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Trends in health libraries 2013
 

Trends in health libraries 2013

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  • Changes in medical information and technology are revolutionizing health care. As clinicians try to incorporate research into practice through comparative effectiveness research and decision support, they increasingly depend on technology to bring evidence to the bedside to improve quality and patient outcomes. Integrating current information into the processes of shared decision making and continuous learning supports the application of evidence in clinical decision making. Health sciences libraries and librarians have an increasingly important role in providing that information to clinicians as well as to patients and their families. Health sciences libraries and librarians, like all participants in the health and health education system, must do more with less. Medical journal prices have increased by more than 30% in 5 years, yet the budgets of academic health sciences libraries (specifically, libraries that are members of the Association of Academic Health Sciences Libraries) increased by only 5.7% during that same period, and their workforce decreased by 11% between 2009 and 2012. 1- 3 As a result, these libraries in the United States and Canada are able to purchase fewer information resources (although they have minimized the declines through creative strategies such as shared purchasing). In trying to reconcile cost with value like other participants in the health care system, health sciences libraries find it necessary to consider the evidence regarding the changing roles and value of health sciences libraries and librarians.
  • Where does the money go to fund this system? Hospitals 30% Other Institutions 10% Physicians 13% Other Professionals 12% Drugs 15% Other 20% Drugs are fastest growing sector (mainly due to increased patent protection), while expenditures on physicians, hospitals and capital are declining (doctors exert their influence on health care costs through their clinical decisions, not their earnings) Other (1996): payment administration 2.4%, public health 5.5%, health research 1.1%
  • Where does the money go to fund this system? Hospitals 30% Other Institutions 10% Physicians 13% Other Professionals 12% Drugs 15% Other 20% Drugs are fastest growing sector (mainly due to increased patent protection), while expenditures on physicians, hospitals and capital are declining (doctors exert their influence on health care costs through their clinical decisions, not their earnings) Other (1996): payment administration 2.4%, public health 5.5%, health research 1.1%
  • Where does the money go to fund this system? Hospitals 30% Other Institutions 10% Physicians 13% Other Professionals 12% Drugs 15% Other 20% Drugs are fastest growing sector (mainly due to increased patent protection), while expenditures on physicians, hospitals and capital are declining (doctors exert their influence on health care costs through their clinical decisions, not their earnings) Other (1996): payment administration 2.4%, public health 5.5%, health research 1.1%
  • Where does the money go to fund this system? Hospitals 30% Other Institutions 10% Physicians 13% Other Professionals 12% Drugs 15% Other 20% Drugs are fastest growing sector (mainly due to increased patent protection), while expenditures on physicians, hospitals and capital are declining (doctors exert their influence on health care costs through their clinical decisions, not their earnings) Other (1996): payment administration 2.4%, public health 5.5%, health research 1.1%
  • A patient’s journey can be made up of a series of waits: routine care, to see specialist, for a test, MRI, for test results, for surgery, for post-acute care 1.5 million Canadian adults said they were unable to find a family doctor in 2003 = 5% of population
  • UN report ranks it 30th overall, mainly because of of its high cost. This falls to 35th when our high income and education levels are considered (they think we should do better than we do) France is first overall (and spends 9.8% of its GDP on health care). Japan is 10th (7.1%), UK 18th (5.8%), US 37th (13.7%)
  • Harper, prime minister since 2006, campaigned on a pledge to reduce waiting times for health care services, but has not launched any major attempt to privatize the system In Aboriginal populations… Higher death rates from infectious diseases, which is associated with inadequate housing and unsanitary conditions Higher suicide and death rates from drowning, fire, homicide, and motor vehicle accidents Are affected by racism and discrimination, which increases risks of psychological distress, depression, and unemployment Often faced with lack of access to opportunities and resources*

Trends in health libraries 2013 Trends in health libraries 2013 Presentation Transcript

