“Modules of Workforce Development: Pragmatic
Approaches to Knowledge Acquisition,
Application, and Information Disseminati...
Enterprise Access to Evidence-Based Literature:
A Dynamic Digital Library for Public Health
Karen Dahlen, Project Consulta...
Enterprise Library Approach to Knowledge Acquisition,
Application & Information Dissemination
Measure Importance of Truste...
Shifting the Culture
to Evidence-Based Practice
• Culture of evidence-based practice was affected when funding for public
...
ENTERPRISE ACCESS TO EVIDENCE-BASED LITERATURE: A
DYNAMIC DIGITAL LIBRARY FOR PUBLIC HEALTH
Background (Why this Project)
...
Council on Linkages:
Academia & Public Health Practice
Public Health Competencies
• Analytic/Assessment Skills
– Reference...
Obstacles to Getting Information
Gathering and Analyzing EB Information
Rapid Detection of Epidemics
Detecting an anthrax
epidemic one day earlier
would sa...
ENTERPRISE ACCESS TO EVIDENCE-BASED LITERATURE: A
DYNAMIC DIGITAL LIBRARY FOR PUBLIC HEALTH
Library Without Signature Buil...
PHIA: Innovative Business Model
Not Tied to Traditional Building
Madison, WI Atlanta, GA
Goal of PHIA
Public Health Information Access
To determine what
resources are core,
useful, evidence-based to
advance publ...
Unique Aspects of Digital Library
• Resides on PHD Intranet (outside a signature building)
without need for id and passwor...
Public Health Departments
& Library Partners
State Public Heath Department Library Partners
AK Alaska Division of Public H...
PHIA Evaluation Process
Tied to Data Model
To advance access to evidence-based
resources in support of improved
public hea...
Data Sets & Sources
• Resource Metrics Collected
• Journal Survey Monkey Identifies
Perceived Need & Library Use.
• Docume...
View of PHIA Digital Libraries
Connecticut Digital Library Arkansas Digital Library
ENTERPRISE ACCESS TO EVIDENCE-BASED LITERATURE: A
DYNAMIC DIGITAL LIBRARY FOR PUBLIC HEALTH
Resources on Digital Library
U...
Databases & Major
Publishers of Resources
PubMed , Other NLM Databases
NAL, CDC & Other Gov’t Resources
CLSI (Clinical Lab...
Identifying Core, Useful, &
Evidence-Based Journals
Publisher Total Use Journal Title Use
Mass Medical Society (1) 14,136 ...
NEJM Use 2010-2013
0
1000
2000
3000
4000
5000
6000
7000
4864
1772
982
554 314 527 337 311
890
308
1183 1178
494 422
2010=2...
298 287
233
175
135
94 90 89 82 78 71
42 32 18 5
ASM: Journal of Clinical Microbiology
Total Use 2013=1729
Oxford University Press Use
Jan-Dec 2013
Total Use by Each PHD
N=13,827 High Use Journal Titles
Journal Title Total Use
Cl...
STAT!Ref E-Books/Tools Provide Basic
Understanding of Topic
Filters & Tools
– Codes[5]
• CPT with RVUs Data File, INGENIX®...
STAT!Ref E- Books
for Public Health
Titles Containing PH Content
E-Book Use
ACP PIER, Journal Club & AHFS DI Essentials (2...
CLSI (Clinical & Laboratory Standards)
20 Documents Used 790 Times
April 21, 2014
Doc # Document Name #
M100
-S24
M100-S24...
Calculations Related
to Enterprise Licensing
State PHD FTE 10% Rule
ADH 2781/1390 139
AKDPH 525 52
BPHC* 1100/550 55
CDPHE...
Article Delivery Costs Via Library Partnerships
May 2011 – April 2012; Cost=$18,384 May 2012 --- April 2013; Cost=$12,241
...
Training Topics Embrace
National and State Interests
Maryland DHMH Health Initiatives
• Health Disparities(sexual minoriti...
Number of Trainings/Diversity of Workforce
STATE PHD Trainings Attendance
RI RIDH 2 30
VT VDH 3 46
ME
MAINE
CDC* 3
52
MA B...
