National Network of Libraries of Medicine
Pacific Northwest Region

Annual Report

May 1, 2004 - April 30, 2005

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Introduction

The mission of the National Network of Libraries of Medicine is to advance the progress of medicine and improve the public health by: 1) providing all U.S. health professionals with equal access to biomedical information; and, 2) improving the public's access to information to enable them to make informed decisions about their health. The Program is coordinated by the National Library of Medicine and carried out through a nationwide network of health science libraries and information centers.

Network goals are:

1. To develop collaborations with NN/LM libraries to improve access to and sharing of biomedical information resources throughout the nation;
2. To promote awareness of and access to biomedical information resources for health professionals and the public; and
3. To develop, promote, and improve access to electronic health information resources by network member libraries, health professionals, and organizations providing health information to the public.

The Statement of Work focuses on:

Continuing to work with the libraries in the network in establishing connections with health professionals in rural and inner city locations who still do not have adequate access to information;
Working with the NN/LM and other organizations to increase public awareness of and access to health information via the Internet, with particular focus on senior citizens, minority populations and persons of low socioeconomic status; and

Strengthening network capabilities through collaborations and by implementing national support centers in key areas of need, such as outreach evaluation, training and distance education.

This annual report covers the period May 2004 through April 2005, Year 4 of the NN/LM PNR 2001 - 2006 contract.

Highlights this year include:

• On October 2 NN/LM PNR presented The Three Ps of Hospital Library Success, a forum focused on strategies for hospital library survival. It took place in conjunction with the annual meeting of the Pacific Northwest Chapter of the Medical Library Association (PNC/MLA). The forum was held in response to feedback at regional and state meetings and a recent NLM site visit to the NN/LM PNR. Network hospital librarians expressed concern that many of their libraries were struggling to survive. The Forum provided a venue for discussion of these concerns with hospital librarians as well as advocates and representatives from important constituencies: health professionals, hospital administrators, information technology professionals and the National Library of Medicine (NLM). The day included panel discussions, problem solving sessions, time for questions and answers and sharing of ideas. The program is on the Web at http://nnlm.gov/pnr/advocacy/forum.html.
  
• The NN/LM PNR Resource Sharing Coordinator is the primary author of the web-based DOCLINE Tutorial. This multimedia tutorial presents the DOCLINE system's features through screen shots, narrative, and 29 brief videos-24 of which were created by Susan Barnes using the Camtasia software application, with the remaining contributed by staff of the NN/LM Mid-Continental Region. Content was created in collaboration with all the regions' DOCLINE coordinators, and the tutorial has been incorporated by NLM into DOCLINE's online help.
  
• NN/LM PNR piloted a new approach to building continuity and programmatic opportunities at national conferences. The American Society of Neuroradiology incorporated training by NN/LM PNR staff into their program and provided free publicity in the conference centers and in their printed program. Based on acceptance of their submitted abstract, the NN/LM PNR Consumer Health Coordinator and the NN/LM MCR Community Outreach Coordinator co-developed a presentation given at the 2005 Health Ministries Association. Future annual conferences for both of these associations will feature exhibits and presentations by NN/LM PNR, regardless of the location, to maintain continuity with association staff and conference attendees.
  
• Increasingly diverse organizations and agencies are joining the NN/LM PNR network and services are being offered to new audiences served by these organizations. Examples of new member organizations:
  • Alaska Health Fair, Fairbanks, AK
  • Catholic Family & Child Service, Ellensburg, WA
  • Cross Cultural Health Care Program Resource Center, Seattle, WA
  • Montana Health Network, Miles City, MT
  • Puget Sound Alliance for Community Technology, Seattle, WA
  • Seattle Indian Health Board, Seattle, WA
  • Street Youth Ministries, Seattle, WA
    
• In the summer of 2004, the Pacific Northwest Regional Medical Library in Seattle convened a series of community roundtable discussions with representatives from non-profit, social service organizations. These workshops were a joint learning activity for the NN/LM PNR and the community organizations invited. The meetings were intended to help strengthen and transform NN/LM PNR outreach efforts around online health information awareness, and to begin to identify and understand the nature of the challenges the NN/LM PNR would face in working with community social service agencies. The core goals of the roundtables were to:
  • Begin to build regional awareness of the NN/LM PNR and its products and services
  • Work to understand the needs of community organizations so that we can produce a clear outreach marketing message and a strategy to address their needs.
  • Discuss how we can develop strategies to support sustainable partnerships with CBOs, including how we can leverage our combined resources or the resources of another project.
    
