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WHAT IS THEWHAT IS THE
INFORMATIONIST?INFORMATIONIST?
PAMELA C. SIEVING, MA, MSPAMELA C. SIEVING, MA, MS
BIOMEDICAL LIBRAR...
WHAT IS AN INFORMATIONIST?WHAT IS AN INFORMATIONIST?
 HISTORY of A NEW IDEAHISTORY of A NEW IDEA
 CURRENT STATUSCURRENT ...
THE EVOLUTION OF A NEW SPECIALIZATIONTHE EVOLUTION OF A NEW SPECIALIZATION
 Gertrude Lamb 1972Gertrude Lamb 1972
““And No...
THE EVOLUTION OF A NEWTHE EVOLUTION OF A NEW
SPECIALIZATIONSPECIALIZATION
 SCURA: CASE-RELATED USE OF THE MEDICAL LITERAT...
THE EVOLUTION OF A NEWTHE EVOLUTION OF A NEW
SPECIALIZATIONSPECIALIZATION
 Davidoff and Florance 2000Davidoff and Floranc...
GOALS OF CLINICAL LIBRARIANSHIPGOALS OF CLINICAL LIBRARIANSHIP
 IMPROVE PATIENT CAREIMPROVE PATIENT CARE
““Deliver patien...
GOALS OF CLINICAL LIBRARIANSHIPGOALS OF CLINICAL LIBRARIANSHIP
 IMPROVE PATIENT CAREIMPROVE PATIENT CARE
 INCREASE INFOR...
GOALS OF CLINICAL LIBRARIANSHIPGOALS OF CLINICAL LIBRARIANSHIP
 IMPROVE PATIENT CAREIMPROVE PATIENT CARE
 INCREASE INFOR...
GOALS OF CLINICAL LIBRARIANSHIPGOALS OF CLINICAL LIBRARIANSHIP
 IMPROVE PATIENT CAREIMPROVE PATIENT CARE
 INCREASE INFOR...
THE INFORMATIONIST:THE INFORMATIONIST:
THE LOGICAL NEXT STEP?THE LOGICAL NEXT STEP?
PUTTING THE CONCEPT INTO PRACTICEPUTTING THE CONCEPT INTO PRACTICE
 MLA Philadelphia RegionalMLA Philadelphia Regional
Ch...
2002 INVITATIONAL CONFERENCE2002 INVITATIONAL CONFERENCE
GOALS:GOALS:
 FACILITATE NATIONAL DISCUSSIONFACILITATE NATIONAL ...
ATTENDED BYATTENDED BY
 ACCREDITING ORGANIZATIONSACCREDITING ORGANIZATIONS
 HEALTH & MEDICAL ASSOCIATIONSHEALTH & MEDICA...
WHY DO WE NEED CLINICAL INFORMATIONISTS?WHY DO WE NEED CLINICAL INFORMATIONISTS?
 INFORMATION IS SCATTERED; NOT WELL INDE...
WHAT DO INFORMATIONISTS DO?WHAT DO INFORMATIONISTS DO?
(What is a librarian doing here, anyway?)(What is a librarian doing...
WHAT DO INFORMATIONISTS DO?WHAT DO INFORMATIONISTS DO?
 ““ROUND” WITHROUND” WITH
PATIENT CARE TEAMPATIENT CARE TEAM
(phys...
WHAT DO INFORMATIONISTS DO?WHAT DO INFORMATIONISTS DO?
 ““ROUND” WITH PATIENTROUND” WITH PATIENT
CARE TEAMCARE TEAM
 RES...
WHAT DO INFORMATIONISTS DO?WHAT DO INFORMATIONISTS DO?
 ““ROUND” WITH PATIENT CARE TEAMROUND” WITH PATIENT CARE TEAM))
 ...
WHAT DO INFORMATIONISTS DO?WHAT DO INFORMATIONISTS DO?
 ““ROUND” WITH PATIENTROUND” WITH PATIENT
CARE TEAMCARE TEAM
 RES...
WHAT DO INFORMATIONISTS DO?WHAT DO INFORMATIONISTS DO?
 ““ROUND” WITH PATIENT CARE TEAMROUND” WITH PATIENT CARE TEAM
 RE...
WHERE WILL WE FIND THE CLINICALWHERE WILL WE FIND THE CLINICAL
INFORMATIONIST?INFORMATIONIST?
WHERE WILL WE FIND THE CLINICALWHERE WILL WE FIND THE CLINICAL
INFORMATIONIST?INFORMATIONIST?
 IN THE CLINICIN THE CLINIC
WHERE WILL WE FIND THE CLINICALWHERE WILL WE FIND THE CLINICAL
INFORMATIONIST?INFORMATIONIST?
 IN THE CLINICIN THE CLINIC...
WHERE WILL WE FIND THE CLINICALWHERE WILL WE FIND THE CLINICAL
INFORMATIONIST?INFORMATIONIST?
 IN THE CLINICIN THE CLINIC...
WHERE WILL WE FIND THE CLINICALWHERE WILL WE FIND THE CLINICAL
INFORMATIONIST?INFORMATIONIST?
 IN THE CLINICIN THE CLINIC...
WHERE WILL WE FIND THE CLINICALWHERE WILL WE FIND THE CLINICAL
INFORMATIONIST?INFORMATIONIST?
 IN THE CLINICIN THE CLINIC...
ARE WE BETTERARE WE BETTER
LIBRARIANSLIBRARIANS
ANSWERING QUESTIONSANSWERING QUESTIONS
AT A DESKAT A DESK
OR IN THE CLINIC...
THE TECHNICAL INFRASTRUCTURE IS INTHE TECHNICAL INFRASTRUCTURE IS IN
PLACE TO SUPPORTPLACE TO SUPPORT
ANYTIME-ANYWHEREANYT...
WHY ARE WE NEEDED??WHY ARE WE NEEDED??
 MEDICALMEDICAL
INFORMATIONINFORMATION
DOUBLES EVERY 19DOUBLES EVERY 19
YEARS (WYATT:YEARS (WYATT:
LANCETLANCET 1991; 338...
 MEDICAL INFORMATION DOUBLES EVERY 19 YEARSMEDICAL INFORMATION DOUBLES EVERY 19 YEARS
 IN US, AT LEAST 44,000 DEATHS EAC...
