If anyone asks me how Woods Hole went, for the time being I spout forth one or more of the following
Amazing. Just amazing.
125 people applied for 1 of the 30 spots there. Why did they pick me?
Why isn't MLA collectively tapping Woods Hole alumni for the Vital Pathways project? Usually followed by an incoherent spiel about membership/organization ROI, future trends with electronic medical records, politics, etc.
Check out this pen, it's also a 1G flash drive!
My advice: Apply next year if this grabs hold of you. I'll be working on an online class to teach others but I guarantee the experience won't come remotely close. The all-expenses paid fellowship is not just for Americans as we had a Norwegian there too (skol!) Our medical library profession needs all the help it can get for navigating and advocating in informatics. If you weren't accepted for the program this year, try again. Keep it real by speaking your truth, your passion, and your intent to go forth and help change things for the better. I did within 6 hours after class was over by connecting two people working at federal agencies who needed to be talking with each other about the projects they're working on!
You may never know what results come of your action, but if you do nothing there will be no result. ~Mahatma Ghandi
Four months ago I attended the Librarians and the EHR: Envisioning the Future continuing education event by our local Medical Library Association (MLA) chapter, PNC/MLA, with a fair amount of guilt. The only reason I was able to go was because I took the place of a colleague who was seriously ill and that is never a cause for joy. I should have shared my 5 pages of notes from the EHR CE long ago, they serve as a brief guide to the presentation audio files although I had to take a phone call in the middle of one of them so there's a gap of information somewhere.
It was there that I learned about the Woods Hole bioinformatics program, although with total bafflement at first: it was one of those things that everyone else already seemed to already know about and I didn't. On the bus home it occurred to me that maybe I should apply and create an online class teaching more about medical librarians' involvement with electronic medical records (EMRs) because I couldn't be the only one who didn't know about the Woods Hole program. If I am, it's ok to laugh at me now that I'm going there in May.
My goal is to share the value from the experience as much as possible because I don't want to be an information silo. I know I can't promise blogging from there beyond a picture a day due to the sheer volume of information we'll be going through. I have since heard from many medical librarians who have been to Woods Hole and heard of several others. I'm curious: What has what you have learned there done for you, your organization, etc.? Are we already collaborating on this as part of MLA advocacy and I've missed the boat entirely? Thank goodness Rachel shared the tip about no elevators there so I only pack what I can haul up the stairs myself!
(I'm sorry for the lack of content since last Friday, I and my family have been ill and that's quite a drain on energy beyond life and work.)
This week's foolery is courtesy of myself in May, 2007 Note: No actual textbooks were incinerated in the production of this picture since I paid WAY too much money for them
Can you tell I didn't particularly enjoy that semester? Combining my payroll & human resources job, family (including a preschooler) and a full time load of distance education graduate classes in biomedical informatics (bottom text), information organization (top text), and electronic databases & services (no text) was not fun. It was, however, a necessity since being a full time student was a condition of the fellowship funding my education, for which I am eternally grateful. I wouldn't say that I hated any of the classes, but the amount of information from them was completely overwhelming to take in all at once.
At the end of May 2009, I will spent a long day en route from Seattle to Boston then take a two hour bus ride to Woods Hole, MA, because I learned on Tuesday that I was awarded a fellowship to study biomedical informatics there for a week.
Yes, one of the same subjects from May 2007 that almost drove me to the brink of insanity, and it gets even better. One or both of the authors of that informatics textbook will likely be there as instructors and one of them is the Director of the entire program. Is it possible to just die of embarrassment now and get it over with?
I'm sharing this in part to avoid an A-Rod situation and come clean from the start: I have zero natural talent here. I have enough existing knowledge to understand the basics of the field but am obsessed with learning even more from an impressive faculty without juggling other classes and the rest of my regular life duties at the same time. Hopefully I will not embarrass myself by asking too many stupid questions. My goal is to develop an online class to bridge the gap to health informatics for medical librarians because I truly believe we are all working towards the same goal (improved health information access) with many of the same tools but aren't speaking the same language.
With an increasing focus on the implementation of electronic medical records (EMRs), it's critical for medical librarians to not only be aware of but become actively involved with their planning and implementation at their facilities since we best understand the information-seeking behavior of our users. Information vendors would be very happy to entirely take over that role from us otherwise.
One of the greatest delights of working in an academic environment is never knowing what fascinating research may unexpectedly cross paths with you each week. Last year I held a lunar meteorite, which will probably retain the OMG COOL award for life because how often do you get to wrap your arms around a very heavy chunk of the Moon? I will never forget how I and everyone else around me was beaming with happiness approaching rapture at being able to do so.
