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Archive for June, 2011

Some news items from the NLM Technical Bulletin

Tuesday, June 7th, 2011

NLM Technical Bulletin, May-Jun 2011, New My NCBI Accounts and E-mail Addresses

In the near future, registering for a My NCBI account will require an e-mail address.

 NLM Technical Bulletin, May-Jun 2011, PubMed Abstract Updated with Epigenomics Data

The PubMed Abstract display will include links to the NCBI Epigenomics database, if applicable.



Award Report: Extending the Reach: Health Information Resources for Unaffiliated Health Professionals–Rochester Regional Library Council

Friday, June 3rd, 2011

This project provided awareness and onsite training sessions for nine health agency partners. These agencies were identified as unaffiliated,  i.e., the health professionals working there (nurses, therapists, social workers, and others)  did not have use of the licensed and expensive electronic resources that are available to personnel at many hospitals and universities.

The plan to provide quality resources to these unaffiliated health professionals was developed under an earlier NN/LM MAR Planning Grant.  Under this project, a gateway on the CLIC-on-Health website was created that brought together links to free quality resources available from such sites as:  PubMed/Medline, MedlinePlus, NOVELNY Health Reference Center Academic, NLM Gateway, and the NLM Drug Information Portal.  Resource training including self-guided online tutorials and user guides were developed and made available for use 24/7.  A training program using the resources available from the For Local Health Professionals section on the CLIC-on-Health website were used as a “gateway” to instruct health professionals in the use of free health resources/databases on the web.

Sixteen awareness/training sessions enabled training for 155 participants.  Informational materials were provided for an additional fifty agency partner staff.  This training included the discussion of freely available health resources and access options for this information, including the role of Rochester area libraries.  The majority of training participants reported an increase in their level of awareness of free health information resources and of options for obtaining needed materials.

The project also enabled contact with academic librarians and their School of Nursing Faculty so nursing students would be made aware of the CLIC-on-Health for Local Health Professionals webpage prior to their graduation, as many of them will be employed in agencies that are unaffiliated.

The project was marketed to an extended group of potential users through the creation of a CLIC-on-Health poster/advertisement that is being sent to area libraries, nursing homes, insurance companies, and other health agencies.

Barbara Ciambor
Outreach Librarian
Rochester Regional Library Council

Award Report: Evaluating MedlinePlus Connect–The Institute for Family Health

Friday, June 3rd, 2011

The Institute for Family Health, a community health center in New York City, collaborated with its project team between July 2010 and April 2011 to develop and pilot test strategies for evaluating MedlinePlus Connect, the National Library of Medicine resource that links patient-specific health information with the patient portal of an electronic health record (EHR) system to relevant consumer health information on MedlinePlus.  MedlinePlus Connect is currently implemented within the Institute’s own patient portal, MyChart-MyHealth.

The project team, which included members from the Instititute, Columbia University, Weill Medical College of Cornell University, and the University of Miami School of Medicine, worked over the course of the NN/LM MAR award contract to achieve the following:

  1. further develop MedlinePlus Connect by creating direct links from medication sections of MyChart-MyHealth to relevant information on MedlinePlus
  2. develop reporting capabilities that will enable comparison of characteristics between MyChart-MyHealth users who do and do not use MedlinePlus Connect
  3. develop a formative pilot study to assess the usability and utility of MedlinePlus Connect to MyChart-MyHealth users

All three objectives were achieved.  Work on the first objective was completed in Fall 2010 and is now implemented in MyChart-MyHealth.  The Institute expanded on this effort by creating additional links from its newly launched Spanish-language MiRecord-MiSalud to Spanish-language information in MedlinePlus. The Institute also provided EHR-based laboratory test data to MedlinePlus staff to facilitate linkage to relevant content in MedlinePlus, and it is working to develop links to allergy and immunization information documented in the patient portal.

The Institute worked with NLM and its EHR vendor Epic to develop a program within MyChart-MyHealth (and its Spanish version) to track use of MedlinePlus Connect.  Patient use of MedlinePlus Connect from MyChart-MyHealth was tracked from 2/21/11 to 4/27/11.   During this period, over 900 Institute patients clicked on links to a wide variety of health topics and nearly 800 separate web pages, with an average of 24 patients per day linking to an average of 1.75 topics.  De-identified tracking data reports were developed to conduct a preliminary analysis of MedlinePlus Connect use by patient characteristics.  A minority (8.9%) of the Institute patients with MyChart-MyHealth accounts used the links during the tracking period.

To better assess patient awareness of MedlinePlus Connect, questions were added to an existing patient telephone interview protocol. This survey is ongoing, but preliminary data from 22 interviews with patients with MyChart-MyHealth accounts found that 18 (82%) of them were not aware of the MedlinePlus Connect links within the portal. These early data suggest that the Institute must develop a strategy to raise patient awareness of MedlinePlus Connect.

The project team developed a usability testing protocol for MedlinePlus Connect that includes a recruitment script, a participant consent form and background questionnaire, and a facilitator guide. The team was unable to recruit eight participants to pilot test the protocol, but it is developing strategies for more effective recruitment.

Overall, this project has led to the development of a series of strategies for assessing the use and usefulness of MedlinePlus Connect among community health center patients.  This work has laid the foundation for a longer term and more comprehensive assessment of MedlinePlus Connect.

Diane Hauser
The Institute for Family Health

Award Report: Improving Health Literacy Skills of Low-Literate Adults–Literacy Volunteers of New Jersey

Friday, June 3rd, 2011

Navigating the U.S. healthcare system is extremely challenging. Two decades of research indicate that today’s health information is presented in ways that are not usable by most Americans, and low-literate adults have less ability to understand and act on health care information when compared to peers with average literacy skills.

This past year, with support from a MAR Health Literacy Award, Literacy Volunteers of New Jersey (LVNJ) offered a series of seven workshops to encourage an increased focus on health literacy within adult literacy programs. LVNJ provides support for 21 programs throughout New Jersey that train volunteers to teach adults to read, write, and communicate in English. Workshops were offered in Mercer, Middlesex, Union, Morris, Monmouth, and Essex counties and were attended by a total of 89 participants.

The first workshop in the series was created for adult literacy program leaders and trainers, who increased their knowledge of health literacy and explored ways to reduce health disparities by working with local health care organizations and providers. Five workshops were geared towards tutors, who examined the changing definitions of health literacy, the impact of low literacy on health, and the role that culture plays in determining health practices and beliefs.  They identified some of the many literacy tasks needed to understand and act on health information and learned how to incorporate skill-building activities into tutoring sessions. Finally, LVNJ piloted a workshop for adult learners on reading medicine labels, using materials from Staying Healthy: An English Learner’s Guide to Health Care and Healthy Living, published by Florida Literacy Coalition. Adult students in this session learned about different kinds of medicines, how to read medicine labels, and how to understand warning labels.

This project provided support to LVNJ’s goal of helping low-literate adults build the skills required to make informed health choices, reduce health risks, and live healthier lives.

Jessica Tomkins, Executive Director
Literacy Volunteers of New Jersey

Award Report: Creating Virtual Offices and Classrooms with Apple’s iPad–Health Sciences Library System, University of Pittsburgh

Friday, June 3rd, 2011

When looking at tablet use across our patron populations, and with experience from our iPad patron circulation program, it became apparent that the Apple iPads would be highly beneficial for our liaison and outreach librarians. Out in the field, many opportunities for instruction are lost due to technology issues. This is especially true for embedded librarians who spend much of their working day outside of the library with their respective health sciences schools or in a clinical setting.

Through a MAR Technology Improvement award, 12 librarians at the Health Sciences Library System of the University of Pittsburgh recieved:

  • Apple iPad (8 GB wi-fi)
  • Apple iPad case
  • keyboard dock
  • charging cables and adapter

Software (app)-wise, HelvetiNote (a note-taking app) and GoodReader (a PDF and MS Office file reader) were provided to each librarian.  Both our university campus and the medical center have robust wi-fi access.

Through the use of the iPads we asked librarians to create a virtual “office” to enhance off-site or on-the-fly consultations and educational or clinical support opportunities. The anticipated outcome of the project was the ability for librarians to provide information support wherever they might be.

Librarians quickly adapted to the new technology. Online surveys were given to gauge usage and impressions of the tablets. Comments included:

  • “fills a need for portable computing that is not filled by laptop computers, PDAs, or smart phones”
  • “easy to use”
  • “LOVE”

Challenges included:

  • not enough time to locate or learn about the apps
  • iPad keyboard is hard to use
  • no Flash or USB
  • if no wi-fi network isavailable, there is no connectivity
  • no out-of-box MS Office products

Overall, 91 percent of the group utilized iPad for off-site work, including:

  • consultations
  • morning report
  • meetings
  • on the hospital floor
  • School of Health Sciences journal club

Based on this project, we recommend that libraries begin to investigate tablet computers as librarian-centered productivity and outreach tools.

Fran Yarger
Assistant Director for Computing and Metadata Services
Health Sciences Library System, University of Pittsburgh/UPMC

Award Report: Consortia Purchasing Award–HSLANJ

Thursday, June 2nd, 2011

The Health Sciences Library Association of New Jersey (HSLANJ) was awarded a Consortia Purchasing / Electronic Resource Access Award from the NN/LM MAR in April 2010.  Since 2002, HSLANJ, through the New Jersey Hospital Association Library (NJHA), has offered hospital and nonprofit health sciences libraries access to low-cost, evidence-based electronic resources through a group licensing program.  When the NJHA library closed in 2009 HSLANJ’s group licensing initiative was left without administrative structure and day-to-day leadership.

Our project encompassed three goals 1) to create a business plan for HSLANJ group licensing initiative (GLI); 2) to provide a structure for the GLI; and 3) to continue the GLI during the transition year.  Library Development Solutions was hired to assist us with the first two goals and our third goal was managed by Robb Mackes.

Library Development Solutions met with HSLANJ group licensing committee members and surveyed HSLANJ and consortia members in Delaware and Pennsylvania served by the GLI before providing a report, which outlined three options for HSLANJ to consider:

  • Establishment of a new group licensing organization GPO
  • Creation of a consortial buying group within HSLANJ
  • Affiliation with an existing consortium with proven experience in database licensing

The report provides detail on each of these three alternatives, giving both pros and cons for each scenario.  While Library Development Solutions was crafting a plan for the future, Robb Mackes and the committee were working with vendors to provide the 2011-2012 group licensing offer.  The success of this initiative can be measured by the number of institutions participating and the amount of resources licensed. Sixty-eight (68) institutions licensed $1,144,547 in resources.

HSLANJ now has the data and information needed to begin expansion of the GLI to the entire NN/LM Middle Atlantic Region.  We recognize that such expansion will be a huge undertaking–one we hope to achieve through partnership with NN/LM MAR or an established consortia.  Next steps include meeting with MAR staff to share our findings and discuss our initiative and sending RFIs to established consortia.

Kerry A. O’Rourke
Co-Chair, HSLANJ Group Licensing Committee




Award Report: Value of Library and Information Services in Patient Care Study

Wednesday, June 1st, 2011

The Value of Library and Information Services in Patient Care Study (hereafter referred to as the Value Study) is a research project designed to understand the value of the health library, information services, and the librarian in patient care. The study employs mixed methods to investigate 1) the use and value of the print and electronic resources provided by the library and 2) the information services (mediated or assisted information requests/searches) provided by the librarian that aid in clinical decision-making. The Value Study has been funded by in part with federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract #N01-LM-6-3501 from the New York University Middle Atlantic Regional Medical Library Program. Additional support is provided by the Hospital Library Section of the Medical Library Association (MLA), the NY/NJ Chapter of MLA; the Philadelphia Chapter of MLA; the Upstate New York and Ontario Chapter of MLA; the New York State Reference and Research Library Resources Councils and the Donald Lindberg Research Fellowship from MLA.

The study builds on previous research, notably that of the Rochester study conducted in the Rochester, NY, area in the early 1990s. The current study updates the Rochester study and recognizes the changed environment in which librarians and library users and non-users seek and find information to make clinical decisions.

The Value Study employed a multi-stage research design with a pilot phase involving 7 libraries and a full phase involving 49 libraries. The University of North Carolina at Chapel Hill (UNC) was awarded a contract to conduct:

  • A survey of physicians, residents and nurses affiliated with participating libraries to assess the value of the library and information services in patient care.
  • Interviews with selected physicians, residents and nurses from participating sites to understand the role of the library resources and the librarian in providing information related to patient care.

The study included a web-based survey of physicians, residents, and nurses. The survey explored the information services used by patient care providers and the impact of the health information on patient care. Similar to the Rochester study, the survey employed a critical incidence approach, whereby respondents were asked to recall a recent occasion an occasion in the last six months when they looked for information resources for patient care (beyond what is available in the patient record, EMR system, or lab results) and to answer questions regarding this occasion.

A pilot study was conducted to ascertain the effectiveness of study design, survey content, structure, and delivery method. The pilot test was conducted in the NN/LM Middle Atlantic Region.  Seven health libraries participated in the pilot test. Participating librarians were responsible for publicizing the survey to their physicians, residents, and nurses. The research team provided the librarians with templates of survey communication: publicity flyer, survey notification, invitation, and three reminders. The web survey was available from September 13, 2010 to November 19, 2010. The survey had 3,217 responses.

The second phase of the pilot test involved qualitative interviews with physicians, residents, and nurses. The goals of the interview were to understand the search behaviors of health professionals, the impact of self-guided searches on patient care, and the value of the librarian in searching and the value of health information (no matter where obtained) in patient care. The research team has conducted 23 interviews from the 201 respondents that were willing to be interviewed.  The research team has transcribed the interviews and uploaded them into an NVivo database for analysis.

For the full study, minor modifications were made to the methodology. The team invited health libraries in U.S. and Canada to participate in order to strengthen the study findings. The study enrolled 108 libraries in the study. Fifty-nine libraries dropped out of the study due mostly to timing and staffing issues. Forty-nine libraries participated in the full study. As in the pilot phase, the participating libraries were asked to complete a brief questionnaire to capture organizational characteristics. Survey Science Group was contracted to administer the web-based survey of physicians, residents, and nurses, both in the pilot phase and full study. Participating librarians were responsible for publicizing the web-based survey to their patient care providers. The research team provided a communication packet for the libraries. The full launch survey was available from March 17, 2011 to May 2, 2011. Over 15,000 providers responded to the survey. The UNC research team has just received the final data set and plans to complete the remaining tasks using the funds from the Donald Lindberg Research Fellowship from the Medical Library Association.

Joanne Gard Marshall
University of North Carolina, Chapel Hill

Award Report: “One-Stop” Shopping for Health Information–Rochester Regional Library Council

Wednesday, June 1st, 2011

CLIC-on-Health, created by the Rochester Regional Library Council (RRLC), is a gateway to quality healthcare information geared to target audiences such as teens, seniors, and health professionals–particularly those unaffiliated with hospitals and universities, and therefore unlikely to have access to licensed electronic resources. CLIC-on-Health is a collaboration of medical, public, and school librarians, and healthcare agencies in the Greater Rochester Region. Its purpose is to provide the people of the greater Rochester, New York, area with the high-quality healthcare information and resources they need to make wise lifestyle and healthcare choices.

