Newbie Medlibs: Experiences

One of the reasons I like Twitter is that I can follow or read about new people with interesting ideas.  On Monday, Steven Chang tweeted a link to his blog post about his experiences and reflections on his first month of being a hospital librarian.

Steven Chang's tweet about being a new hospital librarian

His blog post had me thinking about newbie medical librarians and the support (or lack of support) they have as they start their new jobs. Steven is a medical librarian in Australia, so his library school experience might be a bit different than those of us who got the MLS (or equivalent) in the United States.  I can only speak of my experiences of when I was in library school.  That was many many years ago, I have been a professional medical librarian for over 15 years. My first job out of library school was in a hospital library. While it was a eye opening experience, I feel that I was more prepared than other newbie librarians entering the medical library workforce. I was lucky because the University of Missouri’s School of Information Science & Learning Technologies had several courses for those interested in medical librarianship. Unfortunately, now they only have a course on Consumer Health :(  My course work wasn’t the only thing that helped me.  The wonderful librarians at the J. Otto Lottes Health Sciences Library at the University of Missouri were the people who helped connect the crucial dots in my medical librarianship training.  I did a practicum there and quite frankly that experience helped me out tremendously.

Reflecting on my time in library school got me thinking about things I wouldn’t have known had I not had course and practicum work focused on medical librarianship.

Things that I wouldn’t have known about:

Docline – Medical librarians use a totally different Interlibrary Loan system than every other librarian I know of.  While we do use OCLC for books, almost all of our ILL requests are journal articles and the National Library of Medicine has its own unique ILL system (Docline) that deals with this and this is what every other medical library uses to get articles.

Controlled vocabulary – Oh I learned about it sort of while taking the required cataloging class and my optional indexing and abstracting class. While some databases use subject terms, very few library databases have the structure and the type of control over search terms that MEDLINE does. I did not fully “get” the idea of controlled vocabulary for searching until I started really working a lot with MEDLINE.

The IRB – The institutional review board is the ethical review board that is used to officially approve, monitor, review research involving humans.  Almost any study or survey done within Hospitals and academic medical centers needs to be run by the IRB. This also means your library surveys might need to be run by the IRB.  Since librarians are not studying drugs, therapies, or treatments on patients, it is usually is a pretty straight forward approval process or they simply give you a letter saying you don’t need IRB approval.  However, it is always best to check before you do your own survey or study. This was never ever mentioned in library school. I don’t know of public librarians needing board approval for a study.

Resources – Ok this is sort of a catch all. My library school’s reference class provided a sort of “fly by” of all types of resources that one would in encounter in a general academic or public library. I found that to be a very helpful class as it gave me a sampling of what I need to know to learn the basics of reference and to understand the concept of the reference interview.  However, there are WAY more medical resources out there.  It wasn’t until I did a medical resources class and my practicum did I begin to scratch the surface of medical resources.  BTW my library school life was way before UpToDate, MDConsult (now ClinicalKey), Scopus, Web of Science, etc.  Journals were just starting to go electronic and there were no ebooks.  The Internet and online publishing and multi-media have exploded the amount of and type of medical resources available online compared to when I was in library school.

Carla Funk mentioned at a meeting (I want to say Section Council) at 2013 MLA.  She said that MLA has an interesting generational shift.  She said MLA has lots of librarians with lots of experience (and close to retirement) and lots of librarians just starting off and relatively new to the profession.  There are fewer librarians in the middle of their career.  Both Carla’s unofficial reporting of the MLA demographics and Steven’s blog post has me more wondering more about fostering and mentoring librarians to be medical librarians.  I know we have all heard of the “great retirement” when all of these so called older librarians will all suddenly retire creating massive employment opportunities for new librarians and librarian advancement.  I know because “they” were spouting this theory even when I was in library school over 15 years ago.  Honestly I think we are starting to see it happen.  It isn’t a mass exodus as “they” predicted, but I have seen a lot of directorship and assistant directorship positions posted recently.  I am noticing a large group of new librarians at MLA that are eager to get involved.

I know MLA has several mentorship opportunities:

  • You can find/be a mentor according certain expertise areas of medical librarianship such as administration, continuing education, research, etc.
  • You can also decide to get your provisional AHIP membership in which case you would need an AHIP mentor.

Several posters were presented at the 2014 annual meeting on mentorship or new medical librarianship learning opportunities.

I have found the #medlibs Twitter group and MEDLIB-L to be very helpful too.

I have several questions that I want to bounce off of readers.

