ROUGH ASCII 1 (2:00 - 3:30 MEETING CONSUMER HEALTH INFORMATION NEEDS) SPEAKER: GOOD AFTERNOON. WE ARE GOING TO GET STARTED. MY NAME IS DOROTHY SWAN. I'M THE ASSISTANT DIRECTOR AT THE GREENVILLE LIBRARY AND A MEMBER OF THE LORI COMMITTEE AND I WANT TO THANK YOU FOR COMING TODAY. THE SESSION WE ARE GOING TO BE DOING TODAY IS LEARNING HOW THE ROLE OF CONSUMER HEALTH INFORMATION SERVICE AND LIBRARIES IS RAPIDLY MOVING BEYOND PROVIDING ACCESS TO INFORMATION AND ANSWERING BASIC REFERENCE QUESTIONS. THEREFORE, YOU WILL KNOW HOW MULTITYPE LIBRARIES CAN CONTRIBUTE TO THE HEALTH OF THEIR COMMUNITY, WITH COORDINATED OUTREACH AND COLLABORATION. I ALSO WANT TO MENTION THAT THIS SESSION IS BEING SPONSORED IN ITS ENTIRETY BY AN EXPRESS OUTREACH AWARD FROM THE NATIONAL NETWORK OF LIBRARIES OF MEDICINE, NEW ENGLAND REGION. I WOULD ALSO LIKE TO ACKNOWLEDGE AND THANK HAVIER CRESPO - SORRY IF I SAID THAT WRONG, ASSOCIATE DIRECTOR OF THE NATIONAL NEW ENGLAND REGION, AND THE LIFE-SPAN PARTNER FOR MAKING THIS SESSION POSSIBLE I WOULD LIKE TO INTRODUCE JANE FISHER. SHE IS THE COORDINATOR OF INFORMATION SERVICES AT THE NEW YORK PUBLIC LIBRARY, FOR THE BRANCH LIBRARIES. SHE OVERSEES THE SELECTION OF PRINT AND ELECTRONIC REFERENCE MATERIALS AND REFERENCE RELATED STAFF TRAINING FOR THE 85 BRANCH LIBRARIES. SHE IS RESPONSIBLE FOR A PROGRAM CALLED CHOICES IN HEALTH INFORMATION, A CONSUMER HEALTH SERVICE, WHICH WE WILL LEARN 2 ABOUT TODAY SHE HOLDS AN MBA FROM THE CITY UNIVERSITY OF NEW YORK, AND MLIS FROM THE UNIVERSITY OF WISCONSIN AT MADISON. SHE IS TREASURER OF REFERENCE IN ADULT SERVICES SECTION OF NYLA, SERVES ON THE RUSA MOUSS AND MANAGEMENT REFERENCE COMMITTEE OF ALA AND IS A MEMBER OF THE PUBLIC LIBRARY ASSOCIATION IN THE NEW YORK, NEW JERSEY CHAPTER OF THE MEDICINE LIBRARY ASSOCIATION IN FEBRUARY 2004, JANE ORGANIZED AND PRESENTED A PROGRAM ENTITLED ONE CITY, THREE LIBRARY SYSTEMS, 200 NEIGHBORS - COMMUNITY BUILDING STRATEGIES FOR URBAN PUBLIC LIBRARIES, AT THE PLA CONVERSATION MOST RECENTLY SHE HAS BEEN NAMED 2004 MOVER AND SHAKER IN THE LIBRARY JOURNAL. AND NOW, JANE FISHER SPEAKER: THANK YOU. I'M REALLY HAPPY TO BE HERE. I HAVE JOINT CUSTODY OF A CAR THAT USUALLY SITS IN A PARKING LOT IN NEW YORK CITY DURING THE WEEK. SO IT WAS REALLY A TREAT TO BE ABLE TO GET IN THE CAR AND DRIVE AWAY ON THURSDAY EVENING TO COME HERE TO SPEAK WITH YOU ABOUT SOMETHING THAT I CARE SO MUCH ABOUT, WHICH IS CONSUMER HEALTH AND THE LIBRARIES' ROLE - ALL TYPES OF LIBRARIES' ROLE IN PROVIDING CONSUMER HEALTH INFORMATION TO THE GENERAL PUBLIC. IT'S A LITTLE BIT HARD TO FOLLOW SUCH A FUNNY SPEAKER. HER PRESENTATION WAS WONDERFUL AND DOROTHY PUT THE ADDED PRESSURE ON THE WAY DOWNSTAIRS SAYING ARE YOU GOING TO BE FUNNY? I'M TALKING ABOUT CONSUMER HEALTH. HARD TO FIND SPOTS FOR HUMOR. WE WILL KEEP IT AS LIVELY AS WE CAN. I HOPE THAT I WILL HAVE -- SOME THEORETICAL INFORMATION BUT EVEN MORE THAN THAT, SOME REALLY PRACTICAL IDEAS, PARTICULARLY ON THE TOPIC OF COLLABORATION WHICH I THINK IS REALLY KEY AND IS THE NEXT STEP TOWARD PROVIDING CONSUMER HEALTH INFORMATION SERVICE. I HAVE BEEN AT THE NEW YORK PUBLIC LIBRARY FOR EIGHT YEARS. IN 1999, WE RECEIVED A PRETTY SIZABLE GRANT FROM THE NATIONAL LIBRARY OF MEDICINE. IT WAS A 450,000 GRANT WHICH WE AGREED TO MATCH WITH OTHER FUNDS THAT WE RAISED. SO IT WAS ABOUT A MILLION DOLLARS. A THREE-YEAR PROJECT TO LAUNCH A COMPREHENSIVE CONSUMER HEALTH INFORMATION SERVICE FOR THE BRANCH LIBRARIES IN THE NEW YORK PUBLIC LIBRARY THE PRIVATE MONEY FOR THAT PROJECT, THE NLM MONEY AND OTHER PRIVATE MONEY IS FINISHED AT THIS POINT SO WE REALLY ARE IN AN INTEGRATION MODE. AND THAT'S BEEN AN ADDITIONAL STRUGGLE ON TOP OF IT. FOR ANY OF YOU WHO HAVE GRANT FUNDED PROJECTS THAT ENDED, YOU NEED TO CONVINCE THE STAFF THAT IT'S NOT GOING AWAY. WE'VE SUCCEEDED. WE ARE MAINTAINING IT. THIS IS GREAT. I THINK WE ARE DOING A PRETTY GOOD JOB AND I WILL SHARE SOME OF THAT WITH YOU TODAY. THE COMPONENTS OF OUR PROGRAM AT THE NEW YORK PUBLIC LIBRARY IS KNOWN AS "CHOICES IN HEALTH INFORMATION". I HAVE A BROCHURE ABOUT CHOICES HERE THAT WE'LL MAKE SURE YOU CAN GET, AT THE END OF THE SESSION, INCLUDED IN IT ARE STAFF TRAINING, COLLECTION DEVELOPMENT, OUTREACH, PROGRAMS FOR THE PUBLIC, AND EVALUATION. SO I WILL TOUCH ON SOME OF THOSE TODAY. THESE ARE SOME OF THE ISSUES I WANT TO GET AT IN OUR TIME TODAY. TALKING ABOUT BASIC SERVICES AND THEN WHERE WE ARE AT TODAY WITH NEW ROLES FOR CONSUMER HEALTH. THEN GETTING TO COOPERATION AND PARTNERSHIP WHICH ARE SO ESSENTIAL. SOME OF THE ISSUES I THINK ARE HOT TOPICS IN CONSUMER HEALTH - COMMUNITY BUILDING, SERVING ETHNOLINGUISTIC POPULATIONS, AND HEALTH AND LITERACY. HOW IMPORTANT IT SO TO SEE WHERE THOSE TWO INTERCEPT. I'LL TALK A LITTLE BIT ABOUT WITH WEBSITE DESIGN IF YOU ARE DOING CONSUMER HEALTH INFORMATION BUT MORE ON WEBSITES THAT CAN HELP YOU FORM AND KEEP COLLABORATION STRONG. AND THEN EVALUATION AND SOME CONCLUSIONS ABOUT HOW TO GET STARTED. OKAY. THIS IS WHAT I THINK OF AS BASIC CONSUMER HEALTH INFORMATION SERVICE. AND THIS IS NOT MEANT TO BE JUDGMENTAL. I'M NOT SAYING IF YOU ARE NOT DOING THESE BASICS NOW, THEN YOU ARE NOWHERE - BECAUSE WE ARE ALL AT DIFFERENT PHASES IN IT. BUT I THINK HAVING CORE HEALTH COLLECTIONS AND IN THE PUBLIC LIBRARY SETTING, THAT'S WHAT WE'VE STRIVEN FOR - TO HAVE CORE HEALTH COLLECTIONS IN ALL OF OUR BRANCHES. REALLY LOOKING TO GET AWAY FROM THE IDEA THAT IF IT IS HEALTH INFORMATION YOU HAVE TO GO DOWNTOWN FOR THAT. HEALTH INFORMATION - YOU'VE GOT TO GO TO THE MEDICAL LIBRARY IN YOUR AREA FOR THAT. TRY TO HAVE CORE PRINT AND ELECTRONIC COLLECTIONS IN EVERY SITE AND FOR US WITH 85 BRANCH LIBRARIES THAT'S NOT AN INEXPENSIVE UNDERTAKING. BUT IT HAS REALLY HELPED TO KIND OF LEVEL THE PLAYING FIELD AND ALSO HELPED US GET THE POINT ACROSS TO OUR STAFF THAT WE ALL DO CONSUMER HEALTH INFORMATION SERVICE. THIS IS NOT SOMETHING THAT'S RELEGATED TO PEOPLE ON OUR STAFF WHO ARE AT THE HEALTH INFORMATION CENTER IN OUR CENTRAL BUILDING. FOR EXAMPLE, STAFF TRAINING HAS BEEN PARTICULARLY IMPORTANT FOR US AND WE HAVE DONE A VARIETY OF TRAINING WORKSHOPS, SOME FROM THE MEDICAL LIBRARY ASSOCIATION AND IF YOU GO ON TO THE MLA NET.ORG YOU CAN SEE SOME OF THE TRAINING PROGRAMS THAT MLA SPONSORS FOR CONSUMER HEALTH. WE HAVE DONE A BASIC COURSE ON CONSUMER HEALTH IN THE PUBLIC LIBRARY SETTING AND WORKED ON GETTING ALMOST ALL OF OUR STAFF THROUGH THAT COURSE OVER THE THREE-YEAR GRANT PROJECT. OUR STAFF GET MLA CEUs FOR THAT AND START TO WORK TOWARD GETTING THEIR MLA CONSUMER HEALTH CERTIFICATE, WHICH IS SOMETHING THAT SOME OF OUR STAFF HAD PURSUED AND HAD BEEN REALLY INTERESTED IN DOING. WE ALSO HAVE DONE STAFF TRAINING ON MEDICAL VOCABULARY, SORT OF HELP THEM FEEL MORE COMFORTABLE WITH THE TERMINOLOGY THAT THEY MIGHT BE HEARING ON THE REFERENCE DESK. THEN WE HAVE DONE SOME STAFF TRAINING ON OTHER MORE ADVANCED TOPICS, FOR STAFF IF THEY WERE INTERESTED. WE WERE SURPRISED THAT THE LEVEL OF INTEREST WAS REALLY STRONG. WE DID TOPICS ON AIDS AND HIV INFORMATION, ON CANCER INFORMATION, FOR STAFF THAT WANTED TO LEARN HOW TO SEARCH MEDLINE AND TOXNET AND SOME OF THE OTHER NLM DATA BASES. WE OFFERED A VARIETY OF STAFF TRAINING OPPORTUNITIES, AND WHAT WE WERE REALLY TRYING TO EMPHASIZE TO THE STAFF HERE WAS THAT CONSUMER HEALTH QUESTIONS ARE DIFFERENT FROM GEOGRAPHY, HISTORY, AND LITERATURE QUESTIONS. AND I THINK WE SAW A TREND, THE PUBLIC COMING MORE AND MORE TO THE PUBLIC LIBRARY, LOOKING FOR CONSUMER HEALTH INFORMATION. HAVING LESS TIME WITH THEIR PHYSICIANS, BEING LESS LIKELY TO JUST TAKE WHAT THE PHYSICIAN SAID AS GOSPEL, AND WANTING TO DO SOME MORE HOMEWORK. WE DIDN'T WANT OUR STAFF TO FEEL THAT THEY SHOULD BE SHY OF TACKLING THOSE QUESTIONS. OUR GOAL WAS TO GET OUR STAFF AND ALL OF OUR PROGRAMS COMFORTABLE WITH HEALTH INFORMATION QUESTION SO THEY WOULDN'T BE INCLINED TO SAY "OH HEALTH INFORMATION, YOU'VE GOT TO GO DOWNTOWN" OR CALL THE NEW YORK ACADEMY OF MEDICINE. OUR GOAL WAS FOR THEM TO MAKE A REALLY GOOD FAITH EFFORT TO ANSWER THE QUESTION WITH ON-SITE RESOURCES AS WELL AS ON-LINE RESOURCES. SOME OF THE STAFF, THEY SOMETIMES