Recap: My notes on RSS for Clinicians

Just so I have it all in one place, below are the notes that Michael Stephens kindly posted on Tame The Web. I have tweaked the formatting to make these long notes more readable, and have added a few updates that are in bolded font. If you’ve already read what was posted at TTW, skip to the bolded stuff. Once I get this out of the way, future posts will address some really good points that Michelle Kraft brought up, and will share both ideas and tools to help Medical Librarians take every possible advantage of RSS for the clinicians they serve.

On the theme of how to sell RSS, I’d like to share how I’m ’selling’ RSS to physicians in my small medical library in central New York State.

A big challenge for physicians and other clinicians (especially those not in an academic setting) is staying on top of new developments in their field. This is usually referred to as “Current Awareness.”

Medical Librarians have done a number of things over the years to help clinicians with their current awareness needs. One older technique is to photocopy the table of contents of new issues of Medical Journals when they arrive at the library, and distribute them to the clinicians who want them.

This is, of course, very labor-intensive and time-consuming, and many medical libraries had to stop doing it because they no longer had the resources. A more recent method is for the library to subscribe to distribution lists that email the table of contents of a particular journal to the subscriber. The librarian can, of course, set up email filters to forward the right tables of contents to the right clinicians, but this method still has significant problems.

  • Not all Journals offer this service
  • The library must still maintain a complex list of which clinician wants which tables of contents
  • This isn’t very customizable. A gastroenterologist could, for instance, only want to see updates on Inflammatory Bowel Disease, and might not want to have to slog through all the tables of contents to visually scan for those articles that address his/her specific interests. Some physicians subscribe to these emailed tables of contents themselves, and find that they are glutted with so many items they DON’T want that they don’t have time to filter through and find the ones they DO want. Frustrated, some give up trying to stay on top of their current awareness efforts. This isn’t good for them, and it isn’t good for their patients.

But current awareness is more important than ever with the emphasis in recent years on Evidence-Based Medicine. The physicians I’ve spoken with on this topic have a very clear idea of what the problem is: They need the best and latest information, but they don’t have the time to filter the information for what they need, and medical libraries frequently don’t have the resources to filter it for them. Here’s where the opportunity to “sell” RSS comes in.

“How would you like it,” I asked our hospital’s head of surgery, “if you had one list of items from news or medical publishing on exactly the information you want. Imagine you could flip through this list and check off items as ‘not interested’, ‘maybe later’, or ‘the library must get me the full text of this article’. And what if, when you wanted the full text, you could click a couple of times to order it from the library?”

His eyes widened. “That’s possible?”

I asked him what the most essential journals he wanted to keep up with were and where he looked for news on general surgery. I then created a Google Reader account for him and subscribed to these sources. I then sent him the following:

Hello, Dr. Xxxxxxxx-

I have set up for you RSS feeds of the tables of contents for the three journals you named as most important to you (plus “General Surgery” headlines from Medscape) in a free Google Reader account (this comes with a bunch of other free services from Google that you may be interested in- please let me know).

Go here: http://www.google.com/reader/view/

Login ID: XXXXX.XXXXX

Password: XXXXXXXX

This should let you browse through each item very quickly. If you don’t want to read further, just move to the next item.

If you want the full text of the article, go to “More Actions” and choose “Gmail this”. From there, you can send the citation directly to library@.org

If you just want to mark the article for review later, “star” it. Later, you can select “Your starred items” to see a list of just items you “starred.”

You can also add any labels you want to any item so you can find what you want later. (see attached image)

aggregator screen cap

There’s lots more you can do with this, and I know this will be an easier way for you to manage your current awareness than email. For instance:

  • You don’t have to use Google Reader for these feeds. You could install a reader on your computer like Abilon , use another web-based reader like Bloglines , or use Firefox browser extensions like Sage .
  • You can add not only feed that others have created but CREATE custom feeds via PubMed or HubMed. For instance, you could create a feed that would give you an item every time the phrase “General Surgeon” appears in Medline’s indices, in ANY medical journal. You could also use a service like Google News to add an item to your Reader whenever the term “general surgeon” (or any other phrase or combination of phrases) appears in popular mainstream news.

Please do let me know if/when you’d like some one-on-one time in which we can maximize the benefit of this technology to you. I have begun the process of building a web site to help Physicians learn and do this sort of thing on their own, but that is, at best, months away from completion.

Any feedback you care to offer, in any format, would be extremely welcome and help to shape the way similar services are made useful to other physicians.

Next, I showed this email to the Hospital’s Vice President of Medical Affairs, pointing out that he could use RSS feeds to stay on top of hospital management journals and news, too.

