Medical Informatics Section, Medical Library Association Meeting Minutes in Dallas, YEAR

2008 Top Technology Trends for Medical Libraries
Panel discussion at the Medical Library Association Annual Meeting, Chicago

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I. Eric's Top Tech Trends

Web Gadgets:

Web gadgets are small applications objects that can offer cool and dynamic content and can be placed on any page on the web. Gadgets can personalize and enhance the web experience when you're at work (to-do list, calendar) or just passing time (news, games). More importantly, perhaps, is that gadgets can be used by libraries to expose web content so it can be discovered where ever on the network a customer may be working.

QR Codes:

Most people are familiar with the bar code, from its use on library books to the checkout line at the grocery. The standard barcode is very limited in the about of data it contains, essential a single line of text. The next generation of bar code is known as the QR (quick response) code. While conventional bar codes can store about 20 digits of information, a single QR code is capable of handling 7,089 characters including numeric and alphabetic characters, symbols, and binary data.

II. Sadie's Top Tech Trends

Gluing social networks together:

If you have played around with any of the social networking platforms (Facebook, Myspace, LinkedIn, Plaxo, etc.) you may have noticed that it is a pain to enter and maintain information about you and your relationships on multiple sites. You may have also noticed that you want to share some of the things that you do online with your friends, other things with your colleagues, and still other items with your family members.

OpenID, OpenAuth, and the Social Graph API - will allow identity and authorization information to be shared between trusted sites. Use one account to access all of your social networks. As you join a new one, allow it to see parts of your data on one where you have already defined your relationships. As you update your relationships on one social network, have it reflected on the others where you participate. Furthermore, we are moving to a place where you can share some of your information with some people and other information with other people.

http://openid.net/
http://code.google.com/apis/socialgraph/
http://socialgraph-resources.googlecode.com/svn/trunk/samples/findcontacts.html
[enter bradfitz.com and click Find Connections]

In my opinion, this will make participation in this arena easier and more attractive for Libraries. I have heard some agonizing amongst librarians about whether we should be participating in Facebook or not. "Isn't it like the Librarian showing up at a fraternity party offering to do some quick PubMed searches?" But what if we could hook into an existing ID/authorization platform where people are choosing to share appropriate information with us? What if our Web site could recognize that the person looking at a page is a 2nd year nursing Phd student in the pediatrics department who is friends with someone who just signed up for a PubMed class? Couldn't the site better recommend resources for him or her?

Another trend that is going to make it easier for Libraries to participate in the social networking platforms arena is Open Social. Open Social is an API that allows a developer to build an application that works on multiple platforms, including MySpace, LinkedIn, Friendster, and others (but not Facebook). At least you only have to build the application twice!
http://code.google.com/apis/opensocial/

III. Bart's Top Tech Trends

Learning Management Software

The landscape of Learning Management Software (LMS) has become muddled over the past few years. For example, in 2005 Blackboard purchased WebCT, its then main competitor, and is currently phasing the division out. Don’t assume Blackboard has a lock on the LMS market. Last year Blackboard lost 7% of its market share to competitors. Who is the upstart? That remains to be seen. There appears to be a battle raging between open source vs fee-based software in the LMS market. The increasingly popular open source project moodle saw its market share increase from 4% to 10% last year, while the higher education driven Sakai project gained traction at colleges and universities. Fee-based software vendors ANGEL and D2L also gained market share.

If there is a real trend in the LMS market, it appears that universities are anxious for better solutions and they are willing to invest time, money, and resources. Consider the EDUCAUSE survey, Software Trends in Higher Education 2002 – 2004, where 13% of institutions surveyed had considered changing their LMS in the next 3 years. More recently results from the 2007 Distance Education Survey conducted by the Instructional Technology Council of Community Colleges found 31% of respondents reported were considering changing their LMS. While each survey queried different user populations, the increase is striking when taking into account the changes in market share over the past year.

Moodle
http://moodle.org/

Angel
http://www.angellearning.com

Desire2Learn
http://www.desire2learn.com/

Blackboard/Web CT
http://www.blackboard.com

Sakai
http://sakaiproject.org/

Sakai Map
http://sakaiproject.org/index.php?option=com_wrapper&Itemid=588

VI. Michelle's Top Trends

Hospital2.0

Diverse organizations are getting into PHRs (Personal Health Records) or PCHRS (personally controlled health records), there are some 200 products out there that call themselves PHRs. Non health businesses as well as traditional healthcare companies see it as a business opportunity, making for some interesting bed fellows. Cleveland Clinic reports to have more than 100,000 patients with personal health records. Cleveland Clinic partnered with Google in a pilot project to link the health information for 10,000 of its patients with Google's personal health records. Mayo Clinic and New York Presbyterian Hospital partnered with Microsoft's HealthVault. IBM partners with WebMD, 80% of IBM's eligivle employees are using WebMD's PHR to store their health information. Many US employers to actively involve their employees in health benefit, provider and treatment decisions.

Still huge questions on data security, data ownership, etc. Many PHR companies plan on using ad revenue as support and creating questions about security of personal health information and what ads patients see. Implentation and standardization may take quite a while since most doctors office records are paper and not online and the number of PHR products seems to be growing. You could for a while have a situation where one's employer encourages use of one product while the hospital encourages another.

What are the information resource implications? What sorts of health information can patients find or link to from with in the record? Still somewhat unclear and depends on the PHR model.

Microsoft is investigating supporting its system with advertising revenue from their health information search engine.
Consumers put their health information into WebMD's PHR and can use the health assessment tools such as WebMD Health Search which not only delivers relevant search results, Symptom Checker which allows patients to pinpoint potential conditions associated with their physical symptoms.
Google is very secretive as to what their product will have but it appears they will be doing similar things. One report stated it will be a sort of "health guide" with suggested treatments and drug interaction warnings, pages with health-related reminders and health provider directories.

It is a new area with limited users. Very few people in the United States actually have online PHRs, various sources say that it is between 2%-11% of the population. So what does this mean for librarians? The Medical Library Association (MLA) and the National Library of Medicine (NLM) are jointly charging an Electronic Personal Health Record Task Force with reviewing the current state-of-the-art of PHRs with a main focus on examining how linkages to high quality health information and medical librarians can be provided from within these records. It definitely presents a new way way for people to have access to information and opens opportunity for search engines to "auto search" and automatically provide consumer health information based off of information within the records.

Google Jockey Links:

MyPHR Tour
http://www.myphr.com/resources/tour.asp

Video on PHRs from AHRQ
http://www.ahrq.gov/consumer/phrvid.htm

Cleveland Clinic and Google PHR
http://cms.clevelandclinic.org/body.cfm?id=487

Microsoft's HealthVault with screen shots
http://www.microsoft.com/presspass/events/healthvault/coverage.mspx

WebMD's PHR
http://www.webmd.com/phr

MLA/NLM Joint Electronic Personal Health Record Task Force
http://www.mlanet.org/members/directory/taskforces/ephr.html

V. Gabe's Top Tech Trends

iPhones and Other Mobile Devices

We are increasingly a mobile society and there is a great emphasis on being "connected" at all times.

Last June (on June 29th to be exact), Apple released the iPhone. While I don't want this to be a Mac vs. PC talk, Apple's device has spawned a revolution as one of the first (and most innovative to-date) Mobile Internet Devices (MIDs). Yes, I know... another acronym.

There are other devices in the pipeline such as:
Nuviphone
Nokia Tube Phone
Google phone with Android OS
Instinct
LG Secret

Why is this a revolution?

Let's start with the iPhone features:

8GB or 16GB flash drive
Mac OS X
Syncs with both Win and Mac
2MP Camera
3.5” touch screen
“Real” Web browsing
“Innovative interface”

The last two bullets are the most important. "Real" Web browsing is what makes this device a MID. We are no longer bound to PDA programs downloaded and installed to our personal devices. We can access real websites.
The "innovative interface" refers to the multi-touch interface with proximity detection. These capabilities are already being copied by other devices. While there still are some limitations with these features, these capabilities add an arsenal of tools at our patron's fingertips.

What does this mean to us?

Whether we are on board with the idea of MIDs or not, they will continue to come. From what we can tell at this point it will not require us to retool any content like PDAs required but having familiarity with the devices and the limitations would be helpful.

VI. Wallace's Top Tech Trends

Two fairly recent phenomena have challenged library service – 1) the need to integrate mobile devices into library services as described by Gabe, and 2) health science students moving about campus and library in groups of 4 to 6 students. These 4-headed-people-pods are a result of the changing health science curriculum evolving from lecture and response to problem-based learning. Now it’s – “Here's the patients problems, you guys go out and work as a group to learn the systems and therapies involved and come back to discuss your diagnosis and treatment.” The principal behind the new curriculum design is the expectation that students are to come to class knowing the subject matter and are prepared to apply the information. Class time is spent wrestling with alternatives and decision-making rather than rote learning. The forming of people pods is also mirrored by granting agencies favoring interdisciplinary groups working together on increasingly complex interventions. This “faces-to-faces” phenomenon is also reinforced in the creation of institutes, centers, the ever-present-every-where-we-turn committee, faculty shared governance, etc.

At U of F we are just beginning to conceptualize a “collaboration commons” that supports group work through enhanced technologies. We will begin with baby steps using existing single and multiple plasma screens, multiple keyboards, whiteboards on rollers, scanners, plotters, large concave desk surfaces. This will require that we pull our fanciest technologies out from behind locked doors to a highly visible, public area in the main lobby. The location is unabashedly chosen to create a “things are happening here" energy. The success of the center will be dependent on our ability to introduce multi-touch, interactive surfaces that are natural and intuitive – technologies that encourage rather than impede interaction. Bill Gates noted at the 2008 Consumer Electronics Show that “display technology is not just improving in quality, but also in the way that we interact with large surfaces” moving from single mouse, single keyboard, single display. The ultimate goal will be technology that allows and records multiple touches and even gestures – yes, Minority Report but without Tom Cruise. Existing technology that allows multiple users include Mimio and eBeam styli. Interactive tabletops like DiamondTouch encourages brainstorming. Chairs are wired so that the software can distinguish who is touching the table. The SmartSkin project can determine hand positions thus distinguishing among users. Microsoft Surface table available late 2008 – tracks up to 40 simultaneous touches. See Stanford’s iRoom. The now standard 8 X 10 foot, 12.5 million pixel, Vizwalls installed on 11 campuses in North Carolina use rear projection which encourages groups of users to stand flush to the screen to not only see but to make new discoveries. We are working with Panasonic trying to get them to loan/give us a Life Screen for experimentation.

Our motivation to address the above work issues with technology increases as we see a growing number of groups huddled around a single computer monitor, straining to see and straining to participate.

Links:

Michael Haller, “Interactive Displays and Next-generation Interfaces” in Becta Research Report. Emerging Technologies for Learning. v. 3, March 2008, pp. 91-101.
http://partners.becta.org.uk/upload-dir/downloads/page_documents/research/emerging_technologies08_chapter6.pdf

Minority Report Becomes Reality.
http://www.youtube.com/watch?v=PLhMVNdplJc

Warcraft Panel.
http://www.youtube.com/watch?v=5O1bTNbbWk4

Vizwall.
http://www.cyviz.com/vizwall.html

LifeScreen.
http://www.time.com/time/specials/2007/style_design/article/0,28804,1727737_1727684_1727601,00.html

Stanford iRoom.
http://iwork.stanford.edu/pubs/iRoom-general-video-abstract.pdf

2008 Top Technology Trends for Medical Libraries Panel discussion at the Medical Library Association Annual Meeting, Chicago