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The organization of the digital library.

As digital information proliferates and the difficulties of managing it threaten to overwhelm traditional publication and information delivery processes, new visions of a digital library are forming. Exactly what a digital library is and how it is to be organized have not yet been determined, and bibliographic organization of digital information has not been sufficiently addressed. Bibliography is the systematic description or classification of writings or publications considered as material objects. In today's digital world, such material objects may no longer be relevant, but the need for systematic description remains. The important issue is not whether digital bibliography is needed but, instead, whether or not existing bibliographic techniques are appropriate for this new media. A second issue is the location of the responsibility for a new digital bibliography. Does it rest with medical informaticians, often the producers of this new digital information, or with librarians, traditionally the classifiers of information? Developments in both medical informatics and medical librarianship indicate a need for greater collaboration between these specialties in order to achieve their common purpose--the creation, classification, and dissemination of scholarly information.

Bibliography of Medicine↗

The use of free resources in a subscription-based digital library: a case study of the North Carolina AHEC Digital Library.

BACKGROUND: The North Carolina (NC) Area Health Education Center's (AHEC) Digital Library (ADL) is a web portal designed to meet the information needs of health professionals across the state by pulling together a set of resources from numerous different sources and linking a pool of users to only the resources for which they have eligibility. Although the ADL was designed with the primary purpose of linking health care professionals to a set of licensed resources, the ADL also contains a significant number of links to free resources. These resources are available to any ADL member logging into their ADL account and to guest visitors to the ADL. While there are regular assessments of the subscription resources in the ADL as to utility and frequency of use, up until this point there has been no systematic analysis of the use of the overall set of free resources. It was decided to undertake an examination of the usage of ADL free resources over a 6-month period to analyze the utility of these resources to both ADL members and guests. METHODS: Each time a resource is accessed through the ADL, it is logged in a table. This study used a SQL query to pull every free resource accessed between November 1, 2005 and April 30, 2006. An additional query also pulled the user information for each free resource accessed. Once the queries of the database were complete, the results were imported into an Excel spreadsheet and analyzed using basic descriptive statistics. RESULTS: The vast majority of resource use through the ADL is to licensed resources. There are 2056 free resource URLs in the ADL, to which 1351 were linked out, meaning there was at least one link out to 65% of the free resources. The single most popular free resource was PubMed with 4803 link outs or nearly 20% of the total link outs to free resources. The breakdown of free resource use by different use groups indicates that the highest percentage of use of free resources was by guests followed by institutional affiliates and AHEC Faculty/Staff. The next 3 highest user groups accessing free resources are: paid members, preceptors, and residents. CONCLUSION: The only free resource capturing a significant number of link outs is the free link to PubMed. This reflects the importance placed on traditional medical literature searching by the ADL clinical user base. Institutional affiliates access free resources through the ADL with the second highest frequency of all the user groups. Finally, in analyzing use of free resources, it is important to note the overall limitations of this survey. While link outs are excellent indicators of frequency of use they do not provide any information about the ultimate usefulness of the resource being accessed. Further studies would need to examine not only the quantitative use of resources, but also their qualitative importance to the user.

Journal Article↗

A distributed, collaborative, structuring model for a clinical-guideline digital-library.

The Digital Electronic Guideline Library (DeGeL) is a Web-based framework and a set of distributed tools that facilitate gradual conversion of clinical guidelines from free text, through semi-structured text, to a fully structured, executable representation. Thus, guidelines exist in a hybrid, multiple-format representation The three formats support increasingly sophisticated computational tasks. The tools perform semantic markup, classification, search, and browsing, and support computational modules that we are developing, for run-time application and retrospective quality assessment. We describe the DeGeL architecture and its collaborative-authoring authorization model, which is based on (1) multiple medical-specialty authoring groups, each including a group manager who controls group authorizations, and (2) a hierarchical authorization model based on the different functions involved in the hybrid guideline-specification process. We have implemented the core modules of the DeGeL architecture and demonstrated distributed markup and retrieval using the knowledge roles of two guidelines ontologies (Asbru and GEM). We are currently evaluating several of the DeGeL tools.

Computer Communication Networks↗

The digital library: an oxymoron?

"Virtual libraries" and "digital libraries" have become stock phrases of our times. But what do they really mean? While digital refers to a new form of document encoding and must be approached from that perspective, virtual resonates with aspects that modern philosophy treats with benign neglect at best. The word virtual harbors the notion of potential, and therein lies its hidden strength. Although strong commercial interests try to use the shift to a digital environment to redefine the political economy of knowledge, and thus virtualize libraries into a state of almost complete impotence, all hope is not lost. Librarians of virtualized libraries may well discover that they have re-empowered institutions if they place human interaction at the heart of their operations. In other words, rather than envisioning themselves as knowledge bankers sitting on treasure vaults of knowledge, they should see themselves as "hearts" dynamizing human communities. They should also see themselves as an essential part of these communities, and not as external repositories of knowledge. In this fashion, they will avoid the fate of becoming an oxymoron.

Forecasting↗

Using knowledge management practices to develop a state-of-the-art digital library.

Diffusing knowledge management practices within an organization encourages and facilitates reuse of the institution's knowledge commodity. Following knowledge management practices, the Eskind Biomedical Library (EBL) has created a Digital Library that uses a holistic approach for integration of information and skills to best represent both explicit and tacit knowledge inherent in libraries. EBL's Digital Library exemplifies a clear attempt to organize institutional knowledge in the field of librarianship, in an effort to positively impact clinical, research, and educational processes in the medical center.

Academic Medical Centers↗

Clinical Digital Libraries Project: design approach and exploratory assessment of timely use in clinical environments.

OBJECTIVE: The paper describes and evaluates the use of Clinical Digital Libraries Project (CDLP) digital library collections in terms of their facilitation of timely clinical information seeking. DESIGN: A convenience sample of CDLP Web server log activity over a twelve-month period (7/2002 to 6/2003) was analyzed for evidence of timely information seeking after users were referred to digital library clinical topic pages from Web search engines. Sample searches were limited to those originating from medical schools (26% North American and 19% non-North American) and from hospitals or clinics (51% North American and 4% non-North American). MEASUREMENT: Timeliness was determined based on a calculation of the difference between the timestamps of the first and last Web server log "hit" during each search in the sample. The calculated differences were mapped into one of three ranges: less than one minute, one to three minutes, and three to five minutes. RESULTS: Of the 864 searches analyzed, 48% were less than 1 minute, 41% were 1 to 3 minutes, and 11% were 3 to 5 minutes. These results were further analyzed by environment (medical schools versus hospitals or clinics) and by geographic location (North America versus non-North American). Searches reflected a consistent pattern of less than 1 minute in these environments. Though the results were not consistent on a month-by-month basis over the entire time period, data for 8 of 12 months showed that searches shorter than 1 minute predominated and data for 1 month showed an equal number of less than 1 minute and 1 to 3 minute searches. CONCLUSIONS: The CDLP digital library collections provided timely access to high-quality Web clinical resources when used for information seeking in medical education and hospital or clinic environments from North American and non-North American locations and consistently provided access to the sought information within the documented two-minute standard. The limitations of the use of Web server data warrant an exploratory assessment. This research also suggests the need for further investigation in the area of timely digital library collection services to clinical environments.

Geography↗

The Virtual Hospital: experiences in creating and sustaining a digital library.

A university and its faculty encompass a wealth of content, which is often freely supplied to commercial publishers who profit from it. Emerging digital library technology holds promise for allowing the creation of digital libraries and digital presses that can allow faculty and universities to bypass commercial publishers, retain control of their content, and distribute it directly to users, allowing the university and faculty to better serve their constituencies. The purpose of this paper is to show how this can be done. A methodology for overcoming the technical, social, political, and economic barriers involved in creating, distributing and organizing a digital library was developed, implemented, and refined over seven years. Over the seven years, 120 textbooks and booklets were placed in the Virtual Hospital digital library, from 159 authors in twenty-nine departments and four colleges at The University of Iowa. The digital library received extensive use by individuals around the world. A new paradigm for academic publishing was created, involving a university and faculty owned peer reviewed digital press implemented using digital library technology. The concept has been embraced by The University of Iowa, and it has pledged to sustain the digital press in order to allow. The University of Iowa to fulfill its mission of creating, organizing, and disseminating information better.