ENTERPRISE ACCESS TO EVIDENCE-BASED LITERATURE: A
DYNAMIC DIGITAL LIBRARY FOR PUBLIC HEALTH
Enterprise Efficiencies
Unique...
Cost Efficiencies:
Article Analysis
Direct Access to Articles Alternative Article Delivery
Contract Year Total # Amount $
...
Enterprise Licensing Efficiencies: Single Titles
Contract Year May 2012-April 2013
Journal Title # Uses Cost
Per Use
Repla...
PHIA: Innovative Business Model
• Enterprise licensing saves time, money, and effort.
• Central management of IP addresses...
EVALUATION PROCESSES
Levels of Data Collection
• Journal SurveyMonkey (baseline data for PHIA and PHD)
• Enterprise Licens...
Results
• Digital libraries will be in place in 17 PHDs by July.
• Full-text access to more than 150 e-journals, 5
databas...
NACCHO Award Brings
Recognition to Project
• March 2012 and 2013, the PHIA PHD Digital Library Project received
a “promisi...
Testimonial
“Great recognition for this very valuable
initiative. Kudos and thank you.”
Jewel Mullen, MD, MPH, MPA, Commis...
Discussion & Outcome
How Do We?
• Expand PHIA to all 50 states.
• Enhance partnerships & relationships.
• Continuously tra...
Phi atlanta naccho conference 2014 ver ( 2 )
Upcoming SlideShare
Loading in …5
×

Phi atlanta naccho conference 2014 ver ( 2 )

359 views
285 views

Published on

This presentation describes the librarian's role in providing evidence based resources to improve public health.

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
359
On SlideShare
0
From Embeds
0
Number of Embeds
13
Actions
Shares
0
Downloads
2
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Phi atlanta naccho conference 2014 ver ( 2 )

  1. 1. “Modules of Workforce Development: Pragmatic Approaches to Knowledge Acquisition, Application, and Information Dissemination” Enterprise Access to Evidence-Based Literature: A Dynamic Digital Library for Public Health
  2. 2. Enterprise Access to Evidence-Based Literature: A Dynamic Digital Library for Public Health Karen Dahlen, Project Consultant Elaine Martin, Director New England Region NN/LM Lamar Soutter Library University of Massachusetts Medical School This project is currently funded by the NLM via contract through the NN/LM, New England Region
  3. 3. Enterprise Library Approach to Knowledge Acquisition, Application & Information Dissemination Measure Importance of Trusted Information Access Ensure Direct Access from Intranet-Based Site Access (Without Name/Password Required) Support Core Competencies/Training Use Survey Instruments Adapted to the Location Relate Cost Efficiencies to Enterprise Licensing/Creative Partnerships Document Institutional Change in a Dynamic Environment Evaluate Over Time (Illustrate Efficiencies)
  4. 4. Shifting the Culture to Evidence-Based Practice • Culture of evidence-based practice was affected when funding for public health libraries was eliminated. • State Libraries (in many states) were mandated to support state agencies, but had no collections to support public health. • Streamlined access to resources through the Digital Library Platform-- along with trust in new relationships--prompted resurgence in use of resources and has facilitated this cultural shift. • Training stimulated access to resources reviving evidence-based interest and relationship to practice. • Project has the ability to leverage government resources (NLM, CDC, NAL) to improve evidence-based practice.
