Check out the July issue of NIH News in Health, the monthly newsletter bringing you practical health news and tips based on the latest NIH research. Topics featured this month include: sun exposure, food safety, and physical activity for seniors.
Archive for 2014
NER has a small amount of additional funds to put towards awards. As a result the office will accept a second round of proposals due August 29, 2014. You can find the proposal requirements here: http://nnlm.gov/ner/funding/. The number of awarded projects and amount of funding available is small and ideal for technology awards or express outreach projects. All projects will need to be completed by April 30th. Please look over the information carefully and if you are thinking of a project or have an idea and want someone to bounce the idea off of give us a call. We are happy to help.
IMPORTANT: Please let us know by July 25th, 2014 if you will be applying. Proposals are due August 29, 2014
There are two categories of funding:
Express Outreach Awards
- Express Outreach is the broad category of awards for projects involving community outreach, professional development, and instructional design.
- Library Services to Health Agencies Awards supports outreach to health related organizations based on the unit cost of services (document delivery, reference consultations, and training sessions) to be provided.
- Member Program Awards is for development of a training program directed at health information professionals or healthcare providers in areas related to health information access.
- Community Preparedness is for collaborative planning or promotion of community resources for emergency preparedness.
- Community Engagement Awards support short-term outreach projects that involve advancing health information resources in collaboration with local community groups. These projects are smaller than extensive outreach subcontracts.
- Exhibits Awards are for members’ participation at venues that promote health information resources. Funds support registration and fees, travel, and related expenses. Members can promote their local library resources while promoting the National Library of Medicine.
- Health Information Research Awards supports the development and implementation of a project investigating outcomes related to health information interventions.
- Library Digitization Awards enable libraries to increase accessibility within and without the institution of local collections that are not currently available for use.
- Technology Improvement Awards is for supporting equipment purchases to broaden electronic access to health information.
Knowledge Management Projects
The primary purpose of the Knowledge Management Project funding is to stimulate innovations in biomedical knowledge management and information services at the health care institution or health system level. The intent of funding is to assist network members in the establishment of Healthcare Knowledge Service Centers within their healthcare institutions.
Please contact Mary Piorun with questions:
Congratulations to NER’s health statistics book discussion project participants! Nine New England Region librarians were accepted to participate in the project. This project is an exciting opportunity to play an important role to teach how to see through the hype of health news reporting, know what questions to ask, and learn how to understand statistics. We are very excited that the authors of Know Your Chances: Understanding Health Statistics, Stephen Woloshin and Lisa Schwartz, will collaborate with us. This project is hosted by the Healthy Communities COI.
Project participants include:
- Donna Belcinski, Greenwich Hospital, Connecticut
- Maureen Dunn, Concord Hospital Library, New Hampshire
- Joanne Doucette, Massachusetts College of Pharmacy and Health Sciences Library
- Jeannine Gluck, ECHN Library, Connecticut
- Jane Kearns, Hartness Library, CCV/VTC, Vermont
- Barbara Keef, Windham Public Library, Maine
- Lauren Olewnick, Castleton State College Library, Vermont
- Margaret Perkins, Medway Public Library, Massachusetts
- Stacy Wein, Copley Hospital Library, Vermont
Participants will collaborate with the authors to create book discussion materials and then lead a book discussion in their community. The book is available in PubMed Health.
In March, NER hosted a webinar presented by the authors. You can view the recording.
Margot Malachowski, the NER’s Healthy Communities COI Leader, and I are coordinating the project together. We also plan to host the book discussion in our communities.
Project participants will author an article together to disseminate the results.
Health Literacy and Community Engagement Coordinator
This opinion piece was written by Jennifer D. Miglus, NNLM/NER Health IT Community of Interest leader for 2014-2015. Information about this COI can be found here: http://nnlm.gov/ner/communitiesofinterest/healthit.html
In the spring of 2014, NNLM/NER hosted two webinars on librarians and ways they might be involved with their institutions’ Electronic Health Records (EHRs). Suggestions ranged from embedding a search request form in a homegrown system (Vanderbilt) to piloting ways to link out to basic patient education and point of care resources (St. Louis Children’s). The Biomedical Informatics department at the University of Utah, School of Medicine is exploring ways to streamline requests for answers to complex questions, and John Halamka of Harvard, which also uses its own in-house system, would look to librarians for patient education information resources, metadata indexing of data uploaded to EHRs, and possibly the curation of decision support rules.
