Characteristics of personal health records: findings of the Medical Library Association/National Library of Medicine Joint Electronic Personal Health Record Task Force

Objectives:

The Medical Library Association (MLA)/National Library of Medicine (NLM) Joint Electronic Personal Health Record Task Force examined the current state of personal health records (PHRs).

Methods:

A working definition of PHRs was formulated, and a database was built with fields for specified PHR characteristics. PHRs were identified and listed. Each task force member was assigned a portion of the list for data gathering. Findings were recorded in the database.

Results:

Of the 117 PHRs identified, 91 were viable. Almost half were standalone products. A number used national standards for nomenclature and/or record structure. Less than half were mobile device enabled. Some were publicly available, and others were offered only to enrollees of particular health plans or employees at particular institutions. A few were targeted to special health conditions.

Conclusions:

The PHR field is very dynamic. While most PHR products have some common elements, their features can vary. PHRs can link their users with librarians and information resources. MLA and NLM have taken an active role in making this connection and in encouraging librarians to assume this assistance role with PHRs.

Highlights

• A variety of personal health records (PHRs) exist with some tied to medical health records and others offered as standalone products.
• Librarians can be connected to PHR users through inclusion of an assistance statement in PHRs.
• PHRs offer librarians another means of providing consumers with quality health information.

Implications

• PHR user support is a new role for medical librarians.
• Medical librarians need to be proactive in their communities to educate consumers about PHRs.
• Given the dynamic nature of this market, medical librarians should make a concerted effort to stay abreast of trends in this area.

     

Librarian instruction-delivery modality preferences for professional continuing education

Objectives:

Attending professional continuing education (CE) is an important component of librarianship. This research study identified librarians'' preferences in delivery modalities of instruction for professional CE. The study also identified influential factors associated with attending CE classes.

Methods:

Five instruction-delivery modalities and six influential factors were identified for inclusion in an online survey. The survey completed by members of the American Library Association (ALA), Special Libraries Association (SLA), and Medical Library Association (MLA) provided the data for analysis of librarian preferences and influential factors.

Results:

The majority of respondents were MLA members, followed by ALA and SLA members. Librarians from all three library associations preferred the face-to-face instructional modality. The most influential factor associated with the decision to attend a professional CE class was cost.

Conclusions:

All five instruction-delivery modalities present useful structures for imparting professional CE. As librarians'' experience with different modalities increases and as technology improves, preferences in instruction delivery may shift. But at present, face-to-face remains the most preferred modality. Based on the results of this study, cost was the most influential factor associated with attending a CE class. This may change as additional influential factors are identified and analyzed in future studies.

Highlights

• Despite the many technological advances in the education arena, librarians prefer face-to-face instruction (direct interaction with instructors and other participants, hands-on experience, focused learning). This creates a dilemma as increased budgetary constraints are a barrier to attending face-to-face professional continuing education (CE) classes.
• Librarians in all age groups preferred the traditional classroom style of face-to-face instruction to web-based methods.

Implications

• Instructors and course designers face a challenge in incorporating the perceived advantages of face-to-face instruction into the more affordable modalities of online instruction.
• As cost becomes more of a factor for attending professional CE classes, web-based asynchronous and synchronous modalities offer important, less expensive, alternatives.

     

Teaching Web 2.0 technologies using Web 2.0 technologies

Objectives:

The research evaluated participant satisfaction with the content and format of the “Web 2.0 101: Introduction to Second Generation Web Tools” course and measured the impact of the course on participants'' self-evaluated knowledge of Web 2.0 tools.

Methods:

The “Web 2.0 101” online course was based loosely on the Learning 2.0 model. Content was provided through a course blog and covered a wide range of Web 2.0 tools. All Medical Library Association members were invited to participate. Participants were asked to complete a post-course survey. Respondents who completed the entire course or who completed part of the course self-evaluated their knowledge of nine social software tools and concepts prior to and after the course using a Likert scale. Additional qualitative information about course strengths and weaknesses was also gathered.

Results:

Respondents'' self-ratings showed a significant change in perceived knowledge for each tool, using a matched pair Wilcoxon signed rank analysis (P<0.0001 for each tool/concept). Overall satisfaction with the course appeared high. Hands-on exercises were the most frequently identified strength of the course; the length and time-consuming nature of the course were considered weaknesses by some.

Conclusion:

Learning 2.0-style courses, though demanding time and self-motivation from participants, can increase knowledge of Web 2.0 tools.

