Electronic Medical Record and Library Resources
Wolter Kluwer | Ovid Sunrise Seminar: No Password Required
One of my NC AHEC colleagues, Donna Flake, presented an Ovid Sunrise seminar on a project we developed using our ADL portal to provide library resources integrated into their hospital’s medical record. I was happy to see a blog posting from the MLA blog on this presentation.
This project entailed providing direct access to the NC AHEC Digital Library (ADL) and its licensed resources through the New Hanover Regional Medical Center (Wilmington, NC). The exciting part of this project has been the initial results that indicate that physician use of library resources has increased four-fold since providing this direct linkage through the EMR. The other exciting result is that the resources accessed through the EMR access to the portal are fairly broad based. The physicians are using the full spectrum of databases we provide (Ovid’s Medline, the EBMR databases) as well as accessing full text journals.
In our meetings with vendors, EMR integration is all the buzz. My early concern (not well formulated) is that any one resource or vendor not become the dominant or only resource offered through an institution’s EMR. The early results from the EMR integration project in Wilmington, indicate that the physicians are using a broad range of resources and it would be (I think) too bad to see that range of options narrowed to only those offered through any one vendor. We have two vendors doing the “hard sell” to become the resource of choice for EMR’s. Its early in my thinking on this topic and its been a long day, so I’m not going to belabor this posting.
I need to do some research on this last thought, but one of our institutions had provided access to our entire digital library on a physicians intranet (not the EMR). The only way to access one very popular resource at this institution was through our library portal. At the time this very popular resource was added the usage stats for our portal from this institution skyrocketed. The interesting thing was that access to all resources in our portal by physicians coming in through their intranet increased. The vendor for this very popular product put a bit of pressure on the institution to provide a direct link to the resource on the physicians intranet. The link to this very popular resource was still available through the digital library portal, but also available directly on the intranet. What is interesting is that not only did the stats to the portal drop by physicians who had been accessing the portal for this very popular resource, but stats to other resources by physicians accessing the portal through their intranet also dropped. I don’t have the hard numbers to prove this pulled together yet, but my early impression is that when other library resources are presented in conunction with very popular point of care products other resources get a usage boost (much like the impulse shopping enticements at check out lines), but that when popular point of care products are presented outside of the library context, usage of other library resources does not get an additional or supplementary boost from the poc usage. It will be interesting to see how usage stats evolve as the poc products improve their linking to citations. I do apologize for the preliminary nature of this thought.
Libraries vs. Publishers??
The Joint IFLA/IPA Statement on Open Access
A recent posting on the liblicense list pointed to the IFLA/IPA Joint Statement on Enhancing the Debate on Open Access. As I have been following some of the OA debate, I have been a bit dismayed to see the debate become a bit more polarized over time. Even the discussions of peer review have become in many ways overly black and white. The press release posted on the IFLA site affirms that the debate has become, “oftentimes heated and polarised.” The goal of the statement is to, “call for a more rational, evidence based debate on open access.” The two sides agree that the goal is to provide the broadest access to information. It will be interesting to see how the discourse evolves moving forward.
Digital Communication and Tenure
In a similar vein, a recent article in the May 26, 2009 News section of Inside Higher Ed deals with allowing for digital communications to play a role in the tenure process. There were many similarities in the discussion to the issues raised in the OA debate. Some of the issues highlighted in this news release include the roles that publishers play in the tenure process because, “what people have done on promotion and tenure committees is to say ‘OK, this was accepted by Cambridge University Press. I don’t need to read it because I know it’s quality….In the past, we have been paying presses to do our promotion decisions.” One of the key issues is that, “Material shouldn’t be judged inferior when it is identical to traditional work in every way except medium.” The second key issue identified in this article is that, “New systems are needed to evaluate scholarship that is unique in digital form.” As the tenure processes evolve there will be definite impacts on the OA/peer review debate.
The More Things Change… The More Things Stay the Same
As I was thinking about all of the above (OA, peer review, tenure, publishers, libraries) I came across an interesting blog posting on the Political Mavens Blog. When I saw a blog posting by Judith Klinghoffer entitled, “Public Libraries a Threat to Books and Magazines?” , my first thought was oh my something more about the Google Books settlement, or budgets or something of that ilk. I was delightfully surprised to discover this was about publisher’s worries about Andrew Carnegie’s efforts to build libraries throughout the country destroying the publishing industry. It was a delightful read at the end of the day.
