Regional Advisory Committee Meeting

by Elaine Graham

The PSRML Regional Advisory Committee (RAC) met at UCLA on April 5, 2000. Current members of the RAC are:

Health Professional Members
Gerald Ackerman, Northeastern Area Health Education Center, Elko, NV; Gwendolyn Doebbert, Center for Health Statistics, State of California, Sacramento, CA; Russ Toth, California AIDS Clearinghouse, Los Angeles, CA

Medical Library Group Representatives
Hawaii-Pacific Chapter of the Medical Library Association: Sharon Berglund, Hawaii Medical Library, Honolulu, HI; Medical Library Group of Southern California and Arizona: Gloria Arredondo, Arrowhead Regional Medical Center, Colton, CA; Northern California and Nevada Medical Library Group: Ysabel Bertolucci, Kaiser Permanente Medical Center, Oakland, CA

At Large Members
Florence Jakus, Las Vegas Clark County Library District, Las Vegas, NV; Cynthia Henderson, Samuel Merritt College, Oakland, CA; Jenny Reiswig, University of California, San Diego, La Jolla, CA; Mary Lou Goldstein, Scottsdale Healthcare, Scottsdale, AZ; John Kallenberg, Fresno County Library, Fresno, CA

Resource Library Representatives
John Breinich, Hawaii Medical Library, Honolulu, HI; David Rios, Loma Linda University, Loma Linda, CA; Tom Rindfleisch, Stanford University Medical Center, Stanford, CA

The objectives of the meeting were to gather ideas about future directions for health sciences libraries, to obtain input for planning and developing future NN/LM programs, and to get feedback about ongoing PSRML programs and services.

FUTURE DIRECTIONS FOR LIBRARIES

RAC members were asked to describe what they envision for their libraries in the next five years (or longer). Member comments included:

The library of the next decade will acquire digital access to all information.
The library has a role as the mediator of access to digital resources (e.g., licensing).
The concept of a library as a "place" will endure - it will be an access point for archives of older materials and a center for document delivery management. It will house librarians who add value to resources through teaching and guiding information access.
The teaching role of libraries will evolve - libraries will make information and instruction available on demand, in a just-in-time mode.
Libraries will be involved in tailoring, targeting, and mediating; for example, libraries can create a user interface that integrates information resources.
Health sciences libraries will make referrals to appropriate information resources for consumers.
Getting connected to the Internet will be vital. Libraries will deal much more with video and other media.
The library will need to be "turned inside out" to bring information to the workplace.
Research is important to be aware of usage trends (for example, usage of print journals that have online equivalents and of titles that are not online).
There is concern that the increasing tendency of users to use only materials available digitally will lead to poor scholarship.
Digitizing should be considered as a national priority - what does it mean for the library to consider digitizing the entire collection?
Libraries will be more involved in health professional education (e.g., doing video capture of classes to be put up on the Internet and expanding media labs for use of video and electronic resources).
There will be more demand for service to remote sites (for example, video conferencing and online, tailored instruction). However, there will still be a desire for a person to facilitate and answer questions (adding back the human factor).
The Internet is still a barrier for some users. The digital divide by age groups is disappearing. The CD-ROM format persists as an easy-to-use technology that is sometimes more available to individual users.
Enhancing information retrieval - through organizing, indexing, and applying metadata - will continue to be a key library function.

INTERNET CONNECTIVITY

RAC members were asked to consider the question of Internet access: is there widespread Internet access within institutions, and where it's available, can end users readily access it?

At some health sciences institutions, Internet access has been provided initially to all via the institutional network, but incidents or firewall concerns have led to removing institution-wide access. In some instances, the library is separated from the institution's network and has Internet access through its own service provider. In these cases, users have Internet access, but not from their desk tops. On the other hand, many institutions now have less fear about firewall issues. Technical firewall problems created difficulties in accessing electronic subscriptions at some locations; those problems were resolved with a proxy server. One library reported that because of an Internet prank, the library was losing its generic login access to electronic resources; the library will be able to use only resources that can be authenticated by individual passwords. Some individuals, such as residents and physicians, will have their own login IDs; who decides who deserves a login ID? Use of Internet computers in libraries for entertainment or checking investments puts a strain on scarce resources when the number of workstations is limited and many users are competing for access.

Public libraries are still trying to get enough workstations for Internet access. Public library patrons use various Internet applications, from doing research to checking their e-mail. Filtering Internet access is a major concern for public libraries; the State of Hawaii is considering a statewide filtering law for public libraries.

