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National Network of Libraries of Medicine
Pacific Northwest Region

Quarterly Report

May - July 2001

Introduction: In this first quarter of a new contract, the staff spent considerable time and effort discussing how to implement our proposed community-based approach to outreach. This is not explicitly reflected in this report, but it underlies most that was done during this quarter. The approach is based on what we have learned from our experience conducting outreach in under-resourced communities, especially those of American Indians/Alaskan Natives, and evaluating this work. It is dependent on knowing the community, its needs and assets, and delivering a service that fits the audience. Some of what we have still to work out is a more complete understanding of what constitutes a community and how this focus will change what we do. One change we are already noticing is viewing our entire program as an integrated series of interventions, rather than as separate program areas: regardless of the program area, the basis for everything we do is the health and information/technology context of the community.Whatever segment we train or otherwise serve, we are linked to the needs of the community through a chain: health librarians serve care providers (and, in some cases, patients and the public); care providers serve patients and their families; public librarians serve the public; and the public, as a whole, comprise the community. In subsequent quarters we will be attempting to re-invent health information outreach so that it is driven by the needs of the communities we serve.

A. Network Programs

1. Health Professional Access to Information Services

Jun. 29: S. Barnes and N. Rambo met with representatives of the Washington State Library to discuss a suite of electronic information services the state library plans to provide to state health department staff on a pilot basis, and to introduce to them what the RML does.

S. Barnes and N. Rambo planned a Public Health Document Delivery study to examine how staffs of state public health agencies use the literature. S. Barnes drafted objectives for the study. Funds (from the preceding contract) were allocated to the University of Alaska, Idaho State University, Montana State University, and Oregon Health & Science University toward the end of the last quarter. The study will begin in the succeeding quarter.

2. Assess Needs of Health Science Librarians

S. Barnes collaborated with Michele Schewe, Washington Medical Librarians Association representative to the Washington State Library�s Statewide Database Licensing Committee, to provide information about options and issues of importance to Washington librarians.

3. Network Membership Program

A network membership request form for the Pacific Northwest Region was added to our Web site, at <>. This form facilitates applications for funding from us, since we provide funding to network members only.

At the MLA annual meeting, S. Barnes facilitated the Network Coordinators� meeting, at which initial decisions about membership renewal for the new contract were made.

4. Document Delivery

Five libraries joined DOCLINE this quarter.

Developed a Web site, at <>, to assist library staff in using PubMed�s LinkOut service to connect users to electronic journals.

Developed a mechanism to update SERHOLD data at the Pacific Northwest Region�s public SERHOLD Web site, using DOCLINE/SERHOLD data. Recruited four member libraries to participate in a pilot project to test programs developed by OCLC to transfer serials holdings data from SERHOLD to OCLC WorldCat.

5. Resource Libraries

With NLM�s concurrence, we issued an RFP for Resource Library projects and received 3 applications by the Jun. 15 deadline.

6. Communication

The Spring 2001 issue of the Dragonfly published 5 original articles. Topics included: the Gates Foundation-funded, Tribal Connections-related, project in the Four Corners area of the Southwest, an update on SERHOLD and the public's access to health information, funding opportunities in the new RML contract, an account of a consumer health outreach project in Idaho from the project�s principle investigator and the story of connections funding for Wallowa County, Oregon called �What Happens When a Whole County is Connected for Health Information?�

25 messages were sent out from PNRNews, the NN/LM PNR e-mail distribution list. These included forwarded announcements from NLM, Dragonfly articles, and announcements of immediate interest or importance to RML constituents in the region.

Alaska Airlines Magazine, June 2001 (p. 26-31, 84-88), had an article entitled "Wellness on the Web." Carolyn Latteier, the author, interviewed N. Press, Consumer Health Coordinator, for the piece. N. Press is quoted several times, as is Eve-Marie LaCroix from NLM. Written for the traveling public, the article discusses how to evaluate health websites, and presents what the author describes as "a sampling of Websites that provide good health information."

The PNR outreach funding to Wallowa County, Oregon was described in "Chance meeting in Troy yields high speed Internet," Wallowa County Chieftain, May 10, 2001. The article includes an interview with Conni Curry, the librarian in Troy, OR.