CD-ROM↗

Secure medical digital libraries.

In this paper, a secure medical digital library is presented. It is based on the CORBA specifications for distributed systems. The described approach relies on a three-tier architecture. Interaction between the medical digital library and its users is achieved through a Web server. The choice of employing Web technology for the dissemination of medical data has many advantages compared to older approaches, but also poses extra requirements that need to be fulfilled. Thus, special attention is paid to the distinguished nature of such medical data, whose integrity and confidentiality should be preserved at all costs. This is achieved through the employment of Trusted Third Parties (TTP) technology for the support of the required security services. Additionally, the proposed digital library employs smartcards for the management of the various security tokens that are used from the above services.

Computer Security↗

Extending the role of a healthcare digital library environment to support orthopaedic research.

A digital archive, together with its users and its contents, does not exist in isolation; there is a cycle of activities which provides the context for the archive's existence. In arguing for the broadening of the traditional view of digital libraries as merely collections towards the processes of collecting and deploying, we have developed an extend ed digital library environment for orthopaedic surgeons which bridges the gap between the undertaking of experimental work and the dissemination of its results through electronic publication.

Biomedical Research↗

Bridging the gap between research and practice: The development of a digital library of research syntheses.

This article describes the development of a digital library as a resource for clinicians and researchers working with women with HIV infection. We wanted to find a new way of communicating the findings from the 114 studies that we used as the method case. The development of the SandBar Digital Library (http://sonweb.unc.edu/sandbar), a product of a 5-year project to develop the analytic techniques for qualitative metasynthesis, is described from its inception, including analyses of the potential users and how they might use such a resource. The Digital Library evolved over a 3-year period, with continuous feedback from a group of researchers and clinicians who are also experts in the care of HIV-positive people. It provides a concise and comprehensive compilation of findings in two major areas of concern for the seropositive women who were the participants in the studies: motherhood and stigma.

Attitude of Health Personnel↗

Solutions to challenges facing a university digital library and press.

During the creation of a university digital library and press intended to serve as a medical reference and education tool for health care providers and their patients, six distinct and complex digital publishing challenges were encountered. Over nine years, through a multidisciplinary approach, solutions were devised to the challenges of digital content ownership, management, mirroring, translation, interactions with users, and archiving. The result is a unique, author-owned, internationally mirrored, university digital library and press that serves as an authoritative medical reference and education tool for users around the world. The purpose of this paper is to share the valuable digital publishing lessons learned and outline the challenges facing university digital libraries and presses.

Hospitals↗

Digital Libraries and Recent Medical Informatics Research. Findings from the IMIA Yearbook of Medical Informatics 2001.

The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of recent excellent papers on medical informatics research (http://www.med.uni-heidelberg.de/mi/yearbook/index.htm). The special topic of the just published Yearbook 2001 is "Digital Libraries and Medicine". Digital libraries have changed dramatically and will continue to change the way we work with medical knowledge. The selected papers present recent research and new results on digital libraries. As usual, the Yearbook 2001 also contains a variety of papers on other subjects relevant to medical informatics, such as Electronic Patient Records, Health Information Systems, Health and Clinical Management, Decision Support Systems, Education, as well as Image and Signal Processing. This paper will briefly introduce the contributions covering digital libraries and will show how medical informatics research contributes to this important topic.

Humans↗

Information retrieval in digital libraries: bringing search to the net.

A digital library enables users to interact effectively with information distributed across a network. These network information systems support search and display of items from organized collections. In the historical evolution of digital libraries, the mechanisms for retrieval of scientific literature have been particularly important. Grand visions in 1960 led first to the development of text search, from bibliographic databases to full-text retrieval. Next, research prototypes catalyzed the rise of document search, from multimedia browsing across local-area networks to distributed search on the Internet. By 2010, the visions will be realized, with concept search enabling semantic retrieval across large collections.

