Category: Uncategorized

Supporting Researchers through Library Data Services

As the director of the Samuel J. Wood and C.V. Starr Biomedical Information Center, Terrie Wheeler believes that one important role for a medial library is to lessen the administrative burden on researchers so they can “move the science forward,” as she puts it. NEJM LibraryHub spoke to her recently about some of the ways her library does this.

Q: Tell us about the Weill Cornell Medicine Data Core, which the library helped develop and now administers.

A: Data Core is a secure computing and storage environment where our researchers and their collaborators can put patient data they want to analyze. Researchers are granted access to the data if they are permitted by the data use agreements, which the library manages, and are approved by our Institutional Review Board. Initially, the Data Core data sets were available only to the Department of Population Health Sciences, but now they’re available to the entire college. The Data Core is a Windows environment, in the cloud, which is accessed from a custom app. Inside the Data Core, we install all the statistical analysis tools researchers may need — RStudio, SAS, Stata, GraphPad, etc. The data cannot be exported from the Core without HITRUST-certified librarians reviewing it to make sure it is de-identified.

Other schools have data cores; however, I don’t know of any other school where the library administers it. We try to put ourselves in the shoes of researchers. Their deadlines are short and they need their data fast, so we need to be responsive.

We also are seeking approval to host New York state Medicaid data in our Data Core. This required filling out over 100 pages of security and systems questionnaires, and it took 14 months to complete! We have now submitted it to New York State and are awaiting approval. Once approved, the library will be able to submit additional requests on behalf of other researchers, with a much faster approval time. In a similar manner, the Data Core has successfully negotiated access to other valuable data, allowing researchers to focus on data analysis, instead of acquisition and paperwork. We like to think of our facilitation of access to these patient data sets as “interlibrary loans”.

The Data Core became an invaluable asset during the recent COVID-19 pandemic. Within days a COVID-19 research data repository was set up in the Data Core by researchers on the Research Informatics Team. As the Data Core team must ensure access and availability of computational resources, requests for access or support skyrocketed, increasing by 100 percent over our pre-COVID rate.

Q: Can you talk to us about the library’s grant writing service? How did this come about?

A: When I first interviewed for the director’s job, I was told by our research dean that the library should start a grant-writing service. When I got the job and started asking my staff about what was important to them and what types of skills they wanted to grow, I discovered that one of our staff members had been an editor in New Zealand and he was actually quite good at scientific writing. So he now heads up our editing service. Another grant editor works at our front desk and is also a professor at a community college.

The team, which has about four people doing editing part-time, does light to medium editing. We’ll help with grammar and structure. We’ll make sure the researcher is meeting all the NIH requirements. Maybe the scientist hasn’t put the punch at the top. Maybe he or she has gotten muddled in the details of the science and lost the bigger picture, so the editor will help re-fabricate that bigger picture. A couple of our librarians are excellent statisticians, so they can do a quick review of the statistics if needed. But we will not touch the science because that’s the scientist’s bailiwick.

And we’re making a difference in a big way. Since the grant editing service began about four years ago, we have helped bring in $41 million in grant funding. We usually target junior researchers with this service, for whom English may be their second language, although a recent success was a senior researcher who needed help with a multi-consortium resubmission. The NIH gives you two chances, so the second time around he worked closely with us and got the grant.

Q: Are there other ways that the library tries to reduce the administrative burden for researchers?

The library has developed, maintains, and oversees Weill Cornell’s installation of VIVO, an open-source researcher profiling system. VIVO has about 86,000 views a month and pulls information from multiple authoritative systems, ensuring that researchers have a rich and accurate web presence.

We also focus on providing high-quality bibliometrics to our users. With our publications reporting system, VIVO Dashboard, we take each article that a researcher has written and benchmark it against 200 other articles that are written in the same year in the same research area and are the same article type — research articles to research articles, review articles to review articles.

Administrators can access a dashboard that shows researchers’ citation impact — where it falls in the percentile ranking for its discipline. The dashboard also allows the school to see the return on investment in different research areas over time. We can track return on investment for individuals, divisions, departments, and the entire school. I write the promotion and tenure letters that go before the Board of Overseers, and we include the research impact information from VIVO Dashboard. Of course, it’s just one number, and you’re looking at it in context with other things.

