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The iLibrarian - Health Informatics Librarianship
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The iLibrarianHealth Informatics Librarianship
A New Role for the 21st Century
Chris Kiess, BA, MLSResearch Coordinator
Regenstrief Institute, Inc.
Further Resources Available at: http://web.me.com/kiess/iLibrarian/Home.html
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Background
• Eli Lilly – Portal Development• Polis Center – Geospatial data, Metadata development• Columbus Regional Hospital – Information & Knowledge
Specialist• MS in Health Informatics expected 2010• Regenstrief Institute Current Projects:
AHRQ 8 ACTION CDS – OncwatchAHRQ Hospital Acquired Infection (HAI) Assessment ProjectAHRQ Testing the Spread & Implementation of Novel Methods to Reduce MRSA
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Presentation Overview
• Defining & Delineating Roles• Understanding Health Science Informatics in
Context• Practical informatics applications in Health
Science Librarianship (HSL)• Future roles
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Who
Am I?
Your Changing Role as an InformationProfessional
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Definitions, definitions, definitions
What is a Health Informatics (HI) Professional?
DB AnalystProgrammer
DesignerInformation Scientist
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What is a librarian?
Ssshing Booklover
Programmer
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The lines between our roles and
professions are becoming unclear
Definitions areUnclear (stereotypes)
Best definitionsare vague ones –
serve little purpose, but allow for variance
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• New Roles• Less patronage• Mngmt. of “resources”• Delivery of
Information• Point-of-care• Web, web, web
• A new role – small threat
• Little knowledge of info science
• Tech heavy• Often discipline
specific• Interest = cds, emr,
phr, lis, his, hl7
Librarianship Informatics
Is informatics a threat or compliment/supplement given the above comparison?
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My HI Definition
Health Informatics is a transdisciplinary field of research utilizing the application of cognitive sciences, computer sciences, health sciences, design and information sciences to efficiently provide communication and information services and resources where they are needed, when they are needed and above all to facilitate “information in context.”
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Multidisciplinary: We work together, but stay within the confines of our discipline and comingle disciplines
Interdisciplinary: Coordination between disciplines to approach problems in a new way
Transdisciplinary: Moving across, between, within and without disciplines to form new paradigms and understand complexity of the world, an organization, a system, etc.
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So Is Informatics Just About Technology?
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Information Specialist in Context
Information in Context
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Is a Journal article good enough?
King & MacDonald (2004) Roles for Librarians
1. Sort Information 2. Evaluate Information based on user needs3. Transforming (transferring) information (ensuring it is used)
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Medical Librarianship
Clinical Librarianship
Informationist
Health Informatics Librarian
Informaticist
Service-based Automation-basedCustomer Focused
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Research NeedBest PracticeLatest Study Results
Patient EducationGuidelinesClinical Question
CDS, Labs,Immediate Need
Health InformaticsHealth Information – Levels of Need
Medical Librarianship
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25 years ago, you had to travel for information
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Today
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As our abilities change, thus do our roles
• Technology enables transfer of information• Move information – push, “here and now”• Studies = 40% of medical questions not
answered• The need has always been present, but the
ability has not
Cogdill, K. W., Friedman, C. P., Jenkins, C. G., Mays, B. E. & Sharp, M. C. Information needs and information seeking in community medical education. Academic Medicine 2000, 75, 484–6.
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The Medium has Changed More Than the Technology
• Writing is a technology in itself – as are books• The need for managing and retrieving information
resources remains regardless of medium• Book, scrolls, databases = information repositories
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Ironically, as our ability to produce information and increase access to that same information increases, our ability to assimilate, manage and disseminate decreases.
Are we approaching a new “Dark Age?”
Are we decreasing in intelligence as a response to technological enabling?
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Informatics Roles for Health Science Librarians
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Clinical Librarian - 1971
• Attend rounds• Direct contact (often w/pt.)• Involvement with research• Committee involvement• Point-of-care
ACARI R, LAMB G. The librarian in clinical care. Hosp Med Staf 1977 Dec; 6(12):18–23.
