I saw some interesting comments on MEDLIB-L not too long ago:
“I do not think MLA, HLS, its officers, certainly not academic medical center librarians, understand that hospital libraries have ten years of life left,” writes the anonymous commenter. The commenter appears to hear the Joint Commission and others saying, “Let technology provide us with the information we need,” instead of relying on librarians.
The commenter continues:
How many IT people you know who use libraries? I know one PhD student who is excited that some paper she has written has been asked to be published in some obscure “journal” in the IT field. Frightening! Down right scary. I am old enough to be leaving the work where the techie future picture is not a pretty one for me. Where idiots with ear plugs and i-pods think they know what life is about. God save us, everyone.
This post is a reply to the anonymous commenter (who I’ll call “Nonnie”) and those who share his/her views. I can’t promise that my views will be the same in six months, but this is how I’m thinking lately.
Nonnie, I think you’re absolutely right about one thing: Hospital libraries as we know them may not exist in a decade or two. However, I don’t see this in the same dark way that you appear to. I think they’ll still exist, but will be significantly different.
As I see it, the job of the hospital librarian has been primarily to utilize expertise in the application of information tools to either:
- Find and/or evaluate health information for clinicians,
- assist clinicians in the use of tools for finding and/or evaluating health information,
or
- teach clinicians how to use the tools effectively so that they can find and/or evaluate health information for themselves.
What’s changing now at an incredibly quick pace is only the tools themselves as they become increasingly digital. The mission and the role are exactly the same.
The question becomes: How do hospital librarians set about to manage this change and continue to be invaluable to a hospital?
First: The hospital librarian must recognize that this challenge is NOT unique to hospital libraries (or libraries generally)
This very same kind of change is having its way with a LOT of other professions.
Putting aside the way information technologies are transforming other kinds of industries, lets look at a few changes just in healthcare:
- Physicians are faced with CPOE in hospitals and increasing pressure to implement EMRs in their own practices.
- Hospital nurses are transitioning to EMRs that manage nursing workflow and make patient charts completely digital. Drugs are frequently dispensed from stations that are really networked computers. Computer literacy is quickly becoming a requirement of the nursing profession.
- Hospital Environmental Services Departments now have to manage their own databases of Material Safety Data Sheets.
- Hospital HR departments have to care about the export formats of their HR software and whether their chosen carriers can parse their export files. Time clocks are almost entirely computerized and someone in HR has to be a systems admin.
- Hospital Staff Development departments have to manage and record in-service activities digitally.
- Hospital foundations and development offices absolutely must utilize one of several donor/donation database management software options.
- Account management and patient financial management have been transformed by computers and communications with insurance carriers are largely on-line now.
- Many hospitals are utilizing sophisticated software to help manage their purchasing and inventory with more efficiency and at lower costs.
- How about the variety of kinds of systems issues faced by Health Information Management departments? Imagine what changes they’re facing as hospitals convert to EMRs.
- How about the challenges faced by Radiology departments as they must become masters of PACS systems?
Where computers used to support healthcare, they’re now essential, elemental parts of it.
Hospital librarians need to let go of the idea that the challenge they face is unique (or even unusual) and get on with learning the new skills. This profession is not a special sort of victim and dealing with technological change shouldn’t be new to librarians. When my mentor first had to learn to put the telephone handset into a special cradle to dial up a distant computer and execute queries with a highly specialized syntax, I don’t think she complained about having to learn these new skills. I think she was excited about what this new technology could do for her library. It is now our turn to get excited about what new technologies can do for our libraries. Hospital libraries should be the first department facing and mastering these challenges so that they can help departments that aren’t so fortunate as to be staffed with information professionals.
Second: The hospital librarian must become a technologist
Wait! Come back! It isn’t as scary or difficult as it sounds!
“Nonnie” seems to say that a lot of IS staffers aren’t any good at using information tools. I see some truth in this generalization. Some IS professionals I’ve met in the last seven years or so are a little like auto mechanics who don’t know how to drive. (That’s okay, by the way. Their jobs don’t require them to be experts at using or teaching particular applications.) But here’s the thing: I think that as the tools of health information management (HIM) and health librarianship become increasingly digital, the hospital departments of IS, HIM and Library Services will be strongly tied to each other, overseen by a common person in senior management (probably the CIO)1. But since so many IS people are like mechanics who don’t know how to drive, it’ll be the role of librarians to be expert drivers and driving instructors. In my experience, librarians are frequently the best possible advocates for the needs of a hospital’s technology users. In our hospital, the library teaches computer orientation classes, teaches classes on using various computer applications (including our EMR), writes user documentation and makes house calls throughout the hospital to help users solve their computer problems. Not only do I think this will be a growing trend, I think it is a trend hospital libraries should embrace. We’re already expert at teaching people how to use information tools- who could be better equipped to perform this essential function?
At this point, some readers are wondering what about this makes the librarian a technologist. Short answer: You don’t have to be a programmer to be a technologist. Someone who is expert in using these computer tools and can teach others to use them is a technologist. There’s been a growing trend for years now in which programmers develop tools to let people who don’t know how to code (but who can understand a little bit about programming conceptually) make new applications without ever writing a lick of code. I’ve seen people who know very little about (X)HTML make useful Web pages with a WYSIWYG editor like Dreamweaver or Google Page Creator. Tools like Pipes, Popfly and Dapper (among many others) are letting users who understand the ideas make new and useful tools.
