The following blog post doesn't really have much to do with libraries or information of anything of that ilk but last Thursday on my way to work I fell off my bike after a rather stupid-looking black Alsatian ran into me. Fortunately it happened in the park right behind Lewisham Hospital so I made my way over to A&E and was seen and tended to by the lovely staff there very efficiently. The upshot of the whole affair is that I have fractured my humerus, of which the only humorous - ha, ha! - thing is that I can say I now literally have a chip on my shoulder, and am reduced to living my life with one arm.
The timing isn't great - I am maid of honour at my sister's wedding in two weeks time and while the colours of the occasion are yellow and purple, I'm not sure the horrendous bruising on my inside upper arm are really what people want to see! But it could have been a lot worse - it's my left, not my right arm that is out of action, I fell just outside a hospital and I have incredible family, friends and work colleagues who have rallied around and given me so much love and support I am overwhelmed with gratitude! It has also been interesting seeing the NHS from the other side and I am so impressed by the care I was given at Lewisham Hospital. All the staff I encountered were friendly, efficient, professional, and up on the latest evidence. The nurse practitioner who wrote out my pain meds prescription came back a few minutes after giving me the scrip and changed it based on new research she had heard about from consulting with a colleague.
I am back there tomorrow morning for an apppointment at the fracture clinic so am hoping all shall be well. At some point I am going to write a post on living life with one arm and rate various activities one takes for granted on a sliding scale from relatively easy to impossible. Which shall hopefully be quite amusing but also remind me how lucky I am. After all, some people live their whole lives missing a vital limb and this will be my tribute to them!
Tuesday, 17 May 2011
A new library website
Tomorrow (18 May 2011) sees the launch of a shiny new website for SLHT Library & Knowledge Services. The library manager at PRU and myself have been hard at work over the last few weeks and months getting all the pages ship-shape to launch for Knowledge Awareness Week 2011. We have been fortunate in that we only had to adapt an already-existing website but has still been quite a challenge deciding what to keep, what to get rid of, how the whole thing should be organised and how to make it visually appealing!
The website is run on the open source content management program Joomla! , which I had no experience of previously but I found it pretty easy to use. We decided quite early on that we didn't want just text and had the idea of using blue textboxes of varying hues for people navigate round the site. One of the trickiest parts was trying to get these boxes all the same width and height as they are all dependent on each other.
We also had to agree on the language used across the site and ensure everything was consistent across all the pages, like what pages should open in a new window and having hover-text over links. It's always the small things that take the longest!
However the last documents were uploaded today and linked in so it looks as though we have ourselves a website! I am pleased with it and really glad to have something decent to present to our users that they can use on and off-site. Now we just have to make sure everyone knows about it!
The website is run on the open source content management program Joomla! , which I had no experience of previously but I found it pretty easy to use. We decided quite early on that we didn't want just text and had the idea of using blue textboxes of varying hues for people navigate round the site. One of the trickiest parts was trying to get these boxes all the same width and height as they are all dependent on each other.
We also had to agree on the language used across the site and ensure everything was consistent across all the pages, like what pages should open in a new window and having hover-text over links. It's always the small things that take the longest!
However the last documents were uploaded today and linked in so it looks as though we have ourselves a website! I am pleased with it and really glad to have something decent to present to our users that they can use on and off-site. Now we just have to make sure everyone knows about it!
Healthy Lives, Healthy People need a Healthy Information Strategy
I stumbled across a news item in this week's CILIP Update/Gazette which I wanted to make a note of as I thought it was rather good. A blog post by Guy Daines, CILIP's Director of Policy and Advocacy on the official responses to yet another of the government's White Papers on health and the NHS. This time it was the turn of public health in "Healthy Lives Healthy People" and once more there is no mention of the role of information, evidence-based practice, information literacy, research or the part libraries have in bringing about change and influencing clinical practice. As Daines points out, "it remains important to assert the crucial role librarians, knowledge officers and other information specialists already play in promoting and facilitating an evidence-based approach and how a modest investment in such skills and services can help effect the transformation desired" but as always the question is how best to convey this message to those making decisions.