• The National Library of Medicine Symposium on Community-Based Health Information Outreach was conducted December 2-3 at the National Institutes of Health Campus, Bethesda, MD. The goal was to bring together a diverse audience to discuss new models and strategies for providing resources and services to medically underserved groups, with an emphasis on partnerships with community -based organizations. The symposium was attended by a diverse group of approximately 150 participants, including librarians, representatives from a variety of private and government agencies, members of community-based organizations and academicians. Catherine Burroughs was a member of the steering committee and chaired the panel on Outcomes and Evaluation; Sherrilynne Fuller presented lessons learned about community-based outreach in tribal communities; and Roy Sahali moderated the afternoon discussion panel with representatives of community-based organizations.
  
• Sherrilynne Fuller participated in a series of meetings and presentations along with a group of National Institutes of Health administrators in Anchorage and Kotzebue, Alaska, February 11-16, 2005. Meetings were held with Southcentral Foundation administrators and included tours of the Southcentral Foundation headquarters as well as the Alaska Native Medical Center. The group were fortunate to participate in a health and wellness fair sponsored by the Southcentral Foundation. Sherrilynne Fuller and David Nash, National Library of Medicine did a presentation on finding quality consumer health information and staffed a very popular booth which offered handouts and MedlinePlus demonstration. In Kotzebue, the group did presentations for students at the Kotzebue K-12 schools and met with teachers and librarians to discuss health information access. A scheduled visit by Fuller and several members of the group to the Buckland Community was unsuccessful due to the weather but has now been re-scheduled for September 2005.

A. Network Programs

1. Health Professional Access to Information Services
As part of the initiative to work with the public health workforce, Linda Milgrom attended the Regional Network Steering Committee of the Northwest Center for Public Health Practice, October 13 and 14. Workforce development coordinators and Focus Area G coordinators from AK, ID, MT, OR, WA and WY and tribal representatives participated. RML staff have attended for several years and find this a very valuable forum for contacting public health leaders. L. Milgrom contacted all PNR Resource Libraries to share names and contact information.

2. Assess Needs of Health Science Librarians
We conducted a survey of libraries' use of electronic document delivery and barriers to its use. We found that use of EDD to receive copies has increased in all formats (i.e., receive via email pdf or tiff; pickup from Web pdf or tiff); use of EDD to send copies has increased, but only in use of email pdf or tiff -- not in provision of Web pickup; several of the barriers to use have decreased in importance ("not sure how to begin," "insufficient IT support," "cannot afford scanner," "cannot afford software") but the "firewall prevents it" barrier has assumed greater prominence.

We initiated a survey to determine what scholarly communication and open access activities are being conducted in the region, and learn what support from the RML and NLM is desired .

3. Network Membership Program

MEMBERS	2004-05	2003-04
Full	156	157
Affiliate	187	156
TOTAL	343	322

4. Document Delivery

	2004-05	2003-04
SERHOLD Participants	146	150
DOCLINE Participants	156	160

The tutorial for DOCLINE Version 2.x was developed, releases and updated by S. Barnes, Resource Sharing Coordinator.

In October, the first DOCLINE class held in conjunction with the National Training Center and Clearinghouse's PubMed training took place here. This DOCLINE class was advertised with the PubMed class, and registration was handled by the NTCC. We also conducted local publicity for the class, and had a good registration of 9 people. Those who attended received 2 MLA CE credits.