In the next year, we will deploy ReCiter, a homegrown open-source publication management system, which uses machine learning and available identity data to allow administrators to easily maintain publication lists for thousands of scholars.

 

Q: This last question doesn’t fit into the category of reducing administrative burden, but we know it’s something you’re very proud of. Can you tell us about SMARTFest?

Terrie Wheeler (left) with Susan Haering and Mike Tavares of NEJM Group at SMARTFest 2020

 A: It began the year before I arrived at the library as a modest event — an opportunity for students, faculty, researchers, and others to meet with ITS [Information Technologies and Services] and library staff, view demos of services and learn about significant IT projects planned for the upcoming year. Now in its seventh year, SMARTFest has grown into a campus-wide event with library, IT and educational vendors targeting every kind of user, demonstrations, high-end food, and raffle prizes. A critical part of SMARTFest is keeping our users informed about library and IT services available to them. This year we had over 1,600 people attend; 25 vendors and we pulled in about $24,000. The library and ITS, which co-sponsors SMARTFest with us, had 27 booths, too. The event gets bigger every year. We have four different levels of sponsorship for vendors. The event takes place in the middle of February when it’s snowy and cold, so it’s our big mid-winter celebration.

SMARTFest’s biggest takeaway is that it empowers our library team and ITS — who bear the brunt of everybody’s complaining when IT equipment doesn’t work. SMARTFest is the one day a year when library and ITS expertise can shine. It’s just incredible to see everyone so proud of what they do. Last year, I had people attend from other universities to see how we do it. Even the vice provost of administration is a big fan. After it’s over, my staff and ITS toast each other and celebrate with champagne, stories, and a will to make this event even bigger and better the following year.

 

NEJM launching a monthly Perspective series

In honor of the 50th Anniversary of the National Academy of Medicine, NEJM is launching a new Perspective series: A Half-Century of Progress in Health: The National Academy of Medicine at 50. The series highlights the Academy’s enormous progress in health and biomedical science, with notable effects on patient safety, the AIDS crisis, and human genomics, among other fields.

Each article features an Academy member’s expert synopsis of a breakthrough field of medicine, including historic milestones and future expectations.

The first article, “Four Decades of HIV/AIDS — Much Accomplished, Much to Do,” authored by Anthony S. Fauci, M.D., and H. Clifford Lane, M.D., was published in the July 2, 2020, issue. The series is expected to comprise a total of 12 articles to be published monthly in the first issue of each month.

Meet Eric Rubin, MD, PhD, Infectious Disease Expert and Now Editor-in-Chief of the New England Journal of Medicine

Eric Rubin, MD, PhD, the new editor-in-chief of the New England Journal of Medicine (NEJM), is a leading infectious disease expert, renowned for his groundbreaking tuberculosis research. He was selected for the role of editor-in-chief in June 2019 after a worldwide search and took over the top editorial post in September.

Before becoming editor-in-chief, Dr. Rubin was an associate editor at NEJM. Associate editors are chosen for their expertise in major areas of medicine. He was also the chair of the Harvard T.H. Chan School of Public Health Department of Immunology and Infectious Diseases and the Irene Heinz Given Professor of Immunology and Infectious Diseases. Dr. Rubin will continue to run his lab focusing on TB and maintain his very small clinical practice at Brigham and Women’s Hospital in Boston. He believes retaining those responsibilities will make him a better editor-in-chief.

“I look at manuscripts differently because I’m an active researcher, submitting manuscripts to journals as well, so I appreciate what authors go through,” he explained. “And because of my lab work, I’m comfortable assessing the basic science component of manuscripts. I’m also comfortable with how to message work for a clinical audience. My work in the lab makes me value research that can truly change things.”

Dr. Rubin’s research focuses on the pathogenesis of tuberculosis, as well as prevention and treatment. His lab has developed many of the genetic tools used to study the causative organism, Mycobacterium tuberculosis, and has used them to understand the molecular mechanisms underlying virulence, susceptibility, and resistance to antibiotics.

Dr. Rubin grew up in a middle-class family in Brockton, a city south of Boston. His salesman father, whom he describes as one of the funniest people he ever knew, decided early on that his son would go to medical school — the acme of achievement in his eyes. An academically gifted student, Dr. Rubin had his pick of elite schools and Princeton was at the top of his list. But his father had other ideas. He bought his son five Harvard t-shirts and said he was free to attend the college of his choice, but that he would look odd wearing those shirts at Princeton. Dr. Rubin graduated from Harvard and went on to earn an MD/PhD from Tufts University School of Medicine.