7. Regional Advisory Committee

The Consumer Health Information Advisory Group continued to provide expert advice to the RML. During this quarter N. Press asked the Group to consider the question: How can public librarians safely help the public find health information needed? The Group's creative and extensive response was summarized by N. Press and published in our newsletter. We received the following (excerpted) e-mail message regarding the value of this article:

From: Susan Long <>

�My compliments on the "9 Ways ... " article on providing health information to the public. The information is so wonderfully presented - it will be of real use to me ... and my library doesn't even serve the public! Nevertheless, as the health information professional in my organization, I am frequently asked questions about consumer health info. Right now, I'm working with the Patient and Family Education Committee as it grapples with Internet information concerns related to use with patients and in web development. The information coming out of the your consumer health program has already been of tremendous value, and the "9 Ways" provides great guidance ��

8. Monitor region�s programs

9. User Feedback

N. Press tracked questions that users posed to the RML staff during 1 week to assist us in assessing whether our ongoing Web site development is likely to help answer user questions or not.

10. Training Facility

11. NLM User/Non-User Needs Assessment

12. NLM Grants

The announcement of NLM�s additional June 22 submission date for Internet Connections Grants generated more interest in our region than any other previous NLM funding announcement. L. Milgrom responded to 13 inquiries or requests for sample proposals.

13. Follow-up with NLM-funded Projects

B. Outreach Programs



Sponsoring Organization



May 18

Hermiston, OR

Good Shepherd Community Hospital


N. Press

May 22

Anchorage, AK

NW Regional Primary Care Association



Jun 5

Seattle, WA

University of Washington Health Sciences Library


L. Milgrom

Jun 6

Seattle, WA

University of Washington Health Sciences Library


L. Milgrom

Jun 8

Seattle, WA

Washington Medical Libraries Association


L. Milgrom, S. Barnes

1. Outreach to Health Professionals

May 5: C. Burroughs and R. Sahali participated on a panel at the mid-year meeting of the Society of Public Health Educators, held in Seattle. They presented on the Tribal Connections project and evaluation of health information outreach.

May 15-17: N. Rambo was an invited participant at the American Medical Informatics Association Spring Congress on Public Health Informatics in Atlanta. He participated as a resource person in the Training and Workforce Development track. He also participated in a pre-conference working group to develop competencies in public health informatics.

Jul 12: N. Rambo presented the findings of an information needs and Internet use survey that he facilitated with staff of a unit of the Washington State Department of Health, in Olympia, at an annual all-staff meeting of the unit.

Jul 13: The RML staff met with John Coombs, Associate Dean of the University of Washington School of Medicine, to discuss possible collaborations involving the RML�s community-based approach to outreach and the medical school�s several rural clerkships.

2. Consumer Health Information Services

Jul 10: N. Press participated in the Consumer Health Coordinators teleconference and wrote the summary from the conference.

N. Press advertised the NTCC classes to librarians over various library discussion lists in the region. Before the advertisement went out not many people had registered for the classes that were scheduled in the region, but shortly after the announcement was made, the classes filled up. Public, community college, and special librarians are interested in learning more about health information retrieval.

We sent out many promotional items to librarians in the region who were teaching classes, having community health fairs, or simply want pens on the circulation desk as a constant reminder of the good health information in MEDLINEplus. Some of the most popular consumer promotional items are MEDLINEplus tote bags, pens, bookmarks, and Health Hotlines. Librarians found out about our promotional items mainly through the exhibits we have held at various library meetings.

Staff of the Northwest Indian College, Bellingham, WA, asked N. Press to create a detailed outline for a proposed 1-quarter course on retrieving and evaluating health information on the Web. The course outline was developed and has been submitted to the College. Due to considerable turnover at the college no action has yet been taken regarding the course.

We are concerned that DOCLINE does not meet the NN/LM's mission of service to the public. Four examples: 1) only 5 libraries from the Pacific Northwest are listed on the MEDLINEplus libraries page, <>, even though 90 libraries are found if one searches DOCUSER for libraries in the Pacific Northwest that offer service to the public or have a consumer health collection. We received clarification that the MEDLINEplus page is not generated from DOCUSER since the DOCUSER questions and data are not adequate. 2) Since NLM did not make DOCUSER public, the NN/LM chose to develop a way to make this information available to public librarians and others on the NN/LM server. The presentation of the information on the NN/LM web site is peculiar due to its source: NLM's DOCUSER. 3) We understand that Region 7 is experimenting with developing a new directory to point public libraries to appropriate health libraries. Apparently DOCUSER data as currently presented is not adequate. We may learn much from Region 7 about what information other libraries need to know about health libraries that is not currently in DOCUSER. 4) SERHOLD information is important to public libraries (as expressed at our region's Advisory Group meeting). Public library patrons also have a need to obtain copies of articles from MEDLINE. However, SERHOLD data have not been made public except the few files which have been made available by FTP from Region 6. We suggest that Consumer Health Coordinators and the MEDLINEplus Development Team be consulted in the DOCLINE Interface Review, which will include a review of DOCUSER.

