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National Network of Libraries of Medicine
Pacific Northwest Region

Quarterly Report

August - October 2001

Summary: This period was marked by increasing activity at several librarian and health professional conferences: 4 training sessions with a total of 35 trainees, 10 presentations, and 11 exhibits. In Network Programs, the process of updating network member information, in order to produce a new regional member directory, began during this period with a request to all members to update their own data in DOCUSER. We began working with a state library association to explore the feasibility of a consortial journal purchase arrangement with Ovid, Inc., for full-text access to a package of journals member libraries would not otherwise be able to afford. In Outreach Programs, we continued the process of defining our target groups and refining our approach for reaching these groups most effectively: establishing links with communities, assessing needs, and emphasizing partnerships and flexibility in addressing needs. This period also marked the beginning of an enhancement project (a continued phase of the Tribal Connections project) to evaluate a model for health information outreach to Native American communities, using a model developed during prior phases of the project.

A. Network Programs

Date

Location

Sponsor

Activity

No.

Staff

1

8/28

Boise, ID

St. Luke�s Reg Med Center

Train

6

Milgrom

2

8/29

Boise, ID

St. Luke�s Reg Med Center

Train

6

Milgrom

3

9/9-

Gleneden Bch, OR

PNC/MLA

Exhibit

35

RML staff

4

9/11

Gleneden Bch, OR

PNC/MLA

Present

8

Milgrom

5

9/12

Gleneden Bch, OR

PNC/MLA

Present

40

Press

6

9/13

Gleneden Bch, OR

PNC/MLA

Present

30

Barnes

7

10/5

Pocatello, ID

Idaho Library Assn

Exhibit

47

Barnes

8

10/9

Sun Valley, ID

ID Health Information Assn

Present

18

Barnes

1. Health Professional Access to Information Services

A videotape of the October 18 CDC/AHA/Public Health Foundation/Public Health Training Network satellite teleconference, �Anthrax: What Every Clinician Should Know,� was obtained for the lending library. As each new teleconference is held, a videotape will be acquired, added to the lending library, and announced.

2. Assess Needs of Health Science Librarians

Sep. 10-12: The annual meeting of the Pacific Northwest Chapter of MLA was held at Gleneden Beach, OR. The entire professional staff of the RML attended and participated in all or portions of the meeting. Activities of individuals are detailed elsewhere throughout this report. One of the main reasons for attending this meeting is for staff to talk to network members and learn what the trends are in network libraries.

The Washington Medical Library Association Internet Users� Group discussion on consortial purchasing�and a follow-up discussion at PNC/MLA�confirmed interest in this state among health libraries in making purchases as a group. Subsequent messages from other states have shown that interest exists across the region. We provided assistance to WMLA in establishing trials of Ovid and EBSCO products and it is hoped to expand this assistance/coordination to other states as well.

3. Network Membership Program

The announcement of new funding opportunities (mini-awards for exhibits or training and outreach project awards for which network membership is a requirement) proved to be a good way to attract Affiliate Members: 6 new Affiliate Members joined this quarter.

Note: eventually we will use DOCUSER to keep track of our Affiliate Members � input and updating will be performed by our office since the learning curve for DOCUSER is too steep to expect Affiliate Members to do their own data input. At present, though, we have not entered data for any Affiliate Members. This is because, with this new membership category, there is a need to go back into the data and divide our current members into the two categories of full Member and Affiliate Member. This will be done once our region wide DOCUSER update (being performed in preparation for printing a new regional directory) is completed.

4. Document Delivery

The introduction of DOCLINE 1.3 went fairly smoothly in this region. DOCLINE libraries were enthusiastic about all the improvements except the changed printing procedures.

Several libraries complained about the timing of this update � it came up over the weekend, so that libraries were surprised by it first thing Monday morning. NLM did announce its impending arrival late the preceding week, but many missed the announcement. More, and earlier, publicity should be conducted for future new DOCLINE versions. We were not able to publicize it ourselves � NLM does not want us to announce system changes and developments until they are ready to have them announced. It is difficult to strike the right balance between waiting to announce a development until its readiness is assured, and announcing it in time (and several times) so that the message sinks into our membership.

Updating the DOCLINE Tutorial to reflect the changes brought by DOCLINE 1.3 is in progress. It is necessary to revise almost the entire tutorial.

5. Resource Libraries

Internal (RML staff) and external (UW and non-UW) reviews of 3 applications for Outreach Funding for Resource Libraries were completed. Announcement of awards will be made as soon as NLM approval is final.

