Tom Roper's Weblog

ICML and EAHIL 2017: Wednesday afternoon: if the doctors don’t read, people will die

After lunch in the Dublin sunshine (words I thought I was unlikely to write), and an Elsevier master-class on e-resources and value, the afternoon began with the second plenary speaker, Richard Corbridge, Chief Information Office of the Health Service Executive and Chief Executive of eHealth Ireland. 

Richard, advised by a careers questionnaire administered at school to become a health librarian, asked if our profession were what he called the sense-makers. Ireland has a complex health system; why is digital health worth doing? He introduced us to St Isidore, patron saint of computer scientists, and nominated Bob Dylan as the patron saint of e-health. With paper systems, it is hard to protect and share information.  At Heathrow’s new Terminal  5, when it opened, airport staff were puzzled to find huge numbers of people in the gentlemen’s lavatories; they thought that the solution was to provide more, until they asked people why they were in the gents, and discovered that it was the only place it was possible to hear the tannoy announcements.He quoted the example of Cork maternity hospital, which went paperless overnight. Ireland now has a universally used Individual Patient Identifier, and pilot projects in epilepsy, haemophilia and bipolar disorder. Instead of basing their strategy on what vendors offer, they have used a series of personas, who represent particular patients with particular needs and conditions, and ask vendors to say what their system can do for the personas. It's a ten-year project, and they’ve made progress. If we leave IT to IT, he said, it won’t be right, citing a UK project which digitised paper, but in black and white, not colour, although colour mattered to the end-user. There’s no simple clear answer, but there is an answer.  

Then I chose a stream of papers on the theme of Integration. First was Iain Sinclair of Health Improvement Scotland, who described the methodology he used to evaluate the EEvIT: evidence and evaluation for improvement team who support improvement work in NHS Scotland.

Then Victoria Treadway, Clinicial Librarian, spoke, accompanied by a Clinical Fellow whose name I failed to catch, I fear, and a Critical Care consultant, Dr Girendra Sadera. Victoria explained the role of an embedded librarian as knowledge mobiliser in critical care. This was one of the most interesting presentations, from the purely selfish point of view that I too work with, inter alia, Intensive Care. Victoria has been working with them for six years. In critical care, most clinical decisions are only supported by low level evidence. Phase one of their project, a collaboration between the library, the Trust and Liverpool University, was to survey the knowledge needs of critical care clinicians,  phase two to provide customised library and knowledge services and phase three to asses impact, reflect, and assess transferability. They ran a 22 statement questionnaire, with a 38% (? I may have this figure wrong) response rate. They also held ten semi-structured interviews and focus groups. Staff felt that the service benefitted patients and clinical decision-making, and they liked personal delivery. Some didn’t know about library services, some knew and didn’t use, some knew and used. A thematic analysis of the interviews highlighted communication and access to information. Victoria offers scheduled teaching, a pop-up library, support for journal clubs and a question of the month. Echoing our experience in Brighton she said that a clinical librarian presence on ward rounds is a way to put a foot in the door, but is not that highly valued. There was a point about uniforms that I didn’t catch —was it that she wears a uniform on the CCU?  Free pens always work, as do posters, and piggybacking on unit study days. Critical Care have a Facebook group, including a Facebook journal club and Victoria will be sent questions on Facebook Messenger.  They’re keen to involve patients, and get patient and family views, so plan a follow-up study on patient and family needs in critical care. ‘Embedded librarians have to overcome complex cultural factors beyond their control’ she said, in words that struck chords with all the clinical librarians in the audience.  

Then Susan Smith and Doug Knock presented Health Education England’s Library and Knowledge Services Value and Impact toolkit. An existing value and impact toolkit was felt to be too acute-sector focused. They conducted a  literature review, conducted a baseline survey, and analysed the Library Quality Assurance Framework (LQAF). The tools they developed are all available on the Knowledge for Healthcare blog. Doug startled us with a slide of the Gummy (or is it Gummi) Bear of Impact. Embedded services, teaching and current awareness services were all areas where impact assessment was necessary, but were served poorly by existing tools. They’ve developed some impact interview templates, freely available, and a submission form so anyone can submit case studies of impact. They were great assisted by Alison Brettle’s work on impact. 