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Clinical Librarian - Variants
• Informationist (Davidoff &Florance)• Information Professional (SLA)• Information Specialist in Context (ISIC)• Information & Knowledge Professional• Does “librarian” still accurately encompass
our role?
Davidoff F, Florance V. The informationist: a new health profession? [editorial]. Ann Intern Med 2000 Jun 20;132(12):996–8.
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Columbus Regional Hospital (CRH)
• 6 month pilot of rounding• Attended nurse meetings, committee
meetings, ICU & CVU Rounds• Pharmacy championed – not nursing• Mixed success, general failure• Approached in April of 2008 by CNS to revise
service in CVU unit
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Other Projects at CRH – Thinking Decades Ahead
• TOC via email• SWOC (SwetsWise Online Content) – enabled
full automation of TOC• IP Authentication for 95% of materials• Cut 50% of print within 2 years• Doubled “esources”• RSS, Blog, PR, Web Presence?
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Built custom Search Engine
For Patient
Education Needs
Informatics approach for Information literacy = Automated filtering
Information Literacy
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David Rothman’s Medical Search Engine: An OPAC for the Web?http://davidrothman.net/consumer-health-and-patient-education-information-search-engine/
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Is this informatics in practice or simply an evolution of our roles?
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What We Should Know as Librarians
• Technological proficiency is the exception & not the norm in librarianship
• Should know basic Web Development• Do you know an IP address from a postal
address?• Basic knowledge of HCI, IA, Usability• Must be an expert in Online Information
Retrieval!
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Optional Knowledge
• Computer Networking• Basic Database Knowledge• Light Programming (Java, Python, PHP)• Social networks, Human Factors, HIB• Mapping flows and Processes (Systems
Engineering)
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Informatics Cannot Be Just About Technology
Why the “IT Guy” & Technology Cannot Solve All of Your Problems
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Greatest Failure at CRH“The OPAC Incident”
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Implementation &
Approach Lacked
Sociotechnical Considerations.
Why did it fail?
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Need + Organizational Culture + Desire
Effort Required to Gain Information
Existing Knowledge +
Illustrates why informatics approaches are important
Information Behavior Model
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“The OPAC Incident” Revisited from Sociotechnical Perspective
• More technology/resources not the answer• “Information in Context” – Do you know
what the context is?• Use new tool or capitalize off existing tools to
minimize workflow adjustment
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Sociotechnical Considerations
• Novel use of technology• Misuse of technology• Workarounds• Unintended Consequences• Changes/shifts in power• Technology Humans
Influences
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Sociotechnical Approach Tools
• Ethnographies• Mapping workflow – workflow diagrams• Focus Groups• Immersion• Interviews• Surveys
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Better Approach to OPAC – Informatics Approach
• Move access closer to currently used resources (Google Scholar, Pubmed)
• Implement link resolver• Linkout via PubMed• OCLC/Worldcat• A Little AJAX = Your own Widget
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An Even Better Approach – Sociotechnical Approach
• Study your users• What they say they do is often different from
what they do• Josette Jones, Nursing Study found nurses
would use browser bookmark tab at stations to seek authoritative sites.
• What can we do with this sort of information?
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Information Literacy & Informatics
• Automation• Education• Organizational
Programming• Pt. Ed & Clarian• Positive Deviance
Approach
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Diffusion of Innovations
Rogers EM, Rogers E. Diffusion of Innovations, 5th Edition. 5th ed. Free Press; 2003.
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Future Focus for HSL
• Federated search, link resolvers, single point of access from multiple web apps.
• Organizational information mngmt.• Knowledge Management• Informatics Partnerships• Ubiquitous Computing• Library as a virtual space – not physical
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Closing Points
• Your role is truly defined by you• Get technical • Think 20 years from now & avoid short term
thinking• Balance technical with social• Understand your users• Embrace Pragmatism
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Questions/Discussion