Upcoming regional goodness: PNC/MLA in October

Just as we've collectively settled down from the fun & excitement of our Medical Library Association (MLA) 2008 conference in Chicago, Michelle Goodwin gave us a taste of what's in store for us in the Pacific Northwest Chapter of the Medical Library Association (PNC/MLA):

The Pacific Northwest chapter of the Medical Library Association is planning an exciting continuing education event October 3 & 4 at the beautifully appointed Watertown Hotel (not far from the University of Washington) in Seattle. With the unseasonably cool weather, many of you may be wondering if the cool, crisp days of autumn are already upon us. Fortunately, we still have a few months before September is here, so you have plenty of time to sign up for the PNC '08 Education Update.

Forty rooms have been set aside for members at a reduced rate of $145/night. The Friday evening Welcome Reception will be held at the Portage Bay Cafe. We are excited to offer several valuable, interesting courses for our education update, including:

* "Electronic Health Records & the Health Sciences Librarian: A Forum"
- Thomas Payne, Sara Pimental, Kaye Martin, Emily Hull & Judith Hayes ($35)
* "Data Collection for Health Information Outreach" - Susan Barnes ($50 members/$80 non-members)
* "Hands-On Web 2.0: Collaboration, Embeddable Web, Online Software, and
New Ways of Sharing Information" - Greg Notess ($50 members/$80 non-members)
* "Value-added Searching" - Mary Ellen Bates ($50 members/$80 non-members)

The Hands-on Web 2.0 class will be held in the UW Health Sciences Library computer classroom; all other classes will be held at the Watertown Hotel.

With captivating topics and nationally-renowned speakers, this is an event not to be missed! Additional details will be forthcoming on the PNC/MLA website.


Regards,
PNC/MLA Professional Development Committee

Personally, I'm quite excited about the electronic health record (EHR) forum as I hold Dr. Tom Payne in high regard. The integration of EHRs with current, quality medical information for both clinicians and patients is a strong interest of mine, and I'm delighted he's agreed to join us for what should be an interesting discussion of how we as medical librarians can be part of this essential part of healthcare information systems.

I must confess to being completely Web 2.0ed out (is 2.0ed a word?) although I've enjoyed articles from Greg Notess (of Search Engine Showdown fame) when I was in school and his presentation at our regional conference last year in Billings, MT so I may have to give that a go as well.

Plus ça change, plus c'est la même chose: Change, communication & connectivity

My first professional medical librarianship job began on May 1st and it's been quite a ride over the past 3 weeks. At one point I had spent as many business days in the office as I had working days for various class, work meetings & one-day-only MLA conference activities in Chicago. My brain has not had a break from active work mode since Mother's Day on May 11th until tonight!

I missed out on a substantial amount of conference activities and face-to-face networking opportunities, but did have the benefit of briefly being there in the first place. Combining that experience with being able to attend the first live webcast of an MLA plenary at 7am with my son while semi-mini-blogging about it on Twitter was somewhat surreal. Thanks to the careful logging eye of the Emerging Technologies Librarian, I found out I talk way too much even when I'm getting breakfast wrapped up and everyone out the door for work & the school bus (lunches were packed at 6:30 am) then telecommute by working on my web class design in Moodle for the rest of the day. Sorry, housecleaning in heels and pearls was not on the agenda then or ever.

I'm only becoming more fascinated by all the discussion about change in the medlib field especially where the integration of recent communication technology with our work is concerned. Strip the 'Web 2.0' jargon and that's all it comes down to. Since I'm completely new perhaps I don't quite understand the full history and context, but what exactly is the big deal here? We as a society have put on our pants, picked up the phone, then took our phones everywhere with us to connect with others. How is this any different?

Then I read posts regarding how this year's face-to-face conference experience is apparently quite different than the norm and I have to take a step back. Lucretia McClure, whom I had no problem stopping in the hall to introduce myself and take a picture with then walked hand-in-hand with her into the Bearded Pigs gig, said at the New Members Breakfast that she didn't know another person at her first conference.

That was anything but the case for me, not only due to the rather strange combination of real life connections I have in both Texas and the Pacific Northwest, but because I talk too much on Twitter. There was a whole legion of people planning to be in Chicago who actually wanted to spend their valuable time meeting this total newbie. I've been involved in online communities since the early 1990s so I know how that online to face-to-face meeting dynamic goes, however this is the first time that I have been the newbie not only as far as the communication medium but the entire field to begin with.

I have never felt so simultaneously intimidated (the knowledge/experience factor) yet comfortable in a community as I did whenever I was with one or more of them. They offered me cash (I had lost my debit card), drinks, conversation, and even called out to me to connect when I was unaware of who they were in the massive sea of humanity at our conference. I still hate that I wasn't able to connect with several of them. I'm fairly certain that, like Lucretia McClure, I have met people at my first conference that are going to be my friends for life.

However, I'm not satisfied by this. The plenary webcast is a start, but what's next? Where is a collective online community for our organization that integrates all communication methods and honestly welcomes new member participation and leadership? I know for a fact there are plenty of other bright medlibs out there who aren't involved nor feel particularly welcome, but we need the collective strength of everyone and not just yearly conference attendees. Geographic location, family commitments, funding (even driving instead of flying is too expensive now!), time off from our jobs, and our own organization's infrastructure not only challenges community-building but in some cases actively discourages it.

We promote anytime/anywhere access to information and resources in the most efficient way possible for our users, and I want to be part of whatever it takes to do the same for our own organization plus encourage this vital sense of community. I have other online community friends of 8+ years I have never met yet we're closer than family. My dear mentor has given me everything with a fellowship for my education and has asked for nothing. The time for me to give back and have the most effective and lasting impact is now. Highly ambitious words for a 3-week-old, I know, but it's a vision I have and can't let die.

Making the C list, Google Health & advertising

As a followup to last week's post about not making the HMO C list regarding Web 2.0 mentions, I actually did beginning the next day according to my statistics. My guess is it's due to linking directly to the source article. Hello out there! :)

It is with this experience in mind regarding health information on the web that I'm mulling over the recent public debut of Google Health, an online electronic health record (EHR) that is owned by the person who creates it but has import capability from the electronic medical records (EMRs) of healthcare and other organizations that have partnered with them.

This sounded great to me, until I dug around to find out exactly who these partners are

Google Health Partners: About our partners

Google Health is an open platform. We publish our technical documentation and anyone who wants to integrate or partner with us can do so. We don’t work exclusively with any organization or company. We partner with doctors, hospitals, medical clinics and groups, retail pharmacies, health insurance plans, laboratories, pharmacy benefit managers (PBMs), and interesting companies that offer personalized online health tools to our users.

"Interesting companies that offer personalized online health tools" sounds suspiciously vague to me. Seeking more information about just how the partnerships work, I checked out the developer policies in place for them. Under the Data Use section is

Only use Google Health user data for the purposes disclosed in your privacy policy, and obtain users' opt-in consent if personally identifiable health data will be used for ad targeting.

Clearly label advertising

and in Notices is

• Promotional* notices must be clearly labeled as promotional
• Promotional notices may be sent a maximum of once per week per user
• Links in notices must open in a new window or provide a working back button

* Definition of promotional: Promotional materials are any materials that promote a product or service - such as encouraging the user to purchase or "ask their doctor" about a specific item. This includes coupons and sale announcements, as well as drug advertisements.

Contrast this to Frequently Asked Question (FAQ) #6

6. If it’s free, how does Google make money off Google Health?

Much like other Google products we offer, Google Health is free to anyone who uses it. There are no ads in Google Health. Our primary focus is providing a good user experience and meeting our users' needs.

So, as I understand it, Google Health itself will not have advertising as part of its basic platform. If users opt in to use third-party applications as part of their Google Health records, then there could be advertising generated from them.

This fact is not currently stated anywhere in the FAQ or the general user information that I can locate, but there is You can also use Google Health to access a host of online services and tools, from a variety of third-party companies, that can help you better manage your care. in FAQ #3 that states outside applications are possible to integrate in your Google Health record.

I'm concerned about this, especially regarding user populations with low web and/or health literacy who may 'keep clicking' to access applications without reading the terms of service or understanding the consequences of sharing their personal health information with them.

I have not signed up for my own account as I'm satisfied with my access to my HMO's EMR (got that down as a positive mention, guys?) that is protected under HIPAA and prefer to keep my health information that way.

MLA '08: PubMed Review & NLM Drug Information Portal

If you're in Chicago for MLA 2008, don't miss the NLM theater (Booth 532) as you make your rounds to drop business cards in for iPods & Coach bags while sipping your champagne and eating chocolate dipped strawberries from vendors with enormous marketing budgets! I attended two 20 minute sessions yesterday on what's new & upcoming with PubMed and the relatively recent debut of the NLM Drug Information Portal.

Have you noticed the new Advanced Search (beta) link to the right of the traditional search box in PubMed? Yeah, I hadn't either. Oops. The results I'm currently receiving aren't replicating the all options I remember from the presentation so it may still be a work in progress. New features they displayed include automatic term mapping (ATM), a citation sensor (where recommended citations are featured at the top of results if a search seems to follow that format), enhanced diacritics (no more Americanized äs), and a browser advice section that provides help for users with older versions that aren't compatible with PubMed.

The major change in this beta is the use of ATM in general searches, where they're seeking to move away from being so subject-centric in results (blah blah[MeSH Terms] OR blah blah[Text Word]) by including a range of other options (blah blah[Jour] & a bunch of others I'm not remembering). However, the end result is that more records received when using these ATM search strategies that could be less precise for MyNCBI/RSS feeds and regular users of PubMed are encouraged to use Advanced Search to pare things down may be a good idea. This caused a bit of a ruckus at the presentation I went to and, as always, NLM encourages our feedback by submitting email from the link at the bottom of each page.