After this, we heard After the Disaster: Lessons Learned by Public Librarians in Providing Health Information Services Following a Catastrophic Flood, A paper by Feili Tu-Keefner of South Carolina on disaster response from public libraries after the 2015 hurricanes in North and South Carolina. She was trying to answer the question, can public libraries help public health in the aftermath of a disaster. Public libraries offered centres where people could fill in disaster claims, could help people fill in the complicated forms, provide reliable information and help verify information from other sources — there were, sad to say, various scams promoted after the flooding. Internet access was maintained, and they found that Facebook had considerable reach. Sad to say though, Feili found no connections between public librarians and health librarians.  

I leave the last word to Bennery Rickard of Dr Steeven’s Library in our host city, She spoke on D.E.A.R. Drop Everything And Read “Eochair feasa foghlaim” Learning is the key to knowledge. D.E.A.R will be familiar to anyone in Ireland or Britain with school age children, though it’s new since the heirs to the Roper estates were at school. it’s a fifteen minute reading break in which the whole school, pupils, teachers, administrators stop what they’re doing and read. Bennery and her team decided to introduce this where they worked,  the head-quarters of Ireland’s Health Service Executive.  They linked their initiative with Library Ireland week  and based their campaign on topics, to lead to reading. Used broadcast e-mail. and LibGuides, Twitter and a blog, took a stand in hospital canteen, and prepared packs for senior managers. Bennery reported that they had lots of feedback, and their evaluation showed that it had an impact on CPD and keeping up to date, reaching non-users for little cost. On the other hand, it did involved a lot of photocopying, she found she had to manage expectations, there were some technical barriers, and unhelpful communications protocols. She left us with some words from her son, when she was worried about making a case to senior management. This young man, wise beyond his years, told her, ‘Mummy, tell them if the doctors don’t read, people will die’. 

ICML and EAHIL2017: Wednesday morning

The first day is over, apart from a reception at Trinity College Dublin tonight, so I’ll get my thoughts down on paper before they fade, fragile blooms that they are. There’s an archive and some analytics of the tweets thanks to Symplur at https://www.symplur.com/healthcare-hashtags/icmldub/

The conference was opened by Aoife Lawton, Chair of the International Programme Committee, and National Health Service Librarian, Health Service Executive Dublin. She welcomed us, more than 400 delegates from 33 countries. On the theme of Visibility & Vision: the way forward, she described the challenges of health in Ireland, and how library services have set themselves the goal of providing library services to support a Healthy Ireland, the national framework for improving health and well-being. One of her first ports of call was Britain, where she admired our #amilliondecisions campaign. Ireland has its equivalent,  #EvidenceInformedHealthcare. She warned of the dangers of losing professional visibility and vision. She cited the Australian AHLA standards (which I can’t find, an awful lot of their site is behind a paywall) and the new MLA competencies. Are we still talking about the same things we talked about in 2012? And will we be talking about the same things five years hence in 2022? She advised us to consider the mega-trends in society, and consider what the mega trends in our profession might be.

After the EAHIL President,  Maurella Della Seta, had welcomed us, the first keynote speaker, Hamish Sinclair of the Health Research Board spoke. He pointed out how apt it was that we held our conference in our castle. Dublin Castle was, among many things, the record keeping centre of the colonial administration. We no longer keep knowledge in castles and the researchers of the HRB need vast quantities of data. This is a major national asset that needs management, storage and to be accessible. He gave tribute to the information specialists who work at the HRB, including Louise Farragher. Even when they outsource work, they stipulate that an information specialist must be involved in the project. 

