That many of the challenges and difficulties (see the two lists below) facing medical information specialists, have potential solutions in the near future organisation of the World Wide Web, is widely accepted. The problem facing medical information specialists is how, in the context of the NHS, do we make the Web work for us?
Challenges to health librarianship in a changing NHS
- Primary care led NHS: with more health care taking place away from hospitals information services should be more available to primary care practitioners
- Creation of an evidence-based culture: decision makers are ready to consider using bibliographic information to inform clinical and policy decisions provided the information is made available effectively
Specific difficulties facing health libraries
- Lack of resources
- Increasing demand
- Changing pattern of funding for health libraries in the Internal market
- Continual expansion in published books and journals
A small start has been made by health librarians in the South and West region of the NHS, a large area stretching from Gloucester in the north, to Basingstoke in the east, to Penzance in the west.
The region includes 49 NHS trusts, 12 health authorities, 2 medical schools, colleges of nursing and occupational therapy. During 1994 most of the libraries obtained Internet accounts, some from their own budgets and some through small grants from regional funds.
In April 1995, in a joint initiative between the Regional Library Networks and the Regional Research and Development Directorate, a South and West Health Libraries web site was created. Nine months is a long time in the development of the Web, and the reasons for creating the site now seem a little passe. At the time, there were few classified lists of Internet health resources available at UK sites. David Pencheon was maintaining a site in Cambridge, and collections of URLs were available from Manchester and London. It was hoped that a good collection of URLs would prove useful to librarians in the South West, and that a web site would provide a starting point for librarians beginning to incorporate the Web into their services.
Once the decision to create a site had been made the collection of URLs grew quickly. The site places an emphasis on evidence-based-medicine; tools for librarians such as publishers catalogues, library organisations; search engines; and specialty home pages, along with more usual groupings like electronic journals, electronic texts, patient information guides, and a short-lived and much missed reference librarian site which included a wonderful photo of a bald librarian in a check jacket. Other strengths include occupational health links and databases of current research such as the UKCCCR register.
The other initial section was a news page. Between five and ten items continue to be added most weeks. These might be details of new Web sites, conference announcements, or snippets of news gleaned from discussion lists and newsgroups. Some parts of the original site plan have yet to be implemented: a directory; a union catalogue, a diary of events, and a newsletter.
The site has grown during 1995, and now contains about 250 links (WWW, gopher, and telnet) to health resources. Recently, a backlink into Lycos has been added. The site receives about 75 visits per day on average. Maintaining the site at its present level takes about one hour per week, thanks to the tools available: pages are created and edited in Microsoft Word 6 using the freeware html editor attachment called Internet Assistant. Once created, pages are mounted on a network drive, from where subsequent editing is carried out directly. Like the editor the Web server software came free, and is installed on a departmental UNIX machine. One of the great things about Internet technology is that it is cheap, or as I have been advised to put it, not expensive.
The web site has also served as the core for teaching. In the Summer of 1995 a seminar held in Bristol featured a morning's practical tutorial on the Internet. Feedback indicated that the session was useful to the 20 librarians who attended, and a second seminar is planned for Southampton this March.
Looking to the future
The idea of a locally maintained web-site largely composed of links is becoming redundant as projects such as OMNI begin to take shape. As well as OMNI, during 1996 we can expect initiatives from the National Library of Medicine, along with improved search engines. But useful as the present cataloguing initiatives are, the Web has still yet to deliver any major content, with the exception of OMIM. It is in the area of content that we hope to see major improvements in 1996.
During 1996 we hope that the South and West web site will become a support for distributed working between libraries. In this respect the HeLIN site in Oxford, serving librarians in Anglia and Oxford offers some pointers.
But the biggest challenges are in the areas of policy. Can the NHS create a network which librarians might use to deliver services to its customers wherever they are? Can the barriers to full-text and electronic document delivery be overcome? Can more and better databases become available? One day the Net will be a basic tool for all librarians. In the South and West we have started to get ready.