Panelists: Catherine Arnott Smith (University of Wisconsin, Madison), Michelle Kraft (Cleveland Clinic), Eric Schnell (Ohio State University)
This conference was my first attempt at blogging "on the fly" and the attempt taught me that I cannot successfully blog "on the fly". In short, I missed some of the content and context, particularly in Catherine's presentation.
I was very pleased with this Technology Forum. It provided practical and relevant examples of how social networking and mobile technologies are (or might be) applied. Perhaps most importantly, it kept its audience in mind. That is, all 3 of the panelists recognized that the attendees were information professionals who already have at least some awareness on these topics. I was grateful that Michelle and Eric did not waste time defining what social networking and mobile technologies are. They went immediately to issues of why they are relevant and questions of if and/or how they might be applied.
Catherine did spend a brief moment defining PHRs because of some of the ambiguities inherent in the term. Therefore, it made sense, but she still recognized that she was speaking to people who are aware of consumer health information sources.
(Fortunately, Michelle and Eric also posted their slides on slideshare.net, so I don't feel I have to try to describe their content from my sketchy notes).
Introductions by Max Anderson, GMR Technology Coordinator
Michelle's slides speak for themselves and include examples of libraries that are using social networking technologies.
Should your library use social networking? You should have clear objectives if you decide to use it. Don't just do it because everyone else is doing it.
Eric:
Should medical libraries go mobile?
It depends:
--What are your objectives/goals?
--Do you have adequate staffing for these services?
--How often will you update? Does that schedule match your goals?
--Does the objective match the medium?
--Will your users use it?
--What are your institutional policies?
Catherine:
Personal Health Records, Public Libraries-Early Data from a Study
--HIMSS 2nd quarter of 2009 - only .3% of nonfederal medical records were "truly paperless"
--18% of independent physician practices
--focused around payer, provider, not consumer
Personal Health Record:
The oldest form is the patient-held record, meaning the patient is in control of it.
The earliest is the baby book (early 20th century)
Other forms:
Family Medical Books
Medic Alert
Barcoded Insurance Cards
Compact Cards
Passports
Folders
(These may or may not contain patient added information).
The definition of the term Personal Health Record is unclear.
Basically, it is an application "to help a person gather, store, manage, and share data".
Take Home Point: PHRs are not and never will be the official medical record.
Some insurers have created tools that give the illusion they are the official electronic health record, e.g. test results are tethered to the record
There is a stone wall for quality control desired to prevent muddying official record.
Enables consumer contributions to the official record.
The consumer has control of who has access in time of need.
Patient-held connotes the idea of being "given"; the personal health record is different.
www.myphr.com
National use very low: 1% of adults used online - mostly provider sponsored
Evidence of efficiency is limited. Research is currently limited to:
--Markle Foundation
--Robert Wood Johnson Foundation
Insurers and Payers:
www.projecthealthdesign.org/home - first phase of funded projects
--Patients Like Me
--WebMED
--Google Health create profiles, diagnoses, lab results (Google Health partner - you can import copies of the official medical record if affiliated with a partner) for you or anyone you are given permission to act for the person.
Microsoft-environment in which PHR can happen [context missing].
healthmanager.mayoclinic.com- has interesting applications and resources to put it in context.
Google Health-You can print off a physical copy.
MyHealthEVet - Now free to all US citizens-labs, immunizations, medical events, family health history, activity journal, nutrition, etc.
The Challenge:
The 3rd most popular place for vets to access their PHR is the public library (following home and work).
VA in Madison getting calls from public libraries for vets who need help.
36 libraries statewide
100 individual workers in Wisconsin
Cities 150,00 popularion and up and villages less than 1000
2 of 3 open tribal libraries
Study funded by Specialized Ingo Services@NLM
Emerging Themes in the Study:
--How awful my collection is
--Body blocking-I can't be answering any medical questions. So, where do you refer?
Aware of MEDLINEplus:
professionals-37%
paraprofessionals-19%
Confused with MEDLINE -4 professional, 4 paraprofessional (8%)
Aware of NLM:
[I missed some of the additional numbers in context here]
Professionals-36%
Paraprofessionals- 17%
Aware of NN/LM:
Professionals - 10%
Paraprofessionals - 3%
Top referrals by paraprofessionals:
--website
--people in library
--hospital library
[more-didn't get the entire list]
Top referrals by professionals:
--health care provider
--university medical center library
--hospital library
--local clinic or hospital
--ask a nurse telephone service
Early conclusions:
--Library school teaches you about libraries.
--Privacy is a huge issue re: PHRs.
--General unawareness that medical librarians exist; major consciousness-raising is necessary.
Catherine gratefully acknowledged the NLM (correct?) for funding this research.
She challenged the audience to help her come up with a way to educate people- and give their thoughts about how we can improve these numbers.
Q & A for all 3 panelists:
Q: Do you see Facebook pages and Twitter or any other 2.0 technologies replacing libraries web pages?
A: Not replacing, but work with it a little more seamlessly--not enough customization, need tp work together with RSS feeds and have the SAME info across all 3 websites, but not replacing a regular web site.
Comments: During the NLM update we heard about the Google web search box and that people are confused about MedlinePlus.
Yes, MEDLINEplus is a very confusing name; everyone knows about WebMD because they advertise during the SuperBowl.
Reference librarians in public libraries have a fear of answering medical questions because it is a more sensitive area. They are afraid of giving out too much information or helping someone from a human perspective. We need more outreach to public libraries. We have several large hospitals and we don't hear from any of those in public libraries, either due to training or something else. It's not that there is no desire to help, but just the nature of the sensitivity and dealing with their care, fears of liability, so more outreach would be helpful.
[For Eric] Q: What kind of knowledge is required to make your web page mobile and is ILLiad mobile for these kinds of requests?
A: I don't know about ILLiad, but a web page with a lot of images and text won't work. It looks nasty. You need codes to strip off the extra information; most mobile can't use Flash, which generally requires a separate site or new style sheet for database driven sites or specifically for a mobile version.
[For Catherine] Q: Do you have any idea if public libraries were giving web sites as answers to ref questions that were asked?
A: At minimum, they were pointing people to a shelf. Answers included "the web" or "I just Google" -- not necessarily what we would consider good quality sites.
Comments/Answers--Eric:
Other countries are ahead of U.S. in terms of mobile technologies. The U.S. is18 months to 2 years behind the rest of the world. Other countries use GSM, so they are ahead of the game.
Michelle:
Facebook Pages can allow comments or to push out information. It depends on how the library has it set up.
Q: Re: the Personal health record- how do you access this? Is it intended to eventually act as a medical alert or act as a short medical history?
A: A lot have a medications area where you can record alternative, prescriptions, and OTC and print to show to physician. Most users get an access code through their insurer.
The VA and Google allow you to set your own password. The question is how much and who will know the information/if you forget your password. It could be used for caregiving of chronically ill adolescents or elderly parents; you could give control to family members. The issue is that they are self-reporting how they are doing.
End of Q & A
Max closed by reminding attendees of the GMR Technology Improvement Award.
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