Finally, Michelle Kraft (who blogs as KraftyLibrarian and tweets as @krafty) spoke Her theme was Diversity through Disruption. She cited a number of examples of technological change, such as light-bulbs, e-mail, maps, and disappearing jobs such as switchboard operators, newspaper photographers and journalists. She cited a number of examples of libraries and librarians who have innovated, including our very own Caroline de Brun of Public Health England. 

It was a good optimistic presentation, though I have to say I think she both over-stated and over-simplified her case, and possibly underestimated the progress we have made in Irish, British and European library services. For example, I think most of us already knew that our users access our services on mobile devices, and have made the necessary arrangements for them to work on such platforms. 

After coffee, I went to a consumer health session. While it’s not an area I work in directly, it is a priority for our library and knowledge services, and I thought I might hear something to report back. Bob Gann started off, with an engaging talk on Fake news or clean clear knowledge? Quality in consumer digital health. Bob pointed out that we’ve been talking about these questions for twenty years, and took us through British developments.

He took us through some familiar statistics: 80% of people have looked for health information online, 1 in 5 Google searches is about health, there are over 100,000 health websites, there are 165,000 health apps in the Apple App Store. Cancer Research UK found that over half the cancer articles shared on Facebook contained myths or misinformation  Bob quoted, as did others, @muirgray on clean clear knowledge. The Health on the Net Code is now 20 years old . There’s also the NHS Information Standard. The NHS is relaunching its apps library. The Care Quality Commission is starting to inspect digital services, for example fee-based online consultations with GPs – the day I write this, the Health Service Journal reports that the CQC has found  some digital services to be unsafe – a service that charges £20 for a ten minute video consultation was not prescribing safely. We’ve been talking for twenty years, argued Bob- [perhaps longer, I remember Sally Knight of the Lister Hospital in Stevenage arguing for professional input into public health information in the early nineties -TR] . There are problems of scale - too many resources, pace - we can’t keep up with them, a low awareness of quality marks, and information standards aren’t considered to add any value for providers, certifying processes rather than the information itself. But there are developments: the Patient Information Forum’s Perfect Patient Information Journey project,   the NHS’s Behind the Headlines service and the Tinder Foundation's report  (who have now changed that slightly embarrassing name to the Good Things Programme) Health & digital: Reducing inequalities, improving society An evaluation of the Widening Digital Participation programme

With Health Information Week coming up,  what can librarians do

1. Spread awareness of quality marks for consumer health information
2. Spread critical appraisal skills
3. Campaign and network

 

One of the most interesting things he mentioned was that they had done some work to identify those Clinical Commissioning Groups where both digital exclusion and health inequalities are high.

 

Then Caroline de Brun (vide supra) gave an enthusiastic account of work she did for her PhD, The Librarian will see you now. The Salzburg statement on shared decision making  makes no mention of librarians. She worked with public libraries, offering health information workshops, but found funding was frequently cut and the workshops scrapped. I nopted she had recently delivered one in Crawley public library, not far away.  There’s a lot of resources, but considerable divergence and variation, for example in the area of irritable bowel syndrome. Good information can be hard to find, and Caroline noted the distinction between health literacy and health information literacy. Her literature review found a lot on the poor quality of health websites, but no consensus on which evaluation tools to use, and, again, no librarian involvement in the papers. She proposed two solutions, the COCO database, which she's developing in conjunction with TRIP Database's Jon Brassey and the Peripatetic Outreach Librarian.

 

The last presentations in this session was one on a project in Baltimore in the USA on Project SHARE: Building Teenagers' Skills to Advocate for Improved Health and an Australian paper on Developing a Health Literacy Strategy in a healthcare organisation.

 

In questions, taken, as was the case throughout the conference, at the end of the session, Caroline was asked about the difficulties of involving GPs; she found variation. In Tower Hamlets, GPs were very hard to win over; in Manchester, the opposite was the case. In response to another question, Bob quoted Martha Lane Fox, who had called for three things, a focus on priority populations, ubiquitous connectivity, and better digital literacy of NHS staff. 