Changes that were stated as being in the future with PubMed include MyNCBI data being recoverable, as currently if you forget your login/password you are out of luck, and a My Bibliography feature where authors can create collections of work and save that to search within results. So cool!

I forgot to take notes at the NLM Drug Information Portal, but if you haven't previously checked it out definitely add it to your pharmaceutical toolkit! It's pretty straightforward to play around in the tabs to see what's there, but a feature currently in development is a pill identifier similar to the one at drugs.com. They warned it may be a few months before that section goes live because it's pretty detailed work to take high quality photos of all those pills then map them to all the different shapes, colors and sizes they're in!

Probably not even worthy of the C list: HMO searching for Web 2.0 mentions and responding

In the midst of celebrating Mother's Day and packing for a trip tomorrow, I noticed an article in the paper today that reminded me of a bioethics librarian's recent post about privacy concerns with social bookmarking on a medical library website.

What, if anything, would you write differently in your blog, bookmark on del.icio.us, tweet on Twitter or otherwise communicate online if you knew your physician was reading it? What if you were part of a 'daily roundup' of mentions of your health maintenance organization (HMO) measured by your site traffic and 'comment tone'?

According to the Seattle Times, if you belong to my HMO you may be part of the roundup.

[The HMO] monitors cyber chatter with more vigilance than most major health plans in Washington. A staff member compiles a daily roundup of postings that mention the co-op. Each Web site is ranked by traffic volume. (Major news sources such as CNN.com are on the A list, while obscure blogs rate a C.) Each comment is rated for tone: negative ("Shame on you, [HMO]"); positive ("I feel like a human being here, not a number"); neutral; or mixed.

Note how I am carefully not mentioning said HMO by name here. Also note the newspaper's bias by word choice in the headline. However, this section regarding physicians does not settle well with me.

[Dr. E], the [HMO] physician, goes as far as to believe that blogs could offer direct clinical benefits. [Dr. E] has read patients' personal blogs, in which, he said, they reveal information they never would share with their doctors.

If doctors can find a way to harness such hidden insights, they can better tackle the root causes of ailments, [Dr. E] said. He added that doctors ought to welcome patients who seek health information elsewhere — even if they sometimes consult dubious sources.

I certainly stand by First Amendment rights to free speech and the fact that the internet is anything but private, but am very concerned about the possible integration of said free speech into my print or electronic medical records (EMR). In other words, if I "reveal information" I "never would share with" my physician in my blog and my physician reads it, is he or she then permitted to paste it into my EMR without my knowledge or consent? Send me an email or post a comment about it? EMR records are available to quite a few other entities besides my physician I have a strong relationship with, ranging from insurance agencies to snooping hospital employees. If I bookmark a bunch of websites about Dance Dance Revolution or bacon in del.icio.us that are easily accessible via a widget in my blog, will I be asked about any lifestyle or dietary changes at my next office visit?

If I do happen to make the C list at my HMO, can you please tell me my medlib colleagues there are not the ones conducting this daily search and while these roundups probably don't hold up to the same level as protected health information (PHI) that they aren't left in the break room for casual discussion either?

Week 8 assignment: Mashups & API

I have been waiting 5 days to post this week's assignment because I wanted to review HubMed. It was not until today that I realized HubMed wouldn't work in Firefox and I had to review it with Internet Explorer, which I do not consider acceptable since multiple-browser functionality is key in the 21st century!

I entered my standard not-so-popular search query (Lofgren's Syndrome, something I personally do not recommend having although it's considered the most desirable form of sarcoidosis) side-by-side in HubMed and PubMed and was pleased to see 152 identical results retrieved in the same order. When I tried to resort my results my relevance (something I'm rather curious about, how is this determined?) I received the same dreaded 500 Internal Server Error I did each time I tried searching HubMed in Firefox, which was disappointing. I also wasn't so impressed with the options in HubMed as MyNCBI offers much of the same except for tagging and the proprietary Scopus information for Elsevier subscribers. Perhaps this was all the rage a few years ago but is no longer?

I do like the idea behind creating your own quasi-meta search engine with source information from websites of your choosing using Rollyo though. I would be curious to know more about what algorithms they use to display search results so I can understand their relevance ranking, but I'm also certain their competitors would love to know that as well! A simple search of 'privacy' is difficult to measure the full context of due to its many meanings (patron privacy? privacy policies on websites? outdoor privacy screens thanks to 'sponsored links' aka advertising mixed in with the regular results?) but if there were certain MeSH, jargon or other terms that weren't so ambiguous and commonly mentioned in a select variety of resources this could be a fun & useful way to look for them.

This concludes my assignments for the MLA CE! I will try to update regularly from here on out with various medlib issues, but at the moment I've completed my third day on my first job in my medical library career and it's quite a whirlwind of information. I am hopeful things will settle down later this month!