Highlights

• Course participants'' knowledge of Web 2.0 tools increased significantly.
• Medical Library Association members liked the online course format, particularly the hands-on exercises and self-pacing.
• There was no significant difference in course completion rate or course satisfaction among participants from academic, hospital, or other library settings.
• Few survey respondents pointed specifically to workplace technology blocking as a reason for non-completion, though this underestimates the effect of such blocking on hospital and corporate library staff.

Implications

• MLA members appreciate having online continuing education (CE) courses. New short, online CE courses were developed based on the findings of this survey.
• Hands-on exercises may improve learning and increase motivation.
• Time and self-motivation are necessary for completing online courses.

     

Beyond citation analysis: a model for assessment of research impact

Question:

Is there a means of assessing research impact beyond citation analysis?

Setting:

The case study took place at the Washington University School of Medicine Becker Medical Library.

Method:

This case study analyzed the research study process to identify indicators beyond citation count that demonstrate research impact.

Main Results:

The authors discovered a number of indicators that can be documented for assessment of research impact, as well as resources to locate evidence of impact. As a result of the project, the authors developed a model for assessment of research impact, the Becker Medical Library Model for Assessment of Research.

Conclusion:

Assessment of research impact using traditional citation analysis alone is not a sufficient tool for assessing the impact of research findings, and it is not predictive of subsequent clinical applications resulting in meaningful health outcomes. The Becker Model can be used by both researchers and librarians to document research impact to supplement citation analysis.     

The Library of the Royal Society of Physicians in Budapest becomes today's Semmelweis Medical History Library

Objectives:

The 170-year history of the library of the Royal Society of Medicine in Budapest illustrates both that political and cultural context matter and that “medical” libraries, if they survive, in due course become primarily “medical history” libraries.

Methods:

Two of the authors are on the staff of the Semmelweis Medical History Library; the third is a US scholar who makes frequent use of the library. Together, they avail themselves of archival and published materials—and personal experience with the collection—to establish the context that produced the original library, trace its evolution, and describe its present-day incarnation.

Results:

A tale of transformation emerges that reflects how collections are likely to change. The authors present events and individuals in the life of the Royal Society''s library and paint a picture of the value of today''s Semmelweis Medical History Library. Unique treasures in the collection are described.

Conclusion:

The story told here is of how a particular nineteenth-century library became a twenty-first–century institution. The authors establish its peculiarly Hungarian context and potential value to librarians and historians from outside Hungary. The overall message is that general medical libraries everywhere are perforce likely to become medical historical libraries over time.

Highlights

• Context matters. The historical background of a library helps determine its functions and its future; shifts in modes of publishing affect and monetary concerns shape the development and preservation of an historical collection.
• Libraries evolve. Medical libraries undergo a normal and profoundly useful transformation over time into repositories of medical history.
• Books alone do not a library make: Libraries can and should be settings for continuing education, cultural affirmation, and assistance to scholars by preserving and making available for use a variety of sometimes rare archival and published materials.

Implications

• Knowing the political and cultural background of a library is essential to understanding its history as well as its present-day status.
• Preserving and expanding historical collections demands vigilance and creative management, especially under difficult fiscal and political circumstances. The loyal and diligent work of Hungarians and others who helped build and preserve this library can serve as a model for other threatened collections.
• Sharing the story of a relatively unknown library''s development brings its general assets and unique resources to the attention of a wider audience of librarians and scholars. Few outside Hungary have previously had any way of knowing about the Semmelweis Medical History Library''s rich holdings.

     

Development of the research lifecycle model for library services

Question:

Can the niche services of individual librarians across multiple libraries be developed into a suite of standard services available to all scientists that support the entire research lifecycle?

Setting:

Services at a large, research-intensive state university campus are described.

Method:

Initial data were collected via concept mapping by librarians. Additional data were collected at conferences and meetings through interactive poster presentations.

Main Results:

Services of interest to scientists for each of the stages in the research lifecycle were developed by the team to reflect the wide range of strengths of team members in aggregate.

Conclusion:

Input from researchers was the most effective tool for developing the model. A flexible research lifecycle model can be developed to match the needs of different service groups and the skills of different librarians.     

Health sciences libraries building survey, 1999–2009

Objective:

A survey was conducted of health sciences libraries to obtain information about newer buildings, additions, remodeling, and renovations.

Method:

An online survey was developed, and announcements of survey availability posted to three major email discussion lists: Medical Library Association (MLA), Association of Academic Health Sciences Libraries (AAHSL), and MEDLIB-L. Previous discussions of library building projects on email discussion lists, a literature review, personal communications, and the author''s consulting experiences identified additional projects.

Results:

Seventy-eight health sciences library building projects at seventy-three institutions are reported. Twenty-two are newer facilities built within the last ten years; two are space expansions; forty-five are renovation projects; and nine are combinations of new and renovated space. Six institutions report multiple or ongoing renovation projects during the last ten years.