Dr. Rubin said he’s still in the “scouting” stage of his new job, becoming familiar with NEJM and its operations, but he’s begun thinking about less traditional ways to communicate its content. “Our mission remains unchanged: to deliver highly valuable medical research and reviews to health care professionals. But how we deliver information may change. As the way people consume news evolves, we need to be in front, and not simply responsive. We need to adapt.”

When asked about the areas of medicine that are producing the most exciting research, Dr. Rubin talked about the ways technology is transforming fields like neuroscience. “There are all kinds of new single cell methodologies — very sophisticated approaches that help us understand the behavior of single cells within a large, complex organ like a brain,” he said. “Scientists haven’t yet translated the knowledge into things we do for patients, but it’s very, very interesting research.”

Although his dad is no longer around to delight in his son’s new job, Dr. Rubin knows exactly how he would react. “He would be thrilled. Both my parents were proud of their children. They were pure in their support and love for us.”

Dr. Rubin also serves on several scientific advisory boards to groups interested in infectious disease therapeutics, among them the Global Alliance for TB Drug Development, the Structure-Guided Drug Development Consortium, and the Sub-Saharan African Network for TB/HIV Research Excellence at the KwaZulu-Natal Research Institute for TB-HIV. He has also previously served as an editor for several basic science journals, including PLoS PathogensTuberculosis, and Current Opinion in Microbiology.

 

NEJM Group Launches New Peer-Reviewed Journal on Health Care Innovations

NEJM Catalyst Innovations in Care Delivery, a new subscription-based digital journal from NEJM Group focuses on health care delivery, is now available.

Six times each year, NEJM Catalyst Innovations in Care Delivery will showcase the best ideas for transforming health care delivery from experts around the world, vetted for an audience committed to improving patient outcomes: clinicians, clinical leaders, health care executives, academics, and other key constituents. “This peer-reviewed journal bridges the clinical and executive perspectives, theory and application, and the academic and provider settings,” said Editorial Director Edward Prewitt. “We’ll cover topics such as the payer-provider relationship, alternative payment models, the threat and opportunity of retail health, the future of safety-net hospitals and academic medical centers, analytics for health care delivery, and clinician burnout.” NEJM Catalyst and Clinical Programs at NEJM Group General Manager Matt Cann added, “The journal’s ultimate goal is to improve patient care through innovations that can be put in place in any institution.”

Each issue will feature two long-form articles on the most important ideas in health care delivery. The debut articles discuss a change model that has helped solve complex, intractable health care problems, and how different payment models support or undermine a sustainable health care system. Each issue will additionally contain case studies, expert articles, podcasts, and Insight Reports — a unique NEJM Catalyst product that taps into and analyzes the opinions of the proprietary Insight Council on a range of timely issues. The Insights Council is a group of 12,000 executives, clinical leaders, and clinicians from around the world who serve as the “voice of health care professionals, providing benchmarking and perspective,” as Prewitt puts it. Journal subscribers also have access to NEJM Catalyst web-based events hosted by leading health systems and universities.

Cardiologist and internist Thomas H. Lee, MD, MSc, the chief medical officer of Press Ganey, serves as editor-in-chief, and Harvard Business School Professor Michael E. Porter, one of the leading thinkers on management and competitiveness, co-chairs the editorial board with Dr. Lee.

NEJM Catalyst Innovations in Care Delivery builds on the success of NEJM Catalyst over the previous four years. The former digital platform featured non–peer-reviewed content, while “the new journal raises the bar for innovations that have the most potential to transform health care,” Cann says. “The peer-reviewed articles will have a higher level of rigor in order to contribute to the knowledge base on health care delivery.” The new journal will be indexed immediately in Google Scholar.

Many institutions are already benefiting from full access to the new journal. If you haven’t spoken to us about purchasing a site license, we hope that you will consider doing so here. To find out how to gain access for your patrons, please contact us at institutionsales@nejm.org.

NEJM’s New Case Studies Explore the Impact of Life Circumstances on Health and Health Care

The social determinants of health— the food we eat, the air we breathe, the communities we live in— have a profound impact on our bodies. The health care system is increasingly recognizing this fact and devising ways to address these patient realities.