The VP of MA asked for an appointment to set up his aggregator the next day. UPDATE: I met with the VP of Medical Affairs for over an hour. He grasped the potential benefit to his information needs very quickly, and we set up feeds for him from medical journals (endocrinology/diabetes) and healthcare management journals, as well as custom news feeds on patient safety, regulatory compliance, and accreditation. Lastly, as the VP of MA grinned like a kid in a candy store, we subscribed in his aggregator to the NY Times Food and Wine column.


Hope Leman works at a Medical Library in Oregon, and wanted to build a site where clinicians at her hospital could easily and quickly subscribe to emailed updates for journals that her library subscribes to. She emailed me looking for input. What follows is what I wrote back, arguing that her project, MedGrab, should also offer clinicians RSS feeds.

I personally dislike email distribution of TOCs and encourage other medical librarians to abandon them ion favor of RSS. Here are reasons (off the top of my head) why:

    • I have met too many doctors that end up feeling overwhelmed by the flood of emails in their inbox and eventually give up.
    • One of the advantages of RSS is that you can be more specific (if needed) than TOCs. Example: A gastroenterologist specializing in IBD might not WANT every article from J. Gastroenterology. He/she might prefer just to get articles that contain the terms “crohns”, “colitis” or “inflammatory bowel disease” that appear in that journal.
    • It is much easier and quicker to manage the contents of an aggregator’s reading list than an inbox- especially when the inbox is used for purposes beyond receiving TOCs.
    • It takes time for a physician to open a TOC email and visually scan it for the information that interests him/her. An aggregator’s reading list organizes each article but its title, so a physician can decide instantly whether to ask for the full text from the library, or whether just to move on to the next item (…OR [as Michelle Kraft pointed out] to click on the “Original Item” link and access the article through PubMed Linkouts. Also, RSS is XML, so parsing it is pretty easy. An aggregator’s filters or a feed administrator [more on that concept in future posts] can help filter out information that does not fit the clinician’s needs.)
    • f a physician finds an article via an emailed TOC he/she wants the full-text of, it takes some time to email the details to the library. Many aggregators (like Google Reader) have an “email this item” button. I’m encouraging my first few users to forward the item directly to library@xxxxx.org (my library’s Literature Search/Document Delivery inbox). (OR, as noted by Michelle Kraft, click on the PubMed item for linkouts and go straight to the fulltext, if the library uses PubMed LinkOuts)
    • If the physician forwards the TOC details to the medical library to request full text, the details often WON’T include the PubMed ID. Often, they won’t even include Volume, Issue, or page, either (depending on the whims of the person at the journal’s publisher who decides how TOC contents are formatted). If you set up an RSS feed for that same journal from PubMed, you can be sure to get ALL the information needed to quickly acquire the full text.
    • Some journals don’t have TOC email lists. But you can generate an RSS feed from PubMed for any Journal you want, whether or not they offer TOC emails or RSS feeds. That way it doesn’t even matter that Elsevier (dang them to heck) is so far behind on RSS.
    • RSS is also just XML, really. This means that if you NEED to, you can convert the content of an RSS feed to HTML (for a web page) or to email! That way, you can still have email subscriptions, but ones that are MUCH more specific to the needs of the physician than TOC emails.
  • I don’t think that RSS has to be beyond physicians, and that medical librarians can develop tools to put the use of RSS easily in their reach. I see two ways of doing this, a web-based directory and subscription service and pre-configuration of aggregators.
    • Web-based directory: What I’m working to build (still in planning, not a keystroke of code is written yet) is a site that will let physicians find the sites they want (not dissimilar from rss4medics.com or MedWorm.com), and then subscribe to the feeds with a SINGLE CLICK. UPDATE: A web-based Medical RSS directory and subscription service is being developed to meet the needs of medical librarianship and is in beta now. I hope to provide a lot of detail on it soon.

I plan to make this feasible by allowing physicians to search by discipline, then separate into Medical Professional News, Mainstream Medical News, and Medical Journal articles.

Also making it easy for physicians will be having three subscription buttons for each feed. RSS (generic), Subscribe via BlogLines, and Subscribe via Google. The Bloglines and Google readers are powerful, easy to use, and will work on any computer with a modern web browser. All the physician has to do is find the feed(s) he/she wants, and click the button. That’s it. The physician is subscribed.