Conclusions:

The survey results confirm a continuing migration from print-based to digitally based collections and reveal trends in library space design. Some health sciences libraries report loss of space as they move toward creating space for “community” building. Libraries are becoming more proactive in using or retooling space for concentration, collaboration, contemplation, communication, and socialization. All are moving toward a clearer operational vision of the library as the institution''s information nexus and not merely as a physical location with print collections.

Highlights

• Seventy-eight health sciences library building projects at seventy-three institutions were reported as completed in the last ten years.
• Five health sciences library projects illustrate the diversity of projects reported.
• Eleven trends in health sciences library buildings are identified.
• Numerous challenges are briefly discussed.

Implications

• Changing services and usage patterns demand innovative ways to use library space.
• Libraries are making more proactive efforts to retool library physical space.
• Migration from print to digital collections is continuing at an accelerated pace.
• More library space is now dedicated for “community” building.

     

Linking research to practice: the rise of evidence-based health sciences librarianship

Purpose:

The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work.

Methods:

Four sources of evidence are used to examine the rise of EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement.

Results:

These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice.

Implications:

Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services.     

The lost history of American veterinary medicine: the need for preservation

Objective:

The objective of this study was to survey holdings of ephemeral veterinary literature.

Methods:

WorldCat OCLC catalog, the Library of Congress online catalog, the US National Agricultural Library online catalog, and the Dictionary Catalog of the National Agricultural Library, 1862–1965, were used to determine current library holdings of materials published by veterinary schools that are no longer in existence and veterinary associations that are defunct, veterinary supply catalogs, veterinary house organs, patent medicine publications, and veterinary advertisements. Individual library catalogs were also consulted. In addition, the practice of removing advertisements from bound volumes was examined.

Results:

There are many gaps in the cataloged library holdings of primary source materials relating to the history of the education of veterinarians in the United States.

Conclusions:

A proactive action plan needs to be designed and activated to locate, catalog, and preserve this primary source material of veterinary medicine for posterity.

Highlights

• Veterinary libraries have failed to catalog or retain important primary veterinary source materials.
• Several types of veterinary gray literature, with individual pieces scattered across multiple kinds of libraries, are at high risk for loss from the historical record.

Implications

• Academic, veterinary, medical, and special librarians should be involved in efforts to preserve their institutional, local, and state materials; to identify and locate hidden collections of materials, both in uncataloged collections and in the hands of private collectors; and to mentor new librarians about their role in preserving the history of medicine.
• The results of this survey of primary source materials documenting US veterinary medical education suggest the need for a parallel study of medical education and other health professions education.
• The time is now, not only to digitize important scarce veterinary materials for both preservation and improved access, but also to archive present day institutional output (paper and electronic).

     

Digitizing Dissertations for an Institutional Repository: A Process and Cost Analysis

Objective:

This paper describes the Lamar Soutter Library''s process and costs associated with digitizing 300 doctoral dissertations for a newly implemented institutional repository at the University of Massachusetts Medical School.

Methodology:

Project tasks included identifying metadata elements, obtaining and tracking permissions, converting the dissertations to an electronic format, and coordinating workflow between library departments. Each dissertation was scanned, reviewed for quality control, enhanced with a table of contents, processed through an optical character recognition function, and added to the institutional repository.

Results:

Three hundred and twenty dissertations were digitized and added to the repository for a cost of $23,562, or $0.28 per page. Seventy-four percent of the authors who were contacted (n = 282) granted permission to digitize their dissertations. Processing time per title was 170 minutes, for a total processing time of 906 hours. In the first 17 months, full-text dissertations in the collection were downloaded 17,555 times.

Conclusion:

Locally digitizing dissertations or other scholarly works for inclusion in institutional repositories can be cost effective, especially if small, defined projects are chosen. A successful project serves as an excellent recruitment strategy for the institutional repository and helps libraries build new relationships. Challenges include workflow, cost, policy development, and copyright permissions.

Highlights

• The Lamar Soutter Library partnered with the University of Massachusetts Medical School Graduate School of Biomedical Sciences to digitize doctoral dissertations for inclusion in a newly created institutional repository.
• Seventy-four percent of dissertation authors (209/282) gave permission for the digitization. The cost to process the entire dissertation collection in-house was $23,562, only $1,062 more than the estimate to outsource.
• Digitizing the dissertation collection increased access: the print collection was used 723 times in the past 5 years, while the electronic collection was used 17,555 times in 17 months.

