and I (@krafty) will be moderating the discussion.  As always we will be using the hashtag #medlibs but if you want to further the discussion before/during/or after the regular Thursday night time use the hashtag #moo.

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Be the first to comment - What do you think?  Posted by KraftyLibrarian - December 4, 2013 at 3:48 pm

Categories: Educational Opportunities, MLA Events/News, Technology, Twitter   Tags:

iPad Use & Value is Related to Hospital’s Infrastructure

The iPad is the new darling of the hospital world.  Depending on who you talk to, it can do almost anything.  Perhaps that is why some groups are jumping into the iPad arena before they are ready.  The adoption of any technology depends heavily on whether an institution has the infrastructure to support it.  Here is an example of one residency program testing the use of an iPad before its hospital had the infrastructure to support it.

The article “Resident Impressions of the Clinical Utility and Educational Value of the iPad” published in the November issue of Journal of Mobile Technology in Medicine tried to determine the value of the iPad during clinical rounds and for education.   The authors from Riverside Methodist Hospital gave 119 residents an iPad to use during the 2011-2012 academic year.  The residents gave their opinions on the clinical utility and educational value of the iPad.  The results were disappointing.  “The iPad received low marks for daily clinical utility (14.7%) and efficiency in documentation (7.8%).  It was most valued for sourcing articles outside the hospital (57.8%) and as a research tool (52%).”  Basically residents did not place a high value on the iPad when used in clinical rounding or as an educational tool.

Yes the residents didn’t find the iPad to be useful during clinical rounding, but that is because the hospital really wasn’t ready for the iPad, or any device, to helpful during rounding.

At the time the article was written, the hospital was still writing orders on a paper based chart.  Moving from paper to the iPad is quite a jump for people and hospital technology.  “All resident groups reported problems with utilization of the iPad for medical documentation/progress notes.” If the hospital is still writing orders on paper based charts perhaps it isn’t the iPad to blame but the fact that the hospital hasn’t adopted writing orders electronically.

In addition to writing orders on a paper based chart, the hospital’s other infrastructure items clearly were not ready for the use of iPads.  Further in the article they discuss connectivity problems and EMR access problems.

Connectivity –  “All resident groups noted problems with iPad login-in and connectivity/WiFi.  During the academic year 98 tickets specific for iPad set-up and connectivity issues were reported to Information Technology services.”  Now the authors do mention that it was 98 tickets out of 182,000 global tickets, but when you only have 119 people using iPad, 98 tickets is not good.  Anybody who has been in a deadzone can relate to the frustration of losing network access. Relying upon a network device for clinical use when you have poor connectivity (or difficult to access WiFi) is like relying on a cell phone service in the mountains after a winter storm.

EMR access – Residents were asked to recommend apps and medical tools for the iPad.  “The single most frequently cited application was Riverside’s electronic medical record.” The method by which they access their EMR makes it cumbersome for somebody with an iPad to access it.  “Our EHR is access via remote desktop, requiring a two-step login process.”  So the device that they wanted them to test its clinical use, does not have easy access to the EMR, a major clinical application.

The authors of this study suggest that residency efficiency “may be less positively impacted by the use of the iPad than previously reported.”  I believe the authors are both right and wrong to make this statement.  The authors clearly listed several hospital wide infrastructure issues creating barriers to online access.  “Though log-in and connectivity issues were noted as a significant problem, technology support was rarely utilized.  Residents often found it faster to use a computer than reporting difficulties.  Additionally, electronic order entry is not available at our hospital.”  Not only do these statements reveal the hospital wasn’t ready for adoption of the iPad or any tablet device, but it reflects their residents’ attitude toward their help desk and the speed at which they need things to work to get information.  I think the authors would have been more accurate if they had stated, residency efficiency may be less positively impacted by the use of the iPad if the hospital is not adequately prepared ahead of time for the use of mobile devices.

To study the use of the iPad in a clinical setting when the clinical setting is clearly not ready, is like testing the use of a car in an area where there are no roads.

I look forward to reading other iPad studies where the hospital is not the barrier and we can better determine whether the iPad (or any other tablet) is of clinical value or not.

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Be the first to comment - What do you think?  Posted by KraftyLibrarian - November 19, 2013 at 12:48 pm

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Sacred Cows and Heretical Librarians

Last weekend I had the wonderful opportunity to be the keynote speaker for the Midwest MLA Chapter meeting.  It was a great meeting and I learned so much from so many people.  I LOVE Chapter meetings.  Ask me and I will tell you, the Chapter meeting is a great place to share and learn from other in a much more scaled back and doable scale than the large MLA meeting.  That is not to take anything away from MLA, I just think that a Chapter meeting is more intimate.