Abstracting and Indexing↗

Digital libraries--a quality concept.

The idea of digital libraries is not new, but recent developments have made the realisation of this idea more of a practical possibility than ever before. In particular, the availability of tools for easy access to information and for easy production of new information has encouraged traditional publishers to make their information available in digital networked form. but also made it possible for many individual authors to directly publish their own information on the Internet, bypassing traditional publishers and established bibliographic systems. Managing these new information resources is the task of Internet digital libraries such as OMNI. A key issue is the need to signpost the quality of information sources. A variety of ways of doing this are possible.

Computer Communication Networks↗

Using UMLS to map from a library to a clinical classification: Improving the functionality of a digital library.

The Metathesaurus of the Unified Medical Language System (UMLS) offers the possibility of mapping between various medical vocabularies. The Primary Care Electronic Library (PCEL) contains a database of over six thousand Medical Subject Headings (MeSH terms) describing the resources of the electronic library. We were interested to know if it was possible to map from MeSH to the Systemized Nomenclature of Medicine Clinical Terms (SNOMED CT). Such a mapping would aid healthcare professionals to retrieve relevant data from our digital library as it would enable links between clinical systems and indexed material.

Databases, Bibliographic↗

Next-generation applications in healthcare digital libraries using semantic service composition and coordination.

Healthcare digital libraries (DLs) increasingly make use of dedicated services to access functionality and/or data. Semantic (web) services enhance single services and facilitate compound services, thereby supporting advanced applications on top of a DL. The traditional process management approach tends to focus on process definition at build time rather than on actual service events in run time, and to anticipate failures in order to define appropriate strategies. This paper presents a novel approach where service coordination is distributed among a set of agents. A dedicated component plans compound semantic services on demand for a particular application. In failure, the planner is reinvoked to define contin- gency strategies. Finally, matchmaking is effected at runtime by choosing the appropriate service provider. These combined technologies will provide key support for highly flexible next-generation DL applications. Such technologies are under development within CASCOM.

Information Storage and Retrieval↗

The Virtual Naval Hospital: a digital library for naval primary care providers and patients.

OBJECTIVE: To deliver optimal patient care and promote wellness, naval providers and patients require convenient access to medical information from isolated duty stations. The Internet can lower barriers to accessing information. The goal of this study was to determine the technical feasibility of using the Internet to deliver medical information to isolated naval points of care. METHODS: A digital library for naval primary care providers and patients with an integrated, problem-based interface was developed. The Virtual Naval Hospital (http:/(/)www.vnh.org) was evaluated from sea, undersea, and shore. RESULTS: The digital library was a popular resource. Access to it is currently limited because few ships have Internet access. CONCLUSIONS: The technical feasibility of delivering a digital library of medical information to the deckplates was proven. The digital library will realize its potential when satellite-based access to the Internet becomes available. In the interim, the digital library will also be distributed on CD-ROM.

CD-ROM↗

Promoting health and improving health care in a cost-effective manner through a military digital library.

OBJECTIVE: The Virtual Naval Hospital (VNH) is a digital library designed to meet the information needs of U.S. Navy medical professionals. The goal of this study was to determine whether the VNH promoted health and improved patient care in a cost-effective manner. DESIGN AND MEASUREMENTS: An economic analysis determining the costs and benefits from the perspective of the U.S. Navy was conducted. As part of this analysis, medical professionals were surveyed from February to August 2000. RESULTS: Respondents used the VNH for a variety of professional activities (average, 8.2 h/wk). Respondents (70%) thought that VNH usage improved patient care. Medical providers thought it improved their diagnosis (70%) and treatment (60%). Respondents stated that the VNH affected 81 medical evacuations and 668 sick-in-quarter days. Overall content satisfaction was 94%. The VNH had a net savings of $143,848/yr and a cost/benefit ratio of 55.9%. CONCLUSIONS: The VNH has a beneficial impact on the Navy's health care system by improving health promotion and patient care and by being economically cost-effective.

Cost-Benefit Analysis↗