Implications

• Digitizing student works is an effective way to begin populating an institutional repository.
• In-house digitization projects can be cost-competitive with outsourced alternatives.
• A repository can be a catalyst for developing relationships in the institution by providing the library with a new avenue for outreach.
• Skills and experience gained from a small project can be applied to larger-scale projects.

     

Characteristics of project management at institutions sponsoring National Library of Medicine MedlinePlus Go Local

Objectives:

Through interviews with the National Library of Medicine''s MedlinePlus Go Local collaborators, an evaluation team sought to identify process characteristics that are critical for long-term sustainability of Go Local projects and to describe the impact that Go Local projects have on sponsoring institutions.

Methods:

Go Local project coordinators (n = 44) at 31 sponsor institutions participated in semi-structured interviews about their experiences developing and maintaining Go Local sites. Interviews were summarized, checked for accuracy by the participating librarians, and analyzed using a general inductive methodology.

Results:

Institutional factors that support Go Local projects were identified through the interviews, as well as strategies for staffing and partnerships with external organizations. Positive outcomes for sponsoring institutions also were identified.

Conclusions:

The findings may influence the National Library of Medicine team''s decisions about improvements to its Go Local system and the support it provides to sponsoring institutions. The findings may benefit current sponsoring institutions as well as those considering or planning a Go Local project.

Highlights

• Many project coordinators said they underestimated the level of work their National Library of Medicine (NLM) MedlinePlus Go Local projects would require, but most expressed dedication to the project and optimism about project sustainability.
• An institutional record of community service or outreach and a director who was supportive of the project were important factors in the progress and sustainability of Go Local projects.
• Go Local projects brought recognition to some sponsoring institutions from their parent institutions or their communities and provided opportunities to establish better relations with other libraries and institutions.
• Go Local projects ran more smoothly when a person, even a temporary hire, with dedicated time for the project was in charge during the initial building phase. Volunteer assistance has been difficult to motivate and sustain.

Implications

• NLM''s Go Local proposal guidelines accurately identify the factors that institutions should pay close attention to when planning a Go Local project.
• NLM should emphasize continuity plans to address project coordinator turnover.
• NLM should develop a more formal orientation plan for new project coordinators to assist program continuity at the sponsoring institutions.

     

Use and perceptions of information among family physicians: sources considered accessible,relevant, and reliable

Objectives:

The research determined (1) the information sources that family physicians (FPs) most commonly use to update their general medical knowledge and to make specific clinical decisions, and (2) the information sources FPs found to be most physically accessible, intellectually accessible (easy to understand), reliable (trustworthy), and relevant to their needs.

Methods:

A cross-sectional postal survey of 792 FPs and locum tenens, in full-time or part-time medical practice, currently practicing or on leave of absence in the Canadian province of Saskatchewan was conducted during the period of January to April 2008.

Results:

Of 666 eligible physicians, 331 completed and returned surveys, resulting in a response rate of 49.7% (331/666). Medical textbooks and colleagues in the main patient care setting were the top 2 sources for the purpose of making specific clinical decisions. Medical textbooks were most frequently considered by FPs to be reliable (trustworthy), and colleagues in the main patient care setting were most physically accessible (easy to access).

Conclusions:

When making specific clinical decisions, FPs were most likely to use information from sources that they considered to be reliable and generally physically accessible, suggesting that FPs can best be supported by facilitating easy and convenient access to high-quality information.

Highlights

• Medical textbooks were the most popular information source for family physicians'' (FPs'') clinical decision-making purposes, and medical journals were the most popular information source for the purpose of updating FPs'' general medical knowledge.
• FPs considered medical textbooks to be the most reliable (trustworthy) source, colleagues the most physically accessible, and continuing medical education the most relevant and intellectually accessible.
• The lowest ranked information sources across all four attributes were personal digital assistants, mental health professionals, pharmaceutical sales representatives, and other decision aids.

Implications

• The most popular information sources for clinical decision-making purposes among FPs were sources characterized as reliable and generally physically accessible.
• This study suggests the need for further research into interventions that target information access barriers in FPs'' practice settings and the promotion of reliable evidence for FPs'' clinical decision-making purposes.

     

The value of library and information services in patient care: results of a multisite study

Objective:

The research conducted a large-scale, multisite study on the value and impact of library and information services on patient care.

Methods:

The study used: (1) 2 initial focus groups of librarians; (2) a web-based survey of physicians, residents, and nurses at 56 library sites serving 118 hospitals; and (3) 24 follow-up telephone interviews. Survey respondents were asked to base their responses on a recent incident in which they had sought information for patient care.