3. Training to Support Electronic Access to Health Information

See sections B.1 and B.2.

4. Exhibits and Presentations at Meetings

Jun. 16-19: L. Milgrom and M. Blake assisted at the NLM booth and taught sessions on PubMed, MEDLINEplus, and Turning the Pages at the American Library Association annual meeting in San Francisco.

National Meetings:



Sponsoring Organization


May 3-5

Seattle, WA

Society for Public Health Education

N. Press, C. Burroughs

May 10-11

Chicago, IL

American Geriatrics Society

L. Milgrom, M. Blake

June 10-12

Seattle, WA

Association for Professionals in Infection Control and Epidemiology

L. Milgrom, S. Barnes. L. Reber, M. Blake

June 11-12

Portland, OR

Council of State and Territorial Epidemiologists/Association of Public Health Laboratories

M. Blake, Dolores Judkins (OHSU)

Regional Meetings:



Sponsoring Organization


May 18

Hermiston, OR

Health Fair at Good Shepherd Community Hospital

N. Press

May 19-23

Anchorage, AK

NW Regional Primary Care Association

L. Milgrom

5. Technology Awareness and Integration

Jul 9-14: R. Sahali participated in the 2001 Indian Health Service Technology and Program Support Conference in Albuquerque, New Mexico. He presented on the status of the Tribal Connections project, including challenges faced and the issues related to computer training and factors contributing to the sustainability of this outreach effort. He emphasized that NLM is a potential funding source for Internet connectivity for tribal health programs. He advised the IHS Web team to link to the NLM website in general, especially MEDLINEplus, and to the Tribal Connections site for references specific to Native American health.

6. Library Improvement

7. Connections

R. Sahali has been working with the Affiliated Tribes of Northwest Indians (ATNI) and the Washington State Governors Office on Indian Affairs to cooperatively develop a proposal to regional foundations to fund tribal telecommunications planning, infrastructure, hardware, training, and content. There is the potential to reach all 28 tribes in Washington State. ATNI is the lead (and fiscal) agent on this effort. ATNI has received a $460,000 award from the Seattle Foundation for tribal/consumer telecommunications education. The RML and Tribal Connections are partners in this effort.

C. Enhancements


D. NN/LM Web Service [Added Category]

NN/LM Web Service:
Visits per Month













Working with staff at NLM, M. Boer implemented an automated process for importing daily DOCUSER data in to the NN/LM Web server.

NN/LM Web Service:
/members/reports/ Transmitted













May 4: several RML staff observed a demonstration of a videoconferencing installation used at the University of Washington Medical Center to enable pinpointed communication between 2 sites with many people participating at each site.

May 26: M. Boer and Chris Shaffer (GMR) co-facilitated a meeting of NN/LM Web Developers in Orlando, Florida.

E. Administration, Staff, and Other [Added Category]

May 2 & Jul 11: N. Rambo participated in monthly faculty meetings of the Northwest Center for Public Health Practice (University of Washington School of Public Health and Community Medicine).

May 25: All RML professional staff attended the RML directors meeting, and the associated NN/LM group meetings, in conjunction with the MLA annual meeting in Orlando, FL. Other staff activities at the MLA annual meeting:

N. Press taught the "Teaching the Adult Learner in the Library Setting," a 1-day MLA CE class.

N. Rambo taught, with several other instructors, �The Public Health Knowledge Base,� a 1-day MLA CE class, served on the MLA nominating committee, and presented at the post-conference symposium on building partnerships.

M. Blake, in her new role as Education & Communications Coordinator, has additional responsibilities related to the RML Web site. To support these new tasks she has taken a number of classes and seminars: 1) �Usability Studies of Web Sites�, taught by Candice Benjes-Small, an MLA CE class (at the MLA annual meeting in Orlando, FL); 2) Jul 17: a 2-hour seminar on Web design given by Dr. Sara Kim at the Health Sciences Library of the University of Washington; 3) Jul 19: a 3-hour hands-on �Basic Graphics for the Web� class taught at the University of Washington.

N. Press sponsored Kgaladi Kekani, the MLA Cunningham Fellow, for a week in May.

In May and June, staff participated in interviews of 6 candidates, for 2 Tribal Connections Southwest project positions, funded by the Bill & Melinda Gates Foundation. The trainer position was filled and the resource specialist position closed without being filled. Molly McGetrick of the BIEN! Project staff of New Mexico State University, Las Cruces, NM, is the successful trainer candidate.