NEJM’s 2019 monthly perspective series, Case Studies in Social Medicine, explores the intersection of these social determinants and clinical care, with the goal of helping clinicians, health systems, and others better understand social medicine’s concepts and applications. One recent case study describes the challenges of caring for a depressed, 39-year-old pregnant, migrant farmworker, engaged in heavy physical labor. She moves from farm to farm every few weeks and suffers from regular exposure to pesticides and excessive heat. Another article looks at the case of a factory worker with severe rheumatoid arthritis whose supply of prescribed opioids is newly restricted. He ends up buying oxycodone on the black market.

The once-a-month case studies are co-written by practicing physicians and social medicine scholars.

Engaging with Students and Faculty Through the Liaison Model

 

Liaison models vary from library to library, but what they have in common is that individual staff members serve as a bridge between the library and a specific department, school, or group, offering teaching, learning, and research support. The goal is to improve communication between client and library, ultimately enhancing library services.

We spoke to Brandi Tuttle, Research and Education Librarian at the Duke University Medical Center Library & Archives, about how the liaison model works at her library.

Q: What spurred your library’s adoption of the liaison model?  

A: Our current model is about a dozen years old. There was an earlier version of the model, which employed more of a one-size-fits-all approach. It didn’t take off as hoped and later grew back as a much more tailored program, responsive to student, faculty, and educational program needs. Realizing that learner groups have different needs, librarians embedded themselves into the groups to better understand and serve their populations.

Q: Describe your liaison program.

A: We have eight liaisons and all of us are librarians.  Each liaison supports one or more Duke educational programs such as the doctor of the physical therapy program, physician assistant program, school of medicine, and the school of nursing. We also have a graduate medical education liaison who works with the residents and fellows, a biomedical research liaison who works with all the researchers and the Institute for Animal Care and Use Committee, and a nursing liaison who works with all the hospital nurses.

I’m the liaison to the physician assistant program, the pathologists’ assistant program, and the master of biomedical sciences program, all of which are within the school of medicine. The liaisons meet every two weeks as a team to discuss what’s going on with our groups, what we have on our plate, and whether we need help with anything. There are very busy times of the year for certain educational groups, such as right before the students’ transition to their clinical year rotations and when new cohorts of students start. During those times, we might chip in to help that liaison teach classes, organize an event, or handle an orientation.

Q: What types of classes do you teach?

A: We are most heavily embedded with each program’s evidence-based practice (EBP) courses, as well as those covering clinical resources such as mobile apps and point-of-care tools. We also teach classes to students and faculty on productivity tools, scholarly publishing, systematic reviews, research impact, poster creation, citation management, and more.

Q: What are the goals of liaisons at Duke?

A: Our goals vary depending on the educational program, accreditation requirements, specific initiatives, and the library’s goals.  Generally, our goal is to help our students, faculty, researchers, clinicians, and staff in whatever way they need.  I strive to be their advocate and voice at the table. No matter where I am, whether at a library all-staff meeting, talking with a vendor at a conference, or collaborating with other groups around campus, I always have my user groups in mind.

 Q: Can you give an example of how you have advocated for one of your groups?

A:  Recently, a student in an evidence-based practice class I was teaching mentioned that a specific area of the library seemed not well-lit at night.  As I’m not commonly in that section of the library in the evening, I wasn’t aware of this, but I passed on the information.  Serving as a conduit between our users and the library can bring about a change that ends up benefitting everyone. I think we make the library more approachable simply due to the relationships and connections we’ve fostered over the years.

Q:  Do liaisons need to have expertise in the areas that they cover?

A: While it’s not required, it certainly makes your job easier. The most important thing is to have a strong health sciences library background. You’ll learn the specifics of your program(s), the faculty, the curriculum, the schedule, and more on the job.  Our newest colleague, our physical therapy liaison, was previously a nursing liaison. As long as you come in with academic library experience and some knowledge of the databases and evidence-based practice, you will be fine. In fact, sometimes it may be better to have had experience with a different population. That liaison will bring a different perspective to the job.

Q: How do you get to know the programs that you work with and how do they get to know you?