Results:

Of the 16,122 survey respondents, 3/4 said that they had definitely or probably handled aspects of the patient care situation differently as a result of the information. Among the reported changes were advice given to the patient (48%), diagnosis (25%), and choice of drugs (33%), other treatment (31%), and tests (23%). Almost all of the respondents (95%) said the information resulted in a better informed clinical decision. Respondents reported that the information allowed them to avoid the following adverse events: patient misunderstanding of the disease (23%), additional tests (19%), misdiagnosis (13%), adverse drug reactions (13%), medication errors (12%), and patient mortality (6%).

Conclusions:

Library and information resources were perceived as valuable, and the information obtained was seen as having an impact on patient care.

Highlights

• Library and information resources were perceived as valuable, and the information obtained was seen as having an impact on patient care.
• Electronic access to information resources from multiple locations has increased the ability of health professionals to use these resources for improved patient care.
• The roles of librarians are diversifying to include management of electronic resources, user instruction and support, specialized research and clinical information search services, and involvement in institution-level quality improvement.
• It is possible to conduct a large-scale, multisite study on the value and impact of library services on patient care.

Implications

• Ongoing studies of the value and impact of library and information resources will be important for advocacy and quality improvement.
• Community-Based Participative Research methods hold promise as a way of ensuring the relevance of future research.

     

Basic list of veterinary medical serials,third edition: using a decision matrix to update the core list of veterinary journals

Objective:

This paper presents the methods and results of a study designed to produce the third edition of the “Basic List of Veterinary Medical Serials,” which was established by the Veterinary Medical Libraries Section in 1976 and last updated in 1986.

Methods:

A set of 238 titles were evaluated using a decision matrix in order to systematically assign points for both objective and subjective criteria and determine an overall score for each journal. Criteria included: coverage in four major indexes, scholarly impact rank as tracked in two sources, identification as a recommended journal in preparing for specialty board examinations, and a veterinary librarian survey rating.

Results:

Of the 238 titles considered, a minimum scoring threshold determined the 123 (52%) journals that constituted the final list. The 36 subject categories represented on the list include general and specialty disciplines in veterinary medicine. A ranked list of journals and a list by subject category were produced.

Conclusion:

Serials appearing on the third edition of the “Basic List of Veterinary Medical Serials” met expanded objective measures of quality and impact as well as subjective perceptions of value by both librarians and veterinary practitioners.

Highlights

• The 123 journals on the “Basic List of Veterinary Medical Serials” include 117 journals with a decision matrix score of 15 points or higher, with an additional 6 journals included for more complete subject representation.
• Subject categories with the greatest number of journals are internal medicine, food animal medicine, and research.
• Updates for the third edition of the “Basic List” include 59 new titles and 13 new subject categories.

Implications

• The third edition of the “Basic List” provides a useful collection development and assessment tool for veterinary libraries, as well as general libraries with a need to develop a core collection of veterinary resources.
• The decision matrix approach, using standard quantitative and focused qualitative measures, provides a useful methodology for creating core lists in other disciplines.

     

The effectiveness of the practice of correction and republication in the biomedical literature

Objective:

This research measures the effectiveness of the practice of correction and republication of invalidated articles in the biomedical literature by analyzing the rate of citation of the flawed and corrected versions of scholarly articles over time. If the practice of correction and republication is effective, then the incidence of citation of flawed versions should diminish over time and increased incidence of citation of the republication should be observed.

Methods:

This is a bibliometric study using citation analysis and statistical analysis of pairs of flawed and corrected articles in MEDLINE and Web of Science.

Results:

The difference between citation levels of flawed originals and corrected republications does not approach statistical significance until eight to twelve years post-republication. Results showed substantial variability among bibliographic sources in their provision of authoritative bibliographic information.

Conclusions:

Correction and republication is a marginally effective biblioremediative practice. The data suggest that inappropriate citation behavior may be partly attributable to author ignorance.

Highlights

• The citation of flawed articles occurs at a rate nearly equal to that of corrected versions.
• The practice of correction and republication is only marginally effective and does not prevent the continued citation of flawed articles post-correction, with the analysis finding only a slight reduction in the citation of flawed articles after publication of the corrected version.
• Neither MEDLINE nor Web of Science consistently alert users when dealing with corrected and republished literature.

Implications

• The practice of correction and republication would be more effective if prominent sources of bibliographic information were more consistent in providing users with information about the status of corrected and republished articles and the existence of post-publication modifications to the literature.
• It is incumbent upon the scientific community to raise the profile of post-publication changes to the literature to prevent the wasteful and potentially tragic consequences of scientists and medical professionals applying flawed information. Failure to do so will surely result in a reduction of public trust in the reliability of the scientific literature and its users.