NER Public Health Digital Library Project


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The New England Region's Public Health Digital Library Project was presented by Elaine Martin, DA, and Karen Dahlen. The project aims to build a digital public health library that will help make information resources, such as full-text journal articles, evidence-based guidelines, and systematic reviews available to public health professionals in all 50 U.S. states.

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  • Background: review of public health departments – meet with them to determine and justify interest. The next 7 slides illustrate what we learned. For example, we looked at previous needs assessments in relationship to the literature review.
  • Seven reasons to be involved in “information needs assessment.” An information needs assessment enables: Better understanding of mission critical roles leads to improved business models (or adjustments)
  • Background Issues related to Information Gathering. Validates LaPelle article.
  • PeterBriss --
  • Council on Linkages “Core Competencies” were reviewed in relationship to the project; for compliance and access.
  • Sincepublic health departmentslack access to a library, the project is providing partnerpublic health departments with freeaccess toselected licensed databases, electronic books, and full-text journal articlesthat would otherwise be unavailable to them due to the high cost of subscriptions.Through the project, we hope to gain a better understanding about the usefulness of providing PHDs with access toinformation resourcesidentify what resources: are needed and would be of the most value and affordable to PHDs[Introduce & provide technology for information management ]EndNote software to save, store, and manage information.
  • Specific objectives…Evaluation based on logic model
  • Partners libraries provide document delivery services to each health departmentTheir services are reimbursed by the project
  • The licensed resources (databases, e-books& specific journal titles) are made available through a Digital Library at each health department.This page – only available to staff at the Maine Center for Disease Control and PreventionResources available through IP addressing on each DPH’s website
  • The Oversight person is fairly high in the organization for buy-in purposes and to “lobby” on behalf of the project.The IT contact needs to understand the project, the time it will take to make it happen, and to be aware of why these resources are important. This contact will assist with getting the “digital library” in place, testing the links, and communication with project manager on difficulties when encountered.
  • Connecticut will be the newest PHD added in April/May.Potential users are based on the numbers provided by the lead team. Those in red have been modified to accommodate special situations. MPHD owns 3 hospitals, a prison, food services, and other various businesses; thus we expect somewhere around 1500 to uses promoted resources. Note: We know that BPHC has low statistics; 7/8 people attended the training sessions, and use of resources is low. Basing the number on 33/35 potential users is realistic for actual users of resources. Note: Public health workers include a mix of infectious and chronic disease professionals, nurses, social workers, child & maternal health programs, lab professionals, statisticians, community assessment and environmental professionals. 
  • anyone can access and take a look
  • We held 14 sessions accomodating 184 people; Hathy also did a 1 hour session for the Vermont Division Directors; and 23 attended – for a total of 207.
  • One unexpected outcome was the number of journals wished for (# on individual wishlists).In Colorado (CDPHE) = 253; in Maine = 140; RI said all of Elsevier and Science Direct Journals (otherwise 25)
  • Although there were several unexpected outcomes, one of the more sensitive was the ability for the people responding to add comments to what resources they wanted.
  • * Those receiving the Vermont Journal SurveyMonkey were asked to only complete the survey if they were users of library resources (we expect there are about 100). The purpose of this survey was to find out how many subscriptions were located in PHDs, who was paying for these resources (personal or departmental), and what titles were on their “journal” wish list. This survey was prototyped and tested at the Maine CDC. Only one PHD hasn’t completed the Journal SurveyMonkey – MPHD.
  • This type of information was reviewed in the training session.
  • In Maine, article delivery is supplied first by Maine Medical Center; books requested for loan go through the Maine State Library.
  • These examples are from CDPHE (158)and HN 27; Maine=76;
  • Tied to specific “intranet” page.
  • The number 1 question here asked the Lead-Team Persons what areas of their work needed information support.Policy development and improvementLegislative and political informationInterventions related to health outbreaks and conditionsGrant applications (writing and researching)Workforce planning and training toolsBest public health practices (e.g., model practices)Community/state-wide assessmentsTarget population/topical background information . This information was then transferred to the pre/post training surveys.
  • NER Public Health Digital Library Project

    1. 1. Elaine R. Martin, DA, PIKaren H. Dahlen, MLS, Project CoordinatorApril 28, 2011
    2. 2. Aspects of the Study Review of the Literature Needs Assessment Public Health Departments to be Included Buy-in from Constituents Identification of Resources Platform to House Resources (Digital Library) Training Related to Resources Ongoing Evaluation Tied to Data Model Test Existing “Article Delivery” Model Review Outcomes Relationship of NN/LM, CDC, Other Library Partners
    3. 3. Information Needs Assessment Behaviors of public health researchers and practitioners. Preferences of individuals in the public health workforcerelated to digital content. Identification of duplicative purchases to improve overallspend and efficiencies. Assess time spent finding information and problemsencountered. Implement productivity improvement services andstreamline workflow. Learn what roles the public health workforce considersmission critical. Track changes related to content priorities, knowledgeunderstanding and skill levels over time
    4. 4. Project TeamPrincipal Investigator:Elaine Martin, Director,University of Massachusetts LamarSoutter Library and Director of theNER (North East Region) NN/LMJavier Crespo, Associate Director,NN/LM NER, University ofMassachusettsHathy Simpson, Public HealthCoordinator (NN/LM NER)University of Massachusetts MedicalSchoolKaren Dahlen, ProjectCoordinator --LicensedResources, Consultation &TrainingNational Network/Libraries of MedicineNew England Region (NER)→→
    5. 5. Departments of HealthSelected PHDs for this Project MidContinental Region NN/LM Colorado Department of Public Health & Environment(CDPHE) New England Region NN/LM Boston Public Health Commission Maine Department of Health Massachusetts Department of Public Health New Hampshire DHHS Rhode Island Department of Health Vermont Department of Health Connecticut Department of Public Health
    6. 6. Information Needs ofPublic Health Practitioners Broad range of resources needed Across the Information Continuum Challenges related to information retrieval Lack of time Lack of knowledge Lack of access Want access to: Full-text journal articles News, reports, and conference abstracts Automatic notification of new information Systematic reviews and evidence-based guidelinesLaPelle NR, Luckmann R, Simpson EH, Martin ER. Identifying strategies to improve access to credible and relevantinformation for public health professionals: a qualitative study. BMC Public Health. 2006;6:89.
    7. 7. Public Health Information ContinuumResearch Support for InformationMinimum MaximumNeed access to all levels of the information continuumLaPelle NR, Luckmann R, Simpson EH, Martin ER. Identifying strategies to improve access tocredible and relevant information for public health professionals: a qualitative study. BMC PublicHealth. 2006;6:89.
    8. 8. Template For Improved AccessTo Public Health Information single portal access with a good search engine; automatic alerts regarding newly available information; access to best practice information in many areas of interest thatextend beyond biomedical subject matter; improved access to systematic reviews, summaries and full-textarticles Improved access to the grey literature, Better methods for indexing, filtering, and searching(interoperability); Effective ways to archive information; (citation mgt software) Improvements in existing systems with which they were alreadyfamiliar such as PubMed and others….LaPelle, NR et al. Identifying strategies to improve access to credible and relevant information forpublic health professionals: a qualitative study. BMC Public Health. 2006; 6: 89. Published online2006 April 5. doi: 10.1186/1471-2458-6-89. PMCID: PMC1456961
    9. 9. Background IssuesRelated to Information GatheringVolume 11, Feb 26, 2008 (Outsell, Inc.)Problems GettingInformationMore…. Not enough time Note enough budget Lack of Staff support Hard to determine quality Not knowing what’s available Information too hard to find Too much information to sort Not being able to compareacross informationalternatives Information is too hard to useand access once found Having insufficient trainingon how to search and useinformation Information is not timely/notupdated often enough Full text is not available Information is notcomprehensive enough Insufficient search featuresand options
    10. 10. Interpreting Scientific ResearchMoving it to Practice How does one find the best available science to improve health? What is an evidence-based resource? (Quality of Evidence Working Group) What evidence was considered (quality studies vs opinion)? Is all information equal? (All information is not necessarily equal) Who participated in gathering/interpreting information? It takes 17 years to turn 14% of original research to the benefit of patientcare. (Andrew Balas)Balas AE, Boren S. Managing Clinical Knowledge for Health Care Improvement. Yearbookof Medical Informatics 2000. Stuttgart, Germany: Schattauer; 2000