 MEDICAL INFORMATION DOUBLES EVERY 19 YEARSMEDICAL INFORMATION DOUBLES EVERY 19 YEARS
 IN US, AT LEAST 44,000 DEATHS EAC...
 MEDICAL INFORMATION DOUBLES EVERY 19 YEARSMEDICAL INFORMATION DOUBLES EVERY 19 YEARS
 IN US, UNNECESSARY 44,000 DEATHS/...
SMITH, 1996 (SMITH, 1996 (BMJBMJ 313:1062)313:1062)
 DOCTORS ARE AWAREDOCTORS ARE AWARE
OF INFORMATIONOF INFORMATION
NEED...
ARE CLINICAL GUIDELINES THEARE CLINICAL GUIDELINES THE
ANSWER?ANSWER?
CAN PDA’s DO MORE THANCAN PDA’s DO MORE THAN
PROVIDE...
IMAGINE:IMAGINE:
ONE PATIENTONE PATIENT
5 DIAGNOSES5 DIAGNOSES
EACH DIAGNOSIS HAS 2 POSSIBLEEACH DIAGNOSIS HAS 2 POSSIBLE
...
NO ONE CAN IMAGINE:NO ONE CAN IMAGINE:
ONE PATIENT, 5 DIAGNOSES, EACH WITH 2ONE PATIENT, 5 DIAGNOSES, EACH WITH 2
POSSIBLE...
IN THE NEO-NATAL INTENSIVE CARE UNITIN THE NEO-NATAL INTENSIVE CARE UNIT
HOW MANY DECISIONSHOW MANY DECISIONS
PER BABYPER ...
IN THE CLINICAL RESEARCHIN THE CLINICAL RESEARCH
SETTINGSETTING
WHAT ARE THE COSTS OFWHAT ARE THE COSTS OF
IMPORTANT REFER...
WHICH QUESTIONWHICH QUESTION
WILL MAKE A DIFFERENCEWILL MAKE A DIFFERENCE
TODAY?TODAY?
JOHNS HOPKINS DEATHJOHNS HOPKINS DEATH
SUMMER 2001SUMMER 2001
 HEALTHY VOLUNTEER DIEDHEALTHY VOLUNTEER DIED
 REACTION RE...
TRADITIONAL LIBRARIAN SKILLSTRADITIONAL LIBRARIAN SKILLS
 RECOGNIZE GAP IN KNOWLEDGERECOGNIZE GAP IN KNOWLEDGE
 FORMULAT...
EVIDENCE BASED MEDICINEEVIDENCE BASED MEDICINE
 CONSCIENTIOUS, EXPLICIT and JUDICIOUS USE ofCONSCIENTIOUS, EXPLICIT and J...
GUYATT et al (GUYATT et al (BMJBMJ 2000; 320:954):2000; 320:954):
 MANY CLINICIANS NOT INTERESTED IN SKILLS TOMANY CLINIC...
CLINICAL INFORMATIONISTCLINICAL INFORMATIONIST
 TRADITIONAL SKILLS OF LIBRARIANSTRADITIONAL SKILLS OF LIBRARIANS
 TRAINI...
INFORMATIONISTSINFORMATIONISTS
COMFORTABLY BETWEEN TWO WORLDSCOMFORTABLY BETWEEN TWO WORLDS
PER DAVIDOFF AND FLORANCE:PER ...
OPTIONS FOR EDUCATION AND TRAININGOPTIONS FOR EDUCATION AND TRAINING
OF LIBRARIANS AS INFORMATIONISTSOF LIBRARIANS AS INFO...
OPTIONS FOR EDUCATION AND TRAINING OFOPTIONS FOR EDUCATION AND TRAINING OF
SCIENTISTS, NURSES, PHARMACISTS ANDSCIENTISTS, ...
WHAT ABOUTWHAT ABOUT
RESEARCH INFORMATIONISTS?RESEARCH INFORMATIONISTS?
WHAT ABOUTWHAT ABOUT
RESEARCH INFORMATIONISTS?RESEARCH INFORMATIONISTS?
 ““TWO HOURS IN THE LABTWO HOURS IN THE LAB
WILL ...
WHAT ABOUTWHAT ABOUT
RESEARCH INFORMATIONISTS?RESEARCH INFORMATIONISTS?
 ““TWO HOURS IN THE LABTWO HOURS IN THE LAB
WILL ...
WHAT ABOUTWHAT ABOUT
RESEARCH INFORMATIONISTS?RESEARCH INFORMATIONISTS?
 ““TWO HOURS IN THE LABTWO HOURS IN THE LAB
WILL ...
WHAT ABOUTWHAT ABOUT
RESEARCH INFORMATIONISTS?RESEARCH INFORMATIONISTS?
 ““TWO HOURS IN THE LABTWO HOURS IN THE LAB
WILL ...
PILCH (PILCH (UNPUBLISHED, 2001):UNPUBLISHED, 2001):
NIH RESEARCHERS NEED ASSISTANCE WITH:NIH RESEARCHERS NEED ASSISTANCE ...
CAN INFORMATIONISTS WORK WITHCAN INFORMATIONISTS WORK WITH
PATIENTS?PATIENTS?
 PATIENT INFORMATIONPATIENT INFORMATION
CEN...
CAN INFORMATIONISTS CREATE INFORMATION?CAN INFORMATIONISTS CREATE INFORMATION?
SHOULD THEY?SHOULD THEY?
 META-INFORMATION...
NIH LIBRARY INFORMATIONIST MODELNIH LIBRARY INFORMATIONIST MODEL
 CLINICAL ROUNDSCLINICAL ROUNDS
 ASSISTANCE WITHASSISTA...
VANDERBILT UNIVERSITY MODELVANDERBILT UNIVERSITY MODEL
 CLINICAL LIAISONSCLINICAL LIAISONS
 ROUNDROUND
 FILTERED EBMFIL...
OBSTACLESOBSTACLES
 NO ACADEMIC PROGRAMS ESTABLISHED YETNO ACADEMIC PROGRAMS ESTABLISHED YET
 PERSONAL COSTS FOR ADDITIO...
ADDITIONAL CHALLENGESADDITIONAL CHALLENGES
 NEW MODEL vs OLD MODEL of WHAT A LIBRARIANNEW MODEL vs OLD MODEL of WHAT A LI...
THE FUTURETHE FUTURE
 INCREASING ACCESS TO MOREINCREASING ACCESS TO MORE
INFORMATIONINFORMATION
 NEW TECHNOLOGYNEW TECHN...
HOW WILL WE RESPOND?HOW WILL WE RESPOND?
MAKE VISIBLE WHAT,MAKE VISIBLE WHAT,
WITHOUT YOU,WITHOUT YOU,
MIGHT NEVER HAVE BEENMIGHT NEVER HAVE BEEN
SEEN.SEEN.
--ROBE...
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  1. 1. WHAT IS THEWHAT IS THE INFORMATIONIST?INFORMATIONIST? PAMELA C. SIEVING, MA, MSPAMELA C. SIEVING, MA, MS BIOMEDICAL LIBRARIAN and INFORMATIONISTBIOMEDICAL LIBRARIAN and INFORMATIONIST NATIONAL INSTITUTES OF HEALTH LIBRARYNATIONAL INSTITUTES OF HEALTH LIBRARY BETHESDA, MARYLAND USABETHESDA, MARYLAND USA
  2. 2. WHAT IS AN INFORMATIONIST?WHAT IS AN INFORMATIONIST?  HISTORY of A NEW IDEAHISTORY of A NEW IDEA  CURRENT STATUSCURRENT STATUS  WHY ARE INFORMATIONISTS NEEDED?WHY ARE INFORMATIONISTS NEEDED?  WHAT WILL THEY DO?WHAT WILL THEY DO?  WHERE WILL THEY COME FROM?WHERE WILL THEY COME FROM?  FUTURE CHALLENGESFUTURE CHALLENGES ANDAND OPPORTUNITIESOPPORTUNITIES
  3. 3. THE EVOLUTION OF A NEW SPECIALIZATIONTHE EVOLUTION OF A NEW SPECIALIZATION  Gertrude Lamb 1972Gertrude Lamb 1972 ““And Now, ‘ClinicalAnd Now, ‘Clinical Librarians’ On Rounds”Librarians’ On Rounds” ((JAMAJAMA 1974; 230:521)1974; 230:521)
  4. 4. THE EVOLUTION OF A NEWTHE EVOLUTION OF A NEW SPECIALIZATIONSPECIALIZATION  SCURA: CASE-RELATED USE OF THE MEDICAL LITERATURE:SCURA: CASE-RELATED USE OF THE MEDICAL LITERATURE: CLINICAL LIBRARIAN SERVICES FOR IMPROVING PATIENTCLINICAL LIBRARIAN SERVICES FOR IMPROVING PATIENT CARE.CARE. JAMAJAMA 1981; 245:501981; 245:50  LAMB: A DECADE OF CLINICAL LIBRARIANSHIP (LAMB: A DECADE OF CLINICAL LIBRARIANSHIP (CLINICALCLINICAL LIBRARIAN QUARTRLYLIBRARIAN QUARTRLY 1982; 1:2)1982; 1:2)  VEENSTRA: A CLINICAL LIBRARIAN PROGRAM IN THEVEENSTRA: A CLINICAL LIBRARIAN PROGRAM IN THE INTENSIVE CARE UNIT (INTENSIVE CARE UNIT ( CRITICAL CARE MEDICINECRITICAL CARE MEDICINE 1992; 20:1038)1992; 20:1038)  GIUSE: ADVANCING THE PRACTICE OF CLINICAL MEDICALGIUSE: ADVANCING THE PRACTICE OF CLINICAL MEDICAL LIBRARIANSHIP (LIBRARIANSHIP (BULLETIN OF THE MEDICAL LIBRARYBULLETIN OF THE MEDICAL LIBRARY ASSOCIATIONASSOCIATION 1997; 85:437)1997; 85:437)  SCHACHER: CLINICAL LIBRARIANSHIP: ITS VALUE IN MEDICALSCHACHER: CLINICAL LIBRARIANSHIP: ITS VALUE IN MEDICAL CARE (CARE (ANNALS OF INTERNAL MEDICINEANNALS OF INTERNAL MEDICINE 2001; 134:717)2001; 134:717)
  5. 5. THE EVOLUTION OF A NEWTHE EVOLUTION OF A NEW SPECIALIZATIONSPECIALIZATION  Davidoff and Florance 2000Davidoff and Florance 2000 ““The Informationist: A New Health Profession?”The Informationist: A New Health Profession?” ((Annals of Internal MedicineAnnals of Internal Medicine 2000; 132: 996)2000; 132: 996)
  6. 6. GOALS OF CLINICAL LIBRARIANSHIPGOALS OF CLINICAL LIBRARIANSHIP  IMPROVE PATIENT CAREIMPROVE PATIENT CARE ““Deliver patient-specific information in a timely,Deliver patient-specific information in a timely, cost-effective manner” (Veenstra & Gluck, 1992)cost-effective manner” (Veenstra & Gluck, 1992)
  7. 7. GOALS OF CLINICAL LIBRARIANSHIPGOALS OF CLINICAL LIBRARIANSHIP  IMPROVE PATIENT CAREIMPROVE PATIENT CARE  INCREASE INFORMATION-SEEKING SKILLS OFINCREASE INFORMATION-SEEKING SKILLS OF HEALTH CARE PROVIDERSHEALTH CARE PROVIDERS ““By example and by direct teaching, the clinicalBy example and by direct teaching, the clinical librarian could upgrade the information seekinglibrarian could upgrade the information seeking behavior of the health professional by sharing withbehavior of the health professional by sharing with him the librarian’s skills”him the librarian’s skills” (Lamb, 1982)(Lamb, 1982)
  8. 8. GOALS OF CLINICAL LIBRARIANSHIPGOALS OF CLINICAL LIBRARIANSHIP  IMPROVE PATIENT CAREIMPROVE PATIENT CARE  INCREASE INFORMATION-SEEKING SKILLS OF HEALTH CAREINCREASE INFORMATION-SEEKING SKILLS OF HEALTH CARE PROVIDERSPROVIDERS  CONTRIBUTE TO EDUCATION OF HEALTHCONTRIBUTE TO EDUCATION OF HEALTH CARE PROVIDERSCARE PROVIDERS ““Clinicians who are actively assisted by clinicalClinicians who are actively assisted by clinical librarians are able to gather information from a widelibrarians are able to gather information from a wide selection of medical publications rather than relyingselection of medical publications rather than relying only on memory or the advice of a few colleagues.”only on memory or the advice of a few colleagues.” (Schacher, 2001)(Schacher, 2001)
  9. 9. GOALS OF CLINICAL LIBRARIANSHIPGOALS OF CLINICAL LIBRARIANSHIP  IMPROVE PATIENT CAREIMPROVE PATIENT CARE  INCREASE INFORMATION-SEEKING SKILLS OFINCREASE INFORMATION-SEEKING SKILLS OF HEALTH CARE PROVIDERSHEALTH CARE PROVIDERS  CONTRIBUTE TO EDUCATION OF HEALTH CARECONTRIBUTE TO EDUCATION OF HEALTH CARE PROVIDERSPROVIDERS  ENHANCE STATUS OF MEDICAL LIBRARIANSENHANCE STATUS OF MEDICAL LIBRARIANS
  10. 10. THE INFORMATIONIST:THE INFORMATIONIST: THE LOGICAL NEXT STEP?THE LOGICAL NEXT STEP?
  11. 11. PUTTING THE CONCEPT INTO PRACTICEPUTTING THE CONCEPT INTO PRACTICE  MLA Philadelphia RegionalMLA Philadelphia Regional ChapterChapter Oct. 2000: The MedicalOct. 2000: The Medical Informationist and OtherInformationist and Other Roles for the Librarian in theRoles for the Librarian in the 21st Century (21st Century (Journal of theJournal of the Medical Library AssociationMedical Library Association 2002; v. 90)2002; v. 90)  MLA/NLM conference 2002MLA/NLM conference 2002 at NIH in Bethesdaat NIH in Bethesda
  12. 12. 2002 INVITATIONAL CONFERENCE2002 INVITATIONAL CONFERENCE GOALS:GOALS:  FACILITATE NATIONAL DISCUSSIONFACILITATE NATIONAL DISCUSSION  DERIVE CONSENSUS DEFINITIONDERIVE CONSENSUS DEFINITION  DEVELOP RECOMMENDATIONS FOR ACTIONDEVELOP RECOMMENDATIONS FOR ACTION ININ  CLINICAL DOMAINCLINICAL DOMAIN  RESEARCH DOMAINRESEARCH DOMAIN
  13. 13. ATTENDED BYATTENDED BY  ACCREDITING ORGANIZATIONSACCREDITING ORGANIZATIONS  HEALTH & MEDICAL ASSOCIATIONSHEALTH & MEDICAL ASSOCIATIONS  HOSPITALS & HEALTH SYSTEMSHOSPITALS & HEALTH SYSTEMS  LIBRARY ASSOCIATIONSLIBRARY ASSOCIATIONS  LIBRARIANSHIP EDUCATORSLIBRARIANSHIP EDUCATORS  NLMNLM  NATIONAL NETWORK OF LIBRARIES OF MEDICINENATIONAL NETWORK OF LIBRARIES OF MEDICINE  PRACTICING INFORMATIONISTS & CLINICALPRACTICING INFORMATIONISTS & CLINICAL LIBRARIANSLIBRARIANS
  14. 14. WHY DO WE NEED CLINICAL INFORMATIONISTS?WHY DO WE NEED CLINICAL INFORMATIONISTS?  INFORMATION IS SCATTERED; NOT WELL INDEXEDINFORMATION IS SCATTERED; NOT WELL INDEXED  ELECTRONIC SEARCHES ARE COMPLEXELECTRONIC SEARCHES ARE COMPLEX  THE LINK BETWEEN INFORMATION AND PATIENTTHE LINK BETWEEN INFORMATION AND PATIENT CARE IS OFTEN MISSINGCARE IS OFTEN MISSING  CLINICAL LIBRARIANS HAVE PROVEN THEIR VALUECLINICAL LIBRARIANS HAVE PROVEN THEIR VALUE AND ARE MOVING BEYOND OLD LIMITS ON THEIRAND ARE MOVING BEYOND OLD LIMITS ON THEIR WORKWORK  PHYSICIANS HAVE LIMITED INTEREST ANDPHYSICIANS HAVE LIMITED INTEREST AND EXPERTISE IN SKILLS NECESSARY FOR GOODEXPERTISE IN SKILLS NECESSARY FOR GOOD RETRIEVALRETRIEVAL  IMPORTANCE OF USING PHYSICIAN’S SKILLS andIMPORTANCE OF USING PHYSICIAN’S SKILLS and TIME APPROPRIATELYTIME APPROPRIATELY
  15. 15. WHAT DO INFORMATIONISTS DO?WHAT DO INFORMATIONISTS DO? (What is a librarian doing here, anyway?)(What is a librarian doing here, anyway?)
  16. 16. WHAT DO INFORMATIONISTS DO?WHAT DO INFORMATIONISTS DO?  ““ROUND” WITHROUND” WITH PATIENT CARE TEAMPATIENT CARE TEAM (physicians nurses, dieticians,(physicians nurses, dieticians, pharmacists, therapists,pharmacists, therapists, students)students)
  17. 17. WHAT DO INFORMATIONISTS DO?WHAT DO INFORMATIONISTS DO?  ““ROUND” WITH PATIENTROUND” WITH PATIENT CARE TEAMCARE TEAM  RESPOND TO EXPRESSEDRESPOND TO EXPRESSED INFORMATION NEEDSINFORMATION NEEDS
  18. 18. WHAT DO INFORMATIONISTS DO?WHAT DO INFORMATIONISTS DO?  ““ROUND” WITH PATIENT CARE TEAMROUND” WITH PATIENT CARE TEAM))  RESPOND TO EXPRESSED INFORMATION NEEDSRESPOND TO EXPRESSED INFORMATION NEEDS  ANTICIPATE INFORMATION NEEDSANTICIPATE INFORMATION NEEDS
  19. 19. WHAT DO INFORMATIONISTS DO?WHAT DO INFORMATIONISTS DO?  ““ROUND” WITH PATIENTROUND” WITH PATIENT CARE TEAMCARE TEAM  RESPOND TO EXPRESSEDRESPOND TO EXPRESSED INFORMATION NEEDSINFORMATION NEEDS  ANTICIPATE INFORMATIONANTICIPATE INFORMATION NEEDSNEEDS  INDIVIDUALIZED, POINT-INDIVIDUALIZED, POINT- OF-NEED INSTRUCTIONOF-NEED INSTRUCTION
  20. 20. WHAT DO INFORMATIONISTS DO?WHAT DO INFORMATIONISTS DO?  ““ROUND” WITH PATIENT CARE TEAMROUND” WITH PATIENT CARE TEAM  RESPOND TO EXPRESSED INFORMATION NEEDSRESPOND TO EXPRESSED INFORMATION NEEDS  ANTICIPATE INFORMATION NEEDSANTICIPATE INFORMATION NEEDS  INDIVIDUALIZED, POINT-OF-NEED INSTRUCTIONINDIVIDUALIZED, POINT-OF-NEED INSTRUCTION  CONTRIBUTE TO KNOWLEDGE BASECONTRIBUTE TO KNOWLEDGE BASE
  21. 21. WHERE WILL WE FIND THE CLINICALWHERE WILL WE FIND THE CLINICAL INFORMATIONIST?INFORMATIONIST?
