It just feels a bit chaotic, this scramble to figure out how to work with the EHR’s implementation initiatives. Adam and I were meeting today to finalize our presentation for National AHEC (on using social networking to support GME) and when we were discussing our conclusions I realized that many of the things we are doing to support GME (especially in primary care settings) are quite pertinent. There are 3 main library roles or core functions (as we are calling them in ADL land) that can work in support of EHR implementation.
- Information Retrieval
- Filtering through masses of information
- Evaluating for quality and authority
- Information Organization
- Information Access
- This stems more towards the traditional elements of providing direct pathways into licensed content. the difference being that instead of providing access to journals, books, databases that in these cases librarians might be providing deeper linking to the article or chapter level
The tricky part is how to best apply these skills in the context of EHR implementation. The people who are working EHR implementation that the role of the librarian must be seen as a necessary efficiency rather than as a luxury. Many people with whom I have discussed EHR implementation look at me a bit quizzically and say, “well we are so busy just getting these implemented that we won’t be ready to think about resource integration and linking for a couple of years.” This type of conversation is a golden opportunity to offer to help filter through much of the pertinent news and definitions and deadlines emerging in the field of EHR implementation. This is an ideal time to offer to help organize the piles of forms and documentation. We mustn’t assume that the librarians role in EHR implementation is obvious to the professionals handling the implementation. We must prove our value and be willing to do everything (even if we think that filtering and condensing news is a bit “beneath” our skill level) we are asked – to provide any kind of assistance that we can.
And just because I can’t resist … I don’t think changing our name to informationists will magically make our EHR target audience more visionary when it comes to the role of the librarian in the implementation.
There is a lot of buzz lately about getting EHR’s into primary care practices. Many sessions at MLA focused on libraries and their institution’s EHR implementation. At a casual glance it seemed like many of those were about hospital implementation. The sessions at MLA all focused on the many challenges librarians faced in getting involved in their institution’s EHR implementation. In terms of primary care practice implementation; I’m guessing take those challenges and multiply them by some significant number.
What are the challenges facing librarians as they try to carve out a niche in implementing EHR’s in primary care settings?
- Unlike many (but not all) hospital settings, most primary care practices don’t have an existing relationship or an expectation of a relationship with a medical librarian. In order to work with implementation, librarians may have to develop new relationships/
- The process of implementing an EHR in a primary care setting is in many cases overwhelming the practices and just getting the bare bones minimal implementation up and running in many cases will tax the practices leaving little or no time for adding the library/resources component. Librarians might need to practice watchful waiting to judge when the practices are slightly less stressed.
- There are economic factors at work. In cases where practices don’t currently have subscriptions to resources, there will be added costs for adding library resources. Figuring out how to pay for these resources may call upon librarian’s creativity.
- There are a lot of unknowns about the federal mandate for this implementation. This creates an atmosphere of chaos (which is too strong of a word) and uncertainty. This is a whole new world an often we as librarians don’t know what role to advocate
As medical librarians choose to move forward it will be important to understand the challenges if getting our feet in the door of primary care practices. Understanding these challenges can help develop plans.
Stayed tuned for my next installment … covering possible roles for librarians