A: Our first foothold is usually through the EBP courses that we teach or via our library champions among faculty and staff. As one of the course instructors, I have several meaningful interactions with the physician assistant students through their assignments and project work. I’ve gotten to know my programs by becoming a member of some important committees. For example, I am on the curriculum committee, the admissions committee, and the technology committee for the physician assistant program. I have worked closely with the faculty during their reaccreditation process as well as helped to redesign several courses. Because I have all these different touchpoints with students and faculty, I have a better idea of their daily needs as well as the details of their program.

Q: Besides teaching evidence-based practice, what other sorts of activities do liaisons do to support their groups?

A: Similar to other institutions, our incoming students get an orientation to the library — at the very least to make sure they know they have a liaison librarian, a physical library, and a website full of resources collected with their needs in mind. The liaisons are very knowledgeable about their programs’ curricula as well as what the students and faculty are busy with, such as assignments, preparations for conferences, or program initiatives.

Nearly all our educational groups have a customized online resource guide that organizes article databases, journals, eBooks, websites, and resources useful for their classes and projects. I’ll reach out to students when they start anatomy to remind them about specific resources, such as Acland’s Video Atlas of Human Anatomy, or the many anatomy eBooks we have. Before their clinical rotations, I make sure to point them to the eBooks available by specialty and teach them how to form and answer clinical questions using point-of-care resources.  We have heard repeatedly that they find it helpful that we ensure they have their mobile devices loaded with all the apps Duke provides and give them time to practice answering clinical questions using the apps before they hit the clinical wards. Students are especially thankful when we go through their textbook listings to provide links to those we have available electronically, as this saves them time and money. Many faculty, in conjunction with their liaisons, are more aware of the textbooks and databases that Duke provides access to when they are making their assignments.

Regarding the faculty, I’ll reach out when I know they are preparing paper/poster submissions for the Physician Assistant Education Association Forum, working on tenure and promotion endeavors, or involved in the research.  We help with systematic and literature reviews, citation management, study methodology, data management, assessing research impact, finding materials, and the institutional repository.  My PA faculty will ask about resources before they send students on rotations abroad. For example, they might ask for medical Spanish resources or what resources they’ll be able to access with low connectivity.

Q: How do you onboard new liaisons?

A: Our onboarding is part deliberate, part organic. While we have a long checklist of things we cover with each new colleague, it definitely depends on our new colleague’s experiences and needs. They shadow other liaisons’ classes, cover reference shifts to serve a variety of our library users, meet with other library colleagues and program faculty, and jump into some ongoing projects and committees. We also work with new liaisons to discover their strengths, ideas, and what they like doing, because we want them to make their liaison work their own and enjoy it.

Q:  Do liaisons track the interactions they have with their groups?

A: We track our educational output, taking note in an online system of the specific educational program or patron group, the number of attendees, the length of time, the topics, and the format.  We also track our consultations, orientations, and the searches performed with similar types of information collected. Having this level of detail helps us create a more robust picture of the many ways we serve our educational programs and user groups.

Q: What do you do with the data?

A: We create annual snapshots of the work we’ve done using data and stories to show our impact and the breadth of our services, as well as to provide leadership and administrative stakeholders with specific data. We use the data when we work on library-wide strategic planning and goal setting, in budget considerations, and when setting our research and education departmental goals. Sometimes we have learned something surprising in examining the data, such as an uptick in requests from a specific department. I think this can help both the library and the program plan, tweak assignments, budget, and respond to needs.

Q: What percentage of librarians’ time is spent on their liaison duties?

A: Since part of the role is to always advocate for and communicate with our liaison groups, it’s virtually impossible to tease apart liaison work from general research and education responsibilities. It’s also different for each liaison and can depend on the time of year. For example, in late June/early July, the graduate medical education liaison has a flurry of orientations. Of course, the ongoing work of the researchers, clinicians, and faculty keeps us on our toes.

Q: Do you have any final advice for libraries that want to start a liaison program? 

A: While it may be good to have a standard approach, in the beginning, recognize that each department or group will require customization, depending on needs. And don’t become a silo. Always prioritize information sharing and working as a team within your library and the groups you serve.

 

 

Unleash the full power of your NEJM.org site license with access to NEJM.org anytime, anywhere, and from any device.

The New England Journal of Medicine (NEJM) now offers a remote-access option that supports easier and more flexible access to your NEJM.org institutional site license holdings — beyond the physical library or institutional IP range — anytime, anywhere, and from any device.