    11. 11. Gathering and Analyzing EB InformationRapid Detection of EpidemicsDetecting an anthraxepidemic one day earlierwould save $1-7 billionCDC Presentation byC. Safron citing: AF, EID, V3, N2
    12. 12. PFH’s Council on LinkagesCore Competencies Analytic/Assessment Skills Community Dimensions of Practice Skills Policy Development/Program Planning Skills Basic Public Health Sciences Skills Communication Skills Financial Planning and Management Skills Cultural Competency Skills Leadership and Systems Thinking Skills
    13. 13. Project Goals1. Identify and test useful e-databases, e-books, e-journals,and e-articles in selected public health departments.2. Understand frequency of use of these resources(including full-text access to selective licensed e-resources), who uses the resources, and if such accesscould improve the quality of work in selecteddepartments of health.3. Evaluate usefulness of these resources in relationship torelated to PHF core competencies and PH essentialservices.4. Introduce technology related to informationmanagement: how to save, store, and reuse information.5. Determine what resources/costs affordable for PublicHealth.
    14. 14. Project Objectives Promote selected e-journals and two databases that containevidence-based public health resources in addition toPubMed: Stat!Ref – compilation of full-text E-books (references connectdirectly to PubMed). Global Health – contains public health information back to1912; strong in applied health sciences. New Features of PubMed/PubMed Central and introduction toPHPartners .org. NEJM to assess interest in full-text use. License EndNote X/4 for multiple users. Provide subsidized Article Delivery Service to those whowork in the selected public health departments. Test the EBPH website at the Soutter Library. Evaluate program for cost and extensibility.
    15. 15. Library Partners• Poudre Valley Hospital System, Ft. Collins, CO• Maine Medical Center, Portland, ME• Maine State Library, Augusta, ME (Books)• Dana Medical Library, University of Vermont,Burlington, VT• Rhode Island Hospital/Lifespan/Providence, RI• William A. Hinton, State Laboratory Institute MedicalLibrary and Lemuel Shattuck Hospital (MPHD)• Lamar Soutter Library, University of MassachusettsMedical School, Worcester, MA
    16. 16. Maine CDC Digital Library Page
    17. 17. CDPHE—Digital Library
    18. 18. Summary ofProcesses Related to PLAN Hold on-site meetings with Public Health Departments (PHD) Identify 3-4 key people within each PHD Identify Resources (E) Design a Digital Library Template with input from PHDS (E) Begin an Environmental Scan to learn about organizations Convene a meeting of Project Personnel & PHD lead-team persons (E) Select “training team” and develop “standardized curriculum” Design training to accommodate local needs Train up to 15 people in 7 states (Connecticut will make 8) (E) Facilitate/Customize Digital Library intranet access Identify Library Partners to test and gather data on “article delivery service” Gather and monitor statistics (E) Marketing and advertising resources (E) What new partnerships could be developed? Evaluate , Evaluate, and Evaluate (E)
    19. 19. Public Health Commitment Contact persons (3): Oversight, IT, Team-Lead tofacilitate training, marketing, and access. Onsite visit to introduce the project . Identify coordinator and lead-team group onsite. Attend “train-the-trainer” session in Worcester. Coordinate submittal of surveys and other informationgathering techniques. Coordinate on-sight 2 (half-day ) training sessions. IT commitment related to “digital library page” install; IT EndNote X/4 install and management
    20. 20. Increased Access to e-Resources Databases (including access to full-text articles) PubMed (PubMed Central) – NLM Stat!Ref (30+ e-texts) including Red Book Global Health (archive + current files) E-Tools (Citation Management Software) EndNote (to easily store, retrieve, use or reuse literature, pdf’s orcharts) Improved Access to Alerts (through databases) E-Access to Full-text Journal Articles New England Journal of Medicine Streamlined Article Delivery (for duration of the project) Article Delivery Service through Loansome Doc Based on New/Renewed Library Partnerships Test of U Mass Soutter Library’s EBPH Website List of Journals in Full-Text Public Health Journals by Impact Factor
    21. 21. How were resources chosen? Contain evidence-based, full-text public health content; Connect/interoperable with other resources; Link to some full-text (the e-article +) Vendors were willing to: minimize cost to test usefulness of content; maximize access; provide usage statistics; support training; and assist with license review and understanding.
