Medical Library Tech Trends 2007

I’ve tracked technology trends for the past 5 years to prepare a CE course taught periodically for the Medical Library Association. The context of my trend tracking is to determine if and how one can plan for emerging technologies. In my tracking I’ve observed that in November and December articles, reports, blogs, etc., spill over with technology predictions for the coming year. My second observation is that there is nothing magical about technology changes during a twelve month period and most trends don’t conform to these time limits. Rather than observe annual occurrences, it would be more valuable to identify early adopters who have a knack for applying new technologies in new ways to solve problems or arrive at a service no one knew they needed regardless of the time taken. Then there are also lessons to be learned from those who wait until a technology has earned its patina before using it outside its intended purpose.

Ten years ago tracking technology was easier. A technology – like PDAs – flew solo, independent of other technologies, like a bird flying outside of a flock. Now technology is immersed in the flock and the flock moves as if each technology is connected. The pattern of a single technology is not as interesting or revealing as it used to be, even if we were able to extract it from the circuits and chips it shares.

In doing research during my undergraduate years, I happened across 1915-1916 newspapers with daily, front-page headlines announcing the number of electrocutions caused by the careless hanging of new electrical lines. One article specifically blamed an electrocution due to a town’s decision to hang lines 10 feet high. One can imagine cities and organizations creating an “electrification task force” to determine where electricity should go and what would or should be the next work function to be electrified. In the early 80’s our organization received its first fax machine. A committee was formed and we met 5 or 6 times to develop polices, procedures and, ultimately, make the weighty decision of where the machine would be located. While these two examples are now humorous, we find ourselves quickly moving into an era where the emergence and the skills to use new technology is more natural; trending and tracking innovations loses its appeal as the creative use of the ubiquitous technology becomes the emphasis.

Just as computer networks must build capacity in order to absorb the next technology, we planners and administrators must think about global changes created by technology trends that have moved past swiss-army-knife convergence to performing integrated functions that are more consumer driven and, thus, naturally fit our need at the appropriate time. We should look at the problems we need solving and prepare for the solutions arrival.

Having discounted the trendiness of tracking technology trends, allow me to participate on a level that is meant to be more provocative than correct. Below is a model to manipulate in order to track new technologies and their impact on library services. The model allows for adding the dimension of “transformation” vs. “revision” of services and/or functions. In the model, I have deliberately left the “effective filtering of email spam” as an example in predicting a technology trend before it begins. To my knowledge, no one has developed a truly effective spam filter so it is obvious that someone will in the near future. Identify a major problem with technology and one identifies a fast approaching innovation. Spam filtering is included here because the algorithms or other means someone develops to filter out trash and save important information will be of great interest to librarians who long to filter out trash and save the important. Libraries should be thinking about what this application might look like and what it may mean for libraries and library patrons.

While we entertain ourselves for a few more years with the November and December predictions for the upcoming year and attempt to create models to make sense of it all, future technological innovations will be a flock of technology changes shifting and darting together over time continuous.

Technology Relevancy to Library Services/Function Scale
(Click to Enlarge)

1. Social software - As overall user traffic continues to decrease in our physical libraries, the need to explore new methods of user engagement virtually increases. Social software has the potential to provide a much-needed link between the library and virtual users of our libraries. I am not saying that libraries should rush out and implement a bunch of new software and services. Libraries should be selective about what software they choose to implement and should always solicit feedback from their users about these services. Blogs, wikis, and Facebook are three examples of social software with the potential to engage users where they are.

2. Open source software – Open source software is freely available software which allows you the ability to alter the source code and customize the software or add functionality. Open source in not new by any means but I think there is a lot of untapped potential in this area. There are working examples of open source Integrated Library Systems (ILSs) such as Koha and Evergreen and learning/content management systems such as Moodle and Sakai. When libraries use open source software, they have the potential to use a larger development community dealing with similar users and issues.

3. Mobile information devices – I think that the role of mobile device use in libraries will continue to grow as device functionality increases. We live in a mobile world and people want to access resources and their work while they are on the go. I believe that devices such as the iPhone and the Sony’s new micro computer (Vaio UX) will offer new possibilities and venues for information access on the go.

4. Collaboration tools – In addition to engaging users as I mentioned in the “Social Software” section, I think we will need to find new ways to collaborate with our users. Depending on your installation, Microsoft SharePoint has the potential to integrate many different collaboration and communication tools. There are also services such as Connotea and Zotero which allow users to save, organize, and share references. I think this type of software can offer another venue for librarians to be involved with a research team.

5. Second Life – Second Life is an open-ended virtual world created to offer social interactions between your avatar (virtual self) and other avatars. There is already a group of librarians that have developed Info Island and a virtual reference desk. This is another example of technology that has the potential to meet people where they are.

6. Cloud Architecture – Cloud Architecture consists of two parts: Folksonomies and Tag Clouds. Folksonomies are labels generated by users for objects such as bookmarks and photos. Tag clouds are a way to visually represent more popular labels (or Tag Clouds) used to identify objects. Libraries always struggle with ensuring that the terms we use to describe our services and collections and relevant to users and contain less jargon. Experimenting with the use of cloud architecture could ensure that users find the services and resources they need.

7. Wireless – Wireless technology continues to get faster and is increasingly ubiquitious. Working in synergy with mobile information devices, wireless technology has the potential to take clinical decision making to the point of care. Many of us have experience working with mobile information devices that were not wirelessly connected to the Internet. These devices are only as good as the last time they were connected to a network. Wireless ubiquity will allow users to interact with resources they need when they need them.

8. Mashups – Mashups allow users to create a new service from two or more existing services. Several Web 2.0 services use lightweight programming models which allow users to combine and remix services into new and different services. Libraries can investigate how some of these services could be remixed to offer new services for our users.

9. Streaming Media – Streaming media continues to gain popularity as services such as You Tube and Podcasting continue to develop. I am uncertain of the effects of streaming media on libraries but I think there is potential to use this technology for virtual instruction. We could also facilitate the development and organization of streaming media repositories for other areas of our institution.

10. Catalog Overlays - Products such as Endeca and AquaBrowser are springing up to put a new face on library catalogs and resources. I believe that many libraries are questioning whether the traditional library catalog can continue to link to everything in the library’s collection.

Unlike some of the others here I stopped at 8 things because I really tried not to overlap the others and I tried to look at the things effecting hospital libraries and librarians. I am sure there are many other trends out there that you think are important, so please feel free to comment.

In no particular order…

1. Complete hospital system integration and collaboration:As more and more things become available electronically users (hospital employees) are demanding for everything to be available from one platform and at their finger tips. They want the lab results, EