A National Network of Libraries for Health

Canadian Health Libraries Association / Association des bibliothèques de la santé du Canada

Canada needs a National Network of Libraries for Health (NNLH).

Health practitioners everywhere in the country need the same access to the best information. They all need to share knowledge and evidence. NNLH will provide this access and this capability. NNLH will build a platform for change, cooperation and sustainability upon Canadian values.

Health professionals base decisions on patient-derived data, health system information, professional expertise and national and international research knowledge. However, Canada does not have a systematic way of providing integrated access to this critical information. This submission describes how Canada can take a lead in developing partnerships and networks to ensure that access to this range of information is readily available across the country.

An agency, paralleling those of many other nations, is proposed to strengthen information services provided to professionals and co-ordinate a cross-jurisdictional coalition. Services would include access to bibliographic tools and information warehouses, document delivery, continuing education resources, and training through an integrated web interface. The coalition would build on existing networks and Canadian expertise and centres of excellence.

We are confident that you will find the issues we have raised important and informative to your broader deliberations. We expect that integrated access to information and knowledge will be a common thread through all your recommendations. We look forward to your comments and queries, and -- we hope -- your full support, in particular, a recommendation endorsing a National Network of Libraries for Health to serve health professionals across Canada.

Introduction

The mission of the Canadian Health Libraries Association / Association des bibliothèques de la santé du Canada (CHLA/ABSC) is to improve health and health care by promoting excellence in access to information. CHLA/ABSC was formed in 1976 and runs with an eight member volunteer Board of Directors. Our 400 members include librarians, library technicians and information professionals working in all sectors of health care: hospitals, community health centres, universities, pharmaceutical companies, public libraries, government departments and community colleges (1). We have 18 affiliated chapters across the country.

Medical librarians and clinicians around the world have long recognized the value and importance that the best and most current health information has to health practitioners, patient outcomes and the delivery of health care (2,3). CHLA/ABSC has also recognized and struggled with the remarkably uneven access to health information and knowledge in Canada. Our efforts have met with some success, most notably the recent implementation of DOCLINE in Canada (4). However, neither we nor our individual libraries have the mandate to patch the cracks in health information delivery in Canada. We have no National Library of Medicine or National Network of Libraries of Medicine as the United States and neither the National Library of Canada nor the Canada Institute for Scientific and Technical Information can fill that crucial role. There is no national, interprovincial or cross-jurisdictional coordinating body to ensure health practitioners have cost effective and universal access to the best patient care and health research information.

Our Vision

Our Association has a vision for addressing this dilemma in the unique Canadian context:

"Canadian health libraries and library professionals will contribute to the improvement of the health of Canadians by providing optimal access to knowledge-based information to health professionals in support of clinical care, education, and research, and health consumers to assist them in making informed health care decisions.

We will accomplish this by:

• collaborating with the other key partners in the health information field (5) in the creation and maintenance of technological and human networks at the provincial, national, and international levels;
• supporting and promoting evidence-based health practice;
• identifying, evaluating, organizing and disseminating high-quality, synthesized, published and publicly accessible information, in electronic as well as traditional formats;
• educating students in medicine and other health professions, practising health professionals and health consumers in the identification, use, and management of health information sources;
• making extensive use of informatics and technological applications to provide information where and when it is needed (6)."

We are moving forward on that vision. With the support of Health Canada, and particularly this project's coordinator, Hélène Valin, we are developing a business case to support a proposed National Network of Libraries for Health (NNLH). The steering group working on this proposal consists of:

• Louise Bourbonnais (Association pour l'avancement des sciences et techniques de la documentation)
• Bev Brown (Canada Institute for Scientific and Technical Information)
• Patrick Ellis, Co-Chair, (Past President, CHLA/ABSC)
• Dorothy Fitzgerald (Association of Canadian Medical Colleges)
• Jim Henderson (CHLA/ABSC; Medical Library Service, College of Physicians and Surgeons of B.C.)
• Marty Lovelock (Health Canada)
• Merle McConnell (Health Canada)
• Jessie McGowan, Co-Chair (President, CHLA/ABSC)
• Teresa Prior (CHLA/ABSC; Royal Inland Hospital, Kamloops, B.C.)
• Hélène Valin, Project Coordinator (Health Canada)