 

ICML and EAHIL 2017: the return of conference blogging

I haven’t written here for some time, and for even longer on a conference, but since the number of conferences I’ll be going to for the rest of my career is finite, it might be worth reviving the practice.

I’m in Dublin, at the 12th International Congress on Medical Librarianship (ICML), held jointly with the European Association for Health Information and Libraries (EAHIL). I’ve been to one ICML before, the 8th in 2000 in London, and to several EAHIL, most recently to Seville in 2016. The very first ICML took place in London in 1953. My predecessor, from the days when I worked at the Royal College of Veterinary Surgeons, the late Molly Raymer, took part, and my immediate predecessor there, Benita Horder, attended later ones, as well as the founding conference of the International Conference of Animal Health Information Specialists. See this paper for an account of the first one:

Prime LM. First International Congress on medical librarianship, London, July 20-26, 1953. Bull Med Libr Assoc. 1954 Jan;42(1):32-5.
Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC199671/

See the call for hosts for the 2021 conference, which gives a definitive list of the conferences to date. Sadly the websites for more recent ones have not been maintained or archived. The cobbler’s child...

The conference opens today, but the two days before are dedicated to continuing education courses. On the first day I assisted Shona Kirtley of the EQUATOR Network, Isla Kuhn of Cambridge University,  Rebeca Isabel-Gómez of the Andalusian Health Technology Assessment Agency and Alicia Fátima Gómez Sánchez of Hertfordshire University in running a workshop on the theme Librarians can help address reporting concerns in the biomedical literature, particularly for systematic reviews. Isla provides a far better account than I could on her blog. We hope the slides and supporting material will be on the conference website soon. 

Yesterday was dedicated to catching up with work, and the odd visit to the splendid Chester Beatty library, to Christchurch Cathedral and a small run. I was probably not the first person to search in vain for Jonathan Swift’s memorial in Christchurch (Ubi saeva indignatio), forgetting that he was Dean of St Patrick’s Cathedral a little way away. 

 

 

 

CILIP and the Führerprinzip

There’s a great deal of guff talked about leadership these days. It’s an epidemic. Even a shift supervisor in a fast-food restaurant these days is a leader, it seems.

Whether or not one subscribes to the modern cult of leadership, the proposal that goes to an Extraordinary General Meeting of CILIP on Thursday 23^rd March to establish a ‘Leaders’ Network’ is to be opposed, as a divisive move towards a two-tier membership structure.  A membership organisation like CILIP should apply the Napoleonic principle, that every member carries a marshal’s baton in his or her knapsack. If there is a leaders’ network, it’s the whole organisation.

Like most CILIP members, I’ll be at work when the EGM takes place, but I’ve cast a proxy vote against the proposals. If the meeting is quorate, and if the proposal is passed, I doubt that the network will succeed; given our membership crisis, on which Ridgmount Street has been deafeningly silent  of late - though recent board papers reveal that only 18% of the library and information workforce are now in membership and quote a 2016 membership figure of 12,632 (in 2002 we had 23,000) – it is hard to believe those who do commit to CILIP membership, and fancy themselves as 'leaders' will put their hands into their pockets twice over (the leaders’ network will cost an extra £220 a year, for unclear benefits).

#HASlibcamp

It was the quatercentenary of our national poet’s death, Mrs R was at work, the racing wasn’t up to much, and the cats were asleep on beds, so, having nothing better to do, last Saturday I took myself to London, to City University for the HASLibcamp, my first unconference.

The idea is intriguing, but I wonder precisely how abandoning the trapping of the traditional scientific conference helps. Most of the sessions I attended were not that different to workshop sessions at a conventional conference, indeed one was more or less a lecture with interpolated questions from the floor. One of the principles of unconferences is that if a participant isn’t interested in a session, they should feel free to get up and go to another one. In practice, I think we were all too well brought up and courteous to do so; I saw very little moving around, except if another session had finished early.

