Introduction to trends in health libraries

Health librarians working towards a healthier Canada

In 2004, Tommy Douglas, father of Canadian health care, voted

The Greatest Canadian

See http://www.youtube.com/watch?v=lf1YAznsnVA

•Assignment #2 discussion

•Our (your) philosophy of service

•Our role(s) • To find answers to questions• Authoritative sources & evaluation (of same)• The reference interview (the means)

•System creates information needs (context = user groups)

Talking points for class

Trends in health libraries / in medicine

•For assignment #2, what trend did you identify?

•Share your trend with your neighbour

•Was it difficult to find trends?

•Most important take-away from this assignment?

Empty shelves?Is this our future?

Positive, evolving, value of librarians

• Supporting clinical care: grants, trials & systematic reviews

• Health libraries provide access to print & electronic resources

• Virtually any book or journal is a source of information

• Provide timely & effective reference

• Formats: dictionaries, directories, handbooks, encyclopedias/textbooks, journals

• Concerns: end users not fluent with information• cannot do proper lit reviews • accept what they find in search engines• Health librarians must teach information skills

• One reason why health librarians are vital to evidence-based care

What makes a good reference philosophy?

Philosophy of service

•Think about your ideas around library service for a few minutes

•What kind of librarian or information professional do you want to be (aspire to be)? What is your philosophy of service?

•Share your ideas with a neighbour after a few minutes

•Then, share your ideas with class

Health on the Net (HON) Code

Reference question:

•A patient asks: can you recommend a good website for information about anemia?

•Break question down• Definition (is one needed)?

• What branch of medicine is this?

• What format is needed?

• What reading level?

• Where will you find answers to these questions?

The right information has context

“…Any health system – even the best in the world – is only one ingredient to determine whether your life will be long or short, healthy or sick, full of

fulfillment … or empty with despair…”

The Honourable Roy Romanow, 2004holding documents of

the Romanow Commission

Philosophical orientation in Cdn healthcare

• What is universal health care?Five principles1.Universality: entire population covered2.Comprehensive: medically-necessary services3.Accessible: in practice “no user fees” (added in 1984)4.Portable: from province to province5.Public administration: operated by public agency

• Where do health librarians fit in?

• What’s the prognosis?

Some important health statistics

OECD Health Data 2012 (based on 2010 statistics)

Canada USA Germany

Health dollars as % of GDP 11% 17% 11%

% of public monies spent 70.7% 44.5% 76.9%

Expenses per capita $3678 USD $6714 USD $3371 USD

Practicing MDs 2.1/1000 2.4/1000 3.5/1000

Practicing RNs 8.1/1000 10.5/1000 9.8/1000

MRI Units/million 6.2 26.5 7.7

Life expectancy 80.7 yrs average

78.2 yrs average 80.3 yrs average

Health trends: spending

2010: spending forecasted at $192 billion

Health expenditures 1975-2010

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

55.0

60.0

1975 1980 1985 1990 1995 2000 2005 2010

Year

$' B

illi

on

Hospitals

Physicians

Drugs

Source: National Health Expenditure Trends 1975 to 2010, CIHI

Health system issues

• Health professionals, chronic shortages• Hospitals & health care facilities (with beds)• Community (ambulatory care) vs. acute care• Public health, disease control, SARS, HIV, etc.• Funders (mainly government, charities, foundations)• Planning & coordinating agencies• Industry e.g., pharmaceutical, medical devices• Patients need to engage more

Private vs. public medicine

• In for-profit models of care, patients pay for access to services• There’s no waiting, but it comes at a very high cost• Free markets innovate but they are profit-driven /profit-centred• Bureaucratic systems move slowly

• With universal care, there’s always rationing, triaging• Long waits are common, even in emergency• In emergencies, triaging works well• We wait for non-emergency ‘elective’ services

Medical specialists covered by Canada Health Act

Examples:

• Family practitioner• General practitioner (GP) • Gynecologist• Dermatologist • Orthopedist• Urologist• Pediatrician• Endocrinologist• Oncologist• Others?

What are their information needs?

How good is Canada’s health care system?

• In treating diseases & illnesses?• We perform fine but don’t monitor as much as we could

• Efficient in treating patients• Less so, given other health systems internationally

• Effective in promoting health & preventing disease?• Based on surveys & expenditures, we could be better

• Accountable to the public• We cab do more despite some excellent programs

• e.g., Health Council of Canada cut

• Health care is our most popular (most beloved) social program, central to our Canadian identity (much as hockey is)

Major user groups in medicine

• Association of Faculties of Medicine of Canada• Canadian Health Libraries Association• Canadian Public Health Association • Canadian Health Services Research Foundation• Canadian Nurses Association• Canadian Medical Association• Canadian Association of Occupational Therapists• Canadian Pharmacists Association• Canadian Physiotherapy Association• Canadian Library Association• Dieticians of Canada• Health Canada, Federal Minister of Health • Library and Archives Canada• Public Health Agency of Canada

McGowan J. Canada urgently needs a national network of libraries to access evidence. Healthcare Quarterly. 2006. 9(1): 72-74 .

Key trends• Information technologies key to evidence-based practice

• Spiraling costs, new models of care– Public-private partnerships– Other (shift to community care)

• Culturally-appropriate care for our multicultural communities– Xenophobia– Inequities, esp. rural-urban divide, First Nations, Inuit

• Aging boomers, long-term care

• Privatization? insurance, hospital management, provision of services

• Closing of health libraries due to the Internet

• eHealth & telehealth trends

Browne R, Lasserre K, McTaggart J, Bayley L, McKibbon A, Clark M, Perry GJ, Murphy J. International trends in health science librarianship: part 1 - the English speaking world. Health Info Libr J. 2012 Mar;29(1):75-80.

Article discussion