    22. 22. Use of EndNote Save and store bibliographic references for use/reuse:Manually, through import process, or direct export. Organize references, e.g., through “custom groups.” Use and understand the “cite as you write” featurefor publication, policy and document preparation. Added features, e.g., full text, pictures or graphs toenhance access or improve documentpreparation. Ability to store pdf with record for quick informationretrieval.
    23. 23. Access to Article Delivery ServiceSubsidized Interlibrary Loan Access to LoansomeDoc willbe provided by a local libraryof first resort. Require registration toLoansome Doc to monitorusage. Maintain establishedrelationships with existinglibraries within each state. Utilize University ofMassachusetts SoutterLibrary as last resort.
    24. 24. EvaluationComponentsTo advance library/informationresource access in Public HealthDepartments, there is a need toknow:What resources areneeded?Which e-journals are coreto the work?How information can bemore effectively accessed?How much will theseresources cost? Logic Model Resources, activities, outputs,outcomes Evaluation Plan Environmental Scan (ongoingprocess) Journal SurveyMonkey Baseline Data Pre/Post Training Surveys Metrics (use of resources) Just in time “information checks” Project End Survey
    25. 25. NER PHD New Digital LibraryProject Outcomes (3/20/2011) New and renewed collaborations were strengthened with 4hospitals and 3 public PHD libraries to streamline “articledelivery service.” A new suite of resources was added for testing: 40 new e-journals added and one database. Early, constant and committed communication. Ongoing evaluation has resulted in completed: Journal SurveyMonkey results achieved in 5 PHDs. Pre-post training survey results in all PHDs. Resource usage has been collected and is being reviewed. Three sets of “just-in-time information checks” have beengathered.
    26. 26.  Digital libraries are operational in 7 PHDs Number of resources increased from5 to 45 in less than a year. New Resources were made available onsite through IP addressing. NLM provided a unique link for each PHD to validate use. 18 copies of Endnote were provided to each PHD. PR and Marketing Plan now in place Seven onsite visits to become familiar with PHD partners andenvironment. 16 training sessions were held within six months. Five (5) vendor partnerships went beyond expectations resulting ingreater support.NER PHD New Digital LibraryProject Outcomes (3/20/2011)
    27. 27. NER PHD New Digital LibraryProject Outcomes User Profile View Digital Library Pages Vendor Splash Pages Training Activity Sample Journal SurveyMonkey Results Unexpected Outcome;Collaboration w/Vendors Use Statistics Global Health STAT!Ref NEJM University of Chicago Press E-Resources Newsletter
    28. 28. Statistical PHD User Profile:Estimated NER PHD Users ofTrusted Library ResourcesTotal FTE range from 273to 4000 for a total of8468.We expect about 600 tobe users of theseresources.Red numbers showmodification to the 10%rule.Percentagebased onGatheredDataPotentialUsersPHD Total FTE30% 38 BPHC* 1100/11010% 120 CDPHE 120020% 79 Maine 39535% 157 MPHD 4000/150015% 40 NewHampshire27310% 40 RhodeIsland40015% 45 Vermont 48010% 40 Connecticut800/40010% 596 Total ALL 8648
    29. 29. Collaboration with Vendors Original vendors created splash pages to bringattention to resources available for this project (samplefollows). They supported training components. They worked with the separate PHDs (and with theProject Coordinator to create workable licenses. They attended the “Train-the Trainer Session” at theUniversity of Massachusetts (Worcester) at their ownexpense. They allowed longer than usual “trials” to stay withinthe project framework.