6. Communication

The Summer 2001 issue of Dragonfly was completed and released. Six original articles were published, as well as a reprint of N. Rambo�s article from PH/HA News, Summer/Fall 2001 entitled �Adventures in Outreach: What We Know and What We Don�t.�

247 messages were sent on HLIB-NW, the discussion list managed and maintained by the RML, and used primarily by health librarians in the region.

We sent out 28 announcements on PNRNews, our official distribution list that all network members receive. A new feature was introduced on the list called �Kudos To:� which will be used to report on achievements or interesting work being done by network members.

The review and redesign of the PNR Web site continued. The task group charged with this effort (S. Barnes, M. Blake, M. Boer, C. Burroughs) used input from staff and several network members as a basis for the new design and organization. Emphasis was put on ensuring that the site functions well as a communications tool with network members in particular. The redesigned site will debut next quarter.

7. Regional Advisory Committee

N. Press continued to communicate with and actively seek involvement with the Consumer Health Advisors. The advisor roster is at <http://nnlm.gov/pnr/hip/advisors.html>.

8. Monitor region�s programs

9. User Feedback

From a network member regarding the Dragonfly article �Health Information in Washington State�: Thank you, thank you! For the good information in this email! It�s helpful and very timely. I�m in the process of budget planning for next year and we all know that administrators need convincing news to back our requests!! Once again, Dragonfly comes through.

Another network member thanked her colleagues for the quick responses they gave to a request she put on HLIB-NW. She closed with: �My researcher was much impressed. Thanks for making me look so good! I think HLIB is my very favorite aspect.

10. Training Facility

11. NLM User/Non-User Needs Assessment

As part of our effort to redesign the PNR Web site, we solicited a small number of network members to volunteer for some usability testing. We developed a list of tasks and questions for each participant, who looked at our existing Web site and two versions of the new design, and provided feedback. We used the �think aloud� method in which the participants voiced their thoughts as they navigated the site. We videotaped the screens of their computers and recorded their comments. Some of the major findings were:

  • Brief annotations are preferred over no annotations.
  • Brevity is preferred over wordiness.
  • Our jargon is unclear to many (�RML,� �Evaluation,� �Outreach,� �Finding Information,� �Providing Information,� etc.), reinforcing the need for brief annotations.
  • Repetition of terms in annotations where the terms appear in other category headings is confusing.
  • Intended audience should be made clear.
  • Those who were familiar with the existing Web site and used it regularly preferred it over the new one, others preferred the new one.

12. NLM Grants

L. Milgrom reviewed several drafts of an NLM Connections grant application submitted by Ferry County Memorial Hospital (in a designated frontier county in northeastern Washington State).

13. Follow-up with NLM-funded Projects

L. Milgrom contacted new NLM Connections grantees in the region (information provided by Valerie Florence, EP/NLM) to offer assistance. Since 2 are in Alaska, we discussed local training opportunities with Kathy Murray, Manager of the Alaska Health Sciences Information Service, based at the University of Alaska Anchorage.

N. Press met with and will be working with the EthnoMed/Immigrant Communities Grants Program, Harborview Medical Center (Seattle, WA) that has received grant funding from NLM. She prepared a draft curriculum for the project to use and she will be involved in carrying out training, especially with the Latino community..

A meeting with participants in the Public Health Document Delivery projects was held at the PNC/MLA meeting. Since that time, an e-mail discussion list has been established. Idaho State University has begun its work with a presentation and survey at the meeting of the state public health association in Pocatello. OHSU will begin its work during winter quarter. Alaska and Montana are still conducting planning.

B. Outreach Programs

Date

Location

Sponsor

Act.

Focus

No.

