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
•Assignment #2 discussion
•Our (your) philosophy of service
• 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?
Is this our future?
• 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
•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?
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
78.2 yrs average 80.3 yrs
Health trends: spending
2010: spending forecasted at $192 billion
Health expenditures 1975-2010
1975 1980 1985 1990 1995 2000 2005 2010
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
• Family practitioner
• General practitioner (GP)
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 .
• 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
– 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.