  22. 22. WHERE WILL WE FIND THE CLINICALWHERE WILL WE FIND THE CLINICAL INFORMATIONIST?INFORMATIONIST?  IN THE CLINICIN THE CLINIC
  23. 23. WHERE WILL WE FIND THE CLINICALWHERE WILL WE FIND THE CLINICAL INFORMATIONIST?INFORMATIONIST?  IN THE CLINICIN THE CLINIC  ON ROUNDSON ROUNDS
  24. 24. WHERE WILL WE FIND THE CLINICALWHERE WILL WE FIND THE CLINICAL INFORMATIONIST?INFORMATIONIST?  IN THE CLINICIN THE CLINIC  ON ROUNDSON ROUNDS  AT MEDICAL CONFERENCESAT MEDICAL CONFERENCES
  25. 25. WHERE WILL WE FIND THE CLINICALWHERE WILL WE FIND THE CLINICAL INFORMATIONIST?INFORMATIONIST?  IN THE CLINICIN THE CLINIC  ON ROUNDSON ROUNDS  AT MEDICAL CONFERENCESAT MEDICAL CONFERENCES  IN MEETINGSIN MEETINGS
  26. 26. WHERE WILL WE FIND THE CLINICALWHERE WILL WE FIND THE CLINICAL INFORMATIONIST?INFORMATIONIST?  IN THE CLINICIN THE CLINIC  AT ROUNDSAT ROUNDS  AT MEDICAL CONFERENCESAT MEDICAL CONFERENCES  AT MEETINGSAT MEETINGS  NOT IN THE LIBRARY SONOT IN THE LIBRARY SO OFTEN !?!!??OFTEN !?!!??
  27. 27. ARE WE BETTERARE WE BETTER LIBRARIANSLIBRARIANS ANSWERING QUESTIONSANSWERING QUESTIONS AT A DESKAT A DESK OR IN THE CLINIC?OR IN THE CLINIC?
  28. 28. THE TECHNICAL INFRASTRUCTURE IS INTHE TECHNICAL INFRASTRUCTURE IS IN PLACE TO SUPPORTPLACE TO SUPPORT ANYTIME-ANYWHEREANYTIME-ANYWHERE ACCESS TO INFORMATIONACCESS TO INFORMATION ----FLORANCEFLORANCE, ‘, ‘INFORMATIONISTS, CYBRARIANSINFORMATIONISTS, CYBRARIANS AND BEYOND’AND BEYOND’
  29. 29. WHY ARE WE NEEDED??WHY ARE WE NEEDED??
  30. 30.  MEDICALMEDICAL INFORMATIONINFORMATION DOUBLES EVERY 19DOUBLES EVERY 19 YEARS (WYATT:YEARS (WYATT: LANCETLANCET 1991; 338:1368)1991; 338:1368)
  31. 31.  MEDICAL INFORMATION DOUBLES EVERY 19 YEARSMEDICAL INFORMATION DOUBLES EVERY 19 YEARS  IN US, AT LEAST 44,000 DEATHS EACH YEARIN US, AT LEAST 44,000 DEATHS EACH YEAR FROM MEDICAL ERRORS (Leape:FROM MEDICAL ERRORS (Leape: JAMAJAMA 1994;1994; 272:1851)272:1851)
  32. 32.  MEDICAL INFORMATION DOUBLES EVERY 19 YEARSMEDICAL INFORMATION DOUBLES EVERY 19 YEARS  IN US, AT LEAST 44,000 DEATHS EACH YEAR FROM MEDICALIN US, AT LEAST 44,000 DEATHS EACH YEAR FROM MEDICAL ERRORSERRORS  AVERAGE TIME/PATIENT IS 7-10 MINUTES INAVERAGE TIME/PATIENT IS 7-10 MINUTES IN US (National Ambulatory Medical Care Survey)US (National Ambulatory Medical Care Survey)
  33. 33.  MEDICAL INFORMATION DOUBLES EVERY 19 YEARSMEDICAL INFORMATION DOUBLES EVERY 19 YEARS  IN US, UNNECESSARY 44,000 DEATHS/YEARIN US, UNNECESSARY 44,000 DEATHS/YEAR  AVERAGE TIME/PATIENT IS 7-10 MINUTES IN USAVERAGE TIME/PATIENT IS 7-10 MINUTES IN US  MOST PHYSICIANS PERFORM <ONEMOST PHYSICIANS PERFORM <ONE SEARCH/SEARCH/WEEK (HERSH:WEEK (HERSH: JAMAJAMA 1998; 280:1347)1998; 280:1347)
  34. 34. SMITH, 1996 (SMITH, 1996 (BMJBMJ 313:1062)313:1062)  DOCTORS ARE AWAREDOCTORS ARE AWARE OF INFORMATIONOF INFORMATION NEEDSNEEDS  MOST NEEDS CONCERNMOST NEEDS CONCERN DRUGS AND OTHERDRUGS AND OTHER TREATMENTSTREATMENTS  OFTEN COMPLEX ANDOFTEN COMPLEX AND MULTIDIMENSIONALMULTIDIMENSIONAL  NOT JUST MEDICALNOT JUST MEDICAL KNOWLEDGE NEEDEDKNOWLEDGE NEEDED  MOST GOMOST GO UNANSWEREDUNANSWERED  MOST CAN BEMOST CAN BE ANSWEREDANSWERED  DOCTORS ASK OTHERDOCTORS ASK OTHER DOCTORS MOST OFTENDOCTORS MOST OFTEN  OVERWHELMINGOVERWHELMING INFORMATION ININFORMATION IN DEVELOPEDDEVELOPED COUNTRIESCOUNTRIES
  35. 35. ARE CLINICAL GUIDELINES THEARE CLINICAL GUIDELINES THE ANSWER?ANSWER? CAN PDA’s DO MORE THANCAN PDA’s DO MORE THAN PROVIDE ‘QUICKPROVIDE ‘QUICK AND DIRTY’ ANSWERS?AND DIRTY’ ANSWERS?
