Friday, July 31, 2009

Friday Foolery #45: Pants!

'Tis true. I spent the whole week without any pants on which is an extreme rarity for me.

Skirts and shorts are the only way to go when you have no air conditioning at home and temperatures are in the 90s every day. It then soared to 103 (officially, our house had 104) on July 29th, the hottest day ever recorded in Seattle.

On the plus side, I did get some funky abs toning thanks to daily Slip-n-Slide sessions with the family. On the negative I'm quite sleep deprived, am going in to work today solely for the air conditioning since I normally telecommute on Fridays, and neither hot coffee nor bacon sound all that great. The horror!

Wednesday, July 29, 2009

Blog With Integrity - Why I Write

mystical moose by Steve took it

I approach blogging the same way as when I was the News Director at my college station KSUN in the 1990s. I and my news team was tasked with recording carts for newsbreaks that the DJs would play at set times during their shows. I also add a heavy dose of investigative work thanks to my soft spot for healthcare journalism. My past is very much my present.

It comes down to telling it like it is in truth; the good, the bad, the Elsevier Australasian. I inject my attitude in frequently because this is my blog but I do try to be fair. The more ridiculous something is, the closer I will stick to neutral language to let the story speak (scream?) for itself. I can not allow this space to speak for others except myself, with the exception of guest bloggers who tell their own truth as well.

This is why I'm thrilled to learn about, sign up for and promote Blog With Integrity. I subscribe to this pledge:

By displaying the Blog with Integrity badge or signing the pledge, I assert that the trust of my readers and the blogging community is important to me.

I treat others respectfully, attacking ideas and not people. I also welcome respectful disagreement with my own ideas.

I believe in intellectual property rights, providing links, citing sources, and crediting inspiration where appropriate.

I disclose my material relationships, policies and business practices. My readers will know the difference between editorial, advertorial, and advertising, should I choose to have it. If I do sponsored or paid posts, they are clearly marked.

When collaborating with marketers and PR professionals, I handle myself professionally and abide by basic journalistic standards.

I always present my honest opinions to the best of my ability.

I own my words. Even if I occasionally have to eat them.

This is why critiquing Clinical Reader was important to me. Even if I wasn't threatened for it and covered en masse as a result, even if no one else read a word I wrote, I saw what was wrong and had to say something.

I always will even if everyone else thinks otherwise & I'm in it up to my neck.

Thanks to LibrarianInBlack for the hat tip!

Monday, July 27, 2009

Evaluation 2.0: Clinical Reader

It's been two weeks since I posted my original critique of Clinical Reader.

Website Update

The good news is the 5-star 'according to' the National Library of Medicine and other organizations graphic and the 3 copyrighted images that were being used without permission are gone.

The so-so news is there is still no identification or specific contact information on the website about who is running Clinical Reader or on their Editorial Board. Does 'A junior doctor and a small group of forward thinking young tech programmers' make for an 'authoritative source' for health news and information? (About/Beginnings)

The bad news is in the multimedia section. I've created a one minute screencast demonstrating why

Below is SpringerImages Terms of Use policy section 5b, bold emphasis mine:
You shall not use the Content for commercial purposes, i.e., for the purposes of monetary reward by means of the sale, resale, loan, transfer, hire or other similar form of exploitation of the Content, direct or indirect, including the placement or upload of the Licensed Content on a commercial entity’s internet website.
The definition of a commercial or legal entity is a person or organization that can legally enter a contract, and therefore may be sued for failure to comply with the terms of the contract. (source)

Clinical Reader is a commercial entity. They are soliciting advertising contracts per their Advertising. The wording of Clinical Reader's Privacy Policy section 5 also indicates interest in working with marketing and pharmaceutical companies with We may share your personal information with companies performing services on our behalf (such as direct marketing agents or pharmaceutical companies) who will only use the information to provide that service. The Privacy Policy is about midway down through Clinical Reader's Terms of Use.

Hotlinking, or directly linking to an image and using an outside server's bandwidth to display it on your website, is not considered a good website practice with the exception of banner advertisements. The source of one of the images displayed on Clinical Reader is

This is a new development as the screencast of the Clinical Reader multimedia page from the Google cache dated July 24, 2009 22:54:29 GMT shows nothing from SpringerImages.

Social Media Update

Here is a sampling of blog coverage about this aspect of Clinical Reader, the variety of viewpoints from different audiences is quite interesting.

A comment from David Lee King includes
The web tends to magnify personalities. If you’re a good person, it will show. If you run a company that links to un(typo?)copyrighted stuff & posts fake recommendations, then posts defensive tweets about it … well, that shows too.

Friday, July 24, 2009

Friday Foolery #44: Twitter


Inspired by the aftermath of

Am I done?