SAY, WHAT IF IT'S A FATAL ILLNESS. WHAT IF THE PATRON COMES AND WANTS TO KNOW ABOUT THIS DISEASE AND I LOOK IT UP AND THEY ARE GOING TO DIE IN SIX MONTHS. WE REALLY HAD TO TALK WITH THE STAFF AND GET THEM FEELING MORE COMFORTABLE WITH THE FACT THAT TYPICALLY THAT'S NOT GOING TO HAPPEN. MOST PEOPLE KNOW WHAT THEIR DIAGNOSIS MEANS. THEY MIGHT NEED ADDITIONAL INFORMATION ABOUT IT BUT USUALLY THEY KNOW WHEN IT'S SERIOUS. THEY KNOW WHEN IT'S TERMINAL. WHAT IF I GET SUED FOR GIVING WRONG INFORMATION. I DON'T KNOW IF YOU HEARD THAT AT ALL IN YOUR WORK. BUT THAT'S SOMETHING THAT WE REALLY WORKED ON ADDRESSING . IN FACT, THERE'S NEVER BEEN A SUCCESSFUL LAWSUIT THAT I'M AWARE OF A LIBRARIAN BEING SUED FOR MALPRACTICE FOR GIVING HEALTH INFORMATION. SO WE DID A LOT OF STAFF TRAINING TO GET THE STAFF TO BE MORE COMFORTABLE WITH THEIR ROLE IN HEALTH INFORMATION SERVICES. AND EVEN JUST THE REFERENCE INTERVIEW AND FOLLOW-UP QUESTIONS AND UNDERSTANDING THE DIFFERENCE BETWEEN SYMPATHY AND EMPATHY. THEY JUST REALLY WANTED TO PRACTICE HOW TO REACT WHEN THE PERSON IS UPSET, HAS JUST HEARD BAD NEWS, HOW TO SAY THAT IT MUST BE REALLY TOUGH FOR YOU, LET ME SEE WHAT WE CAN DO TO GIVE YOU SOME INFORMATION. INSTEAD OF GETTING NERVOUS, AND SAYING OH, YOU POOR THING, JUST HELP THEM WITH THE TERMS AND THE PHRASES TO DO THAT GOOD FOLLOW UP WORK. PROGRAMS AND HEALTH CLINICS: MAYBE ALSO BASIC CONSUMER HEALTH INFORMATION SERVICE, WHERE YOU WOULD HAVE A LOCAL ORGANIZATION COME IN AND DO A PROGRAM ABOUT DIABETES OR HEART DISEASE OR HOW TO COMMUNICATE EFFECTIVELY WITH YOUR DOCTOR AND HAVE A QUALIFIED HEALTH EXPERT COME IN AND DO THOSE PROGRAMS. HEALTH CLINICS. - I'M ACTUALLY NOT THAT BIG ON HEALTH CLINICS. I KNOW A LOT OF LIBRARIES LIKE THE IDEA OF DOING BLOOD-PRESSURE SCREENINGS OR OTHER KINDS OF CLINICS IN THE LIBRARY SETTING. I THINK IT'S OKAY IF IT'S NOT COMMERCIAL. BUT SOMETIMES IT ENDS UP TO BE REALLY MORE OF A COMMERCIAL PITCH FOR A PARTICULAR HOSPITAL OR -- MAYBE WITH THE HEARING AID TESTS, THOSE KINDS OF SERVICE PROVIDERS ALSO. BUT LOTS OF LIBRARIES REALLY LIKE IT AND WORKS EFFECTIVELY AS AN OUTREACH TOOL. LINKS TO VETTED WEBSITES. THAT'S SOMETHING I THINK THAT LIBRARIES HAVE GOTTEN REALLY GOOD AT. FINDING GOOD HEALTH INFORMATION WEBSITES TO SHARE WITH THE PUBLIC SO THEY'RE GETTING THE BEST OF THE BEST OF HEALTH INFORMATION THAT'S OUT THERE. IT IS KIND OF BASIC WHERE A LOT OF LIBRARIES ARE RIGHT NOW, PARTICULARLY PUBLIC LIBRARIES. GOOD FIRST STEPS, BUT REALLY NOT COLLABORATIVE, NOT MUCH TO DO WITH PARTNERING. AND WE NEED TO SEE MORE AND MORE OF THAT TO GO TO THE NEXT LEVEL, TO BE BE MORE SUCCESSFUL COLLABORATION AND PARTNERSHIPS - IS REALLY THE NAME OF THE GAME HAVE I MISSED ANY COMPONENTS UP THERE THAT YOU THINK BELONG IN BASIC CONSUMER HEALTH SERVICE? OKAY. SO LET'S THEN MOVE ON AND TALK ABOUT COLLABORATION AND PARTNERSHIPS AND WHAT I HAVE DONE IS KIND OF DIVIDED THIS INTO TALKING ABOUT COLLABORATIONS OF DIFFERENT TYPES. STARTING WITH LIBRARY TO LIBRARY PARTNERSHIPS. AND CERTAINLY ADVANCED TRAINING TOPICS IS A PLACE FOR REAL COLLABORATION. WE WILL LOOK TOWARD EXPERTS IN HOSPITAL LIBRARIES IN OUR CITY TO COME IN AND OFFER SOME ADDITIONAL TRAINING TOPICS FOR US. ONE OF THE THINGS I FOUND -- HAD TO BE A LITTLE BIT CAREFUL OF - HOW MANY OF YOU ARE HERE FROM MEDICAL HEALTH SCIENCES OR HOSPITAL LIBRARIES? OKAY. SO, I HAVE FOUND IN NEW YORK CITY, SOME OF THE MEDICAL LIBRARIES WERE CALLING US SAYING HEY, CONSUMER HEALTH IS HERE. WE WANT TO HELP AND WE WANT TO COME IN AND TRAIN YOU. WE WOULD SAY THAT'S GREAT. BUT THEY REALLY DIDN'T CARE SO MUCH ABOUT WHAT WE FELT OUR TRAINING NEEDS WERE. THEY THOUGHT THEY KNEW WHAT OUR TRAINING NEEDS WERE. AND IN FACT, WE PROBABLY ALREADY HAD TACKLED A LOT OF THE STUFF WHAT WE CONSIDERED OUR BASIC SERVICE AND THAT WAS WHAT THEY WANTED TO COME IN AND TRAIN US FOR. SO WE REALLYHAVE TO TAKE THIS INTO CONSIDERATION. IF YOU ARE THINKING AS A MEDICAL LIBRARIAN, REACHING OUT TO YOUR PUBLIC LIBRARIES, START AT A LEVEL THAT SAYS, YOU KNOW, WE'D LIKE TO WORK WITH YOU. HOW CAN WE HELP,AND THINK ABOUT -- WORK ON -- IF TRAINING IS SOMETHING YOU WANT TO DO, JUST THINK ABOUT A NEEDS ASSESSMENT AND HOW YOU CAN HELP THE PUBLIC LIBRARY DO A NEEDS ASSESSMENT TO SEE WHAT THEY REALLY NEED, INSTEAD OF SAYING WE WILL TRAIN YOU IN X Y AND Z AND NOT GIVING THEM MUCH OF A CHOICE THERE. REFERRALS AND STUMPERS. NOW I MENTIONED EARLIER THAT WE REALLY MAKE THE ATTEMPT NOT TO AUTOMATICALLY REFER QUESTIONS WITHOUT TRYING TO ANSWER THEM WITH ON-SITE RESOURCES. BUT WE DON'T ALWAYS SUCCEED AND IN FACT, WE DO NEED TO BE ABLE TO REFER QUESTIONS TO THE NEXT LEVEL, TO A PROFESSIONAL MEDICAL LIBRARY WHEN WE ARE UNABLE TO MEET THE NEEDS OF THE CLIENT WITH THE RESOURCES ON OUR OWN INFORMATION DESKS. WE ACTUALLY HAVE A WONDERFUL RELATIONSHIP WITH THE NEW YORK ACADEMY OF MEDICINE, WHICH IS A PRIVATE MEDICAL LIBRARY IN NEW YORK CITY, THAT IS OPEN TO THE PUBLIC AND DOES REALLY HAVE AS PART OF ITS MISSION, TO SERVE THE PUBLIC. SO, WE WILL REFER PATRONS TO THE NEW YORK ACADEMY OF MEDICINE LIBRARY WHEN WE ARE UNABLE TO MEET THEIR NEEDS IN THE PUBLIC LIBRARY. IN SOME CASES, WE DO IT BECAUSE IT'S MORE CONVENIENT FOR THE PATRON. IF THE PATRON HAPPENS TO BE IN EAST HARLEM, FOR EXAMPLE, THEY WOULD PROBABLY RATHER GO TO THE NEW YORK ACADEMY OF MEDICINE THAN COME TO MIDTOWN TO OUR CENTRAL HEALTH INFORMATION CENTER, WHERE THEY MIGHT BE ABLE TO ANSWER THE QUESTIONS. SO IT REALLY -- DEPENDS ON YOUR GEOGRAPHY AND WHAT THE RESOURCES ARE IN RHODE ISLAND. WE ALSO HAVE A RELATIONSHIP WITH THE REFERENCE LIBRARIANS AT THIS LIBRARY AND WE CALL THEM WHEN WE'RE STUCK AND WE ENCOURAGE OUR STAFF TO DO THIS. BECAUSE SOMETIMES A CONVERSATIONON BETWEEN A LIBRARIAN AT THE PUBLIC LIBRARIAN AND THE LIBRARIAN AT THE NEW YORK ACADEMY OF MEDICINE IS ALL IT REALLY TAKES TO HELP US BE ABLE TO TAKE THE PATRON TO THE NEXT STEP WITHOUT HAVING TO SEND THEM UP TO THE NEW YORK ACADEMY OF MEDICINE. SO WE HAVE RELATIONSHIPS WITH THE LIBRARIANS AT THE ACADEMY LIBRARY. AND WE WILL CALL THEM AND SAY, HI, IT'S JANE I'M AT THE MID-MANHATTAN LIBRARY. I HAVE A PATRON WHO'S LOOKING FOR BLAH-BLAH BLAH AND I CAN'T SEEM TO FIND THIS DISEASE IN WHATEVER DOCUMENT I'M LOOKING AT,AND GET SOME ADVICE ON HOW TO GET MAYBE JUST A LITTLE BIT MORE INFORMATION SO I CAN ANSWER THAT QUESTION ON A LOCAL LEVEL. WHEN WE DO NEED TO REFER WE HAVE LITTLE PADS OF REFERRAL, WHICH WE CAN JUST JUST RIP OFF. ON ONE SIDE IT'S GOT INFORMATION ABOUT RESOURCES IN THE BRANCH LIBRARIES, HOW TO GET TO THE HEALTH INFORMATION CENTER, AND THEN ON THE OTHER SIDE HOW TO ACCESS THE RESOURCES AT THE NEW YORK ACADEMY OF MEDICINE SO THAT WE CAN GIVE PATRONS SOMETHING TO TAKE WITH THEM WHEN WE MEDIATE TO MAKE THE REFERRAL. THAT'S KIND OF HELPFUL TOO. DOCUMENT DELIVERY IS A SERVICE THAT WE HAVE ALSO WORKED WITH THE NEW YORK ACADEMY OF MEDICINE, TO PROVIDE. IT IS SIMILAR TO DOCLINE THE SYSTEM YOU USE TO GET ARTICLES THROUGH NNLM OR LOANSOME DOC PROVIDERS. WE HAVE AN ARRANGEMENT WITH THE NEW YORK ACADEMY OF MEDICINE, WHEREBY OUR PATRONS WHO NEED ARTICLES FROM HEALTH RELATED JOURNALS WE DON'T HAVE IN OUR COLLECTIONS, CAN GET THEM BY FILLING OUT A FORM, PAYING US A DOLLAR. WE FAX THE FORM TO THE ACADEMY AND THE ACADEMY WILL GET IT FOR US, EITHER FROM THEIR OWN RESOURCES OR IF THEY NEED TO PUT IT THROUGH, DOCLINE THEY WILL, AND SOMETIMES MAYBE HAVE TO GET IT FROM NLM OR SOME OTHER MEDICAL LIBRARY THE ARTICLE CAN BE FAXED DIRECTLY TO THE PATRON OR THE PATRON CAN PICK IT UP AT WHATEVER BRANCH IS CONVENIENT FOR THEM. AND FOR THIS SERVICE, WE PAY $5, THE PATRON PAYS $1 WHICH IS OUR TYPICAL ILL RATE. WE ARE LOOKING AT ACTUALLY DOING AWAY WITH HAVING TO CHARGE AT ALL. IT'S NOT LIKE IT IS A MONEY MAKER FOR US. IT CERTAINLY IS AN ADMINISTRATIVE NUISANCE TO FIGURE OUT HOW TO COLLECT THAT DOLLAR. WHAT DO YOU DO IF YOU CAN'T GET THE ARTICLES. PROBABLY IT WILL BE A FREE SERVICE EVENTUALLY. OUTREACH AND SPECIAL PROJECTS. WE'VE HAD A FEW OPPORTUNITIES TO WORK WITH OTHER LIBRARIES. THE NEW YORK ACADEMY OF MEDICINE IS DOING AN OUTREACH PROJECT RIGHT NOW IN EAST HARLEM AND THEY'RE LOOKING AT SETTING UP SOME