  5. 5. ENTERPRISE ACCESS TO EVIDENCE-BASED LITERATURE: A DYNAMIC DIGITAL LIBRARY FOR PUBLIC HEALTH Background (Why this Project) Project Rationale Partnerships
  6. 6. Council on Linkages: Academia & Public Health Practice Public Health Competencies • Analytic/Assessment Skills – References sources of public health data and information. – Information technology to collect, store, retrieve data. – Utilizes data to address scientific, political, ethical, and social public health issues. • Policy Development/Program Planning Skills – Analyzes information relevant to specific public health policy issues • Public Health Sciences Skills – Conducts a comprehensive review of the scientific evidence related to : a public health issue, concern, or intervention. – Retrieves scientific evidence from a variety of text and electronic sources. • Knowledge Informatics – Access trusted resources directly from the desktop. – Describe relationships and functionality of e- resources to core public health interests. – Introduce specific types of resources: coding and classification tools. • Informatics Skills – Train on interoperable features that support public health work, including connectivity to trusted sites; advanced search filters, use of topical alerts and information mgt software. Competencies: Council on Linkages Project Tied to Competencies
  7. 7. Obstacles to Getting Information
  8. 8. Gathering and Analyzing EB Information Rapid Detection of Epidemics Detecting an anthrax epidemic one day earlier would save $1-7 billion CDC Presentation by C. Safran citing: http://www.cdc.gov/ncidod/eid/vol3no2/kaufman.htm Kaufmann AF, EID, V3, N2
  9. 9. ENTERPRISE ACCESS TO EVIDENCE-BASED LITERATURE: A DYNAMIC DIGITAL LIBRARY FOR PUBLIC HEALTH Library Without Signature Building Goal of the Project Who Participates Objectives & Data Sets Development of Digital Library
  10. 10. PHIA: Innovative Business Model Not Tied to Traditional Building Madison, WI Atlanta, GA
  11. 11. Goal of PHIA Public Health Information Access To determine what resources are core, useful, evidence-based to advance public health practice. Full text directly available through DL Full text available through LP Core to public health
  12. 12. Unique Aspects of Digital Library • Resides on PHD Intranet (outside a signature building) without need for id and password. • Relies on collaboration, interoperability & funding. • Move toward analysis; less time on access • Skills & training support personalized, interactive styles tied to continuum of learning and institutional- specific priorities and projects. • Collection of evidence occurs in many aspects of Brownson wheel not just at the literature review stage. • Fundamental change in the way resources are distributed and utilized.
  13. 13. Public Health Departments & Library Partners State Public Heath Department Library Partners AK Alaska Division of Public Health (AKDH) Univ of Alaska (Anchorage) Medical Library AR Arkansas Department of Health (ADH) Univ of Alabama Medical Sciences Library CO Colorado Dept of Public Health & Environment Poudre Valley Health System Library CT Connecticut Public Health Department University of Conn Maynard Stowe Library HI Hawaii Department of Health University of Hawaii Medical Library IN Indiana State Department of Health Ruth Lily Medical Library, Indiana University KY Kentucky Department for Health University of Kentucky Medical Library ME Maine CDC Maine Medical Center Library MA Boston Public Health Commission* University of Massachusetts Soutter Library MA Massachusetts Public Health Department Lemuel Shattuck Hospital Library MD Maryland Dept of Health & Mental Hygiene University of Maryland HS Library NH New Hampshire DHHS New Hampshire DHHS Library RI Rhode Island Department of Health (RIDH) Rhode Island Hospital/Lifespan VT Vermont Department of Health (VDH) UVM Dana Medical Library WI Wisconsin Department of Health Services Ebling Library of the Health Sciences WV West Virginia Bureau of Public Health West Virginia University Libraries WA Washington State Department of Health University of Washington HS Library