With a seamless and simple pairing of accounts, the remote-access feature increases COUNTER-compliant usage and enhances the value of your NEJM.org subscription. Using any device, every time your patrons sign in to their free NEJM.org account while within the institution’s IP range, their remote access to your institutional site license holdings is automatically authenticated and paired for 60 days.

Visit the NEJM LibraryHub Resource Toolkit to learn more and to request ready-to-use materials for use in your organization’s communications.

 

Tracking over 200 Years of Medical History through the NEJM Online Archives

If you’d like to read any article from the past 207 years of the New England Journal of Medicine, you could take a stroll down to the basement level of Harvard’s storied Countway Medical Library, provided you have privileges.

But an easier way to access any of NEJM’s 150,000 articles from its 8,657 issues is through its digital archive, an invaluable tool for clinicians, researchers, and teachers that became available in 2010. “A lot of journals just have their archived articles in PDF form, but we spent a lot of money to translate our content into HTML so everything is searchable,” says Pam Miller, who headed up the three-year archive project and is assistant to the editor of NEJM. (Articles from 1812 to 1944 are in PDF form). “When you scan something and then convert it to HTML, there’s a lot of quality assurance that needs to be done. For example, we would send out word lists to the proofreaders, and in some cases one word might be spelled 12 different ways over a period of time. So we had to narrow it down to just several spellings to keep things consistent.”

Transforming Paper to Pixels

Scanning is less costly when the originals can be destroyed in the process, so Miller’s goal was to find as many old issues on eBay and other online sources as possible. For those she was unable to locate, she borrowed from the NEJM warehouse and the Countway Library. “In the end, we had to cut bindings and have them rebound. This was OK because when I had spoken to historians at the Countway Library, they said the bindings are not worth a cent,” says Miller. She sent the hard copies to two different out-of-state companies to be scanned, while the quality assurance work was done in-house. Tracking down every NEJM issue and scanning them took about two years.

Miller said a fascinating moment of personal discovery was when she came upon a review from an 1838 journal about breast cancer. “I had had breast cancer myself, so I sent it to my oncologist,” recalls Miller. “At the time, it was astonishing to me how our understanding of breast cancer hadn’t changed that much in more than a century, such as what causes it and how it is spread. They knew at the time that women got cancerous lumps in their breasts, that you had to remove it, and that it often grew back. They also had some primitive types of chemotherapy back then.”

Evolving into the Country’s Leading Medical Journal

The New England Journal of Medicine’s earliest incarnation was as the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science. It was founded at a time when one out of every four children died in infancy and if you underwent surgery, you had a 50-50 chance of dying from complications. Until the mid-19th century, NEJM published mostly medical news that had already been reported elsewhere. Then in 1947, a 54-year-old pediatrician named Joseph Garland, MD, took over the publication’s reins and began giving free subscriptions to every enlisted physician. Many of these new readers went on to distinguished careers in medicine and suddenly NEJM was being read by the most influential doctors in the country. It had become a sought after place to publish important research.

Each editor-in-chief has left his or her editorial fingerprints on NEJM, according to Miller. Current editor-in-chief Jeffrey Drazen, MD, who is a pulmonology researcher, has a preference for research over, say, epidemiology. “Some 65–70 percent of what we publish is a randomized controlled trial of something that will change how we treat patients,” says Miller.

The archives are heavily used. In 2018, readers accessed some 300,000 articles from every time period in NEJM’s history: in fact, one of the most popular articles is from the first issue in January 1812, “Remarks on Angina Pectoris,” a seminal article written by the founder and first editor of NEJM, John Collins Warren, MD, on heart disease. It is still cited today.

If you are interested in purchasing the NEJM archive for your institution, please click here to request a quote.