  36. 36. IMAGINE:IMAGINE: ONE PATIENTONE PATIENT 5 DIAGNOSES5 DIAGNOSES EACH DIAGNOSIS HAS 2 POSSIBLEEACH DIAGNOSIS HAS 2 POSSIBLE TREATMENTS…TREATMENTS…
  37. 37. NO ONE CAN IMAGINE:NO ONE CAN IMAGINE: ONE PATIENT, 5 DIAGNOSES, EACH WITH 2ONE PATIENT, 5 DIAGNOSES, EACH WITH 2 POSSIBLE TREATMENTS…POSSIBLE TREATMENTS… 3,628,800 POSSIBLE TREATMENT3,628,800 POSSIBLE TREATMENT COURSES!COURSES! (Welsby,(Welsby, Journal of Evaluation in Clinical PracticeJournal of Evaluation in Clinical Practice 2002; 8:163)2002; 8:163)
  38. 38. IN THE NEO-NATAL INTENSIVE CARE UNITIN THE NEO-NATAL INTENSIVE CARE UNIT HOW MANY DECISIONSHOW MANY DECISIONS PER BABYPER BABY PER DAY?PER DAY?
  39. 39. IN THE CLINICAL RESEARCHIN THE CLINICAL RESEARCH SETTINGSETTING WHAT ARE THE COSTS OFWHAT ARE THE COSTS OF IMPORTANT REFERENCES MISSED?IMPORTANT REFERENCES MISSED?
  40. 40. WHICH QUESTIONWHICH QUESTION WILL MAKE A DIFFERENCEWILL MAKE A DIFFERENCE TODAY?TODAY?
  41. 41. JOHNS HOPKINS DEATHJOHNS HOPKINS DEATH SUMMER 2001SUMMER 2001  HEALTHY VOLUNTEER DIEDHEALTHY VOLUNTEER DIED  REACTION RECOGNIZED IN THE LITERATURE INREACTION RECOGNIZED IN THE LITERATURE IN ’50’s’50’s  INADEQUATE LITERATURE SEARCH A FACTORINADEQUATE LITERATURE SEARCH A FACTOR  NEW GUIDELINES ADOPTED BY JHU and MLANEW GUIDELINES ADOPTED BY JHU and MLA
  42. 42. TRADITIONAL LIBRARIAN SKILLSTRADITIONAL LIBRARIAN SKILLS  RECOGNIZE GAP IN KNOWLEDGERECOGNIZE GAP IN KNOWLEDGE  FORMULATE QUESTIONFORMULATE QUESTION  SEARCH FOR RELEVANT INFORMATIONSEARCH FOR RELEVANT INFORMATION  FORMULATE ANSWERFORMULATE ANSWER  USE ANSWER TO GUIDE ACTIONUSE ANSWER TO GUIDE ACTION  ““SAVE THE TIME OF THE READER”SAVE THE TIME OF THE READER”
  43. 43. EVIDENCE BASED MEDICINEEVIDENCE BASED MEDICINE  CONSCIENTIOUS, EXPLICIT and JUDICIOUS USE ofCONSCIENTIOUS, EXPLICIT and JUDICIOUS USE of  CURRENT EVIDENCECURRENT EVIDENCE  in MAKING DECISIONSin MAKING DECISIONS  about the CARE OF INDIVIDUAL PATIENTSabout the CARE OF INDIVIDUAL PATIENTS
  44. 44. GUYATT et al (GUYATT et al (BMJBMJ 2000; 320:954):2000; 320:954):  MANY CLINICIANS NOT INTERESTED IN SKILLS TOMANY CLINICIANS NOT INTERESTED IN SKILLS TO FIND AND USE BEST ORIGINAL LITERATUREFIND AND USE BEST ORIGINAL LITERATURE  THOSE THAT DO HAVE NO TIME TO APPLY SKILLSTHOSE THAT DO HAVE NO TIME TO APPLY SKILLS  INCREASED USE OF FILTERED SUMMARIES IN PRINTINCREASED USE OF FILTERED SUMMARIES IN PRINT
  45. 45. CLINICAL INFORMATIONISTCLINICAL INFORMATIONIST  TRADITIONAL SKILLS OF LIBRARIANSTRADITIONAL SKILLS OF LIBRARIANS  TRAINING IN EVIDENCE-BASED MEDICINETRAINING IN EVIDENCE-BASED MEDICINE  INFORMATION IS PRIMARY RESPONSIBILITYINFORMATION IS PRIMARY RESPONSIBILITY  CONTINUALLY IMPROVING THE LIBRARY’S SUPPORTCONTINUALLY IMPROVING THE LIBRARY’S SUPPORT OF INFORMATION NEEDSOF INFORMATION NEEDS
  46. 46. INFORMATIONISTSINFORMATIONISTS COMFORTABLY BETWEEN TWO WORLDSCOMFORTABLY BETWEEN TWO WORLDS PER DAVIDOFF AND FLORANCE:PER DAVIDOFF AND FLORANCE:  TRAINED IN THE ESSENTIALS OF CLINICALTRAINED IN THE ESSENTIALS OF CLINICAL WORK AND ABLE TO FUNCTION IN A CLINICALWORK AND ABLE TO FUNCTION IN A CLINICAL CARE TEAMCARE TEAM  CLEAR AND SOLID UNDERSTANDING OFCLEAR AND SOLID UNDERSTANDING OF INFORMATION SCIENCEINFORMATION SCIENCE -- PRIMARY EDUCATION MAY BE INFORMATION-- PRIMARY EDUCATION MAY BE INFORMATION OR BIOMEDICAL SCIENCEOR BIOMEDICAL SCIENCE