At the beginning everyone can pitch an idea for sessions. Kieran Lamb, until recently doyen of the FADE current awareness and grey literature services in the North West, and I chatted idly about the recent report from the Knowledge for Healthcare Task and Finish Group on Current Awareness services[pdf].  We both felt that the mountains had laboured and brought forth a mouse, and so I thought I’d pitch a session on current awareness, which had also been the topic of the #ukmedlibs chat earlier in the week. Much to my surprise, a reasonable number of people expressed an interest in it, and I found myself with a room to fill, though fortunately not until one of the afternoon sessions.

The first session I attended was pitched by Sarah Rudd, Clinical Librarian at Kingston Hospital, on the role of Clinical Librarians. Sarah’s original pitch was about the role of Clinical Librarians in promoting use of library and knowledge resources, though we ranged far and wide, in a group that contained some clinical librarians, some who were from medical libraries, but not in embedded roles, and others from higher education libraries and beyond. I didn’t tweet this session, and was too busy participating to keep decent notes. While we didn’t solve the central problems of showing clinical library impact, we had a good exchange of views.

After that, I headed for a session led by Gary Green, the sole public librarian at the event, talking about public libraries and health. Gary mentioned Shelf LIFE , an initiative for young people with mental health problems, and the Society of Chief Librarians health ‘offer’.  Some esprit de l’escalier: I forgot to mention in the discussion, and no one else referred to it either, the work of the Patient and Public Information Task and Finish Group. Interesting questions were asked, particularly about the availability of health texts through public libraries. My hunch that, with the collapse of regional inter-lending systems, and the imposition of higher and higher charges for reservations, the picture is bleak. We still seem to be a long way from providing, either in dead tree or digital form

Lunch was provided by us all. I’m afraid to say my contribution came from a certain supermarket at Victoria. I don’t know who made the splendid focaccia, but I very much enjoyed it.  There seemed to be lots left over

Then came the current awareness workshop. As I was leading it, I failed to tweet, and, though I have some notes, they are by no means full. It was a great asset to have someone from a business information service in the room, which was able to tell us about their approach – they make considerable use of RSS, and suggested some useful tools for managing and manipulating feed output. I outlined the position in the NHS, the growth of the KnowledgeShare service and the report of the Task and Finish Group.  We talked about new ways of keeping up to date, for example in emergency medicine with the rise of #FOAMed (Free Open Access Meducation —see this exegesis from the LifeintheFastLane site). Other sound advice from the group included the suggestion, based on bitter experience of services being withdrawn at very short notice, such as Google Reader, that one should regularly back feeds to OPML, and on analytics.  We also asked how we ourselves keep up: Twitter was mentioned, TOCs from the LIS literature and conferences and meetings and Newslet, which was news to me.

I may have chosen badly for my last session. Called Software in research, I thought it might be helpful for our project to try to manage the institutional research output of one of the trusts we serve. Instead, it was aimed more at librarians who curate collections of data. I should have listened to the pitch. Nevertheless, it sparked an interesting conversation with @ggnewed about software emulators.

The tweets from the day have archived and made accessible on Storify which contains ‘more or less’ everything from the day: https://storify.com/lynrobinson/haslibcamp. Other accounts of the day are available at https://haslibcamp16.wordpress.com/event-write-up/

Would I go to an unconference again? Perhaps. I wasn’t thrilled by the format. One thing I did not see the point of was the ‘safer spaces policy‘.  If a professional gathering is going to make participants think, it probably shouldn’t try to be safe at the same time. 

Actum, sodales, ob tempus praeteritum tempus

I shall probably not be awake at midnight, so let me wish everyone a happy new year now. Since one of my abiding memories of 2015 is singing Auld Lang Syne, stone cold sober, in the early afternoon in an Edinburgh University lecture theatre at the EAHIL workshop, I offer below Auld Lang Syne in Latin, by a Canadian Latinist, Harry C Maynard.  