This is the reason why the famous librarian advocates of “social software”2 and “Web 2.0″3 or “Library 2.0″4 are constantly on about these technologies! They can be used to enhance your library’s services at little cost- and if you were able to earn an MLS, they are easily within your ability to learn.
Third: Hospital librarians need to change the way they talk about technology and the way they talk with technologists
Communicating with IS professionals
The best thing about being a power user (expert driver) of technologies is that you are better able to communicate effectively with IS professionals. I’ve known a lot of geeks and am even related to a couple. In my experience, the vast majority of IS professionals are incredibly generous with their knowledge and expertise when you’re willing to make the effort to meet them halfway.
When I was working as a Business Systems Analyst for a benefits data management company, I was expected to use the graphical user interface (GUI) that most other BSA’s did to get information from our databases. It didn’t take long for me to grow frustrated with the GUI’s limitations and envy the programmers for their ability to write queries which fetched exactly the information they wanted at incredible speeds. I asked a couple of the programmers what it would take for me to learn to do that. They look surprised, but were incredibly helpful in finding me some good tutorials and loaning me a good book on the topic. When I came back to them after that with questions about our company’s data model or how to accomplish a particular task, they were incredibly generous and patient, taking huge amounts of time to make sure I walked away knowing how to fish, not just with a fish in hand. They patiently explained how they structured the logic of their programs, and when I did or said something stupid, they were kind and gentle in explaining my mistake to me. Not once did they become exasperated with my questions. Not a single time.
Why were they so helpful? Partially because they were good at what they did and enjoyed sharing their expertise with someone who was genuinely interested. More importantly, they were investing in me. My understanding these things better made me easier to work with. Once they had taught me to speak a few words of “Geek,” I could explain problems I was seeing in a vocabulary that made sense to them and helped us communicate efficiently. With the knowledge they had invested in me, I was better able to help other non-programmers I worked with appreciate the challenges the programmers faced. In my experience, this sort of IS professional isn’t the exception- they’re the norm. They’ll help you- you just have to make the sincere effort to meet them halfway.
Writing about technology
Libraryfolk who write about technology need to stay caught up on how technologists write about technology and use a common vocabulary. This is essential for two reasons. First, so that libraryfolk who read LIS literature about technology can use it as a springboard to explore the larger body of technology literature outside of LIS circles. Second, so that IS professionals can be effectively shown that libraryfolk can keep up with the conversation and can make valuable contributions about the way technologies should work. If we don’t speak a common language (or at least share some vocabulary), we’ll just keep talking past each other.
Engaging with technologists outside of libraries
While we’re talking about technology, we have to be careful about how we present ourselves to technology powers. I don’t think it is advisable to tell Google they’ve lost the respect of medical librarians.5 Frankly, Google doesn’t have to give a rat’s whisker what medical librarians think of it. Instead of giving the impression that we’re emotionally hurt by being left out of the rush to create quality online health information search services, we should be demonstrating what medical librarians can contribute to that efforts as the only professionals on the planet whose job it is to find and evaluate health information.
I know for a fact that there are a lot of medical librarians who are truly expert in seeking health information online, but so few of them are making their voices heard! One of the reasons my respect for Dean Giustini continues to grow (despite the fact that we frequently disagree) is that he makes his voice heard to technology powerhouses. Medical librarians who are expert in online searching need to demonstrate this expertise outside of the LIS community and directly in front of search professionals. Submit articles to technology journals and magazines! Submit them to medical journals (as Dean has to BMJ)!
If the value of the profession is under-rated, I think it may be partially because medical libraryfolk spend too much time talking only to each other.
Fourth: Hospital librarians must accept the reality that their work requires constant learning and development of new skills
“Nonnie” wrote:
I am old enough to be leaving the work where the techie future picture is not a pretty one for me. Where idiots with ear plugs and i-pods think they know what life is about. God save us, everyone.
The problem “Nonnie” illustrates here isn’t the changing workplace- it is the unchanging librarian.
We’re in an age where virtually no professional career path can accommodate someone who finds stagnation of skills acceptable. The UPS driver who balks at the the new tablet computer he’s required to use is silly enough, but this is so much sillier to see in an information professional. Insulting the “idiots with ear plugs and i-pods” is as ridiculous as bemoaning the demise of the card catalog, the horse-drawn carriage and the telegraph. The digitization of information tools is as inevitable as microfilm and microfiche once were, and for similar economic reasons. Librarians are already being faced with the decision to either grow their technology skills or take early retirement.6 This isn’t temporary and the rate of change isn’t likely to slow down any time soon. Instead of mocking iPod users, why not explore the many ways this technology might be used to enhance or expand your library’s services?7
I think this is both the longest and most opinionated thing I’ve posted here. I’d be really grateful to hear your thoughts (good, bad or ugly) in the comments.
July 4th, 2007 | Category: "Social Software", EMRs/EHRs/PHRs, For Medical Libraryfolk, Perception of Libraries/Librarians, Podcasting, Professional Development, Teaching/Training, Technology | Comments (18)
) and I’m still not yet wholly comfortable with the term “Library 2.0″, everything I’ve read that 