Ha! Stay tuned for Monday.

Friday, July 17, 2009

An Open Letter to Clinical Reader

July 19 '09 7:00am edit

Twitter links below have broken due to constantly changing Clinical Reader accounts so I have linked to screenshots.

The latest account on Twitter states that the previous account is unaffiliated with the real website and that they haven't officially started tweeting yet.

A screencast of the website's Google cache, dated July 17, 2009 1:43:11 GMT, scrolls to the bottom of the page to show their link to a Twitter account with a url of

July 17 '09 6:40pm edit

Twitter links below have been changed from @clinicalreader to @clinical_tweets. The original account was apparently deleted then reinstated with a new name, and there's a different @clinicalreader account now.

Dear Whoever Is In Charge,

Previously, with your permission, I posted your co-founder's email apology for your company threatening me on Twitter. That was as a result of my critique of your online information resource that implied an endorsement from a United States government agency that does not issue them to commercial services, and using copyrighted images without permission from their creators.

I found two of those images although there were three including the image your company took, altered, told the owner of the image it was a purchased stock photo, then finally removed it.

I replied to accept your co-founder's apology (my reply is here) and stated at the time I also accept inclusion in the medical librarian's section of your page. At the time I believed your company was sincere, learning from mistakes made, and intending to conduct both your online information resource and social media communication channel with integrity and professional responsibility.

That was a false belief as your company has shown over the course of this week.

I have edited a Google Doc that I believe is the source information for the proposed medical librarian section. I no longer wish to be included. Some of the reasons why include your company making a mockery of your threat to me as 'all very funny and great PR', falsely attributing it to Ben Henley, then after 'taking control from... Canadians' (screenshot) once more twisting the words of others to imply endorsement for your company. I have permission from Martha to post the following screenshots since she has a private account:

Your company refers to your information resource as an 'authoritative source' (Beginnings, About) yet nowhere within your website do you identify yourselves by name nor the institutions you are affiliated with so users may verify your level of authority for themselves. Who are you and your Editorial Team (screenshot)? Where are you located?

Your contact information says to contact you via email and Twitter (your 'dedicated beta feedback form' goes to and nothing specific), yet your company now says 'pls use official channels' (screenshot). What are those official channels? Why are you 'happy to be open' one moment then 'not like your predecessors pls use official channels' (screenshot) the next since taking control from the Canadians? When will you decide upon your 'official channels' and have a consistent message to send across all of them?

How is Clinical Reader is an 'authoritative' resource that 'respects all copyrights and legal restrictions on content and access'? (source)

It is not by assessment measures for health information website quality I'm aware of as a librarian. Your website fails all of the Medical Library Association's suggested criteria for identifying sponsorship, for example.

Clinical Reader has, however, become a case study for why a company's social media presence should be included as part of information resource quality assessment measures. Iris is right on track except for one thing: it's not 'hundreds of people have gone from knowing nothing about this service to being sure that everyone at Clinical Reader is completely insane.'

As of Friday morning it's 3,031 people with 3,990 page views on Monday's critique according to Google Analytics.


Nicole Dettmar, MSIS

Friday Foolery #43: Saving the Squirrel

Poor little guy. We only eat Tillamook yogurt in our house with straight, squirrel-safe sides instead of the deadly Yoplait taper.

Wednesday, July 15, 2009


Feeling gratitude and not expressing it is like wrapping a present and not giving it, by*MizzEl*

What I had to say about Clinical Reader was not of massive importance.

It was a website evaluation and critique, something that librarians, students, journalists and everyone else should be doing on an automatic cognitive basis millions of times a day. My intent is and always will be education, and hopefully both my colleagues and the world now clearly know that United States government organizations do not endorse products or services. [edit: and using copyrighted sources for your own use without the creator's permission isn't cool either!]

What so many of you had to say when I was threatened as a result of my post is important.

I must say thanks for the immediate public support on Twitter to Jacqueline (multiple times), Rachel (likewise), Steve, John (and Patrick's RT), Peter, who brings up something about libraries I didn't see before; Nick (LOL), Amy (ha!), Amy, Connie (also multiple times), Sarah, Shamsha, Martha, Andrew, Erika, Luke, Mark, Laura, Sarah, all of you who commented on these related discussion threads, and everyone else I've likely missed. I wish I could thank you all personally. It is quite humbling to know I am part of an international network of information professionals that is so much greater than I.

I am thankful for blog coverage from Steve, Alan and David for those who aren't on Twitter, which is the overwhelming majority of librarians who should be aware of things like this happening in social media but were probably off in Chicago at the American Library Association conference.

For numerous private messages of support, and especially the dropped jaws and 'WHAT?!'s from my colleagues who are part of my everyday personal life... thank you.

I also must say thanks to Guardian columnist Ben Goldacre of Bad Science.

There was an interesting conversation that occurred yesterday about just what endorsement means and other topics between Ben and Clinical Reader. Some of the tweets have now been deleted.

However, I recorded them all earlier thanks to QuoteURL: one, two, three, and four.

Monday, July 13, 2009

Clinical Reader: Starry ethics fail

July 17 '09 7:40am edit

Closing this entry with an open letter to Clinical Reader.

July 15 '09 7:20am edit

Thank you for your support!

July 14 '09 3:42pm edit

With permission from the author, here is the email apology I received this morning from Clinical Reader. I have replied that I accept it.

I would also like to note that there is mention of the above apology on Twitter yet still not a public apology to me as there was for one of the artists yesterday.

July 13 '09 4:00pm edit:

As of this time, Clinical Reader is or already has removed all images I discussed below from their website. I commend them for their quick attention and responsiveness.

However, there was this before that:

I do not remove my blog articles. I am happy to edit when information within them is in need of updating, as am I doing now, or corrections with clear markings as to what is original and what is corrected.

Others speak well about that legal ramifications part.

Original, unedited post below

It is with concern that I've heard about some of my colleagues promoting and collaborating with the newly launched company, Clinical Reader.

Why? (red scrawl emphasis mine)

This above-the-page-fold graphic is intentional (not accidental, this is clear marketing intent to lend quick visual credibility to the organization) and currently displayed everywhere (homepage, sections pages, multimedia page, the newsletter, etc.) throughout the resource.

It is bogus as far as the National Library of Medicine (NLM) is concerned since the U.S. Government doesn't endorse or grant 5 stars to anything. The NLM Copyright Information page offers more elaboration, bold emphasis mine:

Endorsement: NLM does not endorse or recommend any commercial products, processes, or services. The views and opinions of authors expressed on NLM Web sites do not necessarily state or reflect those of the U.S. Government, and they may not be used for advertising or product endorsement purposes.

But wait, there's more.

Clinical Reader also currently uses two copyrighted images on their Partners (specific original source, copyright notice at bottom) and Advertising pages (from somewhere on Signalnoise). A 'credit' link to a source doesn't honor an image copyright. Even free open source images, such as this set of Springer Images, are often limited to usage for noncommerical purposes. Commercial organizations can well afford to purchase or design their own graphics.

As a medical librarian, I respectfully request that Clinical Reader remove all occurrences of these images from their website immediately. If not, this is my statement of intent that I'll request removal of my blog from their proposed medical librarian resources. I have already notified NLM and the artists involved about these images. All have replied and thanked me for doing so, one noting "They might have credited me, but not cool using my work to sell something."

I uphold the Medical Library Association code of ethics, the Library Society of the World Cod of Ethics, and my professional photographer friends deal with people stealing their copyrighted work all the time. Professional integrity means taking a stand to explain who, what, where, when & why when something is amiss. I'm a bit more direct than some.

carefully review new resources (and re-evaluate the old ones from time to time) for information. Any company that falsifies endorsements and displays copyrighted materials for their own use should raise immediate red flags for librarians. How does it reflect on our profession to recommend a resource that is not compliant for accountability to clinicians, faculty, students and your own colleagues regardless of how nice it looks and functions?

An Aggie does not lie, cheat or steal, or tolerate those who do. - Aggie Code of Honor, Texas A&M University, recipient of a 2003 Institute of Museum and Library Services (IMLS) grant that funded my MSIS education in partnership with the University of North Texas.

Friday, July 10, 2009

Friday Foolery #42: Codslap!

I'm not an American Library Association (ALA) member (when you work only 60% you choose your professional membership dues wisely) and not at the conference in Chicago right now, but part of me wishes I was so I could pick up a copy of this fabulous zine. You can learn the story about the Cod of Ethics here.

I have a codslap of my own to issue to something new currently creating a huge amount of buzz and support among my friends & colleagues, but my own ethics do not allow me to blog on work time even when I'm telecommuting. I'm now off to the morning's unread email diving in 3... 2... 1...

Sunday, July 5, 2009

Electronic Medical Records: Who's On the Menu?

with caption 'EMR's are saving time, money and making people safer how???' by El Mnopo

I recently finished The Last Lecture, the book written after Randy Pausch's inspiring lecture that delved into more of his stories. One of them brought to mind both the error message from an electronic medical record (EMR) above and some frustrating databases I've encountered. Dr. Pausch used to bring in videocassette recorders (VCRs, remember those?) to his classes on one day, then a sledgehammer on the next day to destroy them in front of his startled students. Why?
When we make something hard to use, people get upset. They become so angry that they want to destroy it. We don't want to create things that people will want to destroy.
His hope for his students creating new technologies now is that
Once in a while I come into their minds, swinging that sledgehammer, reminding them of the frustrated masses, yearning for simplicity.
While I can't advocate taking a sledgehammer to EMRs (they cost a heck of a lot more than a VCR) I can certainly understand the temptation to do so from system demonstrations/screenshots I've seen in addition to watching when the nurses, my doctor & lab staff enter data into my own. Simplicity seems to be an impossible dream for current systems, even if they are considered really good ones.

