Update%20on%20The%20National%20Network%20of%20Libraries%20for%20Health%20

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Update on The National Network of Libraries for
Health A Virtual Health Library for Canada
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• Jim Henderson
• for the
• National Network of Libraries for Health Task
  Force
• Canadian Health Libraries Association /
  Association des bibliothèques de la santé du
  Canada
• Life Sciences Library Osler Library of the
  History of Medicine
• McGill University
• jim.henderson_at_mcgill.ca

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• With thanks to Patrick Ellis
• Task Force Co-Chair
• For use of his presentation to the e-Health
  Conference, Toronto, November 2007

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Overview

• Canadian health libraries and nation-wide access
  to e-resources
• International models
• Canadian initiatives
• Review of 2007 events and activities
• Opportunities and challenges

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Key Issues

• Access to knowledge-based resources is critical
  to effective health care practice.
• Many Canadian health professionals face
  significant barriers to access.

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CHLA/ABSC

• Voluntary organization
• Membership 400 librarians, library technicians
  and other library staff from all sectors of
  health care including hospitals, universities,
  drug companies, government agencies, patient
  organizations, public libraries
• Chapters 18 chapters with an additional 400
  members

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CHLA/ABSC

• One of the driving forces of the organization
  since its inception in 1975 has been improvement
  in access to health information in Canada.

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CHLA/ABSC

• Our Clientele
• Practitioners, patients, researchers, students,
  policy makers, facility and program
  administrators
• Major consumers of journal literature
• Growing population of clinicians entering the
  field from evidence-based curricula

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CHLA/ABSC

• Canada is the first country outside the US to
  implement DOCLINE ILL system
• 1997 CHLA/ABSC took the leadership role in
  bringing DOCLINE to Canada
• 2008 Over 400 libraries utilizing DOCLINE in
  Canada

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Access Not a New Issue

• Health libraries and their users have struggled
  for decades with the conundrum of how to support
  the information needs of a highly literate
  clinical population in need of the best available
  information.

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Access A Growing Issue

• High quality information services now provided by
  libraries to health professionals
• BUT
• No coordination to ensure
• Universal, pan-Canadian access
• Cost effectiveness
• Best health research information is available to
  support patient care

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Old Wine, New Bottles

• 2008 Library collections are increasingly
  electronic
• The access model has changed
• The days of bound journal collections and long
  hours slaving over a hot photocopier are gone the
  way of the buffalo. But who can use these brave
  new collections?

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Existing Canadian Model

• Canadian Research Knowledge Network (CRKN)
• http//researchknowledge.ca/en/index.jsp
• Canadian Foundation for Innovation funding.

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CRKN An Existing Canadian Model

• Through its innovative licensing agreements, CRKN
  provides desktop access to electronic versions of
  scholarly journals and research databases for 72
  participating universities across Canada.
  Currently, more than 2,200 scholarly journals are
  available online to over 650,000 university
  researchers and students.

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CRKN An Existing Canadian Model

• CRKN has built a virtual library for the academic
  community.
• Access is based upon institutional affiliation.
• Can a similar model be built that spans the
  health community?

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Models in Other Countries

• National networks of health libraries
• National Network of Libraries of Medicine, US
  National Library of Medicine, National
  Institutes of Health
• National Library for Health, UK National
  Health Service

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United Kingdom

• The mission of the National Library for Health
  (NLH) is to help patients and professionals use
  best current knowledge in decision-making. The
  library consists of three main resources
• 1. Firstly, there is the commitment of 1,275
  librarians who know the local communities, and
  their needs and priorities. The plan is for all
  healthcare organisations to identify a board
  member to be Chief Knowledge Officer, supported
  by a librarian acting as Knowledge Manager.
• 2. The second resource is the national digital
  knowledge base, a single source of knowledge
  catalogued, classified and organised so that it
  is not only easy to find but can be delivered
  through the media that are now available, for
  example digital laboratory reports, and
  e-prescriptions.
• 3. The third resource is the users, organised in
  communities of practice, which manage the
  National Specialist Libraries such as the
  National Library for Cancer or the National
  Library for Knowledge Management.

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Models in Other Countries (contd)

• International coordination
• Pan-American Health Organizations BIREME (Sao
  Paulo, Brazil)
• Infrastructure
• Open access
• National licensing support (HINARI and other WHO
  programs)

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Models in Other Countries (contd)

• National licenses for specific resources
• Australia
• Denmark, Finland, Norway, Sweden
• Scotland, Ireland, Wales
• Spain
• South Africa
• Iceland

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Canada

• National, regional and provincial organizations
  are broadening the delivery of health knowledge
  to the clinicians desktop.
• CMA, CDA, CNA, CAOT, DrsNS, BC Coll Physcns
  Surgns Library, OntarioMD, Univ de Montréal RUIS
  Consortium . . . .

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Provincial Initiatives

• e-HLbc
• http//www.ehlbc.ca/
• Albertas Health Knowledge Network http//www.hkn.
  ca/
• Saskatchewan
• http//www.shirp.ca/

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The Electronic Health Library of BC provides the
academic and health care community of British
Columbia with easy access to online health
library resources. The purpose of the e-HLbc is
to support and improve practice, education, and
research in the health sciences.
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• eHLbc
• 6 health authorities
• 24 publicly-funded post-secondary institutions
• 3 provincial ministries
• College of Physicians and Surgeons

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Association Initiatives

• CMA Clnical Resources
• http//www.cma.ca/index.cfm/ci_id/50587/la_id/1.ht
  m
• NurseOne, the CNA Portal
• http//www.nurseone.ca
• OntarioMD
• http//www.ontariomd.ca

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Evidence-Based Health Care Proof of NNLH Concept

• Canadian Cochrane Library rollout has been
  fragmented and distribution very uneven.
• But . . . other countries have made it work

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Cochrane Proof of NNLH Concept
Australia, Denmark, England, Finland, Ireland,
India, New Zealand, Northern Ireland, Norway,
Scotland, South Africa, all of South and Central
America, Spain, Sweden, Wales and the state of
Wyoming all have unrestricted access.
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Cochrane Proof of NNLH Concept
The Cochrane Library has been licensed for all
citizens of
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Saskatchewan
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New Brunswick
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Northwest Territories
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Nunavut
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Yukon
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Nova Scotia
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Cochrane Proof of NNLH Concept

• How Much Would it Cost?
• Total cost now US 250,000-300,000
• National license US 491,500
• 0.015 per Canadian per year
• Less than double the current investment opens
  access by about 90! 

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CHLA/ABSC Vision

• The NNLH/RNBS will contribute to the
  maintenance and improvement of the health of
  Canadians by promoting and facilitating universal
  access to relevant, peer-reviewed health
  information for practitioners, consumers,
  researchers, policy makers and government
  officials by coordinating virtual library
  linkages.

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History of Task Force Activities

• 2001 Government On Line submission presented
• 2002 CHLA submitted proposal to Romanow
  Commission advocating the need for a NNLH/RNBS
• 2003 NNLH/RNBS Task Force conducted
  environmental scan of provincial initiatives
• April 2004 NNLH/RNBS website went live
• August 2004 Proposal submitted to Health Canada
  promoting a national license for the Cochrane
  Library
• 2005 Stakeholders meeting in Ottawa
• 2005 to 2006 Project Advisory Team formed, RFP
  issued, and RFP contract finalized
• September 2006 Concept of Operations released

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Concept of Operations
Local / Regional Health Libraries
Health Care Professionals
NNLH / RNBS National Coordinating Office
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Concept of Operations
Coordination of existing library programs and
expertise Ensure universal access to knowledge
for health professionals
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• Sir J.A. Muir Gray
• Canadian clinicians and patients need clean,
  clear knowledge /
• Les cliniciens et les patients ont besoin de
  connaissances nettes et claires
• CMAJ 175 (2) 129, 131 (July 18, 2006)

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Recent Events

• 2007
• CMAJ editorial (March) suggesting free Cochrane
  Library access could be forthcoming but not yet
• Announcement of closure of Canadian Health
  Network

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Recent Events

• 2007
• No / Slow Progress
• Ontario LHIN initiatives for electronic
  resource access
• Quebec interRUIS initiatives for electronic
  resource access
• Federal e-Science Library

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Recent Events

• 2007
• Consolidation of definition of knowledge
  translation at CIHR
• Continuing escalation of demand for access to
  clinical electronic resources

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Task Force Activities

• 2007
• Continuing strong support from CISTI and the
  Public Health Agency of Canada and participation
  / support from Canadian Nurses Association

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Task Force Activities

• 2007
• Yet more support for NNLH among professional
  organizations and academic groups confirmed

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Task Force Activities

• 2007
• Endorsement of library-based model including
• Infrastructure
• Training
• Expert searching
• as well as
• Virtual Health Library

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Task Force Activities

• 2007
• Building the business case for a Virtual Health
  Library
• Currently in the environmental scan and
  consultation process

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Task Force Activities

• 2007
• Linking health knowledge to decision making in a
  complex system building a pan-Canadian Virtual
  Health Library

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Opportunities and Challenges

• Can we build a Virtual Health Library based upon
  the exponential growth in Canadian electronic
  libraries?
• Challenges
• Affiliation
• Infrastructure support
• User support

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Opportunities and Challenges

• Can we link the health library knowledge support
  initiatives with the electronic health records
  initiatives?
• Challenges
• - Until now, nobody has asked
• BUT records without knowledge? . .

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• Sir Muir Grey (paraphrased)
• Electronic health records will allow
  practitioners to diagnose and treat more people,
  faster, and in a greater number of communities .
  . .

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• Sir Muir Grey (paraphrased)
• . . . using out-of-date techniques and
  incorrect choices for medications if these
  records are not linked to knowledge sources.

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Summary

• Significant growth in demand for and support of a
  Virtual Health Library
• Endorsement of library-based model
• Growing success of local and regional programs
• Continuing lack of access for many, duplicate
  access for others

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NNLH/RNBS Web Site
http//chla-absc.ca/nnlh/indexe.htm
http//chla-absc.ca/nnlh/indexf.htm

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• Comments Questions??

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