Catherine M. Burroughs

In the past decade, the National Network of Libraries of Medicine (NNLM) and the Medical Library Association recognized an important trend of health sciences librarian involvement in electronic health records (EHR). This trend continues as librarians seek to help solve information challenges in health care settings. In 2016, two regions of the NNLM sponsored a forum focusing on the use of EHR data. Attended by 77 librarians, clinicians and bioinformaticians, the forum confirmed that there are opportunities for librarians to develop roles related to use and analysis of EHR data as evidence for patient care, patient safety and quality improvement.

The National Network of Libraries of Medicine (NN/LM) includes eight Regional Medical Libraries and their Network members who are vital to the National Library of Medicine’s (NLM) outreach efforts to health professionals and consumers. Evaluation is a key component of effective outreach projects. Recognizing the need for guidance about evaluation, an exploratory study was conducted by the Pacific Northwest Regional Medical Library in collaboration with NLM to identify and document evaluation best practices. There were several major outcomes from this study. One is a field manual for librarians, providing a step‐by‐step framework for integrating evaluation within a program. Another outcome is the Outreach Evaluation Resource Center at the Pacific Northwest Regional Medical Library, funded by the NLM to enhance and facilitate skilled and effective use of evaluation in health information outreach. Describes the evolution of these outcomes and lessons learned along the way.

With the advent of the Internet, American Indian/Alaska Native (AI/AN) communities in the Pacific Northwest have new opportunities to access high quality and relevant health information. The Pacific Northwest Regional Medical Library (PNRML), regional headquarters of the National Network of Libraries of Medicine, a program sponsored by the National Library of Medicine, sought to facilitate that access and worked with a selected group of sixteen tribes and native village consortia. The steps were: (1) work with AI/AN communities to arrive at mutually-agreeable health information connectivity objectives and long-term solutions, (2) provide funding to AI/AN communities to ensure Internet connectivity and the presence of Internet workstations for health workers and for the public, and (3) train in effective health information seeking. Community-based approaches helped the PNRML adjust policies and practice for improved information outreach to AI/AN communities in the region. The project participants, collaborating with our staff, successfully carried out many of the community goals and, at the same time, we gained insight about the variables that were barriers or facilitators of success. While we are coming at outreach from a library perspective, the policy and method lessons we learned could apply to a broad variety of outreach endeavors.

In 1997, the National Library of Medicine (NLM), a component of the National Institutes of Health (NIH), initiated a program of intensified outreach to Native Americans, initially focusing on the Pacific Northwest in collaboration with the Pacific Northwest Regional Medical Library (PNRML). This initiative, known as the Tribal Connections Project, emphasized the establishment or strengthening of Internet connections at select Indian reservations and Alaska Native villages and related needs assessment and training. The hope was that these efforts would improve tribal access to health information available via the Internet and the Web. Phase I included sixteen tribal sites--eight in Washington, four in Alaska, two in Montana, and one each in Oregon and Idaho. Phase I results indicate that the project was successful in assessing local needs and building awareness of the Internet, forging new partnerships with and between the participating Indian reservations and Alaska Native villages and other organizations, making real improvements in the information technology (IT) infrastructure and Internet connectivity at fifteen of sixteen sites, and conducting training sessions with several hundred tribal participants across thirteen sites. Most importantly, the project demonstrated the key role of tribal community involvement and empowerment and contributed to development of an outreach evaluation field manual and the evolving concept of community-based outreach. The knowledge gained from Tribal Connections Project Phase I is helping refine and enhance subsequent NLM-sponsored tribal connections and similar community outreach efforts.

This paper focuses on one dimension of personal health information seeking: perception of quality and trustworthiness of information sources. Intensive interviews were conducted using a conversational, unstructured, exploratory interview style. Interviews were conducted at 3 publicly accessible library sites in Arizona, Hawaii and Nevada. Thirty-eight non-experts were interviewed. Three separate and distinct methods used to identify credible health information resources were identified. Consumers may have strong opinions about what they mistrust; use fairly rigorous evaluation protocols; or filter information based on intuition or common sense, eye appeal or an authoritative sounding sponsor or title. Many people use a mix of rational and/or intuitive criteria to assess the health information they use.

End-user search software is designed to simplify online searching for the casual searcher. User-friendly features provide relatively easy online access to remote databases without the need for expert search systems. At issue is whether the simplified features of such software compromise what is potentially retrievable, and if so, whether the missing information is critical to the end user. A study was designed to address this question, particularly as applied to clinicians using a user-friendly search software package such as Grateful Med. Clinician participants compared their Grateful Med search results with a full Elhill search (as performed by an intermediary) and indicated whether references unique to either search were or were not critical to their information needs.