While not quite as exciting as a lunar meteorite, being invited to research discussions by those who are passionate about their field and how their projects can help people is equally interesting to me. On Friday I was pleased to be able to attend a research conversation with Dr. Kent Unruh, a senior fellow with the Division of Biomedical and Health Informatics at the School of Medicine here at the University of Washington.
People organize their personal information to conceptualize what they know, enhance information retrieval in the future, and cue or remember tasks in everyday life. However, studies also suggest that organizing is difficult and people fail to use their information effectively for emergent tasks. In the health-care domain, patients face grave consequences if they cannot access and use information effectively. Arguably, patients have access to more information about their health than at any previous point in history. However, information access is only the first step to managing health care needs. Patients must organize it effectively to support the underlying tasks required to manage their health proactively. Ironically, ever-increasing access to information exacerbates the challenges patients face in using information effectively. In this paper, we describe five barriers patients encounter when organizing their information for use during cancer care. We describe each barrier using rich examples from our triangulated data set, and conclude with four recommendations to help patients organize information more effectively during active treatment.
I'm not too sure we followed the abstract presentation to the letter, but the implications I came away with for ways to help with information organization for cancer patients were
Provide a rich intermediate structure (embed pre-organized links to other related information on insurance, necessary customization that is highly personalized)
Leverage assistance from others (support co-management model, enable assistance from others & organization strategies for their particular situation)
Provide a functional view of information (integrate descriptive & procedural info (who/what/where/when/who), distinguish information for active tasks, represent patient's view of cancer care system) Discovery of time-sensitive financial info in the stack added significantly to emotional stress, sort information/bills by date due instead of date services given.
Incorporate emotional considerations (negative feedback loop of not being able to retrieve information when needed for patient involvement in own care)
What is the role of informatics in cancer care? Clinicians and designers can explore stress reduction techniques, embed cognitive cues & known stress reduction techniques for stress relief in managing information
For the research study background that led to these implications & a great discussion, my notes are over here. I asked about Health Insurance Portability and Accountability Act (HIPAA) & Protected Health Information (PHI) concerns and he responded that he's currently a co-primary investigator (co-PI) on a portal for patients to manage cancer care information that involves portable workstations where clinicians enter & annotate information. I want to know much more about that although it wasn't really the focus of this particular talk, and will definitely keep an eye out for more of his findings in the future.
I also see social networking (such as Facebook pages) as a way to meet the need of being able to "coordinate in common information space between disparate groups" to help out in areas of emotional support, driving to appointments, bringing meals over, helping with childcare and other related activities in a patient's cancer treatment. I'm convinced Facebook is probably already being used this way and I just haven't seen it yet. Blogs are great for sharing cancer diagnosis, treatment and other information with everyone at once and receiving messages of support from loved ones in return but not so much for group coordination from what I've seen, which is sadly way too much.
Yesterday I attended the Washington Medical Librarians Association (WMLA, which is pronounced 'wim-lah' or 'w-m-l-a' depending who you ask) meeting on the beautiful and snowy (?!) Bastyr campus. WMLA '07 was the first time I went to the meeting as a second semester graduate student, and during it I received the news that I would graduate at the end of the year (yay!) This year as a new graduate I actually understood everything, and celebrated the news of accepting my first librarian job (yay!)
After our business meeting and updates from our Regional Medical Library (RML), we learned more from Will Stuivenga (who also went to North Texas, yay!) at the Washington State Library about the upcoming April launch of Wayfinder, a multilingual online library catalog project providing a single search entry covering an initial 250 libraries ranging from public to tribal in our state. It is a partnership between several state library associations and the Online Computer Library Center (OCLC), with funding from the Institute of Museum and Library Services (IMLS, who also funded my degree... yay!) Wayfinder has options to filter search results, such as state region and type of library, and the ability to click directly to search results on individual online library catalogs for users to request a book. When users navigate to other websites, the top bar retains a button to return to Wayfinder with its logo, which was well-designed to reflect our region and the catalog's purpose. It will be interesting to see how well this is marketed & received by the community, I look forward to posting a link to Wayfinder when it's public.
Will was also kind enough to supply our meeting swag: cool WebJunction pens and orange rubber bracelets with Dream. Learn. Achieve. LIBRARIES promoting www.libraries.wa.gov :)
Ann Whitney & Sherrilynne Fuller from UW Health Sciences Libraries presented an update on HEAL-WA, an online portal to evidence-based medicine (EBM) databases for most licensed medical professionals practicing in the state of Washington & the librarians who assist them. HEAL-WA is one of several directives of the Washington State Senate Bill 5930 that passed in 2007, and the portal is currently in very early stages of development with an expected launch in 2009. This is an excellent opportunity to remove barriers to often costly EBM databases funded by a small addition to current licensing fees that is far less than the cost of most monographs in the medical field. Additional updates regarding HEAL-WA's development will be posted in a category of Dragonfly, our RML blog.