  14. 14. PHIA Evaluation Process Tied to Data Model To advance access to evidence-based resources in support of improved public health practice. What resources are high use? What technical issues arise? What resources are missing? How can training be improved? What project components lead to improved efficiencies? What cost efficiencies are involved with an enterprise approach to digital library implementation, and training. • Logic Model – Resources, activities, outputs, outcomes (minutes, visits, trainings, people lists, IP management, levels of troubleshooting, RML reports. • Data Tools – Overarching questions – Journal SurveyMonkey – Pre-Post Training Surveys – Just-in-time Information Checks – Formal Evaluation (interviews & focus group sessions
  15. 15. Data Sets & Sources • Resource Metrics Collected • Journal Survey Monkey Identifies Perceived Need & Library Use. • Document IT technical issues. • Licensing Issues Related to Journals and Databases. • Training Surveys Collected • Preliminary Meetings/Updates Held. • Trainings Held • Year End Evaluation --Interviews & Focus Groups
  16. 16. View of PHIA Digital Libraries Connecticut Digital Library Arkansas Digital Library
  17. 17. ENTERPRISE ACCESS TO EVIDENCE-BASED LITERATURE: A DYNAMIC DIGITAL LIBRARY FOR PUBLIC HEALTH Resources on Digital Library Use of Resources Article Delivery Use & Costs
  18. 18. Databases & Major Publishers of Resources PubMed , Other NLM Databases NAL, CDC & Other Gov’t Resources CLSI (Clinical Laboratory Standards) Global Health Cochrane Library – Systematic Reviews Stat!Ref—E Books (35) -- Coding & Classification ASABE –Health Linked to Agriculture
  19. 19. Identifying Core, Useful, & Evidence-Based Journals Publisher Total Use Journal Title Use Mass Medical Society (1) 14,136 New England Journal of Medicine 14,136 AAP(1) 9,888 Pediatrics 9888 Oxford University Press (20) 23,369 Clinical Infectious Diseases 3147 Springer (18) 2, 485 Maternal & Child Health 474 ASM Journals (12) 3,518 Journal of Clinical Microbiology 1729 Annual Reviews (9) 697 Annual Review Public Health 394 Sage (11) 939 The Diabetes Educator 135 BMJ (9) 2932 British Medical Journal 1832 Mary Ann Liebert (11) 1798 Breast Feeding Medicine 355 University of Chicago Press (6) 955 Infection Control & Hospital Epidemiology 749 Lippincott/Ovid (6) 122 J Public Health Mgt Practice 55
  20. 20. NEJM Use 2010-2013 0 1000 2000 3000 4000 5000 6000 7000 4864 1772 982 554 314 527 337 311 890 308 1183 1178 494 422 2010=2087 2011=11,194 2012=14,022 2013=14,136
  21. 21. 298 287 233 175 135 94 90 89 82 78 71 42 32 18 5 ASM: Journal of Clinical Microbiology Total Use 2013=1729
  22. 22. Oxford University Press Use Jan-Dec 2013 Total Use by Each PHD N=13,827 High Use Journal Titles Journal Title Total Use Clinical Infectious Disease 3147 American Journal of Epidemiology 941 Schizophrenia Bulletin 771 The Journal of Infectious Diseases 627 ICES: Journal of Marine Science 474 JNCI: Journal of the National Cancer Institute 434 Journal of Antimicrobial Chemotherapy 297 International Journal of Epidemiology 288 Alcohol and Alcoholism 274 Journal of Analytical Toxicology 262 Health Promotion International 252 Rheumatology 246 Age and Ageing 240 PHD Total Alaska DPH 1245 Arkansas DH 1483 BPHC 182 CDPHE 608 CT DPH 1234 HI SDH 638 ISDH 700 KYDPH 1134 Maine CDC 757 MDHMH 1427 MDPH 1817 NH DHHS 157 RIDH 620 VDH 709 WI DHS 1116
  23. 23. STAT!Ref E-Books/Tools Provide Basic Understanding of Topic Filters & Tools – Codes[5] • CPT with RVUs Data File, INGENIX® (2011)[1] • ICD-9+CM - Volumes 1, 2 & 3 (2012) – Titles By Discipline[344] Searchable Alerts (by topic) – Functionality with NLM – Chapters link to PubMed – TOXNET linked to Search – Related Concepts/Meta… Functionality with CDC – MMWR, Community Guide;
