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National Network of Libraries of Medicine
Pacific Northwest Region

Quarterly Report

November 2001 - January 2002

A. Network Programs

1. Health Professional Access to Information Services

Videotapes of the CDC satellite teleconferences on bioterrorism that were held in November and December 2001 were acquired and added to the lending library. We publicized their availability and received 14 requests from Pacific Northwest libraries to borrow them.

2. Assess Needs of Health Science Librarians

3. Network Membership Program

The first stage of updating DOCUSER and local People database records for network members was completed. All members were contacted and given four opportunities to check and correct their directory data: a general e-mail via the PNRNews mailing list; an individualized e-mail to those who did not respond to the general e-mail; individualized letters to those who did not respond to the e-mails; and phone calls to the remainder. The DOCUSER and People files are as ready as they can be for generating membership certificates and for our new directory.

DOCUSER records were created for the 14 Affiliate Members (including 2 new this quarter) that have joined during this contract period so far and the procedure will be followed for future new Affiliate Members. 114 DOCUSER records for non-DOCLINE libraries were changed from full Member to Affiliate Member. 14 closed libraries were removed from the list of members. As of the end of this quarter, January 31, 2002, the count is: 158 Members, 140 Affiliate Members, 298 total for the Pacific Northwest region. There are 466 DOCUSER records for our region, including 35 libraries that are closed and 133 libraries that are neither Members nor Affiliate Members. (These 133 libraries are in DOCUSER because NLM supplied them with an ILL some time in the past. The data for these libraries are not kept up-to-date by NLM - nor do we keep them up-to-date. It is impractical to try to maintain them.)

4. Document Delivery

Susan Barnes updated the DOCLINE Tutorial to incorporate the changes brought with version 1.3. The update required revision to almost 75% of the tutorial - essentially a new edition of it has been written and published, with S. Barnes as the sole author. The former co-author, Beth Carlin, has moved on to other responsibilities.

S. Barnes and Michael Boer participated on NLM's DOCLINE Interface Review Team.

5. Resource Libraries

Finding It on the Internet: Health Access for Elders, a proposal of Oregon Health & Science University (Dolores Judkins, P.I.) was selected for funding. Although the start date for the project was November 15, 2001, processing by administrative offices at the UW and OHSU caused delays. Beginning next quarter, progress reports of this project will be included in this report. The PNRML also agreed to support the travel of an outside consultant (Susan Usitalo) who is conducting a follow-up evaluation of a previous resource library project assessing Alaska public health nurses' use of the Internet. The resource library at University of Alaska, Anchorage, is coordinating this project.

6. Communication

The PNR's redesigned web site premiered on December 4. S. Barnes, Maryanne Blake, M. Boer and Catherine Burroughs comprised the Web Group responsible for the months-long review and new design of the site. The following are some of the comments from network members and others elicited by the site's debut:

"The new Web site is beautiful! You said it would be up December 3 and it was! It is sleek, efficient, and capable. Of course, I haven't yet viewed it through the eyes of Lynx, Vischeck, and Bobby (not to mention WAVE, A-Prompt, and W3C CSS Validator) but it will be wonderful." Drexie Malone, graduate student, University of Washington Information School.

"I just checked out your new website today, and boy! I'm seriously impressed. This site is well designed and attractive. It is easy to find everything, even some stuff I didn't know I wanted to find until I saw it on your site. In my opinion, this site is a great example of what a useful Website should be. Good job!" Mary Rainwater, University of Washington.

"Really like the look of the revised site. It is clean and things are easy to find. I am sure that I will use your list of "Lots of links" frequently. Thank you for including the Canadian Health Network." Lea Starr, Manager, Western Regional Partner, Canadian Health Network.

"Great job, it has a clean neat appearance and makes very intuitive the navigation of the site." Kathy Nelson, Librarian, Eastern Idaho Regional Medical Center, Idaho Falls, ID.

The Fall 2001 issue of the newsletter, Dragonfly, was completed in December with four original articles. In January the Winter 2002 issue came out with a new look in keeping with the redesigned PNR Web site. As well as the change in appearance a new feature, the Announcements column, was added. See the User Feedback section for a comment on the Dragonfly.
Due to a recent rash of spam messages invading HLIB-NW, a policy change was made to the discussion list: postings will no long be accepted from non- subscribers. More than 25 HLIB-NW subscribers sent positive comments about the decision.

7. Regional Advisory Committee

8. Monitor region's programs

9. User Feedback

Feedback on Dragonfly:

"Outstanding _Dragonfly_ article on making the web accessible for the disabled. May I make 12 copies to pass along to Madigan's web committee? Yes, I'll add the URL, but I want to know the members have a copy." Marcia I. Batchelor, MSLS, AHIP, Chief, Medical Library, Madigan Army Medical Center.

10. Training Facility

11. NLM User/Non-User Needs Assessment

12. NLM Grants

Linda Milgrom was asked by Valerie Florance to review drafts of her alternative grant application, PHS 398EZ.

13. Follow-up with NLM-funded Projects

L. Milgrom spoke to Christine Sheehan (of SeaView Community Services, Seward, AK), an Internet Connections awardee, regarding training and ideas for future funding.