Work Life Balance
But First… Today at Work
We had a small glitch with our Stat!Ref subscription today (it actually might have started late last week) whereby our concurrency was dropped from 7 down to 2. I don’t get overly flapped by these types of glitches these things happen. This is the first technical problem I’ve had to deal with, with Stat!Ref and I’ve got to say I’ve never had such a positive technical support experience. It was timely (almost immediately resolved), efficient, and thorough. Over all I have positive dealings with most of our vendor tech. support but this far out paced anything I’ve experienced and I just want to say thanks to Joe at Stat!Ref.
Now Back to Work Life Balance
(A steam of conscious ramble)
Back in March MLA offered a distance learning opportunity on, “Finding Work-Life Balance: Strategies for You and Your Institution.” I wasn’t really interested because I don’t compartmentalize my life that way. I agree more with Scott Plutchak’s take on work life issues in his March 18th posting stating that he finds it, “to be more of a juggling act–multiple priorities and responsibilites.” Although its an important issue, the agenda just didn’t seem to speak to my life. I’m very lucky in that my job allows me to maximize my chances of continuing to juggle work and home life (without having any balls to come crashing down on my head). With my laptop and remote desktop I can work as effectively off site as I can from on site. Likewise with cell phones, texts, and emails its easy for home land to bleed into work time. The boundaries just aren’t that clear cut.
I am the primary care giver for my disabled mother so when one of my colleagues asked me how I found time to write this blog, I replied that when one is taking care of someone who is wheelchair bound (ok that’s not the pc term for it, but trust me its the most accurate description) there is a lot of time spent on stand by. I often have time where I can’t start anything major or involved and need to be easily interruptable. Writing this blog fits that bill. Its a fairly minor matter and is easily interrupted.
I have been spending too many afternoons lately at the Duke Clinics (and for those who have read this far, I’m getting back to the original point) and have been happy to discover that they now offer wireless access. I sometimes find it a bit disconcerting that they know people will have enough time while waiting around that we would need wireless access. Despite the fact that I’m at the Duke Clinics on mom issues; I can also multitask and do some work related work. Where is the balance in that? I don’t honestly know. I just know it works for me.
Check this Out – The State of Things – Facebook: A Status Update
We have a nice show on our local PBS station called the State of Things. As I was driving home mid-day today to take my mom to the doctor, I caught much of today’s show on Facebook. It was quite interesting. Check it out if you have the chance.
Marketing New Services: Ebsco’s New Citation Matcher
Ebsco’s Citation Matcher
Ebsco has added a nice new feature: a citation matcher. A full description of this feature can be found at the Ebsco Support Site.. Although librarians know about this because Ebsco has informed us and although we have added this to our Ebsco databases; I’m not sure our end users will be able to find it. Its cleverly hidden at the top of the screen under a link (or navigation tab) called more. Not the height of intuition for sure.
I’m wondering how to best inform our users about this new feature. I could put something in our news section, but I’m fairly certain that doesn’t get read. I don’t have a good mailing list for all our members and would be reluctant to send this out as an email. We can add it to our classes, but a very small percentage of our users attend classes. This adds to an overarching rethinking we are having about marketing and outreach of our resources and services. Once upon a time we had a quarterly newsletter then the pressures of other matters changed it to twice a year, then down to an annual edition. I’m debating creating an online monthly update. We could also leverage existing news services within our parent organizations. Although library school was a long time ago; I’m still wishing there was a bit more offered by way of marketing and outreach elements to my coursework. Who knew??
What Can Libraries Do to Stay Relevant (theatlantic.com)–My Response
What Can Libraries Do to Stay Relevant in the Lives of the Community?
The Atlantic Online Daily Dish Blog today has a posting Ask the Audience: Libraries that raises several points:
- that, “requests for our expertise in navigating the spectrum of information mediums and systems are in overall decline”
- that there is an, “urge to offer more types of materials and services within the library”
- that, “there is also an enormous pull to provide greater forms of outreach through our website and other mobile technologies”
The posting then ends with the question, “What can we do to reverse this trend?”
Although this posting deals with public libraries, I do have several points to raise in response. The first issue is to what trend does the question refer. The trend of decreasing depth of reference questions? The trend towards librarian as guide? The trend towards offering more types of materials and services or the trend to offer greater forms of outreach through the library’s website or other mobile technologies?