SATELLITE LIBRARIES. THEY HAVE ASKED US IF WE WOULD LIKE TO PARTNER IN DOING THAT. OUR PHILOSOPHY OFTEN IS TO JUST SAY YES WHEN THESE OPPORTUNITIES COME UP FOR US. SOMETIMES YOU HAVE TO BE CAREFUL. ARE THE EXPECTATIONS MORE THAN WE CAN HANDLE USUALLY THEY'RE NOT AND USUALLY IT'S A GREAT OPPORTUNITY FOR US TO WORK TOGETHER. SO WE MIGHT OFFER COLLECTION DEVELOPMENT ASSISTANCE. WE ARE NOT USUALLY ASKED TO GO OUT AND STAFF ONE OF THESE SATELLITE LIBRARIES. THAT WOULD BE DIFFICULT FOR US RIGHT NOW WITH OUR STAFFING LEVELS. WE MIGHT ALSO WORK WITH SOME OF OUR STAFF IN THAT PARTICULAR NEIGHBORHOOD WHERE THE SATELLITE LIBRARY IS, TO SPEND A COUPLE OF HOURS HERE AND THERE, WORKING ON OUTREACH MATERIALS, WORKING ON COLLECTION DEVELOPMENT, ET CETERA. WE ALSO RIGHT NOW HAVE A GRANT IN PARTNERING WITH A GROUP CALLED LIBRARIES FOR THE FUTURE, WHICH IS BASED IN NEW YORK CITY. NEW YORK CITY IN PHOENIX BUT THEY DO WORK AROUND THE COUNTRY TO TRY TO GET MORE PUBLIC INFORMATION AVAILABLE, MORE UNDERSTANDABLE PUBLIC INFORMATION AVAILABLE ON THE TOPIC OF THE HUMAN GENOME PROJECT AND HOW HUMAN GENOME RESEARCH CAN IMPACT MINORITY COMMUNITIES IN PARTICULAR. THIS CAN BE A VERY INTERESTING PARTNERSHIP FOR US AND ONE THAT WE HOPE WE CAN PURSUE SOON. PUBLIC HEALTH MATERIALS. WE HAVE A NICE RELATIONSHIP WITH THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE PUBLIC HEALTH LIBRARY. THEY PROVIDE A LOT OF MATERIALS THAT WE USE IN OUR PUBLIC LIBRARY SETTINGS. THEIR MATERIALS ARE REALLY OF THE QUALITY THAT WE TRUST. THEY HAVE PRODUCED A LOT OF VIDEOS THAT WE WOULD THEN MAKE AVAILABLE IN OUR COLLECTIONS, HEALTHY MOTHERS, HEALTHY BABY VIDEOS. POISON PREVENTION AS WELL AS PAMPHLETS. FOR A WHILE WE WEREN'T BIG ON PAMPHLETS. A LOT OF THE PAMPHLETS THAT YOU MIGHT SEE FOR THE PUBLIC COME FROM DRUG COMPANIES. AND WE FELT THAT THE RISK OF IT BEING TOO COMMERCIAL WAS TOO GREAT. SO WE SORT OF DID AWAY WITH IT. BUT WE LIKE THE PAMPHLETS WE HE GET FROM THE PUBLIC HEALTH DEPARTMENT BECAUSE WE KNOW THAT THEY'RE REALLY PRODUCED OR SELECTED IN A WAY THAT WE FEEL GOOD ABOUT THE QUALITY. SO, THE PUBLIC HEALTH DEPARTMENT IS ANOTHER PLACE TO LOOK FOR LIBRARY TO LIBRARY COLLABORATION OR LIBRARY TO AGENCY IF THEY DON'T HAVE A LIBRARY. AND I THINK IT CAN BE REALLY FRUITFUL RELATIONSHIP. OKAY. NEXT. TALK ABOUT THE LIBRARY AND HEALTHCARE SETTINGS. AND THIS CAN BE DIFFICULT. WE HAD SORT OF PIE IN THE SKY IDEAS THAT WE WERE GOING TO GO TALK TO HEALTH CLINICS, TALK TO DOCTORS OFFICES THAT WERE NEAR OUR LIBRARIES, TALK TO HOSPITALS, AND THEY WERE GOING TO BE SO EXCITED TO REFER THEIR PATIENTS TO THE PUBLIC LIBRARY FOR INFORMATION. WE WERE WRONG. THEY WEREN'T REALLY THAT INTERESTED. THEY JUST DIDN'T KNOW -- WELL, COULD THEY TRUST THE PUBLIC LIBRARIANS TO BE DOING REALLY GOOD WORK WITH THIS. SHOULD THEY BE REFERRING THEIR PATIENTS TO THE PUBLIC LIBRARY FOR INFORMATION. SOMETIMES IT WOULD BE MORE OF A COMPETITION ISSUE WHERE THE HOSPITALS HAD THEIR OWN CONSUMER HEALTH SERVICE OF SOME KIND AND THEY REALLY NEEDED TO KEEP THE BUSINESS IN-HOUSE. I CAN UNDERSTAND THAT. SO, WE HAVE HAD TO LOOK FOR OTHER WAYS TO DO LIBRARY HEALTHCARE SETTING COLLABORATION. IT WASN'T AS EASY AS WE ANTICIPATED. WE DO HAVE AND HAVE TRIED A FEW VERSIONS OF AN INFORMATION PRESCRIPTION. YOU MAY HAVE BEEN READING ABOUT THIS. OTHER LIBRARIES - HEALTHCARE LIBRARIES ARE LOOKING AT THIS KIND OF PROGRAM .OUR ORIGINAL GOAL WAS THAT WE WOULD PRODUCE THESE LITTLE PADS. HAD THEM LOOK ABOUT THE SIZE OF PRESCRIPTION PADS. WE WOULD DROP THESE OFF IN THE HEALTHCARE SETTINGS AROUND THE NEIGHBORHOOD AND HOPED THAT THE NURSES AND THE DOCTORS WOULD REQUEST FOR HEALTH INFORMATION ABOUT A DISEASE -- AND THEY WOULD FILL IN THE PATIENT'S DISEASE AND THEN SAY GO TO THE PUBLIC LIBRARY. WELL, OF COURSE, WE GOT PROBABLY FIVE OF THESE BACK. IT JUST WASN'T HAPPENING. WE DIDN'T WANT TO GIVE UP COMPLETELY ON THE IDEA. SO WE RECENTLY PARTNERED WITH THE NEW YORK ACADEMY OF MEDICINE TO PURSUE THIS. I ONLY HAVE ONE COPY BECAUSE -- THIS IS ACTUALLY BRAND NEW. IT'S STILL BEING PRESENTED RIGHT NOW. THIS IS REALLY MORE OF A PROMOTIONAL TOOL THAN AN INFORMATION PRESCRIPTION BUT IT SAYS, NEED HEALTH INFORMATION. INFORMATION RX. KNOW THE QUESTIONS TO ASK. THIS WILL BE IN THE LIBRARIES FOR THE PATRONS TO PICK UP. SO INSTEAD OF EXPECTING THE HEALTHCARE SETTING TO DISTRIBUTE THIS TO THEIR PATIENTS, THIS IS A TOOL THAT'S IN THE BRANCHES FOR THE PATRONS TO PICK UP AND IT HAS DESCRIPTIONS OF WHAT KIND OF HEALTH INFORMATION WE HAVE IN THE NEW YORK PUBLIC LIBRARY AND AT THE NEW YORK ACADEMY OF MEDICINE - WE PRODUCE THIS TOGETHER - AND IT HAS A DESCRIPTION OF OUR SERVICES. AND THERE IS S PLACE FOR THE PATRON TO -- IT SAYS ASK YOUR HEALTHCARE PROVIDER TO PRINT THE NAME OF YOUR CONDITION, DIAGNOSIS, AND TREATMENT OR MEDICATION IN THE SPACES BELOW. THEN SHOW THIS FORM TO THE LIBRARIAN FOR HELP IN FINDING INFORMATION. WHAT DO I HAVE? WHAT SHOULD I DO? WHAT TESTS AND PROCEDURES AM I GETTING? WHAT MEDICATIONS ARE YOU PRESCRIBING FOR ME? WE KNOW THAT OUR PATRONS MAY OR MAY NOT ACTUALLY TAKE THIS TO THE DOCTOR TO FILL THIS IN. BUT WE HOPE IT WILL AT LEAST TRIGGER THEM THAT THEY HAVE THE RIGHT TO ASK THESE QUESTIONS. THAT THEY SHOULD WRITE THINGS DOWN WHEN THEY GO TO THEIR APPOINTMENTS. THAT WE ARE HERE TO HELP THEM FOLLOW UP ON THIS. SO WHETHER THEY ACTUALLY FILL THIS OUT AT THE DOCTOR'S OFFICE OR FILL IT OUT ON THEIR OWN AND BRING IT DOWN TO US OR JUST USE IT AS A REMINDER THAT WE ARE HERE TO HELP, WE THINK IT WILL HELP AND MAYBE GET A LITTLE MORE USE. SO I CAN CERTAINLY LEAVE THIS FOR YOU TO LOOK AT. I'M SORRY I DON'T HAVE EXAMPLES TO DISTRIBUTE. SPEAKERS BUREAU EXCHANGES. I TALKED ABOUT PROGRAMS FOR THE PUBLIC ON VARIOUS TOPICS. WHEN WE IDENTIFY HEALTHCARE SETTINGS THAT HAVE SPEAKERS BUREAUS, WHERE WE REALLY FEEL CONFIDENT THAT THEY ARE OUT THERE ON A PUBLIC SERVICE MISSION AND NOT SO MUCH TO PROMOTE THEIR HOSPITAL, TEN IT IS A NICE OPPORTUNITY FOR US TO CALL IN THOSE SPEAKERS TO DO PROGRAMS FOR THE PUBLIC. WE ARE REALLY SPREAD OUT. WE FIND THAT WE HAVE NO TROUBLE GETTING SPEAKERS WHO SAY, OH, I WOULD LOVE TO COME TO MIDTOWN TO GIVE A TALK AT 3:00 ON A WEDNESDAY AFTERNOON. WELL, IN FACT, THAT'S NOT REALLY WHEN WE NEED THE TALKS. IT'S NOT ALWAYS WHERE WE NEED THE TALKS. SO WE HAVE TRIED TO REALLY ENCOURAGE SPEAKERS WHO SAY THEY'RE VERY INTERESTED IN COMING TO WORK AT TIMES THAT ARE GOOD FOR US. WHICH MIGHT BE AT 6:00 IN THE EVENING RATHER THAN AT 3:00 IN THE AFTERNOON. AND WHEN WE BOOK THEM, WE ASK THAT THEY AGREE TO DO TWO PROGRAMS. SO IF WE ARE GOING TO GIVE THEM THE MIDTOWN VENUE WE WILL ALSO ASK THEM TO DO A SOUTH BRONX OR STATEN ISLAND, SO WE CAN REALLY GET MORE BANG FOR THE BUCK ESPECIALLY IF WE ARE PAYING FOR THE PROGRAM, WHICH TYPICALLY WE ARE NOT. BUT OCCASIONALLY WE WILL. WE ALSO ASK OUR STAFF TO CONSIDER GOING OUT AND TALKING IN DIFFERENT SETTINGS ABOUT THE PUBLIC LIBRARY AND THE ROLE THAT WE CAN PLAY IN HELPING PEOPLE GET INFORMATION AND FULFILLING THEIR INFORMATION NEEDS AND TO TALK ABOUT HEALTHCARE AND MAYBE TALK ABOUT HEALTHCARE ON THE INTERNET BECAUSE THAT'S CERTAINLY SOMETHING THAT WE FEEL -- WE HAVE EXPERTISE IN - TO SHARE HOW TO FIND AND GET GOOD CONSUMER HEALTH INFORMATION ON THE INTERNET. FOR EXAMPLE, I HAVE GONE TO THE HOSPITAL FOR SPECIAL SURGERY AND DONE A PROGRAM IN THEIR AUDITORIUM ON FINDING CONSUMER HEALTH INFORMATION ON THE INTERNET. THAT WAS A PROGRAM THAT THEY THEN MARKETED THROUGH THEIR MAILING LIST TO THEIR PATIENTS. IT WAS A CONSUMER HEALTH PROGRAM FOR THEIR CONSUMERS WHO ARE ALSO OUR CONSUMERS IN THE PUBLIC HEALTH LIBRARY. SO THAT WORKED PRETTY WELL FOR US. MODELS FOR CROSS CULTURAL COMMUNICATION. THIS IS OF ONE OF MY FAVORITE TOPICS. HOW WE PROVIDE REFERENCE SERVICES FOR PEOPLE WHO DON'T SPEAK ENGLISH. HEALTH INFORMATION OR ANY KIND OF INFORMATION REALLY. I THINK THAT THE HOSPITALS HAVE DONE SUCH GOOD WORK HERE -- AND OFTEN IT'S BECAUSE OF THEIR REGULATIONS. IT'S FORCED THEM TO DO REALLY GOOD WORK IN MAKING SURE THAT THEY'RE PROVIDING TRANSLATION SERVICES. WE HAVE NOT DONE SUCH A GOOD JOB IN THE PUBLIC LIBRARY SETTING. I'M NOT SURE ABOUT SCHOOL OR