There are already clear signs the huge plans for the NHS are foundering - perhaps if Mr Lansley had consulted a library professional and had done a bit more background research we wouldn't be in this mess right now....
There are already clear signs the huge plans for the NHS are foundering - perhaps if Mr Lansley had consulted a library professional and had done a bit more background research we wouldn't be in this mess right now....
Thursday, 21 April 2011
Librarians...The New Cupcakes?
It's been ages since I've posted anything on this blog but I came across this article via the wonderful Pop Culture Happy Hour Facebook page (a podcast which I listen to religiously every week) and knew it had to go on here. Thank you Linda Holmes - you hit the nail on the head, as ever!
And for all of you out there who have not yet experienced PCHH (as it is affectionately know) - get thee to iTunes OR visit Linda's MonkeySee blog and give your ears a treat. I should warn however that if you listen to PCHH on public transport you may end up embarrassing yourself!
If you need any further convincing, a large section of the PCHH fans appear to be librarians...
And for all of you out there who have not yet experienced PCHH (as it is affectionately know) - get thee to iTunes OR visit Linda's MonkeySee blog and give your ears a treat. I should warn however that if you listen to PCHH on public transport you may end up embarrassing yourself!
If you need any further convincing, a large section of the PCHH fans appear to be librarians...
Sunday, 7 November 2010
Two very different training sessions and a Face-off!
This week I encountered two very different training scenarios which once again reinforced the variety of skills and experience needed to do this job. Both training sessions occurred on the same day, which probably made the juxtaposition more evident in my mind but I thought it would be a good topic to reflect on in this blog.
The first session was a refresher for the Orthopaedics registrar who had come in to see me last week about his dissertation. His topic was about treating Achilles tendon with various non-surgical immobilisation strategies such as bandaging or binding and in the last session we had done a combination title-MeSH search using surgical and non-surgical terms. Now he wanted to focus on the non-surgical and try searching all fields (.af) instead of just title. I had a suspicion this would definitely increase the number of articles obtained but they might not be as relevant. We built a good search though and in this session I really took a backseat and let him get on with it, making suggestions and giving encouragement when he needed it. He was rather disappointed by the large number of results, especially when we re-ran the search in Embase, CINAHL and AMED and he is going to try title and abstract next, rather than all fields. It was interesting that he never actually looked at his results, just at the number of results and I suspect he felt a bit overwhelmed by it all. I don’t think anyone would be able to fault his search strategy however and it really brought home to me just how individual every search is and the importance of trying different things. It was also reassuring that he had picked up what I had shown him last week and seemed relatively comfortable with using the databases and combining terms. To be honest I don’t think I really needed to be there but I think he wanted some reassurance that he was doing it ‘right’. The session last just under an hour and a half.
My second session took place in the afternoon with a staff nurse who confessed herself she was not comfortable with computers and instructed me to talk to her like she was ‘stupid’. She had the additional problem that she was suffering from vertigo and had difficulty concentrating. But she had an essay to write by the beginning of January and had not written anything academic for over eight years! Our search was on treatment of acne in adolescents, which was fairly straightforward but I found myself having to explain things a few times over and I could tell by the middle of the session she was starting to flag. The session lasted just under an hour.
I have been trying to get the trainees to do more themselves recently, rather than me showing them how to do things, and am finding it incredibly frustrating! I am so familiar with the HDAS interface and use it all the time so watching someone try to use it for the first time and clicking all the wrong things is very difficult for me. It’s very tricky trying to get the balance between keeping the search relevant to them (e.g. choosing a topic that they want to search) while making sure all the basics of searching effectively are covered (e.g. truncation, phrase searching, MeSH). If a user wants to find articles on nursing and mentoring, they naturally want to type “nursing and mentoring” in the search box (like Google!) not “nurs*.ti AND exp NURSING” AND “mentor* and exp MENTORING”. It’s not logical to them, even though it’s perfectly logical to me. This is something I must overcome as it is only by doing that trainees are truly going to learn. Perhaps I should start the session by getting them to put in the terms they would naturally use to search then go from there, demonstrating through trial and error that truncation, phrasing and MeSH terms equals more results and more relevant results (hopefully!).