Initial investigations into the possibility of replicating the docMD project in this region were conducted, and the decision was made to put planning regarding a Pacific Northwest docMD project on hold pending discussion with Resource Library directors at the meeting in October, 2005.

We revised and updated job description for the Resource Sharing/Network Coordinator position and advertised the upcoming vacancy.

5. Resource Libraries
An informal telephone survey of the six Resource Libraries in this region that do not participate in EFTS was done. We learned that one library intends to join but is facing resistance at its university administration level, four intend to join but haven't had time to work on it, and one is resistant to paying the surcharge and has no plans to join.

6. Communication
The Dragonfly newsletter had 39 articles this year. Featured articles included:

• Report of NN/LM Hospital Internet Access Task Force
• Localize PubMed for Your Users
• Big News for LinkOut Libraries
• Electronic Document Delivery News
• The Northwest ILL Conference: What's in It for You?

225 NN/LM and NLM related announcements were distributed via PNRNews this year, an increase from last year of 7%.

821 messages were sent to HLIB-NW, the regional e-mail list for health information community, about a 9% increase from last year.

On March 31, 2005 Dragonfly, the newsletter of the NN/LM PNR, moved to a blog format. It is no longer a quarterly publication. Articles and announcements are published as soon as they are written and are now compiled monthly. A feature of the new design is that readers can make comments about the items that are posted. Announcements and new articles will still be posted on PNRNews and HLIB-NW lists to alert subscribers when new information is available on the blog.

RML staff and librarians and public health staff of the University of Washington hosted Dr. Jack Snyder of NLM. Dr. Snyder talked about NLM and SIS developments and collected comments and concerns of RML.

7. Regional Advisory Committee
Gail Kouame moderated the meeting of the Consumer Health Advisory Committee on February 3 and 4. Part of the meeting was dedicated to updates on topics from the previous meeting and part was used to solicit input and feedback from the group about expanded outreach focus with community-based organizations.

8. Monitor Region's Programs
L. Milgrom and G. Kouame visited the DeArmond Consumer Health Library and the William T. Wood Medical Library at Kootenai Medical Center, Coeur d'Alene, ID.

L. Milgrom and G. Kouame met with staff of Seattle Public Library to discuss outreach to specific ethnic and cultural groups in the city and to tour the new library building.

9. User Feedback
"I would like to thank you for your presentation on MedlinePlus at January's Quarterly Board Meeting. We appreciate you taking the time out of your busy schedule to help deliver valuable information to delegates, staff and community members." -- Pearl Capoeman-Baller, Northwest Portland Area Indian Health Board, Portland, OR

"Just had a chance to look at this [video about the new Loansome Doc System]. Nice job!" -- Marty Magee, NN/LM MidContinental Region

"Just wanted to say "nice job" on the Docline tutorial - you really put that Camtasia class to good use! I did a short tutorial for our Intranet page with no voice over so I can appreciate how much work you put into this!" -- Beula Horak, St. Joseph Hospital Library, Bellingham, WA

"We want to extend a heartfelt thank you for teaching three workshops on accessing health information on the web for local public health assessment coordinators in Washington State. The workshop content, especially the PubMed search strategies, was valuable and highly relevant to the work of this group ... We hope there are future opportunities to partner with NN/LM, Pacific Northwest Region on training workshops and other projects." -- Christie Spice, Community Assessment Liaison, Washington State Department of Health, Olympia, WA

"Montana Health Network and its members want to thank you for the Express Award. This award will allow us to teach the healthcare workers employed by our network facilities how to access and share the wealth of medical information available through your many Internet resources. We appreciate the feedback and assistance your organization provided to us in progressing through the application process. Our grant writer found your staff knowledgeable, helpful and truly a pleasure to work with. I look forward to continuing to work together on important health issues that affect our state." -- Janet Bastian, Montana Health Network, Miles City, MT

10. Training Facility
NN/LM PNR hosted NTCC Gateway class on April 4 and PubMed training on April 5.

NTCC staff used the training facility to teach two PubMed classes (May 3 and 4, 2004) and one Gateway class (May 5). Mark Minie also used the lab to teach the three-day NCBI class, June 14-16. While in Spokane in June, LM and GK visited with Larry Hoffman, IT Director for Washington State University/Spokane. We discussed his interest in hosting a "remote" PubMed session (i.e., possibly one taught in Seattle and broadcast to Spokane). Linda and Gail toured the WSU facility and forwarded information to Maureen Czujak at NTCC.