ACADEMIC LIBRARIES, BUT WE ARE WORKING MORE TOWARD AT LEAST SAYING IF WE CAN'T DO IT IN ENGLISH AND SPANISH, WE ARE NOT GOING TO DO IT FOR ANY PRINTED MATERIALS ABOUT LIBRARY SERVICES. SO WE ARE OF SAYING -- WE'VE GOT TO TRANSLATE EVERYTHING INTO SPANISH. THAT'S ONLY ONE LANGUAGE AND YOU CAN BE SURE THAT WE HAVE A HUGE NEED IN NEW YORK CITY FOR AT LEAST CHINESE AND RANKS RIGHT BEHIND SPANISH AND RUSSIAN. THE OTHER THING I HEAR IN THE PUBLIC LIBRARY SETTING IS, WELL. WE HIRE PAGES FROM THE NEIGHBOURHOOD AND THEY SPEAK THE LANGUAGE OF THE PEOPLE WHO LIVE HERE. SO WE CAN ALWAYS COUNT ON OUR PAGES. I THINK THAT'S A PRETTY WEAK ARGUMENT. IT'S LIKE THE HOSPITAL SAYING, WELL, YOU KNOW WE HAVE THESE CUSTODIANS THAT WE CAN BRING IN TO TRANSLATE WHEN THE PATIENT NEEDS INFORMATION IN THE LANGUAGE THE DOCTOR DOESN'T SPEAK. AND THERE'S A GREAT VIDEO THAT I HAVE SEEN AND I THINK IT'S AN AMA VIDEO BUT I'M NOT 100 PERCENT SURE ABOUT THIS. IT'S JUST SUCH AN EXAMPLE. IT'S ABOUT A DOCTOR WHO NEEDS SOMEBODY TO TRANSLATE. CALLS IN A CUSTODIAN. AND DOES THIS WHOLE INTERVIEW AND TRANSLATING BACK AND FORTH ABOUT -- IT'S A BACK CARE AILMENT AND IT GOES PRETTY WELL. TRANSLATION ISN'T TOO BAD. THEN AT THE VERY END, THE CUSTODIAN TURNS TO THE PATIENT AND SAYS IN SPANISH THE DOCTOR DOESN'T KNOW, "HEY IF THAT DOESN'T WORK OUT FOR YOU GIVE ME A CALL I WILL TELL YOU ABOUT THIS GREAT CHIROPRACTOR I KNOW" AND LEAVES THE ROOM. I FOUND THAT SO INTERESTING AND SO I THINK IN THE LIBRARY SETTING THAT WE -- MAYBE WE CAN'T FIND PROFESSIONAL LIBRARIANS WHO SPEAK EVERY LANGUAGE OUR PATRONS SPEAK AND THAT'S A PROBLEM AND THAT IS SOMETHING WE NEED TO CONTINUE TO INVEST TIME AND RESOURCES IN FIGURING OUT A SOLUTION. BUT DO WE NECESSARILY HAVE TO HAVE MLS LIBRARIANS BEING THE ONLY PEOPLE WHO PROVIDE INFORMATION SERVICES. AND I THINK THAT THERE'S A KIND OF AN IN-BETWEEN PLACE. WE CAN'T JUST SAY OUR HIGH SCHOOL PAGES ARE ALL WE ARE GOING TO HAVE IN THE BRANCH AND YET, WE MAY NOT HAVE ENOUGH LIBRARIANS WHO SPEAK OTHER LANGUAGES BUT THERE'S GOT TO BE SOME KIND OF IN BETWEEN. WE HAVE BEEN TALKING A BIT ABOUT THE CONCEPT OF CULTURE BROKERS AS A WAY OF REACHING OUT TO POPULATIONS THAT SPEAK LANGUAGES OTHER THAN ENGLISH. OR THEY SOMETIMES JUST MAYBE SPEAK ENGLISH BUT THEIR ETHNIC BACKGROUND OR CULTURAL BACKGROUND IS SO DIFFERENT FROM OURS THAT WE FEEL WE ARE NOT REALLY MEETING THEIR NEEDS. FOR EXAMPLE, WE ARE WORKING WITH A PROGRAM THAT -- A GROUP OF AFRICAN, PEOPLE WHO ARE NOW RECENTLY MOVING INTO WEST HARLEM AND THEY ARE VERY SKEPTICAL OF THE PUBLIC LIBRARY. WE ARE TRYING TO FIGURE OUT HOW WE CAN MAKE THEM FEEL MORE AT EASE. CONTACTING THEM DIRECTLY DOESN'T SEEM TO BE HELPING US DO THAT. SO WE ARE WORKING WITH ONE OF THE CULTURAL ORGANIZATIONS IN THE NEIGHBORHOOD AND TALKING WITH THEM ABOUT HOW WE CAN GET THE WORD OUT ABOUT PUBLIC LIBRARIES AND GETTING PEOPLE TO FEEL MORE COMFORTABLE ABOUT COMING TO US. SO THE NOTION OF CULTURE BROKERS I THINK IS ALSO SOMETHING HEALTHCARE SETTINGS ARE DOING AND WE CAN LEARN FROM THEM. ONE OF MY FAVORITE BOOKS ON THIS TOPIC IS "THE SPIRIT CATCHES YOU WHEN YOU FALL DOWN" BY ANN FATAMAN I DON'T KNOW IF YOU KNOW THAT BOOK. IT'S A TERRIFIC READ AND IT'S ABOUT A HMONG FAMILY IN CALIFORNIA WHOSE YOUNG GIRL HAS EPILEPSY. WHEN SHE'S HAVING SEIZURES THE FAMILY THINKS THAT IT'S ACTUALLY THE SPIRIT CATCHING HER AND SHE'S FALLING DOWN AND THAT IT'S SOMETHING TO BE REVERED, NOT SOMETHING TO BE FEARED. AND IN FACT, THE HEALTHCARE SYSTEM JUST HAS SUCH A HARD TIME WORKING WITH THIS FAMILY THAT THEY END UP TAKING THIS GIRL AWAY. IT'S A BEAUTIFUL READ ACTUALLY. I WOULD RECOMMEND THAT. LET'S MOVE ON AND TALK ABOUT LIBRARY AND COMMUNITY BASED ORGANIZATION COLLABORATION AND PARTNERSHIP. YOU KNOW, I RESPECT THAT SARAH ANN LONG SAID THAT COLLABORATION IS HARD. IT'S HARD WORK. IT'S NOT SOMETHING THAT HAPPENS QUICKLY. SHOWING UP, IT'S JUST SO IMPORTANT TO SHOW UP AND TO BE A PART OF THE COMMUNITY. IT'S MUCH EASIER TO JUST STAY IN OUR BUILDINGS AND DO WHAT WE DO AND THINK THEY SHOULD BE LUCKY TO HAVE US, AND THEY SHOULD BE COMING TO US. WHY SHOULD WE REACH OUT. WHEN I RATE COMMUNITY BUILDING HERE, WHAT I'M TALKING ABOUT REALLY IS -- AND THIS IS SOMETHING WE ARE TRYING TO DO AT THE NEW YORK PUBLIC LIBRARY - IS TO GET OUR STAFF AT ALL LEVELS TO PARTICIPATE IN LOCAL COMMUNITY INITIATIVES. TO GET BEYOND JUST THINKING LIBRARY,LIBRARY, LIBRARY. BUT TO BE THINKING THAT THIS IS MY COMMUNITY. AND I HAVE IDENTIFIED THE CORE NEEDS OF THIS COMMUNITY AS WHATEVER. AND I'M GOING TO PARTICIPATE IN THIS NEIGHBORHOOD COALITION OR THIS BUSINESS IMPROVEMENT DISTRICT OR THIS SPECIAL INTEREST GROUP THAT'S GOING ON IN THE NEIGHBORHOOD -- NOT GOING OUT AND FORMING NEW GROUPS NECESSARILY. ALTHOUGH ADVISORY GROUPS FOR CONSUMER HEALTH I THINK CAN BE VERY EFFECTIVE ESPECIALLY IF YOU ARE STARTING A SERVICE. FIND GROUPS AND COALITIONS THAT ARE ALREADY OUT THERE AND JUST SHOW UP AND HAVE A PRESENCE AND PARTICIPATE AND NOT BE THERE BECAUSE YOUR FIRST NEED IS TO TALK ABOUT WHAT THE LIBRARY CAN OFFER. HANG OUT FOR A LITTLE WHILE AND HEAR WHAT THE ISSUES ARE IN THE COMMUNITY. WE REALLY CHALLENGED OUR STAFF TO FEEL THEY DON'T HAVE TO JOIN 50 OF THESE BUT TO FIND ONE OR TWO AND TO MAKE IT THEIR BUSINESS TO SHOW UP. AND THEN AS YOU ARE LEARNING ABOUT WHAT THE NEEDS ARE OF THOSE PARTICULAR GROUPS, THEN YOU CAN BEGIN TO THINK ABOUT WHAT'S THE ROLE OF THE LIBRARY HERE AND INTERJECT THAT. IN THE MEANTIME YOU REALLY BECOME PART OF THE COMMUNITY, WHICH I THINK IS REALLY IMPORTANT. I HAVE A COUPLE LINKS HERE THAT ARE EMBEDDED IN THIS PRESENTATION. SOME EXAMPLES OF HOW WE FOUND GROUPS THAT HAVE HELPED US TO LINK TO COMMUNITY ORGANIZATION. THIS IS THE LIBRARIES FOR THE FUTURE, WHICH -- BY THE WAY WE DO HAVE SLIDE SCREENS FOR YOU THAT HAVE THE URLS PRINTED ON THEM SO DON'T FEEL THAT YOU NEED TO WRITE THIS DOWN. LIBRARIES FOR THE FUTURE HAS A PROGRAM THEY STARTED THIS YEAR IN BROOKLYN, WITH THE BROOKLYN PUBLIC LIBRARY AND THEY HAVE NOW EXPANDED THIS TO BE CITY WIDE AND EVEN A LITTLE BIT BEYOND THE CITY. IT'S SOMETHING THEY CALLED HEALTH ACCESS AND THEY HAVE FORMED A NEW YORK AREA COALITION FOR HEALTH INFORMATION ACCESS, A GROUP THAT WORKS TO MAKE HEALTH INFORMATION MORE ACCESSIBLE TO ALL NEW YORKERS. THEY HAVE REALLY PULLED TOGETHER LIBRARIES OF DIFFERENT TYPES OF LIBRARIES, PUBLIC HEALTH LIBRARY PARTICIPATES, NEW YORK ACADEMY OF MEDICINE PARTICIPATES, ALL THE THREE CITY PUBLIC LIBRARIES PARTICIPATE, AND THE LIBRARIAN AT THE CANCER INFORMATION CENTER PARTICIPATES. COMMUNITY BASED ORGANIZATIONS. THE BROWN HEALTH LINK, THE ARTHUR ASHE INSTITUTE FOR URBAN HEALTH IN BROOKLYN. WE GET THESE GROUPS TO THE TABLE ON A REGULAR BASIS TO TALK ABOUT HEALTH INFORMATION SERVICE. THE OTHER THING WE HAVE DONE - BECAUSE REALLY IT'S NOT JUST ABOUT GETTING TOGETHER AND TALKING ABOUT IT, WE PRODUCED EVENTS THAT WE OPEN TO PEOPLE WHO WORK IN HEALTHCARE SETTINGS. PEOPLE WHO ARE INVOLVED WITH HEALTH INFORMATION INITIATIVES IN CBOS SO WE ARE NOT JUST TALKING TO EACH OTHER, WHICH I THINK LIBRARIANS DO AN AWFUL LOT OF. IT HAS REALLY HELPED US JUST KIND OF PUSH THAT OUT A LITTLE BIT AND LIBRARY FOR THE FUTURE HAS DONE A GREAT JOB DOING THAT. INFORMATION ABOUT THAT MODEL IS HERE ON THIS PAGE SO YOU CAN TAKE A LOOK AND SEE HOW -- IT'S JUST ONE MODEL. WE ALSO HAVE IN NEW YORK, THE METROPOLITAN LIBRARIES COUNCIL. AND THEY HAVE A CONSUMER HEALTH SPECIAL INTEREST GROUP. THAT IS MORE LIBRARIANS TALKING TO LIBRARIANS BUT IT'S MULTITYPE LIBRARY SO AT LEAST THAT'S HELPED SOMEWHAT TO GET BEYOND JUST THE PUBLIC, THE ACADEMIC, THE HEALTH SCIENCES, TO REALLY BRING US TOGETHER WHICH IS NICE LET'S LOOK AT THE BRONX HEALTH LINK. THE BRONX HEALTH LINK IS AN ORGANIZATION THAT STARTED WITH FOUR HOSPITALS IN THE BRONX AND UNDER THE LEADERSHIP OF THE BRONX BUREAU PRESIDENT AND IT WAS REALLY DESIGNED TO THINK ABOUT THE FACT THAT RESOURCES IN THE BRONX ARE INCREDIBLY LIMITED AND IF PEOPLE DIDN'T NETWORK, WE WERE GOING TO MISS OUT ON SOME MAJOR OPPORTUNITIES. SO THE GROUP FORMED SEVERAL YEARS AGO AND REALLY WORKED ON CONNECTING THE PEOPLE OF THE BRONX WITH THE HEALTH INFORMATION SERVICES. WITH