    30. 30. Vendors Splash Pages for this Project
    31. 31. STAT!Ref UsageJuly 2010 thru Feb 2011Retrievalsby TitleDocumentRetrievalsTable ofContentTotalRetrievalsHarrisons Principles of Internal Medicine - 17th Ed. (2008) 2650 2839 5489Merck Manual of Diagnosis and Therapy, The - 18th Ed. (2006) 1445 1842 3287Current Medical Diagnosis & Treatment - 49th Ed. (2010) 734 386 1120Oxford Textbook of Public Health - 5th Ed. (2009) 333 336 669ACP PIER, Journal Club & AHFS DI Essentials 308 276 584Public Health & Preventive Medicine - 15th Ed. (2008) 215 209 424ICD-9-CM - Volumes 1, 2 & 3 (2011) 97 262 359Red Book: 2009 Report of the Committee on Infectious Diseases - 28th Ed. 111 91 202INFECTIOUS DISEASES: The Clinicians Guide to Diagnosis, Treatment, and Prevention 73 91 164ACP Medicine 55 63 118Casarett and Doulls Toxicology: The Basic Science of Poisons - 7th Ed. (2008) 51 65 116Evidence Alerts 115 0 115AHFS Drug Information (2011) 52 62 114Disaster Nursing and Emergency Preparedness for Chemical, Biological, and RadiologicalTerrorism and Other Hazards - 2nd Ed. (2007) 55 37 92
    32. 32. Global Health StatisticsMid June – Mid November Global Health Latest News (BBC,Reuters, Thomson)…reviewing the safetyof GlaxoSmithKlines Pandemrix H1N1flu vaccine 2/1/2011. Global Health has excellent coverage ofpublic health including journals not inPubMed, reports, bulletins, conferenceproceedings and theses. Global Health hosts >11,000 full-textarticles. All Global Health foreign-languageabstracts are translated into English. Updated weeklyPlatformJun-10Jul-10Aug-10Sep-10Oct-10Nov-10YTDTotalCABIPlatformTotalsearchesrun153 6 8 37 193 23 441CABIPlatformTotalsessions32 4 20 14 32 3 117
    33. 33. Institution Publication Sep-10 Oct-10 Nov-10 YTD Total YTD HTML YTD PDFVERMONTDEPARTMENT OFHEALTH()New EnglandJournal ofMedicine 69 102 118 289 243 46NEWHAMPSHIREDHHS()New EnglandJournal ofMedicine 0 33 61 94 66 28COLORADOPUBLIC HEALTH()New EnglandJournal ofMedicine 0 4 42 46 33 13MASSACHUSETTS DPH()New EnglandJournal ofMedicine 0 0 576 576 469 107RHODEISLANDDEPARTMENT OFHEALTH()New EnglandJournal ofMedicine 0 0 10 10 6 4New England Journal of Medicine (NEJM)Usage September Through December 2010
    34. 34. STATE PHD Training Type Date AttendanceRhode Island RIDH Day 1 9/10/2010 16Rhode Island RIDH Day 2 10/01/2010 14Vermont VDPH Day 1 9/21/2010 10Vermont VDPH Day 2 2/18/2011 13Maine Maine CDC Day 1 9/27/2010 19Maine Maine CDC Day 2 9/28/2010 14Massachusetts BPHC Day 1 10/4/2010 7Massachusetts BPHC Day 2 10/5/2010 7Massachusetts MPHD Day 1 11/15/2010 16Massachusetts MPHD Day 2 11/16/2010 14New Hampshire NHDHHS Day 1 11/18/2010 13New Hampshire NHDHHS Day 2 11/19/2010 11Colorado CDPHE Day 1 01/27/2011 16Colorado CDPHE Day 2 01/28/2011 14Total 14 184Summary of Training Activity
    35. 35.  Indentify Name/No of existing journal subscriptions. Who pays for subscriptions (individual or institution)? What journals would those surveyed like to access? Are these journal subscriptions in e- or print format? How else do you receive journal articles for publichealth work? What libraries are used? What frequency are other libraries used?Why a “Journal SurveyMonkey”