NTCC staff used the facility to teach PubMed (October 11) and TONET (October 12). The following day, S. Barnes taught a half-day DOCLINE class.

11. NLM User/Non-User Needs Assessment
In the summer of 2004, the Pacific Northwest Regional Medical Library in Seattle convened a series of community roundtable discussions with representatives from non-profit, social service organizations. These workshops were a joint learning activity for the NN/LM PNR and the community organizations invited. The meetings were intended to help strengthen and transform NN/LM PNR outreach efforts around online health information awareness, and to begin to identify and understand the nature of the challenges the NN/LM PNR would face in working with community social service agencies. The core goals of the roundtables were to:

• Begin to build regional awareness of the NN/LM PNR and its products and services
• Work to understand the needs of community organizations so that we can produce a clear outreach marketing message and a strategy to address their needs.
• Discuss how we can develop strategies to support sustainable partnerships with CBOs, including how we can leverage our combined resources or the resources of another project.

12. NLM Grants
L. Milgrom discussed NLM's AIDS Outreach funding possibilities with Mark Alstead (health Services, Seattle-King County Jail) and with Trina Forest (BABES network). L. Milgrom also visited with Judy Norman; a lactation specialist interested in funding opportunities, and reviewed a draft NLM systems grant being prepared by PKIDS, a community organization in Southwest Washington.

L. Milgrom reviewed Information Systems application submitted by PKIDs (Vancouver, WA) (received good score and will be resubmitted). She also had several conversations with Julie Keller (Nez Perce Tribe, Lapwai, ID) regarding the status of their IADL application. Their proposal, subsequently funded, includes plans for a library in the new clinic.

L. Milgrom discussed potential IADL application with Carolyn Adams (Legacy Hospitals, Portland, OR), wrote letter of support for Information Systems proposal resubmission of PKIDs (Vancouver, WA), and discussed unsuccessful IADL application with Dolores Judkins (OHSU, Portland, OR).

L. Milgrom was asked by NNO to serve on a Technical Assistance/Proposal Writing Committee; first teleconference March 2. C. Burroughs was asked to serve on this committee as resource staff.

13. Follow-up with NLM-funded Projects
While in Northcentral Idaho, L. Milgrom and G. Kouame organized a meeting of librarians from several local agencies -- hospital librarian from Lewiston, ID; public librarian from Lapwai, ID; and grant writer/librarian from Orofino, ID. The group discussed services each currently provides and ways to share skills and resources. Clearwater Valley Memorial Hospital (Orofino) recently completed an NLM IADL grant and is taking the lead in promoting NLM resources in the area. Along with staff at St. Mary's Hospital in Cottonwood, they are also managing a current PNR outreach project to provide training to public librarians in a large three county area.

L. Milgrom also discussed options for continued funding with Steve Teich of OHSU, in the final stages of an NLM IADL project for outreach to nurses in Oregon.

L. Milgrom emailed and offered support to Susie McIntyre, Voices of Hope, Great Falls, MT, recipient of recent Information Systems grant from NLM.

B. Expanded Outreach Programs

1. Outreach to Health Professionals.
G. Kouame provided training sessions with L. Milgrom at the Nez Perce Tribal Clinic in Lapwai, ID June 22-23, 2004

A mini-training award was given to Dolores Judkins of OHSU for her poster and presentation at National Association of School Nurses meeting (July 11-12).

Steve Gallion of the Seattle Indian Health board was awarded a mini-exhibit award in support of the SIHB Spirit Walk health fair, June 5.

L. Milgrom .conducted a workshop on MedlinePlus and PubMed for Highline (WA) School District Occupational and Physical Therapists, November 17.

Maryanne Blake and G. Kouame taught a hands-on class at the Northwest Portland Area Indian Health Board (NPAIHB) in Portland, Oregon on January 27, 2005. It demonstrated PubMed, MedlinePlus and other NLM online resources. Twelve of the NPAIHB staff attended.

L. Milgrom gave a presentation on NLM resources and the NN/LM to Executive Committee, Northwest Portland Area Indian Health Board, Quinault, WA, April 20.

She also taught two hands-on workshops for staff of the Washington Department of Health, Olympia, April 12.

2. Consumer Health Information Services
G. Kouame provided training sessions with L. Milgrom at the Nez Perce Tribal Clinic in Lapwai, ID June 22-23, 2004.

A mini-training award was given to Dolores Judkins of OHSU for her poster and presentation at National Association of School Nurses meeting (July 11-12).

Steve Gallion of the Seattle Indian Health board was awarded a mini-exhibit award in support of the SIHB Spirit Walk health fair, June 5.

The new Web resource "Public Libraries and Community Partners" rolled out August 11. It is linked from several regional and NN/LM national pages as well as MedlinePlus!

G. Kouame provided 32 training sessions to public librarians in response to the NN/LM Public Libraries Initiative. Training resources for many of these sessions featured curriculum content from modules developed for the Initiative:

• "Prescription for Success" - two sessions on November 9, 2004 - Bellingham, WA.
• "Prescription for Success" - three sessions Dec. 14 - 15, 2004 - Kenai, AK.
• "Prescription for Success" - August 25, North Olympic Library System, Port Angeles, WA; September 16, Mid-Columbia Library, Pasco, WA; September 27, Montana State University, Bozeman MT; and October 12, North Central Library District, Ellensburg, WA.
• "Prescription for Success" and "From Snake Oil to Penicillin" classes were offered in Portland - March 14. "Looking in All the Wrong Places" and "Beyond an Apple A Day" classes were offered in Portland - March 28. All sessions were sponsored by PORTALS. Many participants were interested in getting the CH Information Specialist certification through MLA

G. Kouame and R. Sahali met with Sam McGraw of Seattle Goodwill on January 24, 2005 to talk about possible collaboration with their agency

In the summer of 2004, the Pacific Northwest Regional Medical Library in Seattle convened a series of community roundtable discussions with representatives from non-profit, social service organizations. R. Sahali spearheaded the concept and draft of a white paper proposing strategies for reaching and working with community organizations. He also serves and a panelist for the Libraries of the Future, Libraries and Health Information Forum in New York in November.

G. Kouame planned and convened a meeting of the Health Information for the Public (HIIP) Advisory Committee on February 3-4.

3. Training to Support Electronic Access to Health Information
L. Milgrom and G. Kouame traveled to Lapwai, ID June 21-23 to provide consultation and training as a complement to Tribal Connections 3 activity with the Nez Perce Tribe. During the visit, Linda and Gail conducted four hands-on training sessions for tribal health providers and community members, visited the new clinic space (under construction) that will have a health information/library alcove, and met with local librarians to plan future collaboration (see A13 above).

L. Milgrom and G. Koume and traveled to Kalispell, MT September 20-22 in support of the Express Planning award managed by Heidi Sue Adams at Kalispell Regional Medical Center. The Flathead Valley partnership includes public, community college and hospital librarians as well as members of the local public health agency, cancer center, and school district personnel. While in the area, G. Kouame and L. Milgrom taught five workshops for staff of partner agencies and the public.

L. Milgrom and G. Kouame traveled to Kenai, AK to present workshops on NLM resources. Public librarians, along with health professionals and community members attended the sessions.