HEALTH SERVICES NOT JUST HEALTH INFORMATION SERVICES. SO, THE WAY THAT THE NEW YORK PUBLIC LIBRARY PARTICIPATED, THERE WAS -- THEY KIND OF WORKED IN FOUR DIFFERENT AREAS. AND ONE OF THEM WAS HEALTH ACCESS. AND THEY HAD EVENTS ONCE A MONTH, IT WOULD BE A MORNING-LONG EVENT AND IT WAS PRIMARILY A NETWORKING EVENT WHERE PEOPLE FROM ALL OF THE NONPROFITS, THE VOLUNTARY HEALTH ORGANIZATIONS, THE HOSPITALS, MOSTLY THE OUTREACH DEPARTMENTS IN THE HOSPITALS, THE LIBRARIES AND OTHER SERVICES WOULD COME TOGETHER AND THEN THE ORGANIZATION -- THE BRONX HEALTH LINK, WOULD INVITE ONE OR TWO OF THOSE GROUPS TO GIVE A BRIEF PRESENTATION OF WHAT THEIR SERVICES ARE. AND FROM THERE IT KIND OF EVOLVED INTO SOME HEALTH FAIRS. TO GETTING A TABLE TOGETHER AT BRONX HEALTH DAY SO THAT WE WERE DOING MORE AND MORE TOGETHER, WHICH WAS REALLY TERRIFIC. WE WISH WE HAD A MANHATTAN HEALTH LINK AND STATEN ISLAND HEALTH LINK. ONE THING ABOUT THE BRONX - IT'S DEFINITELY THE POOREST BUREAU, BUT THEY JUST GOT NETWORKING DOWN. MANHATTAN THINGS ARE NOT AS COLLABORATIVE, MUCH MORE COMPETITIVE I THINK WITH THE SERVICES IN MANHATTAN COMPETING FOR THE AUDIENCE. HEALTH AND LITERACY, I HAVE A LINK TO ONE WEBSITE WHICH I THINK IS A PRETTY GOOD WEBSITE. BUT I THINK THAT HEALTH LITERACY IS ONE OF THE MOST GALVANIZING ISSUES RIGHT NOW IN CONSUMER HEALTH INFORMATION. DOES ANYONE WANT TO TAKE A STAB AT WHAT I MEAN WHEN I SAY HEALTH LITERACY? I'M NOT SO MUCH THINKING ABOUT HEALTH LITERACY AS HEALTH INFORMATION FOR PEOPLE WHO CAN'T READ AND WRITE AT ALL. BUT HEALTH LITERACY HAS TO DO WITH THE FACT THAT HAVING ACCESS TO EASY TO READ AND EASY TO UNDERSTAND INFORMATION IS IMPORTANT FOR ALL OF US. IT'S PARTICULARLY IMPORTANT FOR PEOPLE WITH LIMITED READING SKILLS. BUT WE CAN ALL BENEFIT. I WOULD IMAGINE THAT YOU HAVE GOTTEN HEALTH INFORMATION THAT YOU HAVE FOUND CONFUSING, WHETHER IT'S INFORMATION ABOUT YOUR INSURANCE OR A MEDICATION THAT YOU HAVE BEEN PRESCRIBED, INFORMATION ABOUT HEALTHCARE PROXIES, LIVING WILLS, ADVANCED DIRECTIVES. IT'S NOT EASY STUFF TO UNDERSTAND. THE RESEARCH THAT WAS MOST EYE OPENING TO ME WAS DONE BY LINDA BAKER IN DETROIT. SHE SHOWED THAT MOST OF THE INFORMATION THAT WAS ON OUR DATA BASES, ELECTRONIC RESOURCES OF HEALTH INFORMATION WAS OF AN 11 TO 12 GRADE LEVEL. AND IN FACT, MOST OF THE PEOPLE THAT WE ARE SERVING ARE READING AT A FOURTH OR FIFTH GRADE LEVEL. SO WE ARE IN THE LIBRARY SETTING AND I THINK THIS IS TRUE IN ALL TYPES OF LIBRARIES, GIVING PEOPLE INFORMATION THAT IS BEYOND THEIR ABILITY TO REALLY UNDERSTAND. AND IT'S A PROBLEM THAT I THINK LEADS TO MEDICATION ERRORS. LEADS TO HUGE COSTS, HOSPITALIZATION COSTS. I DIDN'T BRING IN SPECIFIC STATISTICS ON WHAT IT COSTS US BECAUSE WE ARE NOT PROVIDING INFORMATION PEOPLE CAN READ -- BECAUSE THE CLAIMS ARE ALL OVER THE BOARD. IT'S IN THE MILLIONS OF DOLLARS THAT IS COSTING US JUST BECAUSE WE ARE NOT PROVIDING INFORMATION PEOPLE CAN READ WE ARE SEEING THIS TO BE SOMETHING THAT HOSPITALS ARE TAKING MUCH MORE SERIOUSLY IN TERMS OF THE INFORMATION THAT THEY'RE GIVING OUT TO PEOPLE WITH PRESCRIPTIONS, WITH DISCHARGE PLANNERS, WHATEVER. AND I THINK THAT IT'S A GREAT PLACE FOR LIBRARIES, FOR MULTITYPE LIBRARIES TO REALLY FOCUS THEIR COLLABORATION AND THEIR ENERGY. THE GRANT MAKERS ARE INTERESTED IN THIS RIGHT NOW. WE'VE DONE SEVERAL FORUMS IN NEW YORK CITY THAT PEOPLE -- I WON'T SAY THEY WERE THROWING MONEY AT US, BUT THEY WERE REALLY INTERESTED IN US PURSUING THESE KINDS OF PROGRAMS. LET ME JUST TELL YOU A LITTLE BIT ABOUT THEM. THE FIRST ONE WAS ABOUT THE ROLE -- IT WAS REALLY LIMITED TO LIBRARIANS. IT WAS ABOUT SELECTING AND EVALUATING INFORMATION -- HEALTH INFORMATION FOR OUR COLLECTIONS. SO THAT WE WERE SURE THAT WE HAD THE REQUIRED INFORMATION IN OUR PRINT COLLECTIONS AND OUR DATA BASES, THAT PEOPLE COULD UNDERSTAND. THEN WE DID A SEGMENT -- AN ACTUAL CONFERENCE WHERE WE INVITED LIBRARIANS PLUS CBOS TO COME TO THE TABLE TO LEARN ABOUT SOME OF THE POLICY ISSUES AND REMA READ FROM THE HARVARD SCHOOL OF PUBLIC HEALTH WAS OUR SPEAKER. IF YOU ARE JUST GETTING STARTED IN UNDERSTANDING HEALTH LITERACY, WHY IT'S SUCH AN IMPORTANT ISSUE FOR US, THIS IS A REALLY GREAT PLACE TO START.I WOULD RECOMMEND IT. MOST RECENTLY, WE DID A FULL DAY WORKSHOP ON HOW TO WRITE OR REWRITE INFORMATION SO IT'S READABLE. AND WE DID SOME GREAT WORK WHERE WE TOOK SOME HEALTH INFORMATION BROCHURES AND DID A READABILITY TEST ON IT AND WE SAW JUST HOW NOT READABLE THEY ARE. THEN WE ALSO WORKED ON REWRITING THAT INFORMATION AS WELL AS SOME OF OUR OWN LIBRARY INFORMATION -- OUR LIBRARY SERVICE INFORMATION, OUR LIBRARY WEBSITES -- AND WE WERE ABLE TO WORK WITH THIS AND SHOW HOW REWRITING THIS INFORMATION MADE IT READABLE. IT WASN'T DUMBING DOWN THE INFORMATION, WHICH IS THE THING SOMETIMES YOU HEAR, THAT WE ARE NOT GOING TO DUMB DOWN OUR INFORMATION. WE JUST HEARD THAT AT LUNCH, RIGHT? AND IT'S NOT -- IT'S JUST MAKING IT MORE READABLE. THE REALITY IS THAT WE ALL NEED INFORMATION THAT'S MORE READABLE ABOUT HEALTH, AND THAT WHEN WE ARE GETTING BAD NEWS OR CONFUSING NEWS ABOUT A HEALTHCARE CONDITION, THAT OUR OWN HEALTH LITERACY, EVEN FOR THE BEST OF READERS GOES DOWN A FEW LEVELS. AUDIENCE MEMBER: DO YOU USE FLESH KINCAID READABILITY SPEAKER: WE USED THE FLESH KINCAID READABILITY TEST. I HAVE SEEN SOME PEOPLE USE THIS. AND THEY -- EVERY SPEAKER I HAVE HEARD ON THIS TOPIC HAS SAID DON'T USE THE ONE ON MICROSOFT WORD. IT'S NOT ACCURATE. I'M NOT SURE WHAT THE DIFFERENCE IS. DOING IT BY HAND SUPPOSEDLY GETS A MUCH MORE REALISTIC. AND IT'S NOT LIKE YOU HAVE TO PUT DOWN EVERY SINGLE THING. YOU WRITE FOR THE REST OF YOUR LIFE THROUGH THIS READABILITY FORMULA. YOU DO THIS A FEW TIMES AND YOU GET AN UNDERSTANDING ABOUT HOW TO WRITE SO IT'S READABLE. HOW TO WRITE IN PLAIN ENGLISH. AND YOU GET GOOD AT IT AND YOU DON'T NEED TO TEST YOURSELF ANY MORE. IT JUST BECOMES THE WAY YOU WRITE. I KNOW THAT PEOPLE WHO WORK ON OUR WEBSITES ARE REALLY KEEN ON THIS RIGHT NOW. JUST -- LET'S JUST WRITE SHORT AND SWEET, PLAIN ENGLISH. IT DOESN'T NEED TO BE DULL. IT DOESN'T NEED TO BE DUMBED DOWN. I THINK THAT'S REALLY INTERESTING. LET ME SEE IF I MISSED ANYTHING ON HEALTH LITERACY. I THINK THE ROLE OF LIBRARIES HERE IS TO SEEK EASY TO READ INFORMATION, TO WRITE EASY TO READ INFORMATION, TO UNDERSTAND WHEN A PATRON MIGHT BE BETTER SERVED WITH EASY TO READ INFORMATION. IT GETS INTO A TRAINING ISSUE. AND YOU CAN DO THAT WITH A GOOD REFERENCE INTERVIEW. YOU GET A SENSE OF THE LEVEL OF INFORMATION THE PATRON IS SEEKING. BUT THERE'S NEVER ANY HARM IN GIVING SOMEBODY EASY TO READ INFORMATION, EVEN IF THEY ARE A MEDICAL STUDENT OR PH.D. HOLDER. WE CAN ALL BENEFIT BY EASY TO READ. SO TO GIVE A RANGE IS SOMETIMES HELPFUL. BUT TO PLOP A PATRON DOWN AND SAY, HERE'S THE HEALTH REFERENCE CENTER AND THINK THAT'S GOING TO MEET ALL THEIR NEEDS IS TRICKY. NOW MED LINE PLUS, WHICH WE HAVE BOOK MARKED HERE FOR -- AND BY THE WAY, I ACTUALLY DIDN'T KNOW THAT THE NNLM WAS FUNDING THE PROGRAM TODAY OR THAT THIS GREAT OUTREACH PARTNERSHIP OPPORTUNITY IS GOING OUT WHICH I THINK IS GREAT. IT SOUNDS LIKE THERE ARE SOME EXCELLENT STUFF HAPPENING IN RHODE ISLAND RIGHT NOW, WHICH IS REALLY TERRIFIC. NLM DOES -- MEDLINEPLUS, WHICH IS THE NATIONAL LIBRARY OF MEDICINE'S CONSUMER HEALTH INFORMATION SITE, WHICH REALLY WAS CREATED WHEN MEDLINE, WHICH IS NOT A CONSUMER HEALTH INFORMATION SITE AT ALL, IT'S REALLY AN ABSTRACT INDEXING SERVICE OF THE MEDICAL LITERATURE, WHEN THAT WENT PUBLIC ON-LINE FREE, THEY -- NLM NOTICED THAT CONSUMERS WERE THERE LOOKING FOR CONSUMER HEALTH INFORMATION, NOT DOING REAL MEDLINE SEARCHES, BUT LOOKING FOR CONSUMER HEALTH INFORMATION. IT WAS A WONDERFUL OPPORTUNITY FOR THEM TO CREATE MED LINEPLUS, WHICH I THINK IS THE BEST CONSUMER HEALTH WEBSITE THAT'S OUT THERE. I ALMOST ALWAYS GO TO IT FIRST WHEN I HAVE A HEALTH INFORMATION QUESTION. AND -- I SAY THAT IN ALL SINCERITY -- I PROBABLY SHOULD BE TALKING ABOUT NOAH, I WILL SHOW YOU THAT IN A MOMENT AS THE ONE I REALLY SUPPORT BECAUSE NEW YORK PUBLIC LIBRARY IS A PARTNER OF NOAH. MEDLINEPLUS HAS THE RESOURCES TO REALLY DO IT RIGHT. SO IT'S AN