Segmentation of networks to forestall Internet access can be viewed as a losing battle. Abuse of Internet access is a value problem with the users; legislation will not resolve this issue. We are moving toward ubiquitous Internet access, with convergence of many applications over this "pipe." Misuse of the web in the workplace is a management issue that can be compared to inappropriate use of workplace phones.

Of 61 health jurisdictions in California, 58 counties are linked to the Internet. The cities, with large government bureaucracies, have encountered more barriers to linking than the smaller jurisdictions have.

CONSUMER HEALTH INFORMATION

Public use of MEDLINE has risen dramatically over the last few years since the advent of free access on the National Library of Medicine web site. Subsequently, NLM introduced MEDLINEplus and incorporated consumer health information services into the framework of the NN/LM program. PSRML has begun working with NN/LM members, state libraries, state library associations, and other non-health sciences libraries and agencies to determine existing services, assess needs, and facilitate partnerships. RAC members contributed the following observations on the needs and challenges in providing health information to the public.

Physicians are more involved - they are providing an increased level of follow-up on the information needs of their patients, including providing referrals to consumer health information centers and health sciences libraries.
Consumers need just-in-time information and training. We cannot expect to be able to do the advance training that occurs in academic and health care environments.
The reading level of most material is too high and terminology is too difficult.
Information is not specific enough for the information need.
Information on the topic at the consumer level often doesn't exist.
We need to cater to the margin of what people don't know - a resource doesn't serve you well if it contains what you already know.
Librarians are positioned to do selection and integration of resources for consumers.
Visual information (graphics) is helpful especially when there is a language barrier.
Consumer demand is high for videos on health topics (the demand is high in all age groups, adults as well as children).
The information need is immediate. There is a need for follow up to provide additional information as the consumer progresses from basic to more complex information on a topic. However, when consumers need more than basic consumer-oriented information, they may not be ready for professional-level literature.
Key issues include: 1) Who will digest or "boil down" the information? and 2) How can the information be tailored to the patron?
Different environments foster different types of consumer health information services; hospital services tend to be condition (disease) focused, while mall services tend to focus on wellness issues (e.g., fitness and nutrition).
There is interest in consumer health programs that teach people preventive health practices.
Health education has shifted from classes to individualized, customized information.
Research is needed to show how information affects health decisions.
Groups to work with in promoting consumer health information access include non-health related community groups and agencies, community activities (fairs), churches, neighborhood groups. Beauty parlors and nail shops could be sites for health information to be disseminated between women. Women are recognized as health information seekers, both for themselves and for their families. The aged are another group with a high level of interest in obtaining health information.
Other groups to work with might include unbiased vendors of education materials. Pharmaceutical companies are providing free health information, but may not be unbiased.
Hospitals are interested in consumer health information services as being good for the community and good public relations for the hospital.

OUTREACH TO HEALTH PROFESSIONALS

PSRML conducts outreach to health professionals through exhibits, on-site and distance educational sessions, and consultation on access to health information resources. While many programs have been successful, outreach to inner city clinics and smaller agencies has been hampered by local funding issues and time constraints of participants. In addition to direct outreach efforts, PSRML has awarded subcontracts for outreach programs conducted by NN/LM network members. A workshop is being offered in June to help develop network members' skills in preparing effective grant and contract proposals. RAC member suggestions for encouraging more proposals from network members included: 1) increasing the funding available for each award and 2) encouraging people to rework proposals based on reviewer comments and resubmit them when more funding is available. Also suggested was holding an information summit for community-based organizations to help clarify what is needed. Such a summit would help in assessing needs for training, grants, and other programs and would build coalitions between and among community-based organizations and information service providers. The RAC commended the PSRML outreach team's efforts, noting that they have gone out into communities to work with people in their own environments; this has really made a difference.

LIBRARY NETWORK SERVICES

PSRML and NN/LM network libraries have been preparing for the new web-based DOCLINE, expected to be released in late spring. Courses on business and organizational skills for working effectively within institutions were arranged in response to professional development needs identified during the regional E-Resources Symposium. The Internet connectivity program will continue; there are a number of NN/LM network members not yet connected. The response rate to the recent hospital evaluation survey was excellent; PSRML will be looking at the level of technology demonstrated in network libraries as well as drawing comparisons with results of past evaluations. A survey of Latitudes readers is planned; the newsletter became an electronic publication with the January/February 2000 issue. RAC members discussed PSRML communication and feedback mechanisms, including the regional listserv, newsletter, and RAC discussions.

For additional information on PSRML programs and services, or to contribute your ideas, please contact PSRML at psr-nnlm@library.ucla.edu. Contact information for the Regional Advisory Committee members is listed on the web site at http://www.nnlm.nlm.nih.gov/psr/racweb.html.

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