We also kept in touch with ongoing Outreach Project Awardees:

• St. Mary's Hospital, Cottonwood, ID -- reviewed exhibit and other promotional materials forwarded by Jeanette Gorman
• Public Health Nursing project (OHSU, Portland, OR) -- discussed options for including onsite training with Dolores Judkins
• Technology Training for Trusted Sources in Diverse Communities (Associates in Cultural Exchange, Seattle) -- discussed reporting and training activities with Ginger Kwan
• AHEC/Lincoln County Health Coalition Internet Access Project (AHEC at WSU, Spokane, WA) -- updates on project activities still a problem. LM made repeated efforts to reach project manager. C. Burroughs sent a letter requiring substantial progress by April or termination of the subcontract.

Four proposals for Outreach Project Awards were selected for funding, after review by RML staff and outside reviewers. L. Milgrom coordinated the review, submission of questions and responses from applicants, and communication with NNO. She wrote statements of work for the projects selected, offered feedback and options to those not funded, and shepherded paperwork through University of Washington Office of Sponsored Programs. Official start date will be February 15, 2005. First quarterly reports will be included next quarter. New awardees are:

1. Evaluating and Promoting Health Literacy in Recovering Alcoholics and Addicts at the Seattle Salvation Army Adult Rehabilitation Center (UW Health Sciences Library, Seattle, WA)
2. Skagit County Health Literacy Project (Skagit Valley Hospital, Mount Vernon, WA)
3. Alaska Health Information Outreach Project (Alaska Division of Public Health, Juneau, AK)
4. Walking for Health (Willamette Falls Hospital, Oregon City, OR)

We solicited proposals for new $10,000 express outreach awards, applications due May 6.

We also reviewed and awarded three express planning awards:

1. Voices of Hope (Great Falls, MT) to facilitate a suicide prevention planning process with regional mental health centers, HIS, Montana Department of Public Health and Human Services, and regional task forces.
2. Puget Sound Alliance for Community Technology (PSACT, Seattle, WA) to conduct assessment and training with King County Housing Authority residents and staff.
3. Cross Cultural Health Care Program (Seattle, WA) to plan contribution of Washington State info on multi-lingual and multi-cultural health materials into Refugee Health Information Network.

4. Exhibits and Presentations at Meetings
S. Barnes worked with Denise O'Shea (Technology Coordinator for the Middle Atlantic Region) to develop a 4-hour hands-on LinkOut class, which they co-presented at the National Library of Medicine during the Medical Library Association Annual Meeting.

National exhibits:

• American Society of Neuroradiology, Seattle
• CTCNet, Seattle, June 11-12
• Health Ministries Association, Seattle
• National Association of School Nurses, Seattle
• American Association of Naturopathic Physicians, Seattle
• Rural TeleCon, Spokane, WA
• American Academy of Pediatrics, San Francisco, CA
• Midwives Alliance of North America, Portland, OR
• American College of Emergency Physicians, San Francisco, CA
• American College of Chest Physicians, San Francisco, CA
• Family Physicians Patient Education Conference - San Francisco, CA

Two of these exhibits, ASNR and the Health Ministries Association, were particularly rewarding. In each case, association staff were very receptive of NLM's participation and showed special interest in developing a long-term collaboration. Based on these experiences, LM approached NNO about the possibility of the RML's continuing to work with selected professional groups regardless of the location of their annual conferences. With NNO's concurrence, PNR will work with ASNR and the Health Ministries Association to develop program presentations and exhibit and educational materials that target members. Information on the many program presentations at these national meetings has been entered in the NLM Exhibit System and Outreach Activity Reporting System.