  47. 47. OPTIONS FOR EDUCATION AND TRAININGOPTIONS FOR EDUCATION AND TRAINING OF LIBRARIANS AS INFORMATIONISTSOF LIBRARIANS AS INFORMATIONISTS  DUAL-DEGREE PROGRAMSDUAL-DEGREE PROGRAMS  INTERNSHIPS & FELLOWSHIPSINTERNSHIPS & FELLOWSHIPS  CONTINUING EDUCATION COURSEWORKCONTINUING EDUCATION COURSEWORK  ON-THE-JOB TRAININGON-THE-JOB TRAINING  SPECIALIZED TRAINING PROGRAMSSPECIALIZED TRAINING PROGRAMS  MENTORSHIPSMENTORSHIPS
  48. 48. OPTIONS FOR EDUCATION AND TRAINING OFOPTIONS FOR EDUCATION AND TRAINING OF SCIENTISTS, NURSES, PHARMACISTS ANDSCIENTISTS, NURSES, PHARMACISTS AND PHYSICIANSPHYSICIANS AS CLINICAL INFORMATIONISTSAS CLINICAL INFORMATIONISTS  DUALDUAL OROR COMBINEDCOMBINED DEGREE PROGRAMSDEGREE PROGRAMS  SPECIALIZED TRAININGSPECIALIZED TRAINING PROGRAMS (PROGRAMS (NLM)NLM)  ON THE JOB TRAININGON THE JOB TRAINING  CONTINUING EDUCATIONCONTINUING EDUCATION  FELLOWSHIPSFELLOWSHIPS ANDAND INTERNSHIPSINTERNSHIPS
  49. 49. WHAT ABOUTWHAT ABOUT RESEARCH INFORMATIONISTS?RESEARCH INFORMATIONISTS?
  50. 50. WHAT ABOUTWHAT ABOUT RESEARCH INFORMATIONISTS?RESEARCH INFORMATIONISTS?  ““TWO HOURS IN THE LABTWO HOURS IN THE LAB WILL SAVEWILL SAVE ONE HOUR IN THEONE HOUR IN THE LIBRARY”LIBRARY”
  51. 51. WHAT ABOUTWHAT ABOUT RESEARCH INFORMATIONISTS?RESEARCH INFORMATIONISTS?  ““TWO HOURS IN THE LABTWO HOURS IN THE LAB WILL SAVEWILL SAVE ONE HOUR IN THEONE HOUR IN THE LIBRARY”LIBRARY”  ““ASK FRANK!”ASK FRANK!”
  52. 52. WHAT ABOUTWHAT ABOUT RESEARCH INFORMATIONISTS?RESEARCH INFORMATIONISTS?  ““TWO HOURS IN THE LABTWO HOURS IN THE LAB WILL SAVEWILL SAVE ONE HOUR IN THEONE HOUR IN THE LIBRARY”LIBRARY”  ““ASK FRANK!”ASK FRANK!”  RESTRICTIONS ON ANIMALRESTRICTIONS ON ANIMAL USEUSE
  53. 53. WHAT ABOUTWHAT ABOUT RESEARCH INFORMATIONISTS?RESEARCH INFORMATIONISTS?  ““TWO HOURS IN THE LABTWO HOURS IN THE LAB WILL SAVEWILL SAVE ONE HOUR IN THEONE HOUR IN THE LIBRARY”LIBRARY”  ““ASK FRANK!”ASK FRANK!”  RESTRICTIONS ON ANIMALRESTRICTIONS ON ANIMAL USEUSE  GENETIC DATABASESGENETIC DATABASES
  54. 54. PILCH (PILCH (UNPUBLISHED, 2001):UNPUBLISHED, 2001): NIH RESEARCHERS NEED ASSISTANCE WITH:NIH RESEARCHERS NEED ASSISTANCE WITH:  LITERATURE SEARCHES OUTSIDE OWN AREALITERATURE SEARCHES OUTSIDE OWN AREA  EVALUATION FOR RELEVANCE AND QUALITYEVALUATION FOR RELEVANCE AND QUALITY  APPLICATIONS OF TECHNIQUES AND KNOWLEDGE FROMAPPLICATIONS OF TECHNIQUES AND KNOWLEDGE FROM UNFAMILIAR AREAS OF RESEARCHUNFAMILIAR AREAS OF RESEARCH  RESEARCH UPDATESRESEARCH UPDATES  BACKGROUND INFORMATION SUMMARIESBACKGROUND INFORMATION SUMMARIES  UNFAMILIAR DATABASESUNFAMILIAR DATABASES  SCIENTIFIC TRAINING AND COMPETENCE OFSCIENTIFIC TRAINING AND COMPETENCE OF INFORMATIONIST MOST IMPORTANTINFORMATIONIST MOST IMPORTANT
  55. 55. CAN INFORMATIONISTS WORK WITHCAN INFORMATIONISTS WORK WITH PATIENTS?PATIENTS?  PATIENT INFORMATIONPATIENT INFORMATION CENTERSCENTERS  WEBSITESWEBSITES FORFOR PHYSICIANS,PHYSICIANS, HOSPITALS, PROFESSIONALHOSPITALS, PROFESSIONAL ORGANIZATIONS, DRUGORGANIZATIONS, DRUG COMPANIESCOMPANIES  CYBERSENIORSCYBERSENIORS  34% OF U.S. HOME34% OF U.S. HOME COMPUTER USE IS BYCOMPUTER USE IS BY THOSE OVER 65THOSE OVER 65 ((www.aoa.dhhs.gov/aoa/stats/prowww.aoa.dhhs.gov/aoa/stats/pro file/2001/13.html)file/2001/13.html)
  56. 56. CAN INFORMATIONISTS CREATE INFORMATION?CAN INFORMATIONISTS CREATE INFORMATION? SHOULD THEY?SHOULD THEY?  META-INFORMATIONMETA-INFORMATION  ““INFORMATION about INFORMATION”INFORMATION about INFORMATION”  KNOWLEDGE BASESKNOWLEDGE BASES  ASSESSMENT OF NEW PROGRAMSASSESSMENT OF NEW PROGRAMS  WORK WITH DATABASE PRODUCERSWORK WITH DATABASE PRODUCERS  PARTICIPATE IN EVIDENCE-BASED PROGRAMSPARTICIPATE IN EVIDENCE-BASED PROGRAMS  ORGANIZE INTERNATIONAL and THIRD-WORLDORGANIZE INTERNATIONAL and THIRD-WORLD PROGRAMSPROGRAMS