Both sessions were very interesting in very different ways and I found myself utilising different skills in each one. The first was rigourous on an intellectual level while the second tested my skills in teaching and patience. In terms of what was learned I think the first session was probably more successful but am hoping the nurse took something away which she will be able to put to use later. We did at least find some relevant articles for her essay, so that was a bonus!
On Friday I hosted what I am hoping will become a regular event in the library for the next six weeks or so. It was a Point-of-Care Tools “Face-off” which gave participants the opportunity to test out three leading point-of-care tools currently on the market; Up-to-Date, Best Practice and Dynamed. We subscribe to Up-to-Date through the Trust already but Best Practice (from the BMJ) and Dynamed (an Ebsco product) we have on a trial basis through the London Deanery until 31 December 2010. Basically what they do is present a medical condition and walk the clinician through it from initial diagnosis through to treatment and follow-up, all backed up with the latest evidence. A clinician’s dream you might think (!) but the uptake of these tools has been fairly slow and I really wanted to find out if they have any practical use in the real world by getting those in the real world of medicine to try them out.
I advertised the Face-off to just the medical students and FY1s/FY2s this time around, liaising with the medical students coordinator and emailing all of them, following up with a reminder this week. There wasn’t much interest unfortunately and I’m not sure whether this is because they are too busy or just genuinely not interested. I tried to use hooks in the email to get their attention (e.g. “good medical exam resource”) and even offered food but in the end we only had two medical students come along, plus my manager, the library assistant and a student radiologist. However they were very enthusiastic and gave some very helpful feedback. I kept the session very simple and informal (more of a drop-in rather than an actual session) where they chose one condition and tried out the tools searching on that one topic and filling out an evaluation for each one. Unfortunately we lost access to Dynamed in the afternoon (it had been working fine in the morning) so the session just trialled Up-to-Date and Best Practice. I wrote up their vote and comments on the whiteboard and so far Up-to-Date has 3 votes and Best Practice has 2 votes. Interestingly the clinicians both voted for Best Practice.
I am hoping to run more of these Face-offs every Friday now until mid-December and advertise them to the wider Trust. I now have all the materials set up and it will just be a case of topping up the refreshments every other week or so. Will be sure to record what happens on this blog!
The first session was a refresher for the Orthopaedics registrar who had come in to see me last week about his dissertation. His topic was about treating Achilles tendon with various non-surgical immobilisation strategies such as bandaging or binding and in the last session we had done a combination title-MeSH search using surgical and non-surgical terms. Now he wanted to focus on the non-surgical and try searching all fields (.af) instead of just title. I had a suspicion this would definitely increase the number of articles obtained but they might not be as relevant. We built a good search though and in this session I really took a backseat and let him get on with it, making suggestions and giving encouragement when he needed it. He was rather disappointed by the large number of results, especially when we re-ran the search in Embase, CINAHL and AMED and he is going to try title and abstract next, rather than all fields. It was interesting that he never actually looked at his results, just at the number of results and I suspect he felt a bit overwhelmed by it all. I don’t think anyone would be able to fault his search strategy however and it really brought home to me just how individual every search is and the importance of trying different things. It was also reassuring that he had picked up what I had shown him last week and seemed relatively comfortable with using the databases and combining terms. To be honest I don’t think I really needed to be there but I think he wanted some reassurance that he was doing it ‘right’. The session last just under an hour and a half.
My second session took place in the afternoon with a staff nurse who confessed herself she was not comfortable with computers and instructed me to talk to her like she was ‘stupid’. She had the additional problem that she was suffering from vertigo and had difficulty concentrating. But she had an essay to write by the beginning of January and had not written anything academic for over eight years! Our search was on treatment of acne in adolescents, which was fairly straightforward but I found myself having to explain things a few times over and I could tell by the middle of the session she was starting to flag. The session lasted just under an hour.
I have been trying to get the trainees to do more themselves recently, rather than me showing them how to do things, and am finding it incredibly frustrating! I am so familiar with the HDAS interface and use it all the time so watching someone try to use it for the first time and clicking all the wrong things is very difficult for me. It’s very tricky trying to get the balance between keeping the search relevant to them (e.g. choosing a topic that they want to search) while making sure all the basics of searching effectively are covered (e.g. truncation, phrase searching, MeSH). If a user wants to find articles on nursing and mentoring, they naturally want to type “nursing and mentoring” in the search box (like Google!) not “nurs*.ti AND exp NURSING” AND “mentor* and exp MENTORING”. It’s not logical to them, even though it’s perfectly logical to me. This is something I must overcome as it is only by doing that trainees are truly going to learn. Perhaps I should start the session by getting them to put in the terms they would naturally use to search then go from there, demonstrating through trial and error that truncation, phrasing and MeSH terms equals more results and more relevant results (hopefully!).
Both sessions were very interesting in very different ways and I found myself utilising different skills in each one. The first was rigourous on an intellectual level while the second tested my skills in teaching and patience. In terms of what was learned I think the first session was probably more successful but am hoping the nurse took something away which she will be able to put to use later. We did at least find some relevant articles for her essay, so that was a bonus!
On Friday I hosted what I am hoping will become a regular event in the library for the next six weeks or so. It was a Point-of-Care Tools “Face-off” which gave participants the opportunity to test out three leading point-of-care tools currently on the market; Up-to-Date, Best Practice and Dynamed. We subscribe to Up-to-Date through the Trust already but Best Practice (from the BMJ) and Dynamed (an Ebsco product) we have on a trial basis through the London Deanery until 31 December 2010. Basically what they do is present a medical condition and walk the clinician through it from initial diagnosis through to treatment and follow-up, all backed up with the latest evidence. A clinician’s dream you might think (!) but the uptake of these tools has been fairly slow and I really wanted to find out if they have any practical use in the real world by getting those in the real world of medicine to try them out.
I advertised the Face-off to just the medical students and FY1s/FY2s this time around, liaising with the medical students coordinator and emailing all of them, following up with a reminder this week. There wasn’t much interest unfortunately and I’m not sure whether this is because they are too busy or just genuinely not interested. I tried to use hooks in the email to get their attention (e.g. “good medical exam resource”) and even offered food but in the end we only had two medical students come along, plus my manager, the library assistant and a student radiologist. However they were very enthusiastic and gave some very helpful feedback. I kept the session very simple and informal (more of a drop-in rather than an actual session) where they chose one condition and tried out the tools searching on that one topic and filling out an evaluation for each one. Unfortunately we lost access to Dynamed in the afternoon (it had been working fine in the morning) so the session just trialled Up-to-Date and Best Practice. I wrote up their vote and comments on the whiteboard and so far Up-to-Date has 3 votes and Best Practice has 2 votes. Interestingly the clinicians both voted for Best Practice.
I am hoping to run more of these Face-offs every Friday now until mid-December and advertise them to the wider Trust. I now have all the materials set up and it will just be a case of topping up the refreshments every other week or so. Will be sure to record what happens on this blog!
Saturday, 30 October 2010
A busy October
It has been a very busy few weeks here in the Healthcare Library and I thought I would take a bit of time to reflect on a few things that have happened in the past weeks. My colleague and I did a session at another site hospital last week on critical appraisal, covering both quantitative and qualitative research (she did quan, I did qual) and it went really well! All the participants turned up, which is very unusual, and there was a good mix of doctors, nurses and allied health professionals.
I piloted an exercise found on the ever helpful CATNiP wiki called the “Qualitytative Street exercise” which basically used Quality Street chocolates to explain some of the concepts of qualitative research. Basically everyone had to choose their favourite, eat it then describe what they liked about the chocolate. These terms were written up on the whiteboard and then we put them into categories such as ‘taste’, ‘texture’ or ‘appearance’. We then had a discussion on such issues as focus group recruitment (e.g. nobody asked what the study was about before agreeing to participate!), why people might choose not to take part, how the data were “collected”, data saturation, how the data were analysed and the role of the researcher (how might their answers have differed if they knew I was employed by Nestle...or Cadbury’s?!) We got very positive feedback on the session overall and a few people mentioned they found the qualitative session particularly useful as they do not encounter much in their day-to-day work. I personally found listening to the quantitative session very helpful as it gave me ideas for what to add to my training course.