Regional exhibits:

• Spirit Walk, Seattle, (done by Seattle Indian Health Board)
• Washington Library Assn/Pacific Northwest Library Assn, Wenatchee, WA
• PNC/MLA, Seattle, WA
• Idaho Library Association, Boise, ID

Mini-exhibit awards were made to

• Heather Hill, Benton-Franklin Health District for an exhibit at Infectious Disease Update
• Ann Uffalussy, Missoula Area Parish Nurse Ministries for a health fair
• Sandra Means, Puget Sound Alliance for Community Technology for a health fair
• Liisa Rogers, Healthwise, for the Idaho Library Association exhibit
• Melanie Jones, Kittitas Community Health Library, for a health fair
• Washington Library Association, Spokane, WA
• Montana Library Association, Billings, MT
• Northwest Regional Rural Health Annual Conference, Spokane, WA
• Julie Niederhauser, Kenai Community Library, Kenai Village Health Fair, Kenai, AK

5. Technology Awareness and Integration
The Technology Forum proposed for this contract evolved into a two-session Electronic Document Delivery forum, which was held as part of the Northwest Interlibrary Loan and Resource Sharing conference in Portland, OR in September. The first session focused on Web delivery products and featured presentations by representatives from CLIO, ILLiad, and Relais, introduced by an overview by Eric Schnell of Web delivery principles. The second session presented selected projects and issues: Janet Croft from the University of Oklahoma spoke on licensing issues; Eric Schnell spoke about the NN/LM-funded DocMD project being conducted in the Greater Midwest Region; and Cyril Oberlander from Portland State University presented information about his mobile scanning Ariel booktruck and other new technologies for EDD.

6. Library Improvement
A second round of Electronic Document Delivery awards was advertised and only one application was received-from Empire Health Services in Spokane, WA. These awards were readvertised with a due date of January 31, 2005. Four applications were received and funded.

M. Blake developed a Web page on the NN/LM PNR Web site that brings together resources relevant to hospital librarians. The URL is http://nnlm.gov/pnr/advocacy/index.html. This is to continue the RML's advocacy for health sciences, especially hospital librarians begun at the hospital library forum in October.

7. Connections
G. Kouame went to Oregon Health and Sciences University with other UW Health Sciences librarians for an exchange and learned about OHSU programs and services and attended sessions presented by their librarians (e.g. "Beyond Google" by Andrew Hamilton). She also attended a meeting of the Oregon Health Sciences Library Association with S. Barnes to give and update of RML activities and to hear about their planned activities.

R. Sahali convened the Health Writers Steering Committee pre-planning meeting at the Seattle Indian Health Board to discuss producing the Annual Health Writers Workshop.

R. Sahali assisted Lynn Holder, Director, UW Tribal Community Partnership, Educational Partnerships & Learning Technologies, with planning for the Colville Tribe behavioral health grant proposal to HHS.

C. Enhancements

Five new AEHI projects had an official start date of September 1, 2004 actually began work in November 2004 and submitted their first quarterly reports:

1. African American Reach and Teach Health Ministry: Access to Wellness Project 2004-2005 (Seattle, WA)
2. Electronic Access for Reliable Health and Medical Information Project (Sno-Isle Regional Library, Marysville, WA)
3. Health Reference Triage: Health Resources for Public Librarians (Tuality Health Information Resource Center, Hillsboro, OR)
4. Locating Healthcare Resource for Rural Communities (Oregon Pacific AHEC, Corvallis, OR)
5. Montana Coalition Against Domestic and Sexual Violence (Voices of Hope, Great Falls, MT)

Five COPPA awards in four regions were awarded subcontracts through PNR. A reporting toolkit for these projects was developed (http://nnlm.gov/pnr/funding/coppatoolkit.html) that automatically forwards reports to PNR, the subcontractor�s home RML, and to NNO. First quarterly reports were due February 15, 2005.

D. NN/LM Web Service

"Reports" are how many searches are conducted on DOCUSER data for libraries that offer Loansome Doc and/or reference services. The reports generated indicate that this is a popular service and that it decreases the number of telephone calls for Loansome Doc referrals.

