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

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

Presentation Overview

• Defining & Delineating Roles• Understanding Health Science Informatics in

Context• Practical informatics applications in Health

Science Librarianship (HSL)• Future roles

Who

Am I?

Your Changing Role as an InformationProfessional

Definitions, definitions, definitions

What is a Health Informatics (HI) Professional?

DB AnalystProgrammer

DesignerInformation Scientist

What is a librarian?

Ssshing Booklover

Programmer

The lines between our roles and

professions are becoming unclear

Definitions areUnclear (stereotypes)

Best definitionsare vague ones –

serve little purpose, but allow for variance

• 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?

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.”

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.

So Is Informatics Just About Technology?

Information Specialist in Context

Information in Context

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)

Medical Librarianship

Clinical Librarianship

Informationist

Health Informatics Librarian

Informaticist

Service-based Automation-basedCustomer Focused

Research NeedBest PracticeLatest Study Results

Patient EducationGuidelinesClinical Question

CDS, Labs,Immediate Need

Health InformaticsHealth Information – Levels of Need

Medical Librarianship

25 years ago, you had to travel for information

Today

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.

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

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?

Informatics Roles for Health Science Librarians

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.

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.

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

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?

Built custom Search Engine

For Patient

Education Needs

Informatics approach for Information literacy = Automated filtering

Information Literacy

David Rothman’s Medical Search Engine: An OPAC for the Web?http://davidrothman.net/consumer-health-and-patient-education-information-search-engine/

Is this informatics in practice or simply an evolution of our roles?

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!

Optional Knowledge

• Computer Networking• Basic Database Knowledge• Light Programming (Java, Python, PHP)• Social networks, Human Factors, HIB• Mapping flows and Processes (Systems

Engineering)

Informatics Cannot Be Just About Technology

Why the “IT Guy” & Technology Cannot Solve All of Your Problems

Greatest Failure at CRH“The OPAC Incident”

Implementation &

Approach Lacked

Sociotechnical Considerations.

Why did it fail?

Need + Organizational Culture + Desire

Effort Required to Gain Information

Existing Knowledge +

Illustrates why informatics approaches are important

Information Behavior Model

“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

Sociotechnical Considerations

• Novel use of technology• Misuse of technology• Workarounds• Unintended Consequences• Changes/shifts in power• Technology Humans

Influences

Sociotechnical Approach Tools

• Ethnographies• Mapping workflow – workflow diagrams• Focus Groups• Immersion• Interviews• Surveys

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

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?

Information Literacy & Informatics

• Automation• Education• Organizational

Programming• Pt. Ed & Clarian• Positive Deviance

Approach

Diffusion of Innovations

Rogers EM, Rogers E. Diffusion of Innovations, 5th Edition. 5th ed. Free Press; 2003.

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

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

Questions/Discussion