  24. 24. STAT!Ref E- Books for Public Health Titles Containing PH Content E-Book Use ACP PIER, Journal Club & AHFS DI Essentials (2013) 482 Oxford Textbook of Public Health - 5th Ed. (2009) 407 Manual of Clinical Microbiology - 10th Ed. (2011) 403 AHFS Drug Information (2013) 305 Red Book: 2012 Report of the Committee on Infectious Diseases - 29th Ed. (2012) 241 Emerging Infections Series (2008 - 2010) 216 Textbook of Modern Toxicology, A - 4th Ed. (2010) 209 Coding & Classification Books E-Book Use ICD-9-CM - Volumes 1, 2 & 3 (2013) 881 CPT with RVUs Data File, INGENIX (2013) 474 ICD-10-PCS: Procedure Coding System (2014) 12 ICD-10-CM: Clinical Modification (2014) 15 Diagnostic and Statistical Manual of Mental Disorders 4th Ed. (DSM-IV-TR, 2000) 107
  25. 25. CLSI (Clinical & Laboratory Standards) 20 Documents Used 790 Times April 21, 2014 Doc # Document Name # M100 -S24 M100-S24: Performance Standards for Antimicrobial Susceptibility Testing; Twenty- Fourth Informational Supplement 248 EP09- A3 Measurement Procedure Comparison and Bias Estimation Using Patient Samples; Approved Guideline—Third Ed. 102 EP12- A2 User Protocol for Evaluation of Qualitative Test Performance 55 MM0 9-A2 Nucleic Acid Sequencing Methods in Diagnostic Laboratory Medicine; Approved Guideline—Second Edition 54
  26. 26. Calculations Related to Enterprise Licensing State PHD FTE 10% Rule ADH 2781/1390 139 AKDPH 525 52 BPHC* 1100/550 55 CDPHE 1200/600 60 CT DPH 780 78 Hawaii DPH 3000/1500 150 ISDH 780 78 Kentucky BPH 400 40 MDHMH 8000/4000 400 Maine CDC 395 39 MDPH 3000/1500 150 NH DHHS 279 30 RIDH 400 40 VDH 300 35 WDPHS 400 40 VW DHS 780 78 Washington 1600/800 80 Total PHIA FTE 10,999 1546 Enterprise Licensing is based on 10% of the Total FTE level to capture baseline information and measure use/interest of resources.
  27. 27. Article Delivery Costs Via Library Partnerships May 2011 – April 2012; Cost=$18,384 May 2012 --- April 2013; Cost=$12,241 STATE ILL DD Total Connecticut 0 83 83 Maine 560 364 924 Massachusetts (BPHC) 8 3 11 Massachusetts (MDPH) 1 1 2 New Hampshire 0 0 0 Rhode Island 47 36 83 Vermont 21 191 212 Colorado 323 156 479 Total 960 834 1794 STATE ILL DD Total Connecticut 2 20 22 Maine 154 90 244 Massachusetts (BPHC) 9 10 19 Massachusetts (MDPH) 7 6 13 New Hampshire 0 0 0 Rhode Island 82 79 161 Vermont 54 243 297 Colorado 112 40 152 Arkansas 32 73 105 Kentucky 8 3 11 Wisconsin 0 0 0 Total 462 593 1055
  28. 28. Training Topics Embrace National and State Interests Maryland DHMH Health Initiatives • Health Disparities(sexual minorities) • Preventive Services ACA* HIV Screening • Immigrant Health Undocumented individuals under ACA • Drug Resistant Disease which impacts Impact on TB, STI (plus others) • Health Care Reform and Interpersonal Violence/Domestic Violence • Infectious Diseases; Hepatitis C Virus HIV Infections --HIV and HCV Co-Infection
  29. 29. Number of Trainings/Diversity of Workforce STATE PHD Trainings Attendance RI RIDH 2 30 VT VDH 3 46 ME MAINE CDC* 3 52 MA BPHC* 4 58 MA MPHD* 3 32 NH NH DHHS 2 24 CO CDPHE* 5 100 CT CT DPH* 5 101 KY KDPH 2 46 AR ADH 2 31 WI WI DPH 2 33 AK AK DPH 2 50 HI HI DPH 2 68 IN ISDH 2 60 MD MDHMH 2 38 TOTAL 15 41 769 Maryland Indiana Hawaii Nutrition Specialist (2) State Epidemiologist Education Coordinator (2) Research Statistician Supervisor – Labs + (3) Asthma Coordinators(2 Policy Analyst (2) Injury Prevention Epidemiologist Legislative Liaison Program Mgr (2) Staff Attorney Epidemiologist Epidemiologist Microbiologist ( 2) Research Analyst (2) Medicare Specialist/Advisor (2) Regional Program Director Program Coordinator, SAPB Policy Advisor (2) Director of Prog Evaluation Epidemiologist (3) Psychiatric VT Director of Prog Development Genetic Counselor Executive Ass’t Field Epi Director Tobacco Prevent Mgr Deputy Secretary Access Services Mgr Informatics Analyst Director VSA IT Supervisor Nutritionist