Month	Visits	Reports
May 2004	133,015	1,065
Jun. 2004	132,834	1,102
Jul. 2004	135,155	1,101
Aug. 2004	142,654	1,251
Sep. 2004	144,727	1,114
Oct. 2004	148,684	1,086
Nov. 2004	156,098	1,724
Dec. 2004	141,764	862
Jan. 2005	159,370	2,205
Feb. 2005	164,262	1,544
Mar. 2005	137,456	1,223
Apr. 2005	182,524	1,848

TOTAL VISITS: 1,778,543 ( 148,212 average/month)
TOTAL REPORTS: 16,125 ( 1,344 average/month)

E. Administration, Staff, and Other

G. Kouame is the chair of the CE Committee for the Washington Medical Library Association (WMLA) WMLA sponsored a CE session at the Pacific Northwest Chapter of MLA annual meeting. She was asked to become an ad hoc member of MLA's Health Literacy Task Force.

L. Milgrom and M. Blake attended NCBI training in Seattle.

At the Medical Library Association annual May meeting in Washington, D.C., M. Blake and C. Burroughs taught the class �Measuring the Difference: Strategies for Improving and Evaluating Health Information Outreach Programs�. M. Blake also presented a poster titled The power of community: evaluating HLIB-NW, a regional discussion list.

RML staff participated in the PNC/MLA meeting in Seattle, October 2-4. L. Milgrom gave a brief review of changes to NLM databases and shared the related handout via the Public Folder on nnlm.gov.

G. Kouame, L. Milgrom, C. Burroughs, Michael Boer, R. Sahali and M. Blake attended the CBO Symposium at NLM December 2-3, 2004. PNR staff collaborated with NNLM/MCR to create a poster about Tribal Connections for the Symposium. C. Burroughs, R. Sahali and S. Fuller participated in planning and presenting at the CBO Symposium; C. Burroughs was a member of the steering committee and chaired the Outcomes and Evaluation Panel; R. Sahali co-moderated the panel discussion with representatives of CBOs; and S. Fuller gave a presentation about outreach with tribal communities.

PNR staff also met with Gale Dutcher and John Scott when they visited here to talk about multicultural/multilingual health information issues and needs - January 26, 2005.

M. Blake assisted Claire Hamasu, Mid-Continental Region in conducting the survey for the CBO Symposium held at NLM in December, 2004. M. Blake also contributed to the final analysis and report of the survey results, working with Cindy Olney.

PNR staff attended the MLA Satellite Conference on Public Health, March 9. PNR staff also provided an RML update at the Washington Medical Librarian Association annual conference April 1.

L. Milgrom, Kathi Canese, and staff of GeneClinics had teleconference and discussions regarding special genetics searches/hedges in PubMed.

L. Milgrom attended Beyond Google CE class in conjunction with the WMLA meeting and the Regional Steering Committee meeting, Northwest Center for Public Health Practice, Seattle.

L. Milgrom also served as a peer reviewer for an article about PubMed searching to be published in the Journal of Alternative and Complementary Medicine.

M. Blake took a day-long workshop "Effective Marketing for Libraries" in Bellingham, Washington, sponsored by the Washington State Library. M. Blake co-taught "Measuring Your Impact: Using Evaluation to Demonstrate Value" a class for hospital librarians that M. Blake and Betsy Kelly, Evaluation Coordinator, NN/LM MCR, co-developed. They were invited to teach on March 4 by the NN/LM NER in Worcester, MA and over fifty librarians attended the day-long workshop.

C. Burroughs chaired a planning committee (R. Sahali, S. Barnes, G. Kouame) and convened a full staff retreat held February 24 and 25.

S. Fuller attended the Northwest Tribal Leaders Summit on Water Quality in Sitka, AK, April 17-22 and provided a display with environmental health information which was very popular. In addition she did several information presentations on NLM resources.

S. Fuller also met several times with Dr. Charles Iliff, Admissions Specialist from Sheldon Jackson College in Sitka, to discuss developing curriculum content on identifying and evaluating health information resources. Sheldon Jackson College is also interested in developing the health information specialist concept.

In addition S. Fuller met Barbra Holian, Director, Public Relations, SouthEast Alaska Regional Health Consortium, who is very interested in potential train the trainer session and also in our small grants for outreach .