Num amicorum veterum
decet oblivisci?
Annorum heu fugacium
et temporis acti?

CHORUS
Actum, sodales, ob tempus
praeteritum tempus,
priusquam discesserimus,
manus iungamus.

Flores olim decerpsimus
ludentes in pratis,
sed aspera peragravimus
diebus ex illis.
CHORUS

Et agebamus vacuos
dies ad rivulum;
sed dividit iam diu nos
aequor undosum.
CHORUS

I discovered this at http://gaudium-mundo.blogspot.co.uk/2006/12/auld-lang-syne.html and the original translation, with others, may be found at  http://www.poslarchive.com/math/misc/latin-carols.html

What's wrong with scholarly communication in a nutshell

Me (to Mrs R last night): Let's have a bottle of wine with dinner tonight. I had a journal article published today

Mrs R: That's nice, dear, How much did you get paid for it?

Collapse of stout author

Of George's Giraffe and other museum animals

I was delighted to find myself followed on Twitter by @TheKingsGiraffe, the first living giraffe to be seen in England, a gift from Muhammad Ali, Pasha of Egypt to George IV in 1827. The Pasha was fond of giraffe diplomacy, also giving a giraffe to Charles X of France and one to Franz I of Austria. The account has been set up in preparation for an exhibition opening this autumn at the Brighton Royal Pavilion, Exotic Creatures.

 

 

 

 

 

A little research found that the giraffe is not the only museum animal on Twitter. There is a flourishing subculture of museum mascot accounts. There follows a selection:

• Henry Coles Rat, at the National Archives
• Oisin the Deer, at the Market Hall Museum, Warwick
• Bill Sparks, the Royal Marines Museum snake 
• the Leatherback Turtle, St Agnes Museum
• George the Gorilla at Nottingham Natural History Museum
• Svetlana Sturgeon at Hereford Museum 
•  and, perhaps my favourite, The Horniman Walrus

For the purposes of this list I stuck to British museums but there should be an honourable mention for another museum giraffe, Spotticus at the Dublin Natural History Museum. 

The definitive guide to unsubscribing from e-mail lists

This was posted to a list I belong to that has recently been troubled by many requests to unsubscribe sent to the whole list, and consequent grumbling. I have removed information that identifies the list. 

If there's anyone else who'd like to leave the list but has forgotten how, here's a quick reminder of the different ways:

1. The e-mail address appended to all messages received from the list  takes you to a web interface where you can unsubscribe ("Signoff"), access list archives, and change various account settings, such as the form of subject line, individual messages versus daily digest, and temporary suspension of mail delivery.

2. You can also unsubscribe by sending an e-mail message to [...] with the body text (sans quotation marks) "signoff [...]". No subject line is needed.

3. Alternatively, you can send a blank e-mail, with no subject line or body text, to [...]

4. You can e-mail me and ask me to unsubscribe you. This is no trouble and I'm happy to help.

5. You can send an e-mail to [...] with the same request; this will come both to me and to A.N.Other at [...] and the two of us will then race to see who can process your request first.

6. You can send a request to the entire list, who will then e-mail me to complain.  

British library-related twitter chats

I'm current working, with Holly Case and Sam Gilmour, on developing the #ukmedlibs Twitter chat, which, based on the North American #medlibs chats, will bring together British and other interested library and knowledge professionals working in health. who want to exchange views using Twitter.

As part of the preparation, we had to identify other British library-related Twitter chats, so as to avoid clashes (something we didn't quite manage with our first proposal, but we've rectified that).

I could trace these:

• #uklibchat: the first Tuesday of the month
• #chartership chat: every other Thursday evening
• #lrg: library leadership Twitter chat: irregular, topic announced on http://www.joeyanne.co.uk/

If you know of any others, do alert me in the comments below.