  30. 30. ENTERPRISE ACCESS TO EVIDENCE-BASED LITERATURE: A DYNAMIC DIGITAL LIBRARY FOR PUBLIC HEALTH Enterprise Efficiencies Unique Aspects of the Business Model Evaluation Processes
  31. 31. Cost Efficiencies: Article Analysis Direct Access to Articles Alternative Article Delivery Contract Year Total # Amount $ May 2013-March 2014 1038 10,102 May 2012-Apr 2013 1055 12,241 May 2011-Apr 2012 1794 18,385 May 2010-Apr 2011 672 8,263 Contract Year Total # Amount $ May 2013 –April 2014 17+ 285,409 May 2012-Apr 2013 15 200,352 May 2011-Apr 2012 11 156,280 May 2010-Apr 2011 9 96,252
  32. 32. Enterprise Licensing Efficiencies: Single Titles Contract Year May 2012-April 2013 Journal Title # Uses Cost Per Use Replacement Cost Cost of License Am J Tropical Med & Hygiene 410 $1.58 $4,510 $ 650 Am J Respiratory & Critical Care Med 189 $14.28 $2,079 $2700 Health Affairs 2038 1.81 $22,418 $3690 Infection Control & Hospital Epidemiology 749 1.50 $8,239 $1125 Public Health Reports 658 4.69 $7,238 $3085 Intern’l J of Tuberculosis & Lung Diseases 192 5.83 $2112 $1120 Annual Review Series 595 12.60 $6545 $7500 Pediatrics 7846 .68 $86,306 $5300
  33. 33. PHIA: Innovative Business Model • Enterprise licensing saves time, money, and effort. • Central management of IP addresses ensures quick turn-around. • Ability to understand change (System, personnel, environment). • Resources are identified via benchmarking,metrics of direct use through Digital Library, and requests from PHDs. • Journals are identified via “Article Delivery” on Library Partner side. • Alternative delivery of resources strengthens state relationships with immediate access (within 4-24 hours).
  34. 34. EVALUATION PROCESSES Levels of Data Collection • Journal SurveyMonkey (baseline data for PHIA and PHD) • Enterprise Licensing (cost effectiveness over time) • Vendor statistical reports (validates “use of resources”) • Monthly reports from “library partners” (measures use and identify resources to develop Digital Libraries). • Ongoing capture of suggested e-books, journals, and databases to enhance collection • Pre-Post training links – (data related to knowledge of resources) • Feedback from hands-on training • Interviews with leaders and workforce • Focus group sessions (after one year; subsequently) • Quarterly/Annual Reports (submitted to NLM)
  35. 35. Results • Digital libraries will be in place in 17 PHDs by July. • Full-text access to more than 150 e-journals, 5 databases, reports and more. • Introductory sessions have introduced PHD leadership to the project and explained obligations. • More resources have been added to “digital library.” • Structured training has been held in 15 PHDs. • More than 600 people have been trained with backup models currently in test stage.
  36. 36. NACCHO Award Brings Recognition to Project • March 2012 and 2013, the PHIA PHD Digital Library Project received a “promising practice award” from NACCHO. • Presentations have been held at national and local meetings, e.g., APHA in Washington, DC in 2011 and Boston in November 2013. • Article was published in AJPH in January 2014. Project was cited in August 2012 EID (CDPHE). • Presentations have been made at national public health meetings, national and regional library meetings.
  37. 37. Testimonial “Great recognition for this very valuable initiative. Kudos and thank you.” Jewel Mullen, MD, MPH, MPA, Commissioner, Connecticut Department of Public Health
  38. 38. Discussion & Outcome How Do We? • Expand PHIA to all 50 states. • Enhance partnerships & relationships. • Continuously train PH Workforce to improve competencies (knowledge and skills) given staff turnover. • Build a sustainable model including cost structure and project management.

×