The National Network of Libraries for Health supports the key themes of the Commission:

Canadian Values

Universality: NNLH will work in partnership with provincial health departments, national associations, rural health professionals and other stakeholders to establish a national framework to benefit all health professionals in Canada.

Sustainability

NNLH would be well positioned to support several key Government commitments. Through partnerships with existing health information and knowledge providers, NNLH would strengthen access to information for health professionals. It would complement initiatives undertaken to build a fast lane for Canada on the information highway. The network would particularly benefit the professionals in rural and remote areas as well as allied health professionals not served by existing health science library networks.

Health professionals working from a common knowledge base will provide Canadians with the same level of care across jurisdictions and in rural as in urban settings. While the highest quality care is not always the least expensive, studies have found that the cost of the best care reflecting the most up-to-date research is usually cheaper (7).

Managing Change

The NNLH will support continuing education for health professionals in using tools for locating and applying evidence and knowledge. Librarian assistance and support will be available. When full-text articles are not available on the network, the NNLH will offer health professionals a registry of document delivery suppliers.

• NNLH encourages continuing education by providing tools for and courses on information searching.
• NNLH supports research by enabling access to relevant databases.

Cooperative Relations

NNLH would coordinate services provided to health professionals across jurisdictions. It will provide the tools to search bibliographic databases and journals for relevant articles, ensuring that Canadian information is readily available. Through an integrated web interface, the NNLH will allow health professionals access to key resources in a timely manner. The network will provide a gateway to peer reviewed journals, evidence-based literature and important unpublished information such as hospital protocols.

• NNLH acknowledges the value of existing health information and knowledge networks and health science libraries and seeks to complement and enhance services offered to health professionals.
• NNLH recognizes the critical role information and library services play in supporting health professionals and evidence-based health care.
• NNLH provides equitable access to health information by targeting health professionals not currently reached by the health information and knowledge providers.

References

(1) What is CHLA, February 25, 1999. http://www.chla-absc/english/chlawhat.html
(2) Marshall JG. "The impact of the hospital library on clinical decision making: The Rochester study." Bulletin of the Medical Library Association; 1992; 80(2): 169-178
(3) McGowan JJ, Richwine M. "Electronic information access in support of clinical decision making: a comparative study of the impact on rural health care outcomes." Proceedings of the American Medical Informatics Association Symposium; 2000: 565-569
(4) DOCLINE in Canada. http://www.nrc.ca/cisti/med/docline_e.shtml
(5) For example, Health Canada (Health Canada Advisory Council on Health Info-Structure); Industry Canada (Telehealth Initiative); Canada Institute for Scientific and Technical Information (CISTI); Canadian Institute for Health Information (CIHI); HealNet, the Canadian health care and research industry; health related centres of excellence and public groups involved in health care and research, including disease-specific lobby and support groups.
(6) The Role Of Health Libraries And Library Professionals In A National Health Information Network In Canada, October 27, 1998. http://www.chla-absc/english/chlarole.html. Adopted by the Canadian Health Libraries Association / Association des bibliothèques de la santé du Canada Board of Directors, 27 October 1997. Adopted by the Association pour l'avancement des sciences et des techniques de la documentation, 8 November 1997. Endorsed by the Association of Canadian Teaching Hospitals, February 1998. Ratified by the Association of Canadian Medical Colleges / Association des facultés de médecine du Canada Board of Directors, April 23, 1998.
(7) Klein MS et al. "Effect of online literature searching on length of stay and patient care costs" Academic medicine 1994 Jun; 69(6):489-95.