PNRML librarians attended a presentation by Debra Ketchell (Deputy Director, University of Washington Health Sciences Library) on PrimeAnswers, an innovative web-based information resource developed as a result of an NLM Information Systems grant. Ms. Ketchell is the P.I. on the grant.

Nancy Press worked with the NLM-funded consumer health project at Harborview Medical Center in Seattle. The project's target audience is seven immigrant and refugee communities in the Seattle area: Oromo, Somali, Ethiopian, Tigrean, Cambodian, Vietnamese, and Latino. The project's methodology is to train community trainers who will tailor the curriculum and share with their own communities. N. Press developed the curriculum template <> and then taught the curriculum to representatives of the communities on Jan. 5. N. Press is also the lead for work with the Latino community.

B. Outreach Programs

Date Location Sponsor Activity


No. of Attendees Staff
1 11/02/01 Seattle, WA

University of


Presentation HP, Cons 14

Sahali, Press

2 11/09/01 Hermiston, OR Oregon Council of Health Educators Training HP 9




San Francisco, CA American College of Rheumatology Exhibit HP 192

Milgrom, Boer, Buttner


11/15/01 -11/16/01

Seattle, WA AAFP Annual Conference on Patient Education Exhibit HP 119

Blake, Barnes

5 11/16/01 Kennewick, WA Center for Children with Special Needs Training HP, Cons 21 Sety

11/26/10 -11/28/01

Spokane, WA National Congress of American Indians Exhibit Conn 246 Sahali

11/29/01 -12/01/01

Girdwood, AK National Alaska Native/American Indian Nurses Assc Exhibit HP, Cons 37 Press
8 12/01/01

Girdwood, AK

Nat'l Alaska Native/American Indian Nurses Assc Presentation HP, Cons 35


9 01/05/02 Seattle, WA EthnoMed Project Training Cons 24

Press, Howard, Owens

10 01/14/02 Bow, WA NW Portland Area Indian Health Board Presentation




Press, Sahali

11 01/22/02 Seattle, WA Puget Sound Nurses Association Training HP 23 Blake

Focus (targeted program area): HP=health professional, Cons=consumer, TA=technology awareness, LI=library improvement, Conn=connections

PNRML received 3 applications for Outreach Project Awards. A committee of RML staff and external reviewers read and rated the proposals. With NLM concurrence, 2 were selected for funding. Both projects-"Cyber Health Camp" by the AHEC of Southwest Oregon (Roseburg, OR), and "Cross Cultural Health Care Program Resource Center" by the Pacific Medical Center (Seattle, WA) began mid-quarter. Reports of each will be submitted with the PNRML quarterly report beginning next quarter.

1. Outreach to Health Professionals

N. Press was selected by the Northwest Chapter of the Society of Public Health Educators (SOPHE) to be the region's CDCynergy trainer. N. Press will attend training at CDC in February 2002 and will then train health educators in health promotion program management, strategy, and evaluation. N. Rambo participated in a steering committee meeting of the Northwest Center for Public Health Practice regional network on Jan. 15. This meeting included members from the 6 states of the partnership network: AK, ID, MT, OR, WA, and WY. In addition, Distance Learning Coordinators and Health Alert Network Coordinators from the states were also invited to this meeting. Mr. Rambo gave a presentation on the role of the NN/LM in serving the public health workforce in the region, and invited the Distance Learning Coordinators to be advisors-representing the information and continuing education needs of the public health workforce-to the PNRML. The initial response was positive. Brief follow-up has netted 4 of the 5 in the PNR region. (The remaining DLC, from Wyoming, is in the Midcontinental Region. She, too, is potentially enthusiastic about participating. Mr. Rambo explained the regional jurisdiction to her and will put her in touch with the Midcontinental RML, and inform the Claire Hamasu and Kay McCloskey of the contact.)

2. Consumer Health Information Services

Roy Sahali and N. Press presented on outreach to underserved communities as part of a noon hour lecture series at the University of Washington Medical Center, Nov. 1, explaining how they have worked in communities with different needs and ways of communicating.

N. Press completed a first draft of a consumer health information page for the IHS national web site, at the request of Theresa Cullen, MD, MS, National Informatics Consultant, Indian Health Service, Tucson, AZ. Steps taken: 1) solicited topic suggestions from IHS personnel, National Alaska Native/American Indian Nurses Association, National Indian Education Association, Northwest Portland Area Indian Health Board priority topics, 2) chose sites on topics, using Medlineplus criteria with latitude in the case of easy to read information, 3) in process of reviewing textual sites for reading level and coding reading level score in html for each site (view source to see the scores), 4) in process of eliminating all web pages with reading score above 6th grade, 5) made up the "help" page for consumers wanting strategy help or wanting directions for further information, and 6) demonstrated the pages to the Northwest Portland Area Indian Health Board for review.

Initial response from IHS is positive. T. Cullen has already shown the pages to the IHS Clinical Directors who were grateful to have an easy-to-read web site available for their patients. Future steps are: 1) receive feedback from IHS and revise, 2) revise graphics and format to increase the visual appeal, 3) test usability with a small group, 4) ask for feedback from a larger group of native community members and health educators, 5) revise again, 6) put web page up where IHS will link to it, 7) publicize web page, and 8) maintain web page.