Our journal survey finished at the beginning of October but between one thing and another I didn’t get a chance to look through the results properly until Friday, when I had to send the results to my manager and the manager on our other site for a meeting on Tuesday about journal selection for the coming year. We had 151 responses in the end and it was very interesting going through the results. We received a lot of useful suggestions for how we could improve the service as well as a huge list of recommended journal titles. I do not envy the managers trying to decide which ones to take and which ones to discard! One very positive result was seeing how well the NHS resources are used – the majority of respondents said they used library.nhs.uk, HILO or MyAthens to access e-journals. The next favourite access point is Google which is not surprising really. Another interesting result was that only half of the respondents prefer electronic access to journals over print. 18% prefer print and 27% have no preference. The respondents seemed fairly satisfied with the provision of e-journals and print journals, ease of access and promotion and the top titles read at the Trust are BMJ, New England Journal of Medicine, Lancet, Nursing Standard, British Journal of Midwifery and Stroke. Some of the suggestions for improvement were a bit outrageous, such as having print copies of all journals at all three sites (exactly what we are trying to avoid!) and “electronic access via British Library services” (which if left to the devices of our users would wipe out our entire budget in a week) but others were very helpful such as targeted email services for specific subjects and coming to speak at team meetings and inductions. The survey certainly identified areas where further training is needed.
Finally I have been working away on my very first book review! An email went round a few weeks ago asking for volunteers to review a couple of books for the HLG newsletter. My manager forwarded it on to me and one of the books “Technology Training in Libraries” caught my attention so I got in touch with the person offering and volunteered to do the review. The book is part of the Facet ‘Tech Set’ series and was a very interesting read. I enjoyed the experience of writing up about it and will put the link to my review when it is published in the newsletter, hopefully next month.
I have been very busy with one-to-one sessions, especially as degree courses are starting up again. I had an Orthopaedics registrar in the other morning who wanted a very comprehensive literature search for his dissertation and I was grateful once again that a Masters degree is required for becoming a qualified librarian as the first thing he asked was whether I had experience in carrying out research. If I hadn’t done a Masters and gone through the experience of carrying out my research project I probably would have felt quite intimidated but as it was I could answer in the affirmative and he seemed quite impressed that a postgrad qualification was required for being a librarian!
I piloted an exercise found on the ever helpful CATNiP wiki called the “Qualitytative Street exercise” which basically used Quality Street chocolates to explain some of the concepts of qualitative research. Basically everyone had to choose their favourite, eat it then describe what they liked about the chocolate. These terms were written up on the whiteboard and then we put them into categories such as ‘taste’, ‘texture’ or ‘appearance’. We then had a discussion on such issues as focus group recruitment (e.g. nobody asked what the study was about before agreeing to participate!), why people might choose not to take part, how the data were “collected”, data saturation, how the data were analysed and the role of the researcher (how might their answers have differed if they knew I was employed by Nestle...or Cadbury’s?!) We got very positive feedback on the session overall and a few people mentioned they found the qualitative session particularly useful as they do not encounter much in their day-to-day work. I personally found listening to the quantitative session very helpful as it gave me ideas for what to add to my training course.
Our journal survey finished at the beginning of October but between one thing and another I didn’t get a chance to look through the results properly until Friday, when I had to send the results to my manager and the manager on our other site for a meeting on Tuesday about journal selection for the coming year. We had 151 responses in the end and it was very interesting going through the results. We received a lot of useful suggestions for how we could improve the service as well as a huge list of recommended journal titles. I do not envy the managers trying to decide which ones to take and which ones to discard! One very positive result was seeing how well the NHS resources are used – the majority of respondents said they used library.nhs.uk, HILO or MyAthens to access e-journals. The next favourite access point is Google which is not surprising really. Another interesting result was that only half of the respondents prefer electronic access to journals over print. 18% prefer print and 27% have no preference. The respondents seemed fairly satisfied with the provision of e-journals and print journals, ease of access and promotion and the top titles read at the Trust are BMJ, New England Journal of Medicine, Lancet, Nursing Standard, British Journal of Midwifery and Stroke. Some of the suggestions for improvement were a bit outrageous, such as having print copies of all journals at all three sites (exactly what we are trying to avoid!) and “electronic access via British Library services” (which if left to the devices of our users would wipe out our entire budget in a week) but others were very helpful such as targeted email services for specific subjects and coming to speak at team meetings and inductions. The survey certainly identified areas where further training is needed.