Staff

1

8/8-

Corvallis, OR

PNLA

E

Cons

40

Blake

2

8/15

Omak, WA

Mid-Valley Hospital

P

HP

7

Milgrom

3

8/15

Omak, WA

Mid-Valley Hospital

C

HP

4

Milgrom

4

8/16

Republic, WA

Ferry Co Memorial Hospital

P

HP

3

Milgrom

5

8/27

Inchelium, WA

Colville Tribal Health Dept

T

Cons

23

Press

6

8/29

Vancouver, WA

Clark Co. Health Teachers

E

Cons

44

Press

7

8/30

Pocatello, ID

Idaho State University

T

HP

23

Milgrom

8

10/8-

Yakima, WA

WA State Joint Conf on Health

E

HP/Cons

109

Press, Rambo

9

10/8-

Sun Valley, ID

Idaho Hospital Assn

E

HP

75

Barnes, +

10

10/15-

Seattle, WA

NW Reg Primary Care Assn/Community Health Assn of Mountain/Plains States

E

HP/Cons

37

Press, Barnes

11

10/20-

San Francisco, CA

Amer Acad of Pediatrics

E

HP

215

Milgrom, Blake

12

10/21

San Francisco, CA

Amer Acad of Pediatrics

P

HP

6

Milgrom

13

10/28-

Billings, MT

Natl Indian Educ Assn

E

Cons

310

Press

14

10/22

Atlanta, GA

Amer Public Health Assn

P

HP

50

Rambo

15

10/29

Billings, MT

Natl Indian Educ Assn

P

Cons

12

Press

16

10/29

Billings, MT

Natl Indian Educ Assn

E

Cons

30

Press

17

10/29

Seattle, WA

WWAMI

E

HP

12

Rambo, ++

Act. (activity): C=consultation, E=exhibit, P=presentation, T=training
Focus (targeted program area): HP=health professional, Cons=consumer, TA=technology awareness, LI=library improvement, Conn=connections
No. (number of attendees/participants)
Act. (activity): C=consultation, E=exhibit, P=presentation, T=training

+ #8: Joan Hust, Kootenai Medical Center, Coeur d�Alene, ID, assisted S. Barnes at the exhibit in entry.

++ #16: Sarah Safranek, U. of Washington Health Sciences Library, participated with N. Rambo in a poster session at the WWAMI (Washington-Wyoming-Alaska-Montana-Idaho) Legislative Conference. This annual meeting brings together state legislators, faculty, and other community stakeholders, from throughout the 5 states comprising the regional medical education program. The poster highlighted the research support of the HSL for faculty and staff and the community health information support of the RML

1. Outreach to Health Professionals

Sep. 24: N. Rambo participated in the steering committee meeting of the Partners in Information Access to Public Health Professionals. While at NLM he also met with Angela Ruffin, Tina McGuire, Gale Dutcher, Elliot Siegel, Fred Wood, and Betsy Humphreys on several RML-related matters.

Oct. 19: N. Rambo was an invited participant in a meeting of CDC Information Centers librarians at the main CDC Information Center, CDC, Atlanta. Mr. Rambo was invited, along with Ms. Kathleen McCloskey of the Midcontinental RML (U. of Utah), to discuss outreach to local public health workers and how CDC Information Centers may play an expanded role in supporting the local public health workforce.

Oct. 21: N. Rambo participated in working group meeting on developing competencies in public health informatics. Staff of CDC�s Public Health Practice Program Office is leading this effort. The group has worked largely via e-mail. The first face-to-face meeting was at the AMIA Spring Congress (on developing a research agenda for public health informatics) in May. A 1st draft of competencies was issued from that discussion, reactions to it were shared in the ensuring months, a 2nd draft was prepared for the 10/21 meeting, and a 3rd (and possibly final) draft will emerge from that.

Through a multi-state medical education program, the University of Washington is the �local� medical school for residents of Washington, Wyoming, Alaska, Montana and Idaho (WWAMI). The inclusion of Wyoming as an important regional partner of our home institution, but not in our NN/LM region, occasionally causes confusion. This quarter, for example, the coordinator of the Wyoming AHEC contacted our office intending to apply for our Outreach Project Awards. As she stated in her email, �As the coordinator for the Wyoming AHEC, a partner in the University of Washington Model States AHEC, I assume we fulfill the requirement as an NN/LM PNR member.� We explained our regional structure and contacted the Midcontinental Region office to follow up with the Wy. AHEC.

2. Consumer Health Information Services

Sep. 13: N. Press was an invited speaker on "A Multi-Disciplinary Regional Approach to Consumer Health Information" during a consumer health panel at the PNC/MLA Annual Meeting. The visuals from her talk are at <http://nnlm.gov/~pressno/pncfall01.html>.

N. Press met with representatives of the following agencies/organizations to lay the groundwork for partnerships in consumer health: U. of Washington Information School and Office of Educational Partnerships; Indian Health Service; Harborview Medical Center EthnoMed/Immigrant Communities Grants Program; Children's Hospital and Regional Medical Center Health Education Department and the Center for Children with Special Needs, Muckleshoot Indian Tribe.>

N. Press is sponsoring a University of Washington Information School student in a Directed Fieldwork Project. Sarah Ellison will be evaluating thesauri for consumer health web sites.

N. Press has been using librarian discussion lists to publicize health Web sites that are of particular interest to public librarians. During this quarter interest was high in bioterrorism, so we publicized the NLM, NIH, and CDC resources.