The purpose of this Technology Improvement Award was:

  • To create a “meta-search” of health websites selected by librarians, allowing users to have a one-stop shopping experience when seeking health information.
  • To create a mobile version of CLIC-on-Health.

In late summer 2010, as work on the project began, the CoH Steering Committee determined the “meta-search” was not needed; MedlinePlus already provided a very similar feature. The Committee noted, however, that mobile computing was becoming more important as a method for people to access the Internet. The Project changed focus to that aspect.  As the project progressed, reports from The Pew Research Center validated our decision to focus on mobile computing.  A March 2011 report stated that 47% of adults get at least some of their news and information on a mobile device.

This project enabled the RRLC to create a mobile application and mobile website for CLIC-on-Health.  Working with a vendor (ITX), we created an “app” for the iPhone (available on iTunes, app name: ClicOnHealth) and Android phones, and a mobile version of the website.

The mobile version of CLIC-on-Health will be particularly useful for nurses and other healthcare professionals that are part of our NN/LM funded Outreach Award Extending the Reach:  Health Information Resources for Unaffiliated Health Professionals.”

Kathy Miller
Executive Director
Rochester Regional Library Council

Award Report: An iPad Lending Library for On Call/Night Float House Staff–Jersey Shore University Medical Center

Wednesday, June 1st, 2011

Jersey Shore University Medical Center offers residency training in categorical medicine, general dentistry, obstetrics and gynecology, pediatrics, and preliminary medicine, as well as an integrated residency in general surgery and fellowships in infectious disease, sports medicine, and geriatric medicine, for a total complement of 85 house staff. As part of their training program, house staff are required to work on-call time duty hours–time beyond the normal work day hours during which they are required to be immediately available–or to work night float hours.

Under the auspices of a MAR Technology Improvement award, the Booker Health Sciences Library purchased eight iPads with peripherals to create a lending library of iPads. Program faculty identified Kindle books for download.  (We discovered that the library could not set up a corporate account with Amazon to purchase Kindle books for download to the iPad.)  The identified Kindle books were purchased in e-book format specific for the internal medicine, pediatrics, and obstetrics and gynecology residency programs with on-call duty hours or night float hours. Lending policies and evaluation criteria are being developed.  Once these policies have been approved by the Graduate Medical Education Committee, the iPads will be loaned to house staff for on-call duty hours or night float hours. The library staff will offer training for every house staff member participating in the project and will serve as technical support during the project.  The library staff will evaluate the house staff’s reaction to and use of the iPads for independent learning or for direct patient care while on call. The library staff will ask each faculty preceptor for these respective house staff to also evaluate the effectiveness of the iPads as a teaching/study modality.

Catherine Boss
Booker Health Sciences Library
Jersey Shore University Medical Center

Change to ILL National Maximum Base Cost

Wednesday, June 1st, 2011

From NLM:

The “National Maximum Charge” that limited Resource Libraries to charging $11 was removed as a requirement for Resource Libraries in the NN/LM contracts for 2011-2016. The change was effective May 1, 2011. As needed, Resource Libraries may raise ILL fees to recover costs. Primary Access Libraries and Other libraries were already able to charge fees necessary for cost recovery. As always, all charges and provided services must comply with the copyright law.

NLM removed the $11 limit because we had received multiple requests from Resource Libraries who stated they were unable to recover their costs at $11 per article. Additionally, Resource Libraries were permitted to charge above the $11 limit via surcharges which caused confusion among network members in regards to the expected charge. The removal of the National Maximum permits all libraries in the Network to charge cost recovery based fees.

As a point of reference on lending, during the previous contract period of May 2006-May 2011, Primary Access Libraries filled nearly 43% of the DOCLINE requests. Resource Libraries filled just over 31% of the requests. “Other” libraries borrowed lent just over 22% of requests.

We recommend that libraries changing their fees provide adequate notice to their regular borrowers, and through regional lists. Borrowers may wish to review their Routing Tables. Borrowers unable to find a lender can route requests to NLM, whose base ILL fee remains unchanged at $9.