Nonetheless, the push is on to mandate EMRs in the United States and Scotland's National Health System is on track to be the first paperless health service in the world.
If you aren't at the table, then you are on the menu.
This response from Dr. Val Jones to Dr. Rob's discussion about a healthcare reform article isn't new but it is relevant to the healthcare information technology (health IT or HIT) stakeholder discussion for EMRs and the amounts of future funding coming down the federal pipeline for them.

Who is at the table? According to Dr. Rob, "Politicians, hospital corporations, pharmaceutical and insurance companies, and lobbyists". There is no mention of physicians or patients, the core of health care, although in theory they are there.

A look at 'Making Health Information Technology Work' at, bold emphasis mine, includes
Health IT will help consumers gather all of their health information in one place so they can consider it in as a whole.
It's important to note this is not about having a patient's health information in one place for a clinician to 'consider it'. How does a complete collection of health information transfer into patients' knowledge and understanding in order for them to 'consider it'? There is no Google Translate button for clinical data in EMRs to convert to consumer health language, and even if there was I wouldn't want to make decisions about my health based on that output.

How do you get the public to care about and support EMRs/health IT? A good first step is the video below that is available here:

How do you get medical librarians to care about and step up to their roles in EMRs and health IT? Yes, there are roles to be had here. Check out Librarians and the EHR: Envisioning the Future, which is where I learned about Woods Hole & why I applied to go there in order to develop a health informatics class geared towards medical librarians' involvement in health IT and particularly EMRs.

It was during a presentation at Woods Hole I learned about medical librarians' front-and-center involvement in a patient information portal not from the presenter himself while he was demonstrating the system, but on Twitter from Rachel Walden with a link to this 2007 JMLA article that covers their experience.

If that doesn't emphasize the fact that nobody will invite medical librarians to the table unless we step right up and take our own seats there, I'm not sure what does.

Perhaps a stronger version of 'you're on the menu' line may help. We are in the 21st century, where medical libraries are being abruptly closed or the librarian retires and institutions decide not to fill the position. Like the video above, the Vital Pathways resources are a step in the right direction for medical library advocacy although rather vague on direct librarian EHR/EMR/HIT involvement and I'm hopeful for much more meat in the white paper.

Perhaps the majority of medical librarians don't care about involvement in health IT. I hope I'm wrong, as there was stiff competition to attend Woods Hole and I know of other bright stars kicking butt out there. One of them wants my tomatillo salsa recipe. Maybe 'Cannot quit' should be our motto!

Friday, July 3, 2009

Friday Foolery #41: 150 years ago tomorrow

Oregon Trail mural Conestoga by mharrsch

In the words of her son, written sometime in the 1930s, a not-so-foolish but true story about my pioneer great-great-great grandmother. I don't have an ounce of her stamina.

I am now to record an event that was of common occurrence, but would no longer be considered possible among normal persons. William D. McIlroy and his wife Elizabeth had started the long journey into the wilderness with full knowledge of the fact that far out in that land of peril a child would be born to them. No physician was in the wagon train and no supplies such as we consider indispensable at the present time. There would be no place to go to for help or to purchase needed material or medicine. Among the pioneer people it was the custom to call in any woman of middle age who had been a mother to help the mother to be in the delivery of the baby. In older established settlements a regular midwife was generally available.

At Grass Springs, west of the summit of the Rocky Mountains, on July the 4th 1859, Sierra Ella McIlroy was born. She was their first child. The wagon train was delayed only one day because of the event, and still all went well with mother and child.

Can you imagine?

The family 1870 Bible page records Grass Springs as 8 miles west of Big Sandy River at Grass Springs then in what was known as Oregon Territory some 20 or 30 miles East of the East Fork of Green River on what was called Lander Cutoff on the road between the Mississippi River and Pacific Coast.

Sadly, the same Bible also records Sierra's death September 21, 1864 at about 4:00 PM at Hope Farm Prairie, Skookum Chuck, Lewis County, Washington Territory. Cause of death was diphtheria, she lasted about 5 hours and her throat closed. Age 5 years, 2 months and 17 days.

Happy 150th 4th of July birthday, great-great-great aunt Sierra. You were clearly way ahead of your current popularity and I wish DTap was around back then for you.