What is the documentation about the decrease in requests for assistance in navigating the information maze? How does the author of this posting define assistance in navigating the information maze (my words). Wouldn’t creating online guides and tutorials, teaching classes, etc also serve as functioning as information navigation assistants.
We actually are seeing some increases in Ask Libs (reference questions coming in via email). Although there is a decrease in in person questions.
There seems to be an implication that there is something wrong with being asked to offer more services and the use of the word “urge” in the posting seems to have a judgement in its tone (I could be wrong in that impression). My question is what is wrong with offering more types of resources and services?
Likewise, I think pushing ourselves to offer more through online portals both web based and mobile is a good and important thing. I don’t find this to be a trend, but a new reality, and I don’t think its something that needs to be reversed.
It would be nice (great even) if librarians were still called upon to provide in depth expert answers, and I think there is still a role for that. I don’t however think that this will continue to be THE primary role for librarians (at least as traditionally definied of someone walking into the library or calling). I think acceptance of the loss, exploring changing roles, and then embracing online potential is the real solution. I fear that hoping to reverse this trend is not going to lead to a bright future for librarians.
Needless to say all thoughts in this posting our mine alone and are posted to stimulate thought and debate
Occam’s Razor and Budget Cuts
Budget Cuts
A thread on the liblicense listserv and a posting on the ResourceShelf.blog starts with the headline, “Seven ARL Libraries Face Major Planned or Potential Budget Cuts”and that’s probably understated. As I think about taking cuts out of the collections budgets — I also think about a little twist on Occam’s Razor (an oversimplication of the “theory” about simplification). The simplest way to deal with budget cuts would be to cut a few big budget items (like oh I don’t know Up to Date, MD Consult, or some Big Deal Journals packages) and of course the specific big budget items would vary from institution to institution. The problem is that in many cases those high ticket items are also the highest used items and the highest valued items. The other problem is that when examining the finances with a price per usage breakdown, those very popular high ticket items in many cases have very low price per use. How to measure price/cost per use is an entirely separate discussion.
Since cutting the high ticket items is most often not an options, those left making collection cut decisions are left with an increasingly complicated and difficult task. The most painless cuts are often for less expensive lesser used items, but it takes a lot of these items to make a 7%, 10%, 15%, 30% cut to the collections budget. Doing cuts journal title by title becomes cumbersome, but what other options are there?
Reading Aloud
Ok, I’ll admit it, I love books. I love to read. I love everything about reading and often regret that I’m not a public librarian. (don’t get me wrong I love my job). On Saturday, there had been an editorial observer in the New York Times called, “Some Thoughts on the Lost Art of Reading Aloud”. This was an interesting little piece about the importance of the act of reading aloud (as opposed to just listening to someone else read aloud). This opinion piece by Verlyn Klinkenborg ends with the observation that, “our idea of reading is incomplete, impoverished, unless we are also taking the time to read aloud.” As I was quickly looking for this online to find the exact quote I came across another piece in the Modesto Bee entitled, “Help children live ‘happily ever after’ — read to them” (by Susan Cassidy accessed 5/18/2009). Although she cites some older research (dating to 1985) about the importance of reading aloud to children leading to stronger reading skills in children, the age of the research makes it no less valid. I love the point she raises that, “In order to become a good reader, one must read a lot; in order to read a lot, one must enjoy reading.” After a Monday that was more Monday than most, its nice to end the day thinking about reading and knowing that people are still writing about the importance of reading in our world. Rock on!!