Finally I have been working away on my very first book review! An email went round a few weeks ago asking for volunteers to review a couple of books for the HLG newsletter. My manager forwarded it on to me and one of the books “Technology Training in Libraries” caught my attention so I got in touch with the person offering and volunteered to do the review. The book is part of the Facet ‘Tech Set’ series and was a very interesting read. I enjoyed the experience of writing up about it and will put the link to my review when it is published in the newsletter, hopefully next month.
I have been very busy with one-to-one sessions, especially as degree courses are starting up again. I had an Orthopaedics registrar in the other morning who wanted a very comprehensive literature search for his dissertation and I was grateful once again that a Masters degree is required for becoming a qualified librarian as the first thing he asked was whether I had experience in carrying out research. If I hadn’t done a Masters and gone through the experience of carrying out my research project I probably would have felt quite intimidated but as it was I could answer in the affirmative and he seemed quite impressed that a postgrad qualification was required for being a librarian!
Sunday, 24 October 2010
An Information Revolution...without libraries?
The Department of Health’s Liberating the NHS: An Information Revolution consultation document was published on Monday this week (18 Oct 2010) and lays out a strategy for the way the NHS should manage information in the future. As Andrew Lansley quite rightly states in the Foreward of the document, “we must not lose sight of the primary purpose of information in the health and care system: to ensure that every patient and service user receives high quality care” (p3). All well and good but the term “information” in this document is somewhat nebulous, used as an umbrella term for everything from patient records to health websites to audit to evidence. Furthermore there is no mention of libraries or library services anywhere in the document apart from a reference to the “Indicators for Quality Improvement library” (p36) which I for one have never heard of.
While the bulk of An Information Revolution is concerned with patient records and the flow of medical data there are certainly a number of areas where libraries are involved or could be involved. Section 4.6 states “in order to grasp the opportunities offered by the information revolution, clinicians and care professionals need to be able to access the best evidence (including international evidence) of outcomes, interventions and risks. Evidence needs to be user-friendly, up-to-date and available at the point of care, to inform discussions with patients and service users…Individual professionals, teams and organisations need to be supported to access information of this kind, which can make all the difference in ensuring safety and effective outcomes” (p36) Ummm, yes – do they not realise that this information is already being provided by hundreds of NHS medical libraries across the country every day? There is a short paragraph dedicated to NHS Evidence, described as a service which “is an important addition to commercially provided data services (which are often subscription-based and aimed at particular specialist audiences)” again ignoring the fact that such subscriptions are usually paid for by NHS library services on behalf of their users.
The document strongly supports better access to medical information for patients, which of course is laudable, but takes a rather simplistic view of what is a very complex subject. The emphasis on the internet as a channel for medical information is very obvious but is fairly silent on the subject of information literacy and evidence-based medicine. The three criteria for effective information is that it should be:
- informing, so that they know it is comprehensive and can be trusted;
- engaging, so that they are willing and able to use it; and
- empowering, so that they know how it can make a difference (p11)
How about authoritative, evidence-based, reliable?
The document states that “for some time now, people have been using the internet to explore a diagnosis after (or before) they visit their doctor” (p10) quoting a study of patient use of the internet which showed 11% of patients for neurology outpatients at the Walton Centre for Neurology and Neurosurgery in Liverpool in 2001-5 accessing the internet prior to clinic attendance. 11%?! It’s hardly statistically significant is it? The document also mentions “the role of websites such as ‘Mumsnet’ in generating new ways of sharing insights and information – including health information – is having a lasting effect on our society. Carers, patients, service users, care workers and clinicians are increasingly able to access forums to discuss the issues that matter to them, and offer support from others with experience of their condition” (p10) and exhorts that “the NHS, local authorities and care providers should be responding to and supporting these new approaches” (p11). Now I have been on a few of these forums in my time and have found them pretty useless to be honest, mainly involving somebody complaining they have a strange rash, followed by a slew of respondents all saying they have something similar but nobody knowing exactly what it is or how it should be treated.