For many librarians, even getting a seat at the table for IT discussions of EHR functionality is a challenge. Institutions are racing to comply with Meaningful Use stage II requirements and an ‘out of the box’ version of an EHR appears to be the only way forward. Institutions with the will and the resources to develop their own EHR in-house are few and far between.
Searching for other avenues for librarians in this area, I came across a report  of a keynote speech for the Association of Academic Health Sciences Libraries (AAHSL) Symposium in 2009 given by Dr. Kenneth D. Mandl. Dr. Mandl has strong credentials. He is associate professor at Harvard Medical School and director of the Intelligent Health Laboratory at the Children’s Hospital Informatics Program, Harvard University-Massachusetts Institute of Technology Division of Health Science Technology. Dr. Mandl believes that “the very nature of EHR systems is deeply flawed.”  His 2012 piece for the New England Journal of Medicine is titled: Escaping the EHR Trap – The Future of Health IT .
Here is a brief synopsis of Dr. Mandl’s NEJM article:
Vendors of EHRs would have you believe that they, and only they, are capable of managing health information in a safe and effective way. This is not the case. There is no reason why healthcare providers should hand over control of their data to these vendors. Furthermore, these systems are hugely expensive and do not talk well with other systems. Often, even the parts of a single system do not work well together.
Dr. Mandl would like to move beyond EHRs and he describes alternative Health IT efforts as “disruptive innovations”. If you’re interested, Jill Lepore has written a thoughtful, well-researched piece in The New Yorker , effectively de-bunking this trendy theory as a way to transform systems. However, this in no way detracts from his argument, and Mandl goes on to give four components of Health IT that could be well served by existing generic technologies.
The first component is secure private storage. Many people will cite privacy concerns and HIPAA when talking about health data management. To those who cleave to EHRs to protect patient privacy, he counters: “Many industries depend as much as health care does on the security and confidentiality of their data.” Banking comes to mind. Are we any less concerned with the safety and security of our financial information than we are of our health data? Last year, influential members of the Health IT community published an article in JAMA promoting “Health Record Banks” . In Health Record Banks, the patient controls his or her patient data which is deposited from all the patient’s providers into a local Record Bank. This is not a fringe idea.
The second component is secure communication. Certainly there are existing protocols that would fulfill this basic need for health information exchange. The Office of the National Coordinator for Health Information Technology (ONC) itself is promoting “a secure communications system for health care based on SMTP (Simple Mail Transfer Protocol)” through its Direct Project.
Documentation tools are the third component of Health IT that could be served by generic technologies. Mandl cites other industries’ project management software. I grant you that these, like EHRs, are also often expensive and proprietary, but Mandl gives Teambox, Basecamp and Huddle as examples of software that could serve.
The fourth component is tools to aid in the analysis of health data. Software applications to facilitate data loading, graphing, mapping and analysis are used practically everywhere. Why should health data require special ones? In sum, while Mandl acknowledges that Health IT has unique requirements, he believes that the tools to accomplish these tasks can be found in “flexible and generic toolkits”.
How can librarians serve institutions grappling with this fractious and complex topic? By doing what they do best; providing information and education. Learn as much as you can about your current institution’s use of EHRs: What system are they using? Can you attend a training session? What problems have they encountered? Then help them find solutions. You might find the opportunity to tell people about the concept of Health Record Banks and point them to the website: http://www.healthbanking.org/. You can point stakeholders to the published literature on alternatives to vendors peddling stand-alone EHRs.
I know that Meaningful Use is marching onward and that institutions are under pressure to be compliant now, with little time to explore other options. I know that there is still huge opposition to information sharing between institutions. I know that politics is not necessarily driven by evidence. However, I believe we can be included in discussions around Health IT at our institutions. We just need to be informed, and we need speak up.
- Curtis, J.A., Electronic health records, platforms, libraries, and evidence: report on the Association of Academic Health Sciences Libraries symposium’s keynote presentation by Kenneth Mandl. Journal of the Medical Library Association: JMLA, 2010. 98(3): p. 206.
- Mandl, K.D. and I.S. Kohane, Escaping the EHR trap—the future of health IT. New England Journal of Medicine, 2012. 366(24): p. 2240-2242.
- Lepore, J., The Disruption Machine: What the gospel of innovation gets wrong. The New Yorker, 2014.
- Yasnoff, W.A., L. Sweeney, and E.H. Shortliffe, Putting health IT on the path to success. JAMA, 2013. 309(10): p. 989-990.