  • Introduction to trends in health libraries Health librarians working towards a healthier Canada In 2004, Tommy Douglas, father of Canadian health care, voted The Greatest Canadian See http://www.youtube.com/watch?v=lf1YAznsnVA
  • •Assignment #2 discussion •Our (your) philosophy of service •Our role(s) • To find answers to questions • Authoritative sources & evaluation (of same) • The reference interview (the means) •System creates information needs (context = user groups) Talking points for class
  • Trends in health libraries / in medicine •For assignment #2, what trend did you identify? •Share your trend with your neighbour •Was it difficult to find trends? •Most important take-away from this assignment? Empty shelves? Is this our future?
  • Positive, evolving, value of librarians
  • • Supporting clinical care: grants, trials & systematic reviews • Health libraries provide access to print & electronic resources • Virtually any book or journal is a source of information • Provide timely & effective reference • Formats: dictionaries, directories, handbooks, encyclopedias/textbooks, journals • Concerns: end users not fluent with information • cannot do proper lit reviews • accept what they find in search engines • Health librarians must teach information skills • One reason why health librarians are vital to evidence-based care What makes a good reference philosophy?
  • Philosophy of service •Think about your ideas around library service for a few minutes •What kind of librarian or information professional do you want to be (aspire to be)? What is your philosophy of service? •Share your ideas with a neighbour after a few minutes •Then, share your ideas with class
  • Health on the Net (HON) Code
  • Reference question: •A patient asks: can you recommend a good website for information about anemia? •Break question down • Definition (is one needed)? • What branch of medicine is this? • What format is needed? • What reading level? • Where will you find answers to these questions?
  • The right information has context “…Any health system – even the best in the world – is only one ingredient to determine whether your life will be long or short, healthy or sick, full of fulfillment … or empty with despair…” The Honourable Roy Romanow, 2004 holding documents of the Romanow Commission
  • Philosophical orientation in Cdn healthcare • What is universal health care? Five principles 1.Universality: entire population covered 2.Comprehensive: medically-necessary services 3.Accessible: in practice “no user fees” (added in 1984) 4.Portable: from province to province 5.Public administration: operated by public agency • Where do health librarians fit in? • What’s the prognosis?
  • Some important health statistics OECD Health Data 2012 (based on 2010 statistics) Canada USA Germany Health dollars as % of GDP 11% 17% 11% % of public monies spent 70.7% 44.5% 76.9% Expenses per capita $3678 USD $6714 USD $3371 USD Practicing MDs 2.1/1000 2.4/1000 3.5/1000 Practicing RNs 8.1/1000 10.5/1000 9.8/1000 MRI Units/million 6.2 26.5 7.7 Life expectancy 80.7 yrs average 78.2 yrs average 80.3 yrs average
  • Health trends: spending 2010: spending forecasted at $192 billion
  • Health expenditures 1975-2010 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0 55.0 60.0 1975 1980 1985 1990 1995 2000 2005 2010 Year $'Billion Hospitals Physicians Drugs Source: National Health Expenditure Trends 1975 to 2010, CIHI
  • Health system issues • Health professionals, chronic shortages • Hospitals & health care facilities (with beds) • Community (ambulatory care) vs. acute care • Public health, disease control, SARS, HIV, etc. • Funders (mainly government, charities, foundations) • Planning & coordinating agencies • Industry e.g., pharmaceutical, medical devices • Patients need to engage more
  • Private vs. public medicine • In for-profit models of care, patients pay for access to services • There’s no waiting, but it comes at a very high cost • Free markets innovate but they are profit-driven /profit-centred • Bureaucratic systems move slowly • With universal care, there’s always rationing, triaging • Long waits are common, even in emergency • In emergencies, triaging works well • We wait for non-emergency ‘elective’ services
  • Medical specialists covered by Canada Health Act Examples: • Family practitioner • General practitioner (GP) • Gynecologist • Dermatologist • Orthopedist • Urologist • Pediatrician • Endocrinologist • Oncologist • Others? What are their information needs?
  • How good is Canada’s health care system? • In treating diseases & illnesses? • We perform fine but don’t monitor as much as we could • Efficient in treating patients • Less so, given other health systems internationally • Effective in promoting health & preventing disease? • Based on surveys & expenditures, we could be better • Accountable to the public • We cab do more despite some excellent programs • e.g., Health Council of Canada cut • Health care is our most popular (most beloved) social program, central to our Canadian identity (much as hockey is)
  • Major user groups in medicine • Association of Faculties of Medicine of Canada • Canadian Health Libraries Association • Canadian Public Health Association • Canadian Health Services Research Foundation • Canadian Nurses Association • Canadian Medical Association • Canadian Association of Occupational Therapists • Canadian Pharmacists Association • Canadian Physiotherapy Association • Canadian Library Association • Dieticians of Canada • Health Canada, Federal Minister of Health • Library and Archives Canada • Public Health Agency of Canada  McGowan J. Canada urgently needs a national network of libraries to access evidence. Healthcare Quarterly. 2006. 9(1): 72-74 .
  • Key trends • Information technologies key to evidence-based practice • Spiraling costs, new models of care – Public-private partnerships – Other (shift to community care) • Culturally-appropriate care for our multicultural communities – Xenophobia – Inequities, esp. rural-urban divide, First Nations, Inuit • Aging boomers, long-term care • Privatization? insurance, hospital management, provision of services • Closing of health libraries due to the Internet • eHealth & telehealth trends
  • Browne R, Lasserre K, McTaggart J, Bayley L, McKibbon A, Clark M, Perry GJ, Murphy J. International trends in health science librarianship: part 1 - the English speaking world. Health Info Libr J. 2012 Mar;29(1):75-80. Article discussion