We put up our first Spanish language page on our Web site, with translation done by Javier Crespo of the New England Region , and reviewed by Mario Javier Pineda, one of our consumer health advisors. The page chosen to be first is entitled, "┬┐Como puede saber si la informaci├│n le sirve?" or "Is this health information good for me?" and is on the Web at <>

3. Training to Support Electronic Access to Health Information \

PNRML awarded a $500 mini-grant to Megan Sety of the Center for Children with Special Needs, Children's Hospital and Regional Medical Center, Seattle, WA, for training sessions in Kennewick and Ellensburg, WA. The hands-on workshops cover basic web searching skills, locating quality information for families and patients, and evaluation of health web sites, targeting health professionals who serve families of special needs children. The first session has been completed and the Outreach Reporting Form is included in this report.

L. Milgrom taught 3 sessions of Keeping Up with PubMed for the National Training Center and Clearinghouse, 2 in Seattle (Jan. 28-29), and 1 in Portland (Jan. 31).

L. Milgrom demonstrated TOXNET and PubMed at the ORAU/SIS booth at the Society of Risk Analysis meeting in Seattle on Dec. 3.

4. Exhibits and Presentations at Meetings

M. Boer assisted GMR staff at the RSNA Annual Meeting in Chicago in Dec. 2001.

N. Press exhibited at and gave a plenary talk at the National Alaskan Native/American Indian Nurses Association meeting. Meeting attendees were mostly minority health professionals.

5. Technology Awareness and Integration

6. Library Improvement

The region's first group purchase of electronic journals was finalized. Twenty-five libraries have subscribed to 140 Lippincott Williams & Wilkins e-journals from Ovid. Libraries are from 4 of the 5 states in the region, plus two libraries from British Columbia. Service started at the beginning of January and initial reactions are favorable.

7. Connections

R. Sahali met several times throughout the quarter with representatives of the Affiliated Tribes of Northwest Indians in support of a Telecommunications Consumer Education project. He participated with ATNI staff in an exhibit at the annual meeting of the National Congress of American Indians, Nov. 26-29, in Spokane, WA. He used the opportunity to network extensively, promote Tribal Connections, and promote the health education resources of the NLM and NN/LM.

Mr. Sahali was instrumental in helping to form the Tech Tribes initiative with several local and regional foundations. These foundations, with involvement of the Washington State Governor's Office of Indian Affairs, are collectively interested in helping to close the digital divide among tribes in the state. Funds have been allocated to implement a tribal visioning conference to be held in the spring of 2002.

C. Enhancements

In Oct. 2002 a 3rd phase of the Tribal Connections project was funded by the NLM Office of Health Information Programs Development. The intent of this phase is to focus on a small number of communities from the 1st project phase to plan and implement a more intensive training program as part of a community-initiated health education/promotion program. These case studies will serve to validate a model for this community-based approach to health information outreach; or, suggest an alternative model.

Project staff will be drawn from the regular PNRML staff, with participation by Cathy Burroughs (Outreach Evaluation and Resource Center), and a project evaluator to be hired.

In Dec., staff met to develop a health information outreach logic model to be applied in the cases to be presented in this current phase of Tribal Connections. The model is based on lessons learned from prior phases of Tribal Connections. The model is the 1st project deliverable to the National Network Office and to OHIPD. A copy is attached to this report.

On Jan. 25, designated project staff met with a facilitator to develop a project "map" of roles and responsibilities (attached), and to sketch a project plan and overall goals.

R. Sahali has screened the communities and identified 3 tribes to participate in this phase of the project: the Samish, Anacortes, WA; Confederated Tribes of the Umatilla, Pendleton, OR; and the Nez Perce, Lapwai, ID. Mr. Sahali will be the project lead for each of these sites. A different PNRML librarian will serve as a liaison to each of the 3 communities: The liaisons and Mr. Sahali, will comprise the community-specific project teams. Each 2-person team will determine, with their community representatives, how the outreach model will be implemented in their community.

D. NN/LM Web Service [Added Category]

During November, based on the fact that the majority of words that people enter in the NN/LM search engine seem to be health topics, we introduced a change in the NN/LM search screens to make searching MEDLINEplus much easier. Due to the vast variability of search words our users enter, analyzing the logs to prove whether this worked or not is a bigger project than we are prepared to take on, but an eyeball analysis of recent logs indicates that progress has been gained.

NN/LM Web Service:
Visits per Month












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












E. Administration, Staff and Other [Added Category]

Three PNRML librarians (L. Milgrom, N. Press, M. Blake) volunteered to spend a day each staffing a local hospital library in Dec. Each considered the experience worthwhile in helping them empathize with network members.

L. Milgrom's 20th anniversary with the University of Washington Libraries was recognized during a Health Sciences Library All-Staff meeting in Dec. Appreciation for Linda's contributions to NLM's online training and outreach programs was expressed in messages from several NLM staff members. PNRML staff provided some irreverence to the observance.