UNSOLICITED PLUG. AND THE LAST THING I WILL SAY ABOUT HEALTH LITERACY -- OH, WHAT I WANTED TO SAY ABOUT MEDLINEPLUS IS THAT IT HAS LINKS TO MANY EASY TO READ DOCUMENTS NOW. THEY TAG THEM AS SUCH, AS EASY TO READ AND YOU CAN ACTUALLY -- IF YOU WANT TO GO JUST TO THE EASY TO READ SECTION OF MEDLINEPLUS. IF YOU ARE REALLY LOOKING TO FIND STUFF THAT'S OUT THERE THAT'S EASY TO READ FOR YOUR PATRONS, OR USERS, OR PATIENTS, TAKE A LOOK AT MEDLINEPLUS. THE LAST THING I WILL SAY ABOUT HEALTH LITERACY IS THAT WE ARE REALLY EXCITED RIGHT NOW IN NEW YORK CITY BECAUSE THERE'S A MAYOR'S TASK FORCE ON THE ISSUE OF HEALTH LITERACY. IT'S BEING PULLED TOGETHER BY THE LITERACY ASSISTANCE CENTER, WHICH IS KIND OF AN UMBRELLA ORGANIZATION OF ALL THE LITERACY PROVIDERS IN NEW YORK CITY, PLUS THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE AND THE LIBRARIES. SO WE ARE REALLY EXCITED TO SEE THIS GET THE ATTENTION OF THE MAYOR, AND FOR HIM TO SEE HOW IMPORTANT THAT IS. THE LAST THING I HAVE HERE ABOUT COMMUNITY BASED ORGANIZATIONS AND LIBRARY COLLABORATION IS TO THINK ABOUT PARTICIPATING IN PROFESSIONAL ASSOCIATIONS AND NOT JUST LIBRARY RELATED. TO THINK ABOUT THE PUBLIC HEALTH ASSOCIATION AS A WAY TO REALLY LOOK AT SOME COLLABORATION BETWEEN LIBRARIES AND PUBLIC HEALTH PROFESSIONALS. OR IF YOU ARE A PUBLIC LIBRARIAN - HOW MANY PUBLIC LIBRARIANS ARE HERE IN THE AUDIENCE? IF YOU ARE A PUBLIC LIBRARIAN, THINK ABOUT JOINING MLA OR AT LEAST YOUR LOCAL CHAPTER OF MLA, MEDICAL LIBRARY ASSOCIATION. AND FOR THOSE OF YOU WHO ARE ALREADY MEDICAL LIBRARY ASSOCIATION MEMBERS, TO WELCOME US WHEN WE COME BECAUSE IT'S A LITTLE INTIMIDATING FOR PUBLIC LIBRARIANS TO GO TO MLA CONFERENCE OR TO COME TO THE LOCAL CHAPTER MEETING. I REMEMBER FEELING VERY UNCOMFORTABLE WHEN I FIRST STARTED GOING TO MLA, BOTH LOCALLY AND AT THE NATIONAL LEVEL. LIKE -- "OH, PUBLIC LIBRARY. THAT'S INTERESTING". THAT WAS KIND OF THE REACTION I FELT I GOT FROM THE MEDICAL LIBRARIANS. "OH, YOUR ORGANIZATION MUST HAVE EXTRA MONEY THIS YEAR OR SOMETHING, AND SO THEY ARE SENDING YOU TO THE MLA CONFERENCE". WE REALLY NEED YOU TO HELP US FEEL MORE WELCOME AT YOUR ASSOCIATION CONFERENCES AND OTHER MEETINGS. SO I WOULD ENCOURAGE THOSE OF YOU WHO ARE MLA REGULARS HERE TO INVITE SOMEBODY FROM A PUBLIC LIBRARY SETTING TO JOIN YOU AND TO MENTOR SOMEBODY TO GET INVOLVED BECAUSE IT'S NOT AN EASY TASK. LET'S MOVE ON TO TALK ABOUT LIBRARIES IN GOVERNMENT AGENCIES. THE HEALTHY PEOPLE 2000, AND HEALTHY PEOPLE 2010 ARE MAJOR NATIONAL PUBLIC HEALTH INITIATIVES TO TRY TO LOOK AT WHAT ARE THE RISKS, WHAT ARE THE HEALTH RISKS THAT ARE MOST PREVALENT IN OUR COMMUNITIES RIGHT NOW. GOOD INFORMATION AS IT RELATES TO BECOMING HEALTHIER IS SOMETHING THAT IS SPREAD THROUGHOUT THAT DOCUMENT, HEALTHY PEOPLE 2010, THE NATIONAL DOCUMENT. I THINK THIS IS TERRIFIC. IN FACT THERE'S EVEN A WHOLE CHAPTER ON HEALTH LITERACY IN THE -- THIS IS THE RHODE ISLAND ONE. HEALTHY PEOPLE 2000, 2010. HEALTHIER RHODE ISLAND BY 2010, A PLAN OF ACTION - THAT HAS THE LEADING HEALTH INDICATORS FOR RHODE ISLAND. AND REALLY TALKS ABOUT STRATEGIES AND BEST PRACTICES FOR LEADING HEALTH INDICATORS FOR RHODE ISLAND. AND I THINK IT'S IMPORTANT THAT LIBRARIANS FROM ALL KINDS OF LIBRARIES ARE PLAYING A ROLE IN THE DEVELOPMENT OF THESE DOCUMENTS AND THE IMPLEMENTATION OF THESE PLANS. THIS IS A PLACE FOR US TO MAKE A SPACE FOR OURSELVES AT THE TABLE. TO SHOW UP, TO MAKE SURE THAT THE GOVERNOR, WHOEVER'S SPONSORING THIS, HAS LIBRARIANS INVOLVED IN THE PLANNING BECAUSE INFORMATION IS THE KEY TO SO MANY OF THESE LEADING HEALTH INDICATORS AND HOW WE WILL RESPOND TO THE HEALTH PROBLEMS THAT ARE AFFECTING OUR COMMUNITIES. I ACTUALLY HAD A REALLY WONDERFUL EXPERIENCE GOING TO THE NATIONAL UNVEILING OF HEALTHY PEOPLE 2000 IN WASHINGTON. I WENT WITH A NURSING PROFESSOR FROM THE HUNTER COLLEGE SCHOOL OF NURSING, WHICH IS ONE OF OUR PROJECT PARTNERS FROM THE EARLY DAYS OF CHOICES. WE HAD NURSES DO INTERNSHIP PROJECTS WITH US THROUGH CHOICES. THAT WAS KIND OF AN INTERESTING PARTNERSHIPS. IT TOOK A WHILE TO GET IT TO REALLY WORK RIGHT. THEY WANTED -- THE NURSING SCHOOL, WANTED THE NURSING STUDENTS TO COME IN AND DO BLOOD PRESSURE CLINICS AND COUNSEL PEOPLE ON HEALTH RELATED TOPICS. WE SAID WE DON'T REALLY OFFER HEALTH INFORMATION COUNSELING. WELL, WHY NOT? THEY ARE NURSING STUDENTS. BECAUSE THEY ARE ONLY GOING TO BE HERE FOR SIX WEEKS EVERY SEMESTER FOR ONE AFTERNOON. WHAT ARE WE GOING TO DO THE REST OF THE TIME? SO WE REALLY TRIED TO FIND A BETTER BALANCE TO WORK WITH THE NURSING INTERNS AND HAD THEM INSTEAD DO VARIOUS OUTREACH PROGRAMS FOR US. ONE OF THEM DID A WHOLE PROGRAM THAT HELPED US OFFER HEALTH INFORMATION SERVICES TO OUR HOME BOUND PATIENTS. WE DID A MAILING AND A FORM AND FOLLOW UP INFORMATION SERVICE SO THEY COULD GET HEALTH INFORMATION BY CONTACTING US. ANYWAY, I WENT TO HEALTHY PEOPLE 2000 AND DID A PRESENTATION THERE WITH THE NURSING SCHOOL PROFESSOR AND THAT WAS ALSO A REALLY NICE WAY TO SHOW HOW A LIBRARY NURSING PROGRAM PARTNERSHIP, REALLY WORKED WELL. NURSING AND ALLIED HEALTH PROGRAMS MAY BE ANOTHER OPPORTUNITY. THERE MAY BE OTHER LIBRARY GOVERNMENT AGENCY OUTREACH OPPORTUNITIES OUT THERE. CERTAINLY JUST BEING SURE THAT YOU ARE INVOLVED IN THINGS THAT ARE HAPPENING IN YOUR OWN COMMUNITY. IF THE DEPARTMENT OF HEALTH IN YOUR OWN COMMUNITY IS SPONSORING A NEW INITIATIVE, THE ROLE OF INFORMATION TO SUPPORT THAT INITIATIVE IS KEY AND YOU ARE THE BEST PEOPLE TO PUSH THAT POINT. SO I WOULD ENCOURAGE YOU TO JUST KEEP TRACK OF WHAT'S GOING ON THERE. HEALTH ON THE WEB. NEXT SLIDE. JUST A COUPLE OF EXAMPLES AND RESOURCES, NOAH WHICH IS NEW YORK ON-LINE ACCESS TO HEALTH. DO ANY OF YOU KNOW NOAH, OR HAVE USED IT? IT'S BEEN AROUND FOR A LONG TIME. IT REALLY NEEDS A FACE LIFT. AND THEY HAVE BEEN WORKING ON A FACE LIFT FOR A LONG TIME BUT THERE'S NOT MUCH MONEY BEHIND NOAH. MOST OF THE WORK IS DONE BY VOLUNTEERS. SO IT'S TAKING SOME TIME TO GET THAT DONE. THEY ACTUALLY HAVE ALL OF THE INFORMATION PUT INTO DATA BASE. EVENTUALLY IT WILL BE A DATA BASE DRIVEN SITE RATHER THAN A STATIC LIST OF LINKS WHICH OCCASIONALLY ARE DEAD LINKS. NOAH WAS STARTED BY A PARTNERSHIP. IT ACTUALLY STARTED BEFORE THE DAYS OF CHOICES. IT WAS THE NEW YORK ACADEMY OF MEDICINE, CITY UNIVERSITY OF NEW YORK AND THE PUBLIC LIBRARIES THAT COLLABORATED. IT WAS REALLY ONE OF THE FIRST BROAD BASED CONSUMER HEALTH WEBSITES THAT'S OUT THERE. AND IT'S STILL A GOOD SITE. RIGHT NOW THE FACT THAT MOST OF THE INFORMATION IS AVAILABLE IN ENGLISH AND SPANISH IS WHAT'S REALLY THE DRAW AND THE NUMBER OF SPANISH HITS IS HUGE. SO THAT'S JUST MY LITTLE PLUG FOR NOAH THE NEXT IS MEDLINE PLUS AND I BET MANY OF YOU HAVE SEEN MED LINE PLUS. BUT MEDLINE PLUS IS EXPERIMENTING WITH SOMETHING CALLED "GO LOCAL". THIS IS GOING TO BE WORTH WATCHING. YOU KNOW MORE ABOUT THIS THAN I DO? AUDIENCE MEMBER: YEAH. SPEAKER: YOU WANT TO SAY ANYTHING ABOUT IT? RIGHT NOW IT'S IN NORTH CAROLINA ONLY. BUT IT'S LOOKING AT TAKING MED LINE PLUS AND LETTING STATES OR MAYBE CITIES -- AUDIENCE MEMBER: STATES -- YES, STATES AND/OR CITIES TO APPLY STATE AND LOCAL LEVEL INFORMATION ON THE NATIONAL WEBSITE SO PEOPLE CAN GET INFORMATION ON A STATE/LOCAL LEVEL USING MEDLINE PLUS. SPEAKER: SO EVENTUALLY IT WILL BE MEDLINE PLUS NORTH CAROLINA, RIGHT? A SECTION OF IT? AUDIENCE MEMBER: YES. NORTH CAROLINA IS PROBABLY THE FIRST AND THEN I THINK -- SPEAKER: LOOKS LIKE MISSOURI IS COMING UP NEXT AUDIENCE MEMBER: AND I THINK IOWA AND COMING UP SOON THERE'S DIFFERENT TRAINING FOR FOLKS WHO ARE INTERESTED IN MOUNTING "GO LOCAL" IN THEIR STATES. IT'S ONE OF THOSE POST MLA ACTIVITIES COMING UP LATER THIS MONTH. SO, FOLKS SHOULD BE HEARING ABOUT THAT IN NEW ENGLAND. SPEAKER: GO AHEAD AND INTRODUCE YOURSELF TO THE GROUP SO THAT THEY WILL KNOW IF THEY WANT TO KNOW MORE ABOUT THIS -- AUDIENCE MEMBER: MY NAME IS HAVIER CRESPO, ASSOCIATE DIRECTOR FOR THE NATIONAL NETWORK OF LIBRARIES OF MEDICINE AND WE ARE BASICALLY A CONTRACT OFFICE THAT DOES TRAINING AND PROMOTION OF NATIONAL LIBRARY OF MEDICINE RESOURCES HERE IN THE NEW ENGLAND REGION. WE ARE BASED OUT OF THE UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL. AND WE HAVE COORDINATORS ON STAFF WHO DO TRAINING OF OUR RESOURCES AT DIFFERENT VENUES. AND WE CATER TO LIBRARIANS, HEALTH PROFESSIONALS AND MAKE OURSELVES AVAILABLE FOR PROGRAMS TO THE PUBLIC AS WELL SPEAKER: AND IF YOU WILL GO BACK TO THE POWERPOINT. I ACTUALLY HAVE A LINK TO YOUR -- JUST CLICK TO THIS ONE THIS IS THE LINK TO NNLM AUDIENCE MEMBER: THAT'S US SPEAKER: THEY CAN HELP YOU IN SO MANY WAYS WITH THE OUTREACH AND THE COLLABORATION AND THE PARTNERSHIP AND THE CONSUMER HEALTH RESOURCES. SO I WAS SO GLAD TO MEET YOU HERE TO SAY A BIT ABOUT IT. SO KEEP AN EYE ON THAT MEDLINE PLUS "GO LOCAL" BECAUSE I THINK THAT CAN BE REALLY INTERESTING. AND THEN LET'S BACKTRACK TO NOAH NOW 24/7. THERE'S ACTUALLY NOT THAT MUCH YOU CAN SEE ON THIS SITE UNFORTUNATELY BECAUSE YOU NEED TO HAVE A LIBRARY CARD TO ACCESS THIS. BUT THIS IS THROUGH CLEV.NET. WHAT THEY HAVE DONE, WHICH I THINK IS FABULOUS. I DESPERATELY WANT THIS TO HAPPEN IN NEW YORK CITY. I JUST KEEP GETTING STUCK BUT WE WILL PURSUE IT. THIS IS THEIR 24/7 REFERENCE SERVICE. AND THEY HAVE A SECTION, THEY PARTNERED WITH -- I CAN'T REMEMBER IF IT'S A HOSPITAL OR A MEDICAL SCHOOL. I THINK IT'S A HOSPITAL. NOW WITH HEALTH AND MEDICAL INFORMATION FROM METRO HEALTH LINE. SO THAT PEOPLE CAN GO TO ASK HEALTH INFORMATION QUESTIONS 24/7 AND REALLY GET PROFESSIONAL HELP, PROFESSIONAL ANSWERS. I THINK THAT'S REALLY SOMETHING FOR US TO STRIVE FOR. THAT'S A GREAT PARTNERSHIP. THAT'S A GREAT PUBLIC LIBRARY ACADEMIC LIBRARY MEDICAL SCHOOL PARTNERSHIP. THE CLOSEST I HAVE GOTTEN SO FAR IS WE HAVE A LIBRARIAN IN OUR HEALTH INFORMATION CENTER WHO SAID "I WANT TO DO VIRTUAL REFERENCE. BUT -- I WANT TO DO VIRTUAL REFERENCE". SHE IS JUST DETERMINED SHE WILL DO VIRTUAL REFERENCE. SHE'S GOING TO MAKE THAT HER SPECIALTY BUT THERE'S ONLY ONE OF HER. WE NEED TO HAVE MORE BACK UP TO DO VIRTUAL HEALTH INFORMATION REFERENCE. AND THEN THE LAST LINK I HAVE ON THIS PARTICULAR HEALTH ON THE WEB SECTION, IT'S NOT THAT IT'S A BEAUTIFUL WEBSITE. PROBABLY MANY OF YOU KNOW ABOUT THIS. HEALTH OBSERVATIONS CALENDAR WHERE YOU CAN GET, IT'S KIND OF LIKE THE DISEASE OF THE WEEK OR DISEASE OF THE MONTH INFORMATION. IT'S GREAT. IT'S A GREAT SOURCE TO -- AND PUBLIC LIBRARIANS OFTEN KNOW ABOUT THIS AND USE THIS TO DO BOOK DISPLAYS OR TO DO PROGRAMS. SHARE THIS INFORMATION WITH YOUR COLLEAGUES AT THE CBOS OR THE HEALTHCARE SETTINGS WHO MAY NOT KNOW ABOUT THIS BECAUSE I THINK IT COULD MAKE SOME REALLY INTERESTING PARTNERSHIPS. IT WILL BE A PRETTY COOL TOOL FOR PUBLIC LIBRARIANS TO SHARE WITH OTHER COLLEAGUES. A FEW WORDS ABOUT HEALTH WEBSITES IN GENERAL. I THINK THAT THE DAYS OF LIBRARIES CREATING HEALTH WEBSITES THAT ARE SIMPLY LINKS TO HEALTH LINKS ARE GONE. PEOPLE ARE MORE LIKELY TO JUST GO TO GOOGLE AND LOOK FOR THEIR INFORMATION THAN SAY OH, I WILL GO TO THE PUBLIC LIBRARY AND SEE IF THEY HAVE LINKS TO HEALTH LINKS. IF YOU ARE LOOKING TO DESIGN A WEBSITE, NO MATTER WHAT TYPE OF LIBRARY, I THINK IT IS IMPORTANT TO JUST KEEP IN MIND SOME OF THE BASICS YOU PROBABLY KNOW ABOUT HEALTH INFORMATION DESIGN, ABOUT WEBSITE DESIGN RATHER, WHICH IS THAT YOU HAVE TO HAVE SOME DYNAMIC CONTENT. YOU HAVE TO HAVE SOMETHING THAT CHANGES ON A REGULAR BASIS. SOMETHING THAT KEEPS PEOPLE COMING BACK FOR MORE. THEN YOUR LIST OF LINKS CAN BE A SIDEBAR OR A COMPONENT OF THE WEBSITE. ONE OF THE THINGS WE HAD ON OUR CHOICES WEBSITE EARLY, FAILED. I'M SO DISAPPOINTED. IT'S IMPORTANT TO TALK ABOUT FAILURES TOO. WE HAD A COMMUNITY HEALTH CALENDAR WHERE WE THOUGHT AH, THIS WILL BE GREAT. PEOPLE WILL WANT TO KNOW ABOUT WHERE THERE ARE BLOOD PRESSURE SCREENINGS OR WHERE THERE'S A DOCTOR TALKING ABOUT FIBROMYALGIA OR WHERE THERE'S A HEALTH FAIR IN THE BRONX. THEY WILL HAVE ONE PLACE TO GO. AND THE IDEA WAS THAT ALL THESE ORGANIZATIONS COULD GO IN AND CLICK ON TO ADD AN EVENT AND PUT IN THEIR EVENT. WE WOULD HAVE THIS ROBUST CALENDAR THAT WOULD BE THE BE ALL AND END ALL HEALTH INFORMATION CALENDAR AND IT WAS OKAY FOR ABOUT A MONTH OR TWO. THEN IT ENDED UP TO BE A TON OF WORK FOR US TO GET THESE ORGANIZATIONS TO EVEN REMEMBER TO ENTER THEIR EVENTS. WE WERE ENTERING THEM FOR THEM. SCOURING THE PAPERS AND WEBSITES. IT GOT TO BE MORE THAN WE COULD KEEP UP WITH. I THINK OTHER COMMUNITIES COULD PROBABLY MAKE IT HAPPEN. MAYBE NEW YORK IS TOO BIG FOR IT. I THROW IT OUT THERE IN CASE IT'S SOMETHING YOU WANT TO CONSIDER. IT'S A NICE ELEMENT OF A CONSUMER HEALTH WEBSITE AND NOT, HARD TO CREATE, WITH THE TECHNOLOGY AVAILABLE THESE DAYS NOT AT ALL HARD TO CREATE. AND THEN LASTLY, LET'S TALK FOR A MINUTE ABOUT EVALUATING OUR SUCCESS AND THIS IS ANOTHER PLACE THAT I THINK IS SO IMPORTANT FOR COLLABORATION, BECAUSE PUBLIC LIBRARIES ARE REALLY GOOD AT MEASURING OUR OUTPUTS. HOW MANY PEOPLE CAME. HOW MANY BOOKS WENT OUT. HOW MANY PEOPLE ATTENDED THIS PROGRAM. WHAT TYPES OF BOOKS WENT OUT MOST OFTEN. BUT OUTCOMES ARE SOMETHING WE REALLY STRUGGLE WITH MEASURING IN THE PUBLIC LIBRARY. HOW DO WE HELP PEOPLE BE HEALTHIER. HOW DO WE HELP PEOPLE ADDRESS THEIR HEALTH CONCERNS. DID THE RATE OF TEEN PREGNANCY IN THE NEIGHBORHOOD GO DOWN BECAUSE OF THIS PROGRAM WE OFFER AND THESE MATERIALS WE OFFER. BECAUSE OF THE ANONYMITY FACTOR IN PUBLIC LIBRARIES WE DON'T ASK WHO PEOPLE ARE AND WE ARE VERY PROUD OF THAT AND OFTEN UNWILLING TO GET BEYOND THAT. ALTHOUGH WE MIGHT HAVE TO, AS MORE AND MORE GRANTS REALLY REQUIRE OUTCOMES MEASUREMENT. BUT IF WE ARE PARTNERING WITH HEALTHCARE ORGANIZATIONS THAT ARE USED TO ASKING FOR THAT INFORMATION OR USED TO MEASURING OUTCOMES, IT COULD BE REALLY NICE, WE COULD REALLY GET SOME GOOD RICH EVALUATION DATA. SOME OF THE OUTCOMES -- SOME OF THE EVALUATION TOOLS WE HAVE USED FOR OUR CHOICES PROGRAM, - WE DEFINITELY DID STAFF FOCUS GROUPS TO START WITH, BECAUSE WE WANTED TO GET A HANDLE ON WHAT WAS MAKING OUR STAFF COMFORTABLE OR UNCOMFORTABLE ABOUT HEALTH INFORMATION SERVICE. HOW COULD WE BETTER SUPPORT AND APPRECIATE THE WORK THEY ARE DOING. SO WE USED FOCUS GROUPS. WE USED A VARIETY OF CUSTOMER SATISFACTION QUESTIONNAIRES. BUT OF COURSE, IN LIBRARIES THOSE ARE SOMEWHAT LIMITED BY THE FACT THAT THE PUBLIC ALMOST ALWAYS THINKS EVERYTHING WE DO IS EXCELLENT AND IT'S HARD TO GET REALLY GOOD CRITICAL DATA OUT OF OUR PATRONS. WE ALSO HAVE DONE SOME WORK WITH TRYING TO GAUGE HOW OFTEN WE WERE MAKING REFERRALS. AND WHETHER OUR PATRONS WERE ACTUALLY FOLLOWING UP WHEN WE HAD TO REFER THEM SOMEWHERE ELSE. WE ACTUALLY TRIED TO USE A FORM AND TO WRITE DOWN PRECISE INFORMATION WHEN WE WERE MAKING REFERRALS. WHAT WE WERE REFERRING FOR. IF IT WAS A GOOD REFERRAL TO BEGIN WITH. BUT THEN ASK THE PATRON TO PRESENT THE FORM -- CARBON COPY OF THE FORM -- AT THE OTHER END SO WE COULD SEE WHAT KIND OF FOLLOW-UP WAS REALLY HAPPENING. SOME LIBRARIANS WOULD REMEMBER TO DO IT. . SOME DIDN'T. SO IT WAS KIND OF MODERATELY EFFECTIVE SO EVALUATION IS CHALLENGING AND I THINK WE OPEN UP BETTER AVENUES FOR EVALUATING OUR OVER-ALL SUCCESS IF WE CAN COLLABORATE WITH OTHER ORGANIZATIONS. I JUST GIVE THAT AS A PLUG THIS IS KIND OF AN INTERESTING WEBSITE. UNIVERSITY OF MICHIGAN HAS PUT TOGETHER JUST FOR UNDERSTANDING EVALUATION IN LIBRARIES. IT'S A TOPIC I'M REALLY INTERESTED IN AND I THOUGHT THIS SITE WAS PRETTY GOOD SO I WANTED TO SHARE IT WITH YOU IN CONCLUSION, I JUST WANT TO MAKE A COUPLE REMARKS ABOUT GETTING STARTED. FIND ONE OR TWO TOPICS. ONE OR TWO HEALTH TOPICS, MAJOR HEALTH CONCERNS IN YOUR NEIGHBORHOODS, IN YOUR COMMUNITIES THAT ARE INTERESTING AND RELEVANT. TACKLE THOSE. START WITH THOSE. DON'T FEEL YOU HAVE TO DO IT ALL AT ONCE. SIMILARLY, FIND ONE OR TWO ORGANIZATIONS TO COLLABORATE WITH. BE AT THE TABLE. SHOWING UP IS THREE QUARTERS OF THE BATTLE. BE PART OF THE COMMUNITY. BE CONCERNED. NOT JUST WITH LIBRARY ISSUES BUT WITH THE OVER-ALL HEALTH AND WELL-BEING OF YOUR COMMUNITY. I THINK THAT IS REALLY IMPORTANT. AND I WOULD ALSO ADD THEN TO FIND STAFF WHO ARE REALLY TURNED ON BY CONSUMER HEALTH INFORMATION. DON'T THINK IT'S GOT TO BE LIMITED TO YOUR TOP MANAGERS. I THINK THAT FINDING STAFF AT ALL LEVELS WHO REALLY ARE INTO THIS, AND THEY'RE OUT THERE. I'M CONVINCED THEY ARE OUT THERE IN EVERY LIBRARY SETTING AND LET THEM LEAD THE WAY FOR YOUR CONSUMER HEALTH SERVICE. LET IT FOSTER AT ALL LEVELS OF THE ORGANIZATION. AND I THINK THAT WILL CARRY YOU FAR. NOW I WOULD BE GLAD TO ANSWER QUESTIONS. WE HAVE ABOUT TEN MORE MINUTES IF ANYBODY HAS ANY PARTICULAR QUESTIONS FOR ME. YES? AUDIENCE MEMBER: I HAVE A QUESTION AS FAR AS THE INTERVIEW ENVIRONMENT. CONFIDENTIALITY ISSUES. IF SOMEONE HAS A HEALTH QUESTION DO YOU TRY TO ASCERTAIN RIGHT AWAY IF IT'S FOR A TERM PAPER OR SCIENCE FAIR PROJECT VERSUS A PERSONAL HEALTH DECISION AIDE OR DOES THAT MATTER AND WOULD YOU DIRECT THEM TO THE SAME RESOURCES OR DIFFERENT ONES? SPEAKER: WE ASK OUR STAFF TO ASSUME THE QUESTION IS PERSONAL AND OF UTMOST IMPORTANCE TO THE PATRON UNTIL YOU HAVE INFORMATION OTHERWISE. IF A YOUNG PERSON COMES TO THE DESK AND ASKS FOR INFORMATION ABOUT DIABETES DON'T ASSUME THAT IT'S FOR A TERM PAPER. SO TO USE THE REFERENCE INTERVIEW, TRY TO FIND OUT HOW MUCH INFORMATION THE PATRON NEEDS, FOR WHAT PURPOSE THEY PLAN TO USE IT FOR, AND USE OUR GOOD REFERENCE INTERVIEWING SKILLS TO DO THAT. THE ANSWER TO THAT MAY DEPEND ON HOW WE DIRECT THEIR INFORMATION. BUT TO NOT ASSUME ANYTHING FROM THE BEGINNING. AND I THINK THAT THAT'S REALLY IMPORTANT. AUDIENCE MEMBER: HOW PRIVATE IS IT, JUST AT THE REGULAR REFERENCE DESK? SPEAKER: IT'S SO HARD. IT USUALLY IS JUST AT THE INFORMATION DESK. ALTHOUGH, WE DO OUR BEST TO GET COMFORTABLE MOVING AWAY FROM THE DESK, WALK TO THE STACKS, WALK TO A CORNER. ESPECIALLY ONCE YOU HEAR IT'S A PERSONAL HEALTH QUESTION. BUT YOU KNOW, IN SOME OF OUR LOCATIONS THAT'S MUCH EASIER THAN IN OTHER LOCATIONS. THAT'S A TOUGH ONE IN THE PUBLIC LIBRARY SETTING I THINK. OTHER QUESTIONS? AUDIENCE MEMBER: YOU TALKED A LITTLE BIT ABOUT VETTING SOURCES LIKE WEBSITES ESPECIALLY. AND I UNDERSTAND THE NEED FOR THAT YOU DON'T WANT TO GO TO LIKE JOE'S BACK ALLEY SURGERY.COM. BUT WHO DOES -- WHEN YOU TALK ABOUT VETTED SITES OR VETTED BOOKS EVEN, ARE YOU DEPENDING ON REVIEWS, IS THAT AN INTERNAL THING? SPEAKER: IT'S TYPICALLY AN INTERNAL THING. I HAVEN'T SEEN ANY GREAT SOURCES FOR GENERAL REVIEWS OF CONSUMER HEALTH SITES. BUT WE HAVE CRITERIA THAT WE USE, WHICH IS -- SOME OF IT IS PUBLISHED OUT THERE. I THINK NOAH HAS A PIECE ON HOW TO EVALUATE CONSUMER HEALTH SITES AND WE USE SIMILAR THINGS THAT WE MIGHT USE FOR EVALUATING PRINT MATERIALS. BUT WE WILL LOOK AT THE AUTHORITY, WE WILL LOOK AT THE DATE. HOW OFTEN IS THE SITE UPDATED. TRY TO REVIEW SOME OF THE SECTIONS, SEE IF THE WRITING IS CLEAR, COMING FROM A RELIABLE SOURCE AND USE THAT. BUT YOU KNOW, MORE AND MORE WITH OUR CHOICES SITE ESPECIALLY, WE ARE NOT LINKING TO HUNDREDS OF WEBSITES. WE ARE LINKING TO SOME OF THE BIG ONES THAT GET PEOPLE TO RELIABLE SITES. MEDLINE PLUS, NOAH AND SOME OF THE OTHER BIG GUYS AND NOT FEELING -- WE SHOULDN'T REPEAT WHAT NOAH ALREADY DOES WHICH IS LINK TO SITES ON DIFFERENT TOPICS THAT THE NOAH VOLUNTEERS SCREEN VERY CAREFULLY. ANYTHING ELSE? AUDIENCE MEMBER: AS SOMEBODY WORKING IN THE PUBLIC LIBRARIES IS VERY SENSITIVE TO YOUR POINT ABOUT NOT ASSUMING THAT THE ACADEMICS -- I THINK THAT IS A VERY VALID POINT. HOW WOULD YOU -- WHAT WOULD BE YOUR RECOMMENDATION FOR COURSES OR FOR TRAINING FOR -- OF LIBRARIANS. WHAT DO YOU SEE FROM YOUR WORK WHAT COURSES WOULD BE HELPFUL? SPEAKER: WELL -- AUDIENCE MEMBER: WHAT WOULD BE HELPFUL TO BEGIN WITH SPEAKER: YEAH. THE BASIC COURSE WE OFFER TO ALL OUR STAFF WAS CONSUMER HEALTH IN THE PUBLIC LIBRARY SETTING. WE HAD SOMEBODY COME IN TO TEACH THAT FROM A MEDICAL LIBRARY AND THEN WE SAW THAT SHE WASN'T MEETING SOME OF OUR NEEDS. SO I ACTUALLY WROTE A CURRICULUM AND THAT WAS APPROVED BY MLA TO TEACH IT MYSELF AND TO GIVE CREDITS TO OUR STAFF BUT FINDING SOMEBODY TO TEACH THE BASICS AND MAYBE THEY MIGHT NOT NEED AN ACADEMIC OR MEDICAL LIBRARIAN TO DO THAT IS A GOOD STARTING POINT. BUT THEN SOME OF THE MORE ADVANCED THINGS LIKE THE HEALTH -- THE MEDICAL VOCABULARY FOR LIBRARIANS COURSE WAS VERY HELPFUL TO OUR STAFF. ADVANCED REFERENCE INTERVIEW CONCEPTS. SOME OF OUR STAFF REALLY WANTED TRAINING IN MEDLINE. SO WE DID OFFER MEDLINE SEARCHING TO STAFF WHO WANTED IT. AND THEN SOME OF THE COURSES THAT WERE BY TOPIC. AIDS INFORMATION OR CANCER INFORMATION. PUBLIC HEALTH INFORMATION. CLINICAL TRIALS. PEOPLE WERE QUITE INTERESTED IN CLINICAL TRIALS. AUDIENCE MEMBER: DO YOU SEE ANY USE AT ALL FOR MED LINE IN THE SENIOR HEALTH SETTING? DO YOU SEE ANY ROLE OR RELEVANCY OF THAT IN THE STREET, WIDER CONSUMER HEALTH SETTING SPEAKER: I THINK SO. ALTHOUGH IT WILL BE LIMITED BECAUSE IT'S BEYOND THE ABILITIES OF MANY PEOPLE TO SEARCH WELL AND TO FIND INFORMATION THEY CAN USE. ON THE OTHER HAND, THERE ARE SOME TOPICS FOR WHICH CONSUMER LEVEL INFORMATION IS JUST NOT AVAILABLE YET. AND SO YOU HAVE TO BE ABLE TO OFFER A STAFF MEMBER TO HELP A PATRON SEARCH MED LINE - TO SEARCH PUBMED SUCCESSFULLY AND CAREFULLY. BECAUSE YOU CAN DO A PRETTY BAD SEARCH ON PUBMED AND THINK YOU HAVE DONE A GREAT SEARCH. SO YOU REALLY HAVE TO HAVE A STAFF MEMBER THAT'S COMFORTABLE WITH IT. I THINK IT CAN BE A USEFUL NEXT STEP SO AT LEAST IN SOME OF THE LIBRARIES YOU CAN OFFER THE PUBLIC HEALTH NET SERVICE. ESPECIALLY IF THEY NEED -- THERE ARE SOME PATRONS I THINK WHO ALSO FEEL THEY NEED TO GET THEIR HANDS ON EVERYTHING ABOUT A SUBJECT, EVEN IF IT'S IN THE MEDICAL LITERATURE AND IT MIGHT BE BEYOND THEIR SCOPE. AND I THINK I WOULD BE ONE OF THOSE PATRONS, YOU KNOW. IF A FAMILY MEMBER WAS DIAGNOSED WITH SOMETHING, I WOULD WANT EVERYTHING. AUDIENCE MEMBER: THAT'S WHAT I'M THINKING SPEAKER: THEN I CAN DECIDE WHAT I CAN HANDLE AND WHAT I CAN'T. BUT I WOULD WANT IT ALL. I WOULD REALLY WANT TO KNOW THAT I HAD DONE A FULL LITERATURE SEARCH. SO I THINK IN THAT REGARD IT CAN BE HELPFUL IN A PUBLIC LIBRARY SETTING AUDIENCE MEMBER: NOT ONLY DO THEY WANT IT ALL THEY ALSO WANT THE CONFIDENCE THAT WHAT YOU ARE SEARCHING IS REALLY AUTHORITATIVE AND THEY ARE GETTING STRAIGHT INFORMATION. WHEN YOU SAY A FAMILY MEMBER IS DIAGNOSED WITH SOMETHING VERY SERIOUS, YOU WOULD HAVE A NUMBER OF OPTIONS TO PURSUE SPEAKER: RIGHT. AUDIENCE MEMBER: YOU MENTIONED THE CHALLENGE OF GETTING A CORE COLLECTION OF PRINT RESOURCES INTO THE BRANCHES. I WONDER IF YOU COULD SAY A LITTLE BIT MORE ABOUT THAT, ABOUT WHAT WERE SOME OF THE MORE DIFFICULT RESOURCES TO JUSTIFY GETTING OUT THERE THAT YOU SUCCEEDED WITH AND WHY. SPEAKER: CORE COLLECTION ISSUE. WE DO ACTUALLY HAVE ON OUR CHOICES WEBSITE, I HAVE A CHOICES BROCHURE HERE, A LIST OF SOME OF THE PRINT RESOURCES, THE CORE PRINT RESOURCES. I DON'T THINK IT WAS AS CHALLENGE GETTING IT INTO THE LIBRARIES AS SOMETIMES IT IS GETTING IT OUT OF THE LIBRARIES WHEN IT'S OLD. THAT IS SUCH A PUBLIC LIBRARY ISSUE PARTICULARLY IN BAD BUDGET TIMES PEOPLE JUST DON'T WANT TO THROW STUFF AWAY. IN GENERAL, THE STAFF WELCOMED IT. THEY WELCOMED HAVING THE ABIM DIRECTORY AS OPPOSED TO JUST THE MEDICAL DIRECTORY FOR NEW YORK STATE. THEY WELCOMED HAVING THE RANGE OF EASY TO READ TO SCHOLARLY MATERIALS ON THEIR SHELVES. AND WE REALLY MADE IT A PRIORITY AND PUT THE MONEY TOWARD GETTING THOSE COLLECTIONS EVERY WHERE. IT WAS WELCOMED AT THE BRANCHES AND THERE ARE OTHER SOURCES TOO FOR CORE COLLECTIONS FOR PUBLIC LIBRARIES OR CORE HEALTH COLLECTIONS FOR SMALLER LIBRARIES. LOTS OF RESOURCES OUT THERE TO DETERMINE THOSE CORE COLLECTIONS. THAT WAS PRIMARILY FOR REFERENCE MATERIALS. THEN WE ALSO HAVE SPENT A SIGNIFICANT AMOUNT OF MONEY ON CIRCULATING HEALTH MATERIALS. NOT SO MUCH THAT WE HAVE A CORE COLLECTION THERE BECAUSE WE BUY A LOT OF HEALTH MATERIALS THAT WE THINK IS THE BEST, THE BEST STUFF THAT'S COMING OUT AND TRY TO BUY THAT FOR MOST BRANCHES. THAT'S WHERE GETTING RID OF IT IS ALWAYS THE CHALLENGE. PEOPLE WOULD RATHER -- I SHOULDN'T ADMIT THIS, OUR STAFF WOULD RATHER HAVE AN OLD ISSUE OF WHAT TO EXPECT WHEN YOU ARE EXPECTING ON THE SHELF THAN NO ISSUE. THAT'S A PROBLEM I THINK. YOU CAN THINK OF OTHER TITLES THAT ARE SIMILAR. WELL, THANK YOU VERY MUCH. (APPLAUSE) SPEAKER: THERE ARE HANDOUTS ON THE FRONT HERE IF YOU WOULD LIKE TO TAKE ONE AND THEY WILL BE POSTED ON THE OLIS SITE PRESENTATION.