We are getting many more requests for promotional materials than we can fill. We were not able to budget adequately for the amounts requested. For example, a consumer health librarian in Idaho, who has received awards for her outreach with community groups, requests about 500 MEDLINEplus pens per month and a similar amount of other promotional materials. We know these are being used for community health fairs, school nurse meetings, and other entirely appropriate occasions. We regret that we cannot satisfy all the requests we are getting.

3. Training to Support Electronic Access to Health Information

Aug. 28-29: L. Milgrom presented 2 PubMed workshops in Boise, ID. Idaho librarians, who had not been able to attend NTCC sponsored classes, hosted the sessions in a small hospital computer lab.

Oct. 21: In conjunction with the RML�s exhibit for the American Academy of Pediatrics, L. Milgrom taught a 1-hour session �PubMed and other Resources of the National Library of Medicine.

4. Exhibits and Presentations at Meetings

Although visitors to our exhibit booth continue to be enthusiastic about NLM, we have noticed a shift in questions and comments. Health professionals either are proficient users of PubMed, and stop to say thank you or ask sophisticated questions, or are transitioning from IGM to PubMed. Those who are worried about the disappearance of IGM generally feel better once we show them PubMed�s Limits feature. Very few are yet aware of MEDLINEplus and our demonstrations of it are always well received.

5. Technology Awareness and Integration

6. Library Improvement

L. Milgrom made site visits to hospitals in Omak and Republic, WA. Neither has a library nor institutional access to information resources. After the visits, Mid-Valley Hospital in Omak made arrangements for document delivery with network member libraries in Spokane and Wenatchee and decided to subscribe to MD Consult. Ferry County Memorial Hospital in Republic submitted a proposal for an NLM Connections Grant.

7. Connections

R.Sahali continues to support the 4 tribes in the 2nd phase of the Tribal Connections project: Taos and Jemez Pueblos in New Mexico, Colorado River Indian Tribes in Arizona, and Shoshone-Paiute in Nevada. Equipment installation, networking and Internet connection are complete or near completion. This enhancement from the prior RML contract supported a portion of larger projects at each site. Each tribe will continue to pursue grants and other support to close their telecommunication gaps. Internet search skills training is pending for all sites except Taos Pueblo, where Barb Hau, a former NLM Informatics Fellow, is working with La Plaza Telecommunity, is providing training. Taos has and will continue to provide training on NML products.

R. Sahali is part of a working group of the Affiliated Tribes of Northwest Indians developing proposals to regional foundations to address aspects of telecommunication needs among Indian communities. The Seattle Foundation awarded $462.000 to the ATNI for a Telephone Consumer Education project. This grant is for staff, promotional materials, classes and a consumer website about basic and emergency telephone services available to tribes and rural communities. This award is the first step in a statewide effort to address the digital divide in Indian country. These efforts are related to Tribal Connection�s continuing emphasis on e-health resources in tribal communities

R. Sahali and Fred Wood, Tribal Connections project officer (Office of Health Information Programs Development Office/NLM) visited 4 Indian communities: Shoshone-Paiute in northern Nevada, Nez Perce in southern Idaho, Umatilla and Grand Ronde, both in Oregon. Three were Tribal Connections sites and 1 was not. The general purpose of the visits was to solicit feedback on: 1) how well Tribal Connections worked with the (project) tribes, 2) determine if and how NLM funded hardware was being used, 3) any hardware enhancements or upgrades after the Tribal Connections intervention. The feedback was uniformly positive.

C. Enhancements

Plans were finalized and funding received during this period for an extension to the Tribal Connections project. The stated purpose of this enhancement will be to test a model for health information outreach in Native American communities. The model will be based on that developed and refined during the prior phases of Tribal Connections. A focus of the work during this phase will be to determine appropriate evaluation criteria. Results of this evaluation will be analyzed and reported. This project phase is to run 2 years. More specifics will be provided as this work begins.

D. NN/LM Web Service [Added Category]

NN/LM Web Service:
Visits per Month

Year

August

September

October

2001

83,831

76,066

88,834

2000

77,540

81,996

93,775

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

Year

August

September

October

2001

6245

5509

6570

2000

7957

8490

9272

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

Aug.14: Molly McGetrick started as the Health Information Computing Trainer for the Tribal Connections Southwest project, funded by the Bill & Melinda Gates Foundation. M. McGetrick will be based in New Mexico (her home) and will be �in residence� with staff in Seattle on an as needed basis.

Aug. 16: M. McGetrick, R. Sahali, and N. Rambo met with Jessica Dorr, project officer for the Bill & Melinda Gates Foundation. The discussion dealt with Tribal Connections Southwest plans, and an update on the Foundation�s related Native American Access to Technology program.

Ms. Blake attended an all-day advanced Dreamweaver class at the University of Washington in September.