Libraries, both medical and public, are extremely well-placed to provide authoritative, reliable information to patients. Many libraries already do and even more would be willing to do so. Why is this not mentioned in An Information Revolution? It may well be that “information cannot be seen as something that is the sole responsibility of the specialist” (p39) but why not harness the knowledge and experience of information specialists such as librarians and avoid reinventing the proverbial wheel?
Finally, I did have to laugh at the statement on page 14: “Whilst any associated costs will need to be met within the Department of Health’s Spending Review settlement, there will be no additional central funding to pay for the information revolution…Whilst there will inevitably be costs, which could fall centrally and/or locally, the information revolution should, ultimately, pay for itself.” Not surprising really that the government thinks good quality information can be produced on the cheap, but it makes the whole document ring rather hollow.
I shall definitely be responding to this consultation document and hope many other medical librarians will as well. After all, there is not going to be an Information Revolution in the NHS without us!
While the bulk of An Information Revolution is concerned with patient records and the flow of medical data there are certainly a number of areas where libraries are involved or could be involved. Section 4.6 states “in order to grasp the opportunities offered by the information revolution, clinicians and care professionals need to be able to access the best evidence (including international evidence) of outcomes, interventions and risks. Evidence needs to be user-friendly, up-to-date and available at the point of care, to inform discussions with patients and service users…Individual professionals, teams and organisations need to be supported to access information of this kind, which can make all the difference in ensuring safety and effective outcomes” (p36) Ummm, yes – do they not realise that this information is already being provided by hundreds of NHS medical libraries across the country every day? There is a short paragraph dedicated to NHS Evidence, described as a service which “is an important addition to commercially provided data services (which are often subscription-based and aimed at particular specialist audiences)” again ignoring the fact that such subscriptions are usually paid for by NHS library services on behalf of their users.
The document strongly supports better access to medical information for patients, which of course is laudable, but takes a rather simplistic view of what is a very complex subject. The emphasis on the internet as a channel for medical information is very obvious but is fairly silent on the subject of information literacy and evidence-based medicine. The three criteria for effective information is that it should be:
- informing, so that they know it is comprehensive and can be trusted;
- engaging, so that they are willing and able to use it; and
- empowering, so that they know how it can make a difference (p11)
How about authoritative, evidence-based, reliable?
The document states that “for some time now, people have been using the internet to explore a diagnosis after (or before) they visit their doctor” (p10) quoting a study of patient use of the internet which showed 11% of patients for neurology outpatients at the Walton Centre for Neurology and Neurosurgery in Liverpool in 2001-5 accessing the internet prior to clinic attendance. 11%?! It’s hardly statistically significant is it? The document also mentions “the role of websites such as ‘Mumsnet’ in generating new ways of sharing insights and information – including health information – is having a lasting effect on our society. Carers, patients, service users, care workers and clinicians are increasingly able to access forums to discuss the issues that matter to them, and offer support from others with experience of their condition” (p10) and exhorts that “the NHS, local authorities and care providers should be responding to and supporting these new approaches” (p11). Now I have been on a few of these forums in my time and have found them pretty useless to be honest, mainly involving somebody complaining they have a strange rash, followed by a slew of respondents all saying they have something similar but nobody knowing exactly what it is or how it should be treated.
Libraries, both medical and public, are extremely well-placed to provide authoritative, reliable information to patients. Many libraries already do and even more would be willing to do so. Why is this not mentioned in An Information Revolution? It may well be that “information cannot be seen as something that is the sole responsibility of the specialist” (p39) but why not harness the knowledge and experience of information specialists such as librarians and avoid reinventing the proverbial wheel?
Finally, I did have to laugh at the statement on page 14: “Whilst any associated costs will need to be met within the Department of Health’s Spending Review settlement, there will be no additional central funding to pay for the information revolution…Whilst there will inevitably be costs, which could fall centrally and/or locally, the information revolution should, ultimately, pay for itself.” Not surprising really that the government thinks good quality information can be produced on the cheap, but it makes the whole document ring rather hollow.
I shall definitely be responding to this consultation document and hope many other medical librarians will as well. After all, there is not going to be an Information Revolution in the NHS without us!
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