    36. 36. Unexpected Outcomes (Comments)Journal SurveyMonkey Depends on the topic and lit searchEPE covers chronic disease, injury and violence, andmaternal and child health. If work-related journals were available, I’d read them I’m not aware of any journals that the Division subscribes to We need access to a wide variety of journals I would like to have access to the full-range of journal optionsthat are available to academia I am not aware of any journals that our program receivesregularly Varies widely depending on specific topic currently underdiscussion/exploration. Varies widely on the health topic
    37. 37. Public HealthDepartmentNo of Surveys Sent Survey ResponseColorado (CDPHE) 254 158 (62%)Maine CDC 100 76 (76%)New Hampshire DHHS 65 27 (41%)Rhode Island 50 19 (38%)Vermont PHD 480* 72 (15%)BPHC 15MPHDNER PHD Journal SurveyMonkeyResults to Date 3/20/2011
    38. 38. Collaboration with EndNote(Thomson Reuters) BenefitsOutput Styles for all Public Health Customers
    39. 39. EndNote: Adding EID StyleEID: Emerging InfectiousDiseaseMMWR: Morbidity &Mortality Weekly Report
    40. 40.  Poudre Valley Hospital System, Ft. Collins, CO. Maine Medical Center, Portland, ME Maine State Library, Augusta, ME (Books) Dana Medical Library (Burlington, VT) Rhode Island Hospital/Lifespan/Providence, RI William A. Hinton, State Laboratory Institute MedicalLibrary and Lemuel Shattuck Hospital (MPHD) Lamar Soutter Library, University of Massachusetts National Library of Medicine NN/LMLibrarian PartnersNER PHD New Digital Library Project
    41. 41. Poudre Valley Health SystemCDPHE Article Delivery Service58 CDPHE employees haveregistered for LoansomeDoc.28 Came from the PVHSMedical Library.6 Were free online23 Came from MAUMAS32 Were filled by otherResource LibrariesPoudre Valley HospitalMedical Center of the RockiesMountain Crest BehavioralHealthcare CenterHarmony CampusArticle Delivery StatisticsOctober 2010 – February 2011Jerry Carlson, MLS, AHIPLibrary Director
    42. 42. Marketing the Digital Library Project e-NewsletterReliable Public Health e-ResourcesE-Newsletter supportsSending to a Colleague
    43. 43. PHD Units/DivisionsResponding to Journal SurveyMonkeyColorado Dept of Public Health &Environment (CDPHE) New Hampshire DHHSWhat Division are you in?Answer OptionsResponsePercentResponse CountAdministrative and FinancialServices Division1.3% 2Executive Directors Office3.8% 6DCEED25.3% 40CHEIS3.8% 6PSD31.6% 50HFEMS8.2% 13EPRD5.7% 9HMWMD5.1% 8APCD7.0% 11WQCD1.9% 3Laboratory Services1.3% 2Environmental Health andSustainability3.8% 6Other Environmental Programs orDivisions1.3% 2Answer Options Response Percent Response CountPublic Health Systems, Policy &Performance7.4% 2Public Health Laboratories18.5% 5Infectious Disease Control11.1% 3Population Health & CommunityServices29.6% 8Public Health Protection18.5% 5Health Services Planning and Review3.7% 1Public Health Statistics and Informatics7.4% 2Directors Office3.7% 1
    44. 44. Marketing Techniques
    45. 45. Evaluation MethodsOngoing in NER PHD Project Information Collected from Lead-Team Persons Related toType of Information Needed. These 8 topical areas became the essence for Pre/PostTraining Surveys Journal SurveyMonkey (tested in Maine) Only one PHD has not completed Review of Resource Licenses Pre/Post Training Surveys Customized links for both Surveys Review of “article requests” from Library Partners Project End Survey
    46. 46.  What Role Can the CDC Play in this Project? How Can the CDC Participate in the National VirtualPH Library Project? What CDC Funding Sources Are Available to Expandthis Project?Questions for Discussion