Irony and the Elsevier/Merck Publishing Debacle
But First…. Today’s News
An interesting news story caught my eye about cancer patients challenging the patenting of genes. This can lead to far ranging questions about the relationship between science and commercial ventures. The ACLU has become involved in this case and they raise the point that what is really patented is knowledge. The question then becomes can knowledge be patented? If so, what are the limits on what knowledge can be patented? An even more interesting question might be the what is knowledge? Much of the argument is against the U.S. Patent office rather than against any specific company. Although this isn’t a direct library issue, it definately touches upon intellectual property issues (far & wide). For a copy of the story see the New York Times (http://www.nytimes.com/2009/05/13/health/13patent.html?ref=health accessed 5/13/2009) or a discussion on the GenomeWeb Daily News http://www.genomeweb.com/dxpgx/aclu-files-suit-against-myriad-over-brca-patents accessed 5/13/2009)
Now Back to Today’s Topic… Irony
My previous posting discussed the Elsevier/Merck Publishing situation. I pointed to the Krafty Librarian’s and the Eagle Dawg Blog postings and added a few comments about the key point as I saw it at the time about physician’s not being able to discern between peer reviewed and marketing articles. I also pointed to the liblicense listserv which is still the most comprehensive coverage of this situation. Today after having a chance to better digest the many points of discussion, I’m focusing on the issue about Open Access. One of the contributers to the list raised the point that its ironic that,
“supporters of open access, have had to endure endless lectures on how OA models are intrinsically corruptible and that protection of the current models is the only way to ensure quality, probity and objectivity. So when it turns out that at the very time these claims were being repeated in Parliament the claimant’s organisation was indulging in practices that most would accept as falling below accepted standards I find myself thinking it rather ironic. ”
This was posted by Dr. David Prosser about the Elsevier’s top management testimony in Parliament (UK or Australian I’m not sure) about OA. Another highlight on the listserv about the relationship between the OA discussion and this situation states that,
“behaviour such as Merck’s and Elsevier’s as described in this thread taints the whole scientific communication process. There is nothing surprising here: when profit seeking is mixed with truth seeking, shenanigans multiply. This is sub-prime publishing at best, designed to satsify stock holders, not researchers. What is surprising is that some people seem surprised by it.”
(posted by Jean-Claude Guedon of University of Montreal). I love this comment and as I mentioned yesterday, I wholeheartedly agree that what continues to surprise me is that anyone has been surprised by this. I actually believe that practices such as ghostwriting articles and other practices of physician’s relationships with corporations have been going on for a long time and maybe its a good thing that the Elsevier/Merck situation has caught people’s attention. The IOM is working on addressing the issue for physicians that would include when they author articles or present research findings. Maybe it is time to look to OA models as a way to correct many issues with our current publishing models.
Web Piracy and Other Ethics and Legal Issues
Merck Published Fake Journal
I was going to write about the “Merck Published Fake Journal” thread that had been burning up the liblicense listserv wires, but the Krafty Library covered it very well in a posting yesterday. For the NC AHEC ILS Network librarians, we are also beginning a thread on our blog (thanks Beth A.). If you have a chance to check out the Krafty Librarian or the liblicense list thread (to follow the thread go to the liblicense listserv and search for the term fake journal (or Merck))These are very thorough coverings of the topic. I’m adding a link to the Eagle Dawg Blog who also posted on this. She raises some evocative questions and is well worth the read as well.
I’d like to say I’m shocked or somehow surprised by this, but it comes as no surprise to me (am I more cynical than most? maybe). Given the pricing practices of many of these big publishing houses– nothing comes as a surprise. Although it is an ethical concern, what I found to be a bigger concern was the problem highlighted at the end of the Krafty Librarian’s post about (citing the Scientist posting)doctors perhaps not being able to discern the difference between a peer reviewed article and a “fake” marketing piece. This for me is the real concern.
A New Chapter in Web Piracy
A headline in our paper today (News & Observer) from the New York Times writer Motoko Rich caught my eye. This article is about the problem of “digital piracy” in the literary world. Although this isn’t directly relevant to my day to day work. It is a fascinating article and raises many interesting questions about the ever changing relationship between technology and copyright and other intellectual property infringements. This had been a known problem in the music and film industry and is just getting to be a problem in the literary world as new devices like the Kindle are growing in popularity. It has also become easier to acquire digital content as publishers are producing more digital editions. We hear about the economic problems in the publishing world and this could impact publishing models. It will be interesting to see how the digital piracy impacts the literary world. I still love to read a print book, but I do love my iTunes. I embrace the digital music revolution but am reluctant to go that route with my pleasure reading. Will the print strong hold continue in book-land? I wonder why digital piracy hasn’t been a bigger issue for online textbooks (probably because the universities are already licensing the content).
Herding Cats
Work Today = Serials Management
Maybe its true that I was the last person on the planet (hyperbole you betcha!) to know that Laryngoscope changed publishers from LWW to Wiley in 2009… This means that Laryngoscope dropped out of the LWW High Impact collection. In retrospect at our renewal in August 2009, I guess I should have specifically asked if any titles were going to be changing. It would be nice (in an ideal sort of world) if our sales reps would actually provide a more full disclosure when we renew our ongoing packages. For some reason Serials Solutions is still showing Laryngoscope as part of the LWW High Impact collection.