Fran Clark from Highline Community College presented an update on the recently revised Library & Information Services (L&IS) program the library there now directs. With a focus on paraprofessional library careers, Highline offers both face-to-face and online classes for programs ranging from an Associates of Applied Sciences (AAS) to K-12 certification taught by library staff who are currently doing what they teach (i.e. the cataloger teaches cataloging, and for the Spring quarter an RML employee will teach the Medical Reference class). Highline welcomes the opportunity to place L&IS interns in libraries, and Fran mentioned she's creating a list of those open to doing so. I need to connect with her as there is a similar project for the Pacific Northwest Chapter of the Medical Library Association (PNC/MLA) I'm working on so we can share resources!
I'm a huge fan of WMLA meetings at Bastyr because of their fantastic vegetarian buffet at the cafeteria, and the cream of asparagus soup with spanakopita for lunch was perfect for our cold, snowy day (yay!) There was also gluten-free gingerbread with some yummy topping for dessert that tasted 'normal' to me and quite delicious. I was bummed out that their bookstore was out of stock on their cookbook and their online recipes don't include it :(
We all kept staring out the window at the snowfall, which was beginning to accumulate by lunchtime, and a decision was made to continue the meeting but cut it a little short. Those traveling back home to Eastern WA left early and I hope they arrived safely since Snoqualmie Pass was closed for a while due to a nasty accident later in the afternoon.
David Masuda, MD and instructor for the UW School of Public Health, gave an informative presentation on Clinical Informatics: The Genie in the Bottle. My program of study was Health Informatics and I still can't give a crystal clear definition of it; I was glad to see he couldn't either. He highlighted the 5 core information issues for clinicians; being patient-specific, a medical knowledgebase, awareness of social influences, logistics (insurance & related) information, and population information. He then nested the physician-patient relationship within a sphere of 5 influencing factors of electronic medical records (EMRs) including 1st degree delivery organizations such as hospitals, 2nd degree delivery organizations such as pharmacies, others such as employers and the community, measurement organizations such as the Joint Commission and CNS, and the "new kids" such as Cerner, Google & Microsoft. Value in the medical field is traditionally seen as an equation of quality over cost; the US cost for healthcare is currently at $1.7 trillion yet we are 30th in quality. Ouch. An unspoken factor in this equation is access, as currently 47 million people in the US are without health insurance including 20% of the population of California. What can we as medical information professionals do to help in all this? His suggestions included working with CE committees, creating sets of articles to respond to issues involving medical errors and difficult cases, and provide information support directly to the hospital administration staff in support of evidence-based clinical care.
Joseph Janes, Associate Professor at the UW iSchool and founding director of the Internet Public Library, presented What To Think About When We Think About Reference. In today's setting, there is more information coming to more people in more ways than ever before. Reference services can be provided in both synchronous and asynchronous methods, but the most important tasks for us as librarians is to determine the appropriate ways for our particular set(s) of users and to make certain they are aware it's a single, value-added service for them. Entry points for reference are up to the user (i.e. face-to-face, phone call, instant message) but it is up to us as the librarian to determine the appropriate exit/conclusion. His perspective is that libraries contain the secret weapon of print resources, but notes these will be a decreasing importance in the long run as more information becomes digital. It is worth the effort for libraries and librarians to learn, play, succeed, fail, share, lead and innovate. Libraries are not just stuff, help & place but also values and interaction, and our users are everyone.
A suggestion he had is to go to bloggers and post relevant input regarding their subject specialties (more on my perspective regarding this in a future post!) and that this is usually received well. As we learned in library school, it is important to do a good reference interview but know you will probably do a few lousy ones the first few times you try a new medium (i.e. instant message).
An example of outreach to online communities includes two new YouTube videos called Research Minutes that Cornell developed to give a brief introduction to scholarly articles and substantive news articles for their undergrad students below:
He closed with a reminder that librarians make humanity more human, and our task is to organize and keep the human record. We need to be central to the information lives of communities, wherever those communities may be, and in an extended notional of library and librarianship we actually have to be better online than we are in person. Social protocols (usually!) guide traditional reference interaction on the phone and face-to-face, but they do not exist on the internet and users can click wherever they choose for information.
Overall this was a very informative and relevant meeting, and it was great to connect again with colleagues to share that I managed to graduate in December and have a new job on the horizon. I'll keep an eye out at MLA '08 in Chicago soon and hopefully be able to find them in the masses there!