    • Pre-configuration of aggregators: In the email that Michael Stephens posted, you’ll see that I did a brief interview with the physician to determine is current awareness needs and wants, then created a Google Reader account and configured it FOR him. All he now has to do is log in and start playing with it. It took me about 30 minutes to find/create the feeds he needed and set them up in his Google Reader account. That may seem like a lot of time spent of the less tech-savvy docs, but the value to the physician is high enough that I’d be okay with it taking an HOUR per physician. Also, once you get them started, most will figure it out and be able to manage their own feed subscriptions. UPDATE: Another, perhaps better idea, is for the Medical Librarian to create and maintain online aggregator accounts for his/her users. That way, the pre-configuration is easier, troubleshooting is easier, and document delivery requests can be integrated and queued up for the medical library. This idea is currently being developed.
  • One of the tenets of Web 2.0 is radical personalization, right? I think that RSS allows for this in ways that email simply cannot touch. The problem used to be that Physicians couldn’t find information they needed. Now the problem is that they have far too much. RSS can help them get EXACTLY what they need- and no more.

Okay! There’s the recap all done! It is all new stuff from here on in.

8 thoughts on “Recap: My notes on RSS for Clinicians

  1. Making huge progress on Medgrab, thanks to you. Now it is a mainly a question of mastering the setting up of everything and then hours and hours of populating it.

  2. Thanks for your hints on how to get health professionals excited about RSS. I am working on getting my nursing faculty on board using bloglines and I am busy gathering RSS feeds for nursing journals. Now if we can just get more publishers on board….

  3. Wendy, that’s one of the many wonderful things about PubMed! (Do I sound like a fanboy? I am.)

    Medline indexes all the clinical journals, and you can generate custom RSS feeds from PubMed (or HubMed)- so we don’t have to be stopped by the failure of publishers to offer RSS feeds. Also, the feeds provided by publishers often don’t include an abstract, never contain the unique PubMed ID, and couldn’t be used to help your patrons use your institution’s PubMed linkouts. For this reason, I think the PubMed RSS feeds are actually preferable to those created by the publishers.

    I’ll also post a long item in the next couple of days on how to CREATE an RSS for for a page that doesn’t have one. Stay tuned. 🙂

    Thanks so much for your comment!

    -David

  4. Dear David,

    Kudos to you for your efforts in this area. I am the Library Technician at Samaritan Medical Center in Watertown, New York, one hour north of Syracuse. Your Blog seems to have caught the eye of quite a few people and one of them was my supervisor Jeff Garvey, Director of Library Services. We are the headquarters for the Hospital Library Program of the Northern New York Library Network (formerly 3Rs Council) and provide library services for most hospitals in Jefferson, Lewis, Oswego and St. Lawrence Counties. Hunter-Rice Health Sciences Library is small in size physically, but our reach electronically keeps the medical professionals and students we serve well armed with the latest information.

    Like many medical libraries, an increasingly critical method of keeping doctors, nurses, allied health professionals, and students informed is through our web site at http://www.samaritanhealth.com/library.htm. The library’s web site is becoming a “central hub” of information dissemination and a vehicle for requesting library services and items. For example, last year we took over the Video Program from United Iroquois Shared Services and patrons can now browse the catalog online and order directly from the web site. We also have our Literature Alerts (known as CLUEs or Clinical Literature UdateEs) online for 3 months.

    I suppose larger medical libraries do not have the resources to provide paper copies of literature alerts to their patrons anymore, but we still do. Although we also provide electronic delivery of literature alerts and TOCs, that form of delivery accounts for less than 5 percent of the total. Despite our best efforts to promote electronic delivery, the number of patrons choosing that delivery method has actually fallen substantially in recent years. Your observations about email overload on physicians’ desktops are apropos. And the problem of computer technophobes in the medical field is a long way from resolving itself.

    Yet your efforts have opened a lot of eyes about the possibilities of setting up RSS feeds directly for end users, resulting in encouraging greater investigation of and participation in electronic delivery on the part of the patron. I will be following your Blog with great interest and hope to contact you directly in the future.

    Mike Chartrand
    Library Technician
    Hunter-Rice Health Sciences Library
    Samaritan Medical Center

  5. Thanks for the great post! As a former nurse it was nigh impossible to stay on top of the current nursing and medical literature. And after an exhausting shift I didn’t want to sift through material I didn’t want to read. As a library student I’m thrilled with the possibilities RSS has to offer special libraries and the libraries in general. In terms of special libraries this is an excellent way to “justify” our importance to the company. It’s a neat way of doing reader’s advisory for professionals.

  6. Pingback: PabloG » Blog Archive » links for 2006-09-01

  7. Thanks for this information David, it is genuinely motivating me! Can you advise a fairly green user of RSS readers if there is a great advantage of using Google Reader over Bloglines? Thankyou so much, I am finding your blog very interesting.

  8. Pingback: Library 2.0 « Romanyone’s Blog