  57. 57. NIH LIBRARY INFORMATIONIST MODELNIH LIBRARY INFORMATIONIST MODEL  CLINICAL ROUNDSCLINICAL ROUNDS  ASSISTANCE WITHASSISTANCE WITH CLINICAL RESEARCHCLINICAL RESEARCH FROM PROTOCOL TOFROM PROTOCOL TO PUBLICATIONPUBLICATION  CONSENSUSCONSENSUS CONFERENCE SUPPORTCONFERENCE SUPPORT  KNOWLEDGE BASEKNOWLEDGE BASE  WEBSITEWEBSITE DEVELOPMENTDEVELOPMENT  EXPLORATIONSEXPLORATIONS BEYOND NIH CAMPUSBEYOND NIH CAMPUS  WHOWHO  COCHRANECOCHRANE COLLABORATIONCOLLABORATION  INTERNATIONALINTERNATIONAL COLLABORATIVECOLLABORATIVE EFFORTS TO CONNECTEFFORTS TO CONNECT MEDICAL KNOWLEDGEMEDICAL KNOWLEDGE AND PATIENT NEEDSAND PATIENT NEEDS
  58. 58. VANDERBILT UNIVERSITY MODELVANDERBILT UNIVERSITY MODEL  CLINICAL LIAISONSCLINICAL LIAISONS  ROUNDROUND  FILTERED EBMFILTERED EBM SEARCHESSEARCHES  KNOWLEDGE BASEKNOWLEDGE BASE  CONTINUAL LEARNINGCONTINUAL LEARNING  SEARCH AND FILTERINGSEARCH AND FILTERING JOURNAL CLUBSJOURNAL CLUBS  50+ MODULES FOR50+ MODULES FOR STAFF DEVELOPMENTSTAFF DEVELOPMENT  FORMAL CLASSESFORMAL CLASSES  RESEARCHRESEARCH INFORMATIONISTSINFORMATIONISTS  PARTICIPATE ONPARTICIPATE ON RESEARCH TEAMSRESEARCH TEAMS  EXPERT SEARCHINGEXPERT SEARCHING  SHARE KNOWLEDGESHARE KNOWLEDGE WITH LIBRARY STAFFWITH LIBRARY STAFF  CONTINUAL LEARNINGCONTINUAL LEARNING WITH SOME ELEMENTSWITH SOME ELEMENTS AS CLINICAL LIAISONSAS CLINICAL LIAISONS
  59. 59. OBSTACLESOBSTACLES  NO ACADEMIC PROGRAMS ESTABLISHED YETNO ACADEMIC PROGRAMS ESTABLISHED YET  PERSONAL COSTS FOR ADDITIONAL DEGREEPERSONAL COSTS FOR ADDITIONAL DEGREE OROR TRAININGTRAINING  UNCERTAIN RECOVERY OF ADDITIONAL COSTSUNCERTAIN RECOVERY OF ADDITIONAL COSTS  DIFFICULTY INTEGRATING PROFESSIONALS WITHDIFFICULTY INTEGRATING PROFESSIONALS WITH DIFFERENT BACKGROUNDS IN SAME POSITIONDIFFERENT BACKGROUNDS IN SAME POSITION  RELUCTANCE OF SOME (PHYSICIANS, RESEARCHERSRELUCTANCE OF SOME (PHYSICIANS, RESEARCHERS)) TO GIVE UP AUTHORITY OR ADMIT LIMITATIONSTO GIVE UP AUTHORITY OR ADMIT LIMITATIONS
  60. 60. ADDITIONAL CHALLENGESADDITIONAL CHALLENGES  NEW MODEL vs OLD MODEL of WHAT A LIBRARIANNEW MODEL vs OLD MODEL of WHAT A LIBRARIAN ISIS  CONTINUAL LEARNING vs INCREASED DEMANDSCONTINUAL LEARNING vs INCREASED DEMANDS ON TIME AND DECREASED FUNDINGON TIME AND DECREASED FUNDING  TWO-TIER STRUCTURE FOR INFORMATIONISTSTWO-TIER STRUCTURE FOR INFORMATIONISTS WITHIN A SINGLE INSTITUTIONWITHIN A SINGLE INSTITUTION  WHO WILL PAY?WHO WILL PAY?  EVALUATION OF NEW PROGRAMSEVALUATION OF NEW PROGRAMS
  61. 61. THE FUTURETHE FUTURE  INCREASING ACCESS TO MOREINCREASING ACCESS TO MORE INFORMATIONINFORMATION  NEW TECHNOLOGYNEW TECHNOLOGY  DEMAND FOR BETTER MEDICAL CAREDEMAND FOR BETTER MEDICAL CARE  NEED TO CONTROL COSTSNEED TO CONTROL COSTS  AGING POPULATIONAGING POPULATION  NEW HEALTH THREATSNEW HEALTH THREATS  MORE ATTENTION TO ETHICS and PATIENTMORE ATTENTION TO ETHICS and PATIENT RIGHTSRIGHTS  BETTER-INFORMED PATIENTSBETTER-INFORMED PATIENTS
  62. 62. HOW WILL WE RESPOND?HOW WILL WE RESPOND?
  63. 63. MAKE VISIBLE WHAT,MAKE VISIBLE WHAT, WITHOUT YOU,WITHOUT YOU, MIGHT NEVER HAVE BEENMIGHT NEVER HAVE BEEN SEEN.SEEN. --ROBERT BRESSON, FILM-MAKER--ROBERT BRESSON, FILM-MAKER
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