Some people at the meeting asked if I was going to post my slides from my presentation.  Yes, they are on SlideShare and I have re-posted them here.

Emerging Technologies & Evolving Library from Michelle Kraft
These slides don’t have a lot of text.  So I feel there needs to be a bit of outline of what I talked about to give them some context.  So here is a brief summary of what I talked about….
Technology is disruptive.  That doesn’t mean it is bad or good, it just changes everything we do.  It could change things for the good or the bad.  An example of a very disruptive technology is the light bulb.  It completely changed the way we as society do things.  Thinking of more recent technologies, the phone is another disruptive technology.  The telephone changed how we communicated to each other.  The cell phone disrupted things again.  Not only were are we able to communicate with each other over long distances, but we can do it wherever and whenever.  The smartphone just ramped things up even more by making our phones the necessary multi-purpose tool of our lives.  We use it to communicate (text, voice, email, Twitter, Instagram, etc). We use it as our own personal computers to find information online and store/create documents. It is our entertainment center for music, movies, books, online radio and podcasts.  The cell phone (among other technologies) have changed we as a society find and share information.  It is has changed the way people find and share information in libraries.  Think of what future technologies will be like and their impact on libraries.  Think of the latest technology, Google Glass, and library possiblities.
People access library websites through their phone… OR they are bypassing the library website all together and using an app (journal app, library database app, library catalog app, etc.) to find information.  They are accessing all of this information wherever and whenever….in the cafeteria, bathroom, in bed, etc.  This change in society’s behavior requires us to change the way we do things.  We must adapt to the changes in society or we face extinction.  Other professions that are dealing with changes in society as a result of technology: US postal service, newspapers, photo journalists, etc.
My presentation was not a doom and gloom thing.  On the contrary…. I said we needed to look at these disruptive technologies as opportunities.  They provide us the opportunity to shape our own destiny.  They allow us to take our services and resources and put them together in different ways to adapt to the changes.  Think of your resources and services as Legos, each one can be put together in different positions.  If something changes or doesn’t work, change the Lego’s position or swap it out.
Swapping out Lego pieces sounds easy but it may not be as easy as you think.  Libraries need to look at the changes in society and start asking themselves some hard questions.  Are the services/resources we provide for ourselves or for our users.  We do a lot of fooling ourselves that some of our traditional services/resources are for our users when really they are for ourselves.  For example, why are we checking in print journals?  Why do we even have print journals?
We need to look at our sacred cows in our library.  We need to evaluate whether we should keep them or kill them.  We can’t just keep them because we have always kept them.  Cows (in real life and virtual) need to be fed and maintained.  If feeding and maintaining them serves a valid purpose to our users, then we should keep them.  If they don’t, then we need to kill them, or they will eat food and take up space of other resources.  I gave several examples of sacred cows.  The one that everybody seemed to latch on to was my cataloging example.  I asked the question, “Do you need a catalog or would an A-Z list suffice?”  Predictably a few catalogers freaked.  What I tried to convey…
  • If you are at a large academic medical institution or even NLM you need a catalog….BUT do you need to catalog the way you are doing right now? Could you be more agile?  Could you do something slightly different?  We are too entrenched in the way we catalog things.
  • If you are small hospital library with only a few shelves of books, you may not need a catalog.  I know it is crazy to think that, but you may not. Perhaps an A-Z list or *gasp* an Excel sheet posted online will do.  Maybe you could tag your holdings in Library Thing.
  • If you are a small hospital library with more than a few shelves of books, but nowhere near what an academic library has perhaps you need a catalog. But do you need to add anything to the catalog other than what our users care about?  Most users only care about title, author, year, edition, URL, and table of contents.  They don’t care if it is 24 inches tall, illustrated and has 246 pages.  Do you need to catalog using MeSH?
Evaluating these sacred cows may cause us to think some pretty heretical librarian thoughts.  The idea of not cataloging is pretty heretical. don’t get stuck on my catalog example.  One hospital librarian at the conference mentioned they did something pretty heretical, they stopped doing research and providing articles to people who were going back to school. She told them they needed to get their research help and articles from the library of the school they were attending.  She said it was a pretty heretical thought to her staff at the time.
Wikipedia’s definition of heresy: “Heresy is any belief or theory that is strongly at variance with established beliefs or customs.”  Long established customs may not be what we need now as our society changes with technology.  In order to evolve we need to look at our services and question our long established services and see if they are really needed or helping us go forward.  If not, why are we doing them?
In sum we need to look at the sacred cows and start thinking heretical librarian thoughts.  We need to always keep trying and never give up.  Let’s not be afraid of failure, failure just tells us what doesn’t work.  We need to know what doesn’t work, to know what does.
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2 comments - What do you think?  Posted by KraftyLibrarian - October 9, 2013 at 1:35 pm

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