  • What are the things that weren’t taught in library school that are unique to medical libraries that new medical librarians need to know?
  • What are other ways we can help or mentor new librarians?
  • Do you think there should be some sort of mentoring to MLA? Similar in spirit to the New Members/Attendees Breakfast that is done at the annual meeting.  But instead of it being about the annual meeting it is about MLA as whole, how it works, what groups are what, the ins and outs of Sections, etc.  If so what is a good way to do that?

I look forward to hearing back from people. Either comment on this blog or my Facebook page or tweet me @krafty.

Splitting My Personality

Long ago when I started playing with Twitter, I was really just testing things out to see how they worked and how I might use it in my day to day personal and professional life.  Well we have long since passed the tipping point.  My little endeavor has moved beyond experimental, more professional people are contacting me through Twitter. More people are following me for information about libraries, information resources, and general biomedical information.  So I have decided to split my Twitter personalities.

@Krafty will focus primarily on libraries, medicine, healthsci, and more professional type of things.  Don’t worry, I will not be a robot. My personality will still come through. I will still participate on #medlibs chats and library conference tweets as @krafty.  I will still send out posts from the Krafty Librarian blog and Facebook page via the @Krafty account.

@Michelle_Kraft (Don’t forget the underscore, there are a lot of Michelle Kraft’s out there) is now my personal account.  Many #medlibs may still want to follow me at this account b/c I will still be tweeting library stuff, but this account will have more personal stuff.  For example: Based off of the successful silent auction bidding on the zombie doll made by @blevinsa I am willing to be there are some #medlibs out there who are interested in discussing Walking Dead on Twitter with me.  However, there are probably a few people following @Krafty who could care less about Walking Dead and don’t know the difference between Sanctuary and sanctuary.  These people might find my Walking Dead posts to be clutter.  Likewise with my posts about the Browns…of course you could probably convince me that my own posts about the Browns are clutter to me.

So if you are a follower of @Krafty please know I am going to be more “professional” and if you don’t mind my personal tweets then you probably want to start following @Michelle_Kraft.

It might be a bumpy transition because I know many friends are used to following @Krafty.  I will try and follow everybody through @Michelle_Kraft but the easiest way for me to do that is just follow the people who follow me…so it might take some time.

 

Catch the Leiter Lecture Live Online Thursday

The Joseph Leiter NLM/MLA Lecture will be on Thursday June 12, 2014 at 1:00pm ET online http://videocast.nih.gov and on the campus of the National Institutes of Health, Bethesda, Maryland.

Terrence Sejnowski, PhD, will discuss “The BRAIN Initiative: Connecting the Dots.”
Dr. Sejnowski is a pioneer in computational neuroscience and his goal is to understand the principles that link brain to behavior. He is interested in the hippocampus, believed to play a major role in learning and memory; and the cerebral cortex, which holds our knowledge of the world and how to interact with it. His laboratory uses both experimental and modeling techniques to study the biophysical properties of synapses and neurons and the population dynamics of large networks of neurons. New computational models and new analytical tools have been developed to understand how the brain represents the world and how new representations are formed through learning algorithms for changing the synaptic strengths of connections between neurons. By studying how the resulting computer simulations can perform operations that resemble the activities of the hippocampus, Dr. Sejnowski hopes to gain new knowledge of how the human brain is capable of learning and storing memories. This knowledge ultimately may provide medical specialists with critical clues to combating Alzheimer’s disease and other disorders that rob people of the critical ability to remember faces, names, places and events.
(from NIH website)

If you are in or nearby Bethesda, I highly recommend going because it is always interesting to hear the lecturer speak in person. But if you are in Cleveland or some other place that makes it impossible for you to physically be at the lecture, then you can watch it online. If for some reason you can’t watch it live then don’t worry the lecture will be recorded and available at http://videocast.nih.gov.

Searching for MLA’s Next Executive Director

We will be sad to see Carla Funk leave as MLA’s executive director. Carla has given us many years of her guidance and wisdom.  Carla will be staying on with us while we search for the next executive director, and the process to select that person has begun.

Linda Walton, MLA’s current President, posted on her Facebook page that the search committee has been formed and we will first be looking at and identifying a search firm to help us find the right candidate.  We will also be review the current job description for the MLA executive director.

We are in the very very beginning of the process (we haven’t even had our first conference call) but as a member of the search committee I would like to ask MLA members if they had any thoughts about what they would like to see in the next executive director.  Feel free to comment on blog.  If you would like your thoughts to be more private you can email me (use the email you find within the MLA membership directory).

Last Chance to Nominate for the Board or President

The last day to submit a name to nominate for the Board or President is May 12th.

I always hear on various discussion groups or from people personally that they are fed up with MLA.

  • MLA isn’t going in the right direction.
  • What has MLA done for me lately?
  • What is MLA doing to help hospital librarians, academic librarians, etc.?
  • MLA is just an “old boys club” unless you have a name you don’t get on any committees.
  • MLA is unresponsive to the needs of the real medical librarian.

You get the idea.  My response is: “What have you done to help shape MLA and change things you find to be a problem?”

Well now is the perfect opportunity for you to help shape the future of MLA.  The 2014 Nominating Committee is asking YOU, the members, to submit the names of fellow members who you think would be good to serve as a Board member or President and who will lead us for the next three years.

Please read through the process for selecting candidates and electing the MLA president-elect and members of the MLA Board http://www.mlanet.org/members/pdf/2009_bylaws.pdf  (pages 2–3  MUST be MLA member and logged in to MLANET to read this document).

The slate will contain at least two candidates for president-elect (president during 2016/17) and at least four candidates for the two vacant board positions (2015–2018).

Job descriptions:

President http://www.mlanet.org/pdf/mla_officer_jobdesc_201002.pdf

Board members http://www.mlanet.org/pdf/mla_bod_jobdesc_200905.pdf

You are responsible for the direction and shape of MLA. You can either actively shape it or you can indirectly shape it through inaction.

Submit your candidates to the MLA 2014/2015 Nominating Committee:

  •  Jane Blumenthal, Chair – janeblum[at sign] umich [dot]edu
  •  Amy Blevins – blevinsamy[at sign] gmail [dot] com
  •  Jonathan Eldredge – jeldredge [at sign] salud.unm [dot] edu
  •  Susan Fowler – susanfowler.library [at sign] gmail [dot] com
  •  Mark E. Funk – mefunk [at sign] med.cornell [dot] edu
  •  Sally Gore – Sally.Gore [at sign] umassmed [dot] edu
  •  Heather N. Holmes – holmesh [at sign] summahealth [dot] org
  •  T. Scott Plutchak – tscott [at sign] uab [dot] edu
  •  James Shedlock –  jshedlock [at sign] rcn [dot] com
  •  Laurie L. Thompson – lauriethompson [at sign] ymail [dot] com

Engage with McGovern Lecturer Prior to MLA 14

It is crunch time and I know everybody going to MLA 14 in Chicago is scrambling to tie up lose ends at work or for Chicago.   But as you go over your schedule for MLA you might want to check out the McGovern Lecturer, Dr. Aaron Carroll’s blog or his Facebook page. Dr. Carroll has invited MLA members and attendees to begin a conversation with him in advance of the annual meeting on topics of interest by posting on his blog, friending him on Facebook, following him on Twitter, or emailing him.

For his lecture, Dr Carrol will be addressing issues on the Affordable Care Act and health care policy.  His blog, “The Incidental Economist: Contemplating health care with a focus on research, an eye on reform,” is “mostly about the U.S. health care system and its organization, how it works, how it fails us, and what to do about it.”  Dr Carroll is one of the Editors in Chief of the blog which also has several contributors who have “professional expertise in an area relevant to the health care system” as researchers and professors in health economics, law and other health service areas.

The Affordable Care Act and its impact on libraries and how librarians can help hospitals deal with certain aspects of it is a bit of a interest for me.  I have taught several classes to library groups in the past year about librarians can better align their goals to that of the hospital.  Since many hospitals goals are now focused around parts of the Affordable Care Act it makes sense that medical libraries develop strategies to support their institution’s Affordable Care Act goals.

For example…How can the medical library help the hospital

  • Prevent readmissions
  • Increase focus on preventive care
  • Improve patient satisfaction
  • Deal with Meaningful Use (not exactly ACA but very entwined)

Depending on the focus of the library or librarian, we might be able to help more than we or our administration realize.  Here is what some libraries are doing already…

  • Partnering with IT or CIO to provide evidence based medicine resources within the EMR
  • Partnering with IT or CIO to make sure that order sets are based on best available evidence
  • Embedded librarians rounding with patient care teams to help provide necessary information for patient care
  • Help provide patient education documents and information and make them accessbile to patients through the patient portal
  • Work with doctors to provide a prescription for health information to the patient through the EMR

Not only is it important the librarians do these things to help their institutions (BTW no one librarian can do it all but they should be doing something) achieve their goals, but it is equally important that we need to be MEASURING our impact.  If we don’t measure it, it didn’t happen.  Measuring can be tricky but it is necessary, especially if you want to keep your library and your job.  Gone are the days where you can say I did 103 MEDLINE searches for doctors and that helped them treat patients.  Really? How do you know those MEDLINE searches helped them? Did you ask what became of the search? Did you track how your information was being used?  All you know is that you did 103 searches. You don’t know whether that was a benefit to the institution or not.  We assume it was, but administration doesn’t assume anything.

I am looking forward to hearing Dr. Carroll speak.  But before I see him at MLA, I am going to try and start to engage with him to find out what we librarians can do to help our institutions deal with the ACA and make our ourselves more valuable to the institution.  I encourage everyone else to do the same with their own thoughts and questions prior to MLA.

 

 

Become an Embase Screener

The Cochrane Collaboration is looking for people to help identify reports of randomized control trials (RCTs) and quasi-RCTs from Embase for publication in the Cochrane Central Register of Controlled Trials (CENTRAL).

The Cochrane Collaboration wants to develop and implement a screening task that is crowd sourced.  A web-based screening tool has already been created.  No prior experience is necessary.  “A quality-control system has been developed so that all records will be viewd by at least two screeners. Records viewed by ‘novice’ screeners will need three consecutive agreements on the record’s relevance for it to then be either published in CENTRAL or ‘rejected.”

This project has been designed to work with people’s “busy lives” in much the same way as other crowd-sourced endeavors.

For more information go to http://bit.ly/1hrI9qX

 

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.

MLA Has a New Website

Last week MLA rolled out its new website.  The old site was long overdue for an update, and this new site is a bit of a change.  As with all new site changes, the new version is going to take some getting used to. MLA wants your thoughts https://www.mlanet.org/about/mlanet_update.html on the new website.

What are some of the “show stopper” issues or missing information.

What is a “show stopper?”  A show stopper is a fundamental problem with a website that makes it or important parts of it totally unusable.  Some examples with this site are:

  • Browser compatibility problems – While it is difficult to design down to IE 7 (which unfortunately many hospitals still have) there seems to be some other problems regarding how it displays with Firefox on Macs.
  • The Forgot Password link doesn’t work. You click on it and you go nowhere.  This aspect is of getting your password is unusable.

Now MLA does know about the browser compatibility problems and the Forgot Password link, so you don’t have to report those again.

What kind of information is missing?  Please remember we can’t have everything on the front page (and we probably already have to much there now) but are there links or other bits of information that you use that you can’t find?For example:

  • The link to the MLA webinar on systematic reviews was missing.
  • The link to the MLA 14 program planner was missing.

MLA has since fixed these two missing links….but are there others that they don’t know about?

Please look at the website https://www.mlanet.org/ and notify MLA of any problems or thoughts at [email protected]

IF you can remember try and also list the problems on the comments on this website.  The list in the comments isn’t meant to dissuade anyone from reporting something that somebody else found (by all means if you think it is important that MLA knows about it, tell them) I just thought it might be helpful to have an unofficial list of issues so that others can learn from what was found.

 

Learn More About MLA Sections and Chapters in Chicago

Every other year at the annual meeting MLA used to hold the Section Shuffle where each of the sections would man a table and talk to members about their section.  Often there were themes and the sections would dress up or have candy and little prizes at the their table to try and entice members over to their table so that they could talk about everything the section is doing and encourage the member to join their section.

Section Council and Chapter Council decided to conduct a survey to determine what members were getting out of Section Shuffle, why people became a member of a Section or Chapter, why they continued (or didn’t) to be a member, and whether there could be alternatives to the Section Shuffle.

To sum the survey up….

  • Members found the Shuffle to be too crowded
  • Some did not like the food at the Shuffle or there wasn’t enough of it
  • Members weren’t always able to get in depth information they about the Sections due to the crowded and chaotic nature of the Shuffle
  • While members may have signed up during the Shuffle…Section engagement was the driving factor for renewal

So the Section and Chapter Council decide to change things up this year.  Instead of a Shuffle, Section and Chapter will be staffing posters during Poster Session 1 on Sunday May 18th highlighting their activities and unique characteristics at MLA ’14 in Chicago. Posters for participating Sections and Chapters will be on display at the MLA Registration Center. While the posters will be staffed during Poster Session 1 they will remain on display throughout MLA ’14 so members can drop by and learn more about the Sections and Chapters any time during the conference.

I have found Sections and Chapters to be a great way to get involved in MLA and my participation in my Sections and Chapters has significantly enriched my MLA membership experience.  So I encourage everyone to stop by a poster and join a Section and/or Chapter.