Serials Management Can be Like Herding Cats
Every couple of years something will happen that will cause me to undertake a thorough review of our journal collections. I do this to ensure that all of the dates are correct, and since I manage resources for a consortium to ensure that all our locations are receiving the resources they are supposed to be receiving. This sounds simple on the surface, but every now and then there will be a break down in the system (like Serials Soutions not catching the change in the High Impact collection). I long for a short cut, but so far haven’t found one. This is why I only do this thorough title by title review once every couple of years.
The Big Bundles
An editorial in the The Rockefeller University Press Journals (this includes titles like the Journal of Cell Biology) entitled, “A challenge to Goliath” (Mike Rossner. Journal of Cell Biology April 27, 2009 doi:10.1083/jcb.200904082 – http://jcb.rupress.org/cgi/content/full/jcb.200904082v1http://jcb.rupress.org/cgi/content/full/jcb.200904082v1) asserts that, “Megapublishers obligate librarians to buy hundreds of journals they do not need in order to access the journals their constituents actually read. The time has come to challenge this business model, which is unsustainable for the libraries.” I have read both sides of this argument and recently attended a talk that presented the opposing side of this discussion (that the Big Bundles are actually overall cost effective and that publishers price increases are not excessive). For now, I want to focus on the arguments raised in this editorial. One of the most intriguing ideas he raises is quantity vs. quality saying, “The megapublishers have preyed upon the long-held criterion that the quality of a library is measured by the quantity of journals available to its constituents. From recent conversations with librarians, it is clear that this approach is changing, and librarians are ready to give up their emphasis on quantity in favor of quality.”
For those following these blog postings, this once again brings us back to the question of value. These difficult economic times are bringing an opportunity to really evaluate the way we as librarians do business and the ways our vendors do business. I don’t have all the answers, but I look forward to the dialog.
Measuring Value
“Value is What You Get” (Warren Buffet)
I mentioned in an earlier post that one of the questions we seek to answer with statistics, is to measure value. As always this started me thinking about value and how to measure it. There have been several interesting posts on the liblicense listserv discussing value. One discussion was in a thread about OA Scholarship at the University of Maryland.
Sandy Thatcher raised the question of, “How does one even begin to measure the “economic value” of OA for, say, a work of literary criticism or a monograph on Hume’s philosophy? We scholarly publishers would dearly like to believe that spreading our specialized content freely worldwide would be a benefit to civilization, but this is an article of faith for us, not something we have any easy way of quantifying economically.”
I think in general librarians face a similar dilemma. We (I hope) firmly believe that we provide an important value for civilization, but I also think sometimes the value we provide is difficult to quantify. I sometimes wonder if we aren’t shooting ourselves in the foot to try to adopt business models about outcomes measures. I’m not saying we should abandon attempts to quantify value, but I do think at some point we need to embrace the value we bring that can’t be measured (rather than trying to pretend that we can measure everything that we can do)
There was a really fascinating post on the liblicense list about quantifying value. Ari Belenkiy raises the interesting point that, “value for civilization does not limit itself to economic value. If kids somewhere are touched because they understand a poem better through a piece of literary criticism, and if that kid’s life is then to be changed in subtle and beautiful ways because of that reading, I believe that constitutes value for civilization and I believe no price can be assigned to it.”
Quantity vs. Quality
In one of those streams of thought that tie together so nicely, the question of value comes into play not only as we think about marketing ourselves, it also comes into play as we think about renewing our resources and dealing with budget cuts. Again I turn to the liblicense listserv. Which has been having a discussiong about the “big” bundles”. These conversations get a bit more complicated to pull out simple “sound bite” summaries. As our library looks at the impending collections cuts, we are looking at things like price per search, price per article, price per session. That is not the only consideration, however, other factors include less tangible items like a work being very important to a small group (or maybe the only key resource for a small group). Just because a particular user group is small doesn’t necessarily mean that their resources should get cut. By virtue of the small size of their group, their price per session, article, search etc will be higher. Should this group be penalized just because they are smaller?
I think that as libraries confront the budget challenges we are going to be confronting questions of value. Value in terms of monetary value (getting good value for our money) And value in terms of worth, merit or importance. What do we value? How can we provide resources and services that reflect our value and values? These are all questions and discussions that need to be ongoing as we decide where to place our library dollars.
This random stream of conscious values data dump is brought to you by virtue of a head cold congested brain so please excuse any lack of coherence.
