National Network of Libraries for Health Concept of Operations

1. National Network of Libraries for Health Concept of Operations

2. Why a National Network? • High quality health care requires evidence-based decisions • In the absence of a national network with equitable and coordinated access to information for health professionals……

3. Many health care providers have little or no access to information resources and services • Others have access from a variety of providers – in some cases with significant duplication • Lack of access impacts significantly on health care practices and costs • Simply providing access to resources without support does not adequately meet needs of front line care providers

4. Developing the COO

5. June 2005 - PHAC/CNA/CMA/CISTI commit funding for development of business case • July 2005 - Project Advisory Team appointed • August 2005 - RFP for development of business case issued • December 2005 - Proposals reviewed and selection finalized Decision made to begin with development and validation of a concept of operations before moving on to development of a business case

6. The consultant, the Project Advisory Team and the Task Force went to work

7. Information gathering

8. Environmental Scan - Models in Other Countries National networks of health libraries • National Network of Libraries of Medicine (U.S.) • National Library for Health (U.K.) • MANY countries have negotiated nation-wide licenses for key resources

9. Environmental Scan Canadian Initiatives Regional initiatives • Alberta Health Knowledge Network • Atlantic Health Knowledge Partnership • E-HLBC • Newfoundland and Labrador Health Knowledge Information Network • Saskatchewan Health Information Resources Partnership

10. Discipline specific initiatives • Canadian Nurses Association NurseOne Portal • Canadian Medical Association • College of Family Physicians of Canada

11. Literature Review Rochester study “At the end of this study the physicians rated the information provided by the librarian more highly than that provided by other information sources such as diagnostic imaging, lab tests, and discussion with colleagues “

12. JIT service • “It has been a pleasure using the JIT service. Patients would be so impressed when I told them that I had access to a medical librarian and that I would be able to get them the latest info on whatever the topic of inquiry. I hope that there will be funding to somehow to keep the service. I'll miss you guys.” • “You know, I love questions. I like my questions; my patients’ questions and I like finding answers. Your service helps.” • “I just wanted to you feedback about how useful and on-target all the answers have been to give my questions. I'm not looking forward to when this “experiment” is over! “

13. NeLH evaluation “an estimated annual cost saving per year of over 25 million dollars, based only on professional’s estimates of time savings in accessing information, and not the actual impact of applying the information to practice”

14. Consultation with Stakeholders

15. Health librarians • Health care providers • Administrators Interviews, focus groups, survey

16. Conclusions Many health care providers face significant barriers in accessing the information they need to support effective practice • cost • geography • technology • time • knowledge

17. Health libraries face increasing demands for resources and services, increases in subscription/licensing costs and decreasing budgets • Professional associations face significant demands from members, but do not have the capacity/resources do this in a vacuum • While internet access to full text electronic resources is of significant benefit, it is only one part of an effective overall strategy to connect health care providers with the information they need

18. While there are excellent national models for the coordination and support of access to consumer health information (CHN) and health data (CIHI) there is no similar structure/mechanism to coordinate and support access to knowledge based information resources and services for Canada’s health professionals • Consequently, fiscal, technological and human resources cannot be effectively coordinated, allocated or leveraged

19. The need for access to high quality, easily accessible, information services and resources continues to grow

20. In the absence of a nationally coordinated solution there will be continued, fragmented growth of local and regional initiatives • redundancy and recreation rather than growth and innovation • significant gaps in access will continue to exist • costs will escalate disproportionately to benefits

21. Sir Muir Gray’s advice: “Build it and they will come”

22. Concept of Operations Local/Regional Health Libraries Health Care Professionals NNLH / RNBS National Coordinating Office

23. Local/Regional Health Libraries • Provide client training and support • Provide reference and literature searching • Provide document delivery/interlibrary loan services • Develop and deploy services, resources and content tailored to specific local needs and constituencies • Contribute and share resources and expertise at a national level • Provide representation on advisory board for NNLH

24. Health Care Providers • Identify information needs • Identify barriers to information access and use • Provide support and advocacy • Provide representation on advisory board for NNLH • Provide expert advice in content selection, evaluation and development • Participate in needs assessment and usability testing

25. National Coordinating Office • identifies and leverages existing local and regional resources to ensure equitable national access; • collaborates with existing libraries, resource centres, associations and agencies to develop and enhance content and linkages • coordinates and manages information on a nationally accessible bilingual portal. • supports local and regional libraries through training and development programs; • provides direct support to those health care providers who have no affiliation with or access to information services, resources, training or support; • and • conducts user needs assessments, usability tests and service evaluations

26. Organization

27. Notional Budget Year 1 • $1,645,000 Year 2 • $2,500,000

28. Benefits of this model • Coordinates and leverages the existing base of resources, services and expertise • Builds on available infrastructure and develops opportunities for local and regional libraries to improve and expand unique services

29. Provides a virtual platform to facilitate knowledge transfer and exchange at a national level • Preserves and provides access to key Canadian health care resources • Effectively identifies and addresses service and resource gaps

30. User-centered – health professionals will be partners in development • Evidence based – development of network will be based on ongoing needs assessment and evaluation

31. Ensures barrier free and equitable access to key information resources and services for health care providers from coast to coast to coast

32. Next Steps • Expand Concept of Operations to a detailed business case Begin with business case for smaller pilot as proof of concept? • Identify sources of funding for business case • Complete and validate business case • Use of business case to solicit funding for pilot/phase1

33. For discussion • Funding sources/cycles • Location and governance • Partnerships • Timelines/windows • Advocates/champions