Sidebar

As part of the NEJM’s 200th birthday celebration in 2012, readers were presented with five influential NEJM articles from different time periods and asked to vote on the most important one. Here are the results, which are all available in the NEJM archive:

1812–1879: Insensibility during Surgical Operations Produced by Inhalation (1846) (Report on using ether anesthesia during a surgery at Massachusetts General Hospital)

1880–1929: Pregnancy and Diabetes Mellitus  (1915)

1930–1959: Intravenous Infusion of Bone Marrow in Patients Receiving Radiation and Chemotherapy (1957)

1960–1969: Studies on an Attenuated Measles Vaccine   (1960)

1970–1979: Antihypertensive Effect of the Oral Angiotensin Converting-Enzyme Inhibitor Sq 14225 in Man  (1978)

1980–1989: Preliminary Report: Findings from the Aspirin Component of the Ongoing Physicians’ Health Study (1988)

NEJM Group to Launch New Journal on Health Care Innovation

A new, online peer-reviewed journal about health care innovation will debut in January 2020. NEJM Catalyst Innovations in Care Delivery will publish scholarly articles, reviews, and case studies written by industry experts on the most promising ideas and trends transforming health care, including alternative payment models, patient-centered care, leadership development, payers-provider alignment, digital health, and more.

A journal subscription also includes access to web events and special reports from the Catalyst Insight Council — a group of 11,000 executives, clinical leaders, and clinicians from around the world— whose opinions will be regularly tapped and collected.

Cardiologist and internist Thomas Lee, MD, the chief medical officer of Press Ganey Associates, will serve as editor-in-chief. Harvard Business School professor Michael Porter, one of the leading thinkers on health care business strategy, will co-chair the editorial board with Dr. Lee.

Librarian without Borders

Anne Seymour has earned her frequent flyer status. When she was associate director of the biomedical library at the University of Pennsylvania, she was instrumental in helping the country of Botswana improve the delivery of medical information to clinicians and patients. She did similar work in Guatemala. Now, as director of the Welch Medical Library at Johns Hopkins University, she has less time to get directly involved in international collaborations, although in 2017 she was the librarian representative to a team that provided guidance on a new medical school in China.

NEJM LibraryHub sat down with Seymour to talk about her library adventures abroad.

Q: Why would a medical library want to set up partnerships with health care systems in developing countries?

 A: People often think this is just something fun and benevolent to do, which is totally true. But as importantly, the projects I have done at Penn and Johns Hopkins have supported the work and missions of these institutions as well as their partner institutions around the world. And anything you can do to boost access to health information for consumers and practitioners improves the health care of the world as well as research capacity, which advances science. These are lofty goals, but they’re true.

It’s fascinating to learn how librarians, researchers, and health care practitioners in other countries do their work, especially in resource-limited settings. There are many ideas and new models you can bring back to your own institution, for example how a new medical library in Botswana, with no tradition of academic medicine or history of print resources, deployed mobile devices. And I can’t tell you how much I have learned in terms of cultural competency.

Q: Tell us about your first project in Botswana.

A: The Perelman School of Medicine at Penn was working with the Botswana Ministry of Health and the University of Botswana (UB) to build a program of HIV treatment and care primarily funded under the U.S. PEPFAR program (President’s Emergency Plan for AIDS Relief). Botswana at that time had the highest HIV rate in the world. Penn was also helping launch the country’s first medical school. My colleagues and I wrote a proposal, with the support of the leadership of the Botswana-UPenn Partnership, to do an information needs assessment focused on practitioners. In 2008, we received funding from The Elsevier Foundation. We learned from the assessment that any information that would be delivered should be on mobile devices because cell phones were becoming ubiquitous and the cellular networks were robust. The other thing we determined is that there needed to be specialized training of librarians to meet the needs of the new medical school. There were no medical librarians in the entire country. Hospitals did have librarians, but those librarians did not have special training.

After we determined the needs, I began working with a colleague who is very involved with the Botswana-UPenn Partnership and mHealth projects, dermatologist Carrie Kovarik, MD. The project was to bring smartphones to residency programs, which they were launching as part of the new University of Botswana medical school program. The residents typically attended medical school outside of Botswana, which the government paid for. The hope was that they would come back to Botswana to work. But because there wasn’t any graduate medical training, there weren’t growth opportunities, so they didn’t always return. As a result, there weren’t a lot of specialists in the country. The new residency program, they hoped, would change that.

Dineo Ketshogileng, a Botswanan librarian who interned at the University of Pennsylvania’s Biomedical Library, enjoys a moment with Ben Franklin.

These small residency programs — 12 internal medicine residents spread out among four sites — had little to no access to information — no textbooks, nothing. We provided smartphones with free medical apps and partnered with some vendors to provide additional content — drug information, evidence-based medicine content, dosage calculators, etc. And the phones had data plans — to access things like PubMed and app updates. The residents said getting smartphones was a lifeline and a lifesaver for them.

Q: Did the pilot lead to any other projects?

A: We published papers on it. Also, the pilot was expanded. The medical school adopted this idea and with funds from an NIH/Fogarty Institute program, the Medical Education Initiative (MEPI), the school was able to distribute tablets for all of their students loaded with content to support their learning, clinical practice, and research. What was exciting is that the pilot grew into a program that was then fully supported by the University of Botswana Medical School.

Also, with the help of the University of Botswana (UB) Medical School, we were able to fund Dineo Ketshogileng, a UB librarian, to come to Penn in 2010 and do an “attachment” or internship for six months at my library.

Ms. Ketshogileng shadowed librarians, met with people, attended classes they taught, and did a lot of self-learning tutorials on different topics, all part of an immersion in medical librarianship. She attended conferences, including the Medical Library Association annual meeting, and we worked on a plan of action for her when she got back to Botswana. She got very involved in our smartphone pilot and the subsequent program distributing tablets to students.

I just spoke with Ms. Ketshogileng, the other day. We are so proud of her accomplishments and how she’s built a program supporting the UB medical school.

Q: After the Botswana work, which we understand included your helping to create an informatics curriculum, you turned your attention to Guatemala. Can you tell us a little about your collaboration there?

A: We built on our experience in Botswana. The project focused on bringing mobile technology to a small hospital in the Lake Atitlan region of Guatemala. Again, we built off of an existing institutional collaboration,

the Guatemala-Penn Partnership. We worked with medical librarians in the two Guatemalan institutions in the partnership (Universidad de San Carlos de Guatemala and Universidad Francisco Marroquin) to build their

Seymour works with an Ugandan infectious disease fellow during a workshop Seymour co-led about information skills for research.

capacity to deliver services to their community. We taught research skills, data management, accessing the literature, managing citations, etc. And we co-taught with the Guatemalan librarians and Penn faculty in a week-long workshop for Guatemalan researchers.

Q: What sorts of international collaborations have you been involved with since you’ve been at Johns Hopkins?

A: My whole team at the Welch Medical Library is engaged globally. Some examples of our work include pre-departure training for students and faculty going abroad for research or practice; week-long, in-country seminars on searching, publishing, and research practices; education and consultation with visiting students and scholars; and presentations at international conferences.

One new area of engagement for me was with Johns Hopkins International (JHI). JHI is a division of Johns Hopkins Medicine that sets up clinical operations in other countries and also consults with countries on practice and

education models. JHI was engaged with a university in China that wanted to establish a new medical school based on the U.S. model of medical education. JHI put together a team of people to do this over several site visits, virtual meetings, and visits from our Chinese colleagues. I went to China as part of one multidisciplinary team that provided consulting services on admissions, IT, library services, and general curriculum. I was there for a week and met with many university leaders, faculty, technology staff, and most importantly, librarians. The university library already had a strong and respected program supporting the existing academic mission but lacked knowledge and expertise on supporting a medical school. We discussed what kinds of resources they should look at, what sorts of staff development they needed to do, what skills were needed, what kinds of partnerships they should look for at the university, and more. We also hosted the university librarian when he came to visit Hopkins and the Welch Library and connected him with many resources and opportunities to grow his team for supporting medical education and research. JHI completed the consultancy and although the new school has not yet launched, we hope to see that happen in the future.

Anne Seymour and a Johns Hopkins colleague with librarians from a Chinese University. Seymour was part of a Johns Hopkins team that consulted with the university on setting up a new medical school.

Q: What advice would you give to colleagues who may be interested in getting involved in these types of international collaborations?

A: First, I would recommend partnering with your own institution because you will be fulfilling the broader mission, which will result in any initiatives being sustainable and grounded in your institutional goals.

Take advantage of the existing resources and learn about the work of other medical librarians. There’s a lot going on in this area. The Medical Library Association has an International Cooperation Section where you can learn a lot — such as who you might want to partner within your own institution and what kinds of funding opportunities are out there.

Q: Any final words on your experience with these projects?

A: One of the most important things I do in my work is to build my network — my network at my institution and my global network. This work exponentially expanded my global network. Also, when you’re traveling with the leadership of a medical school to a place like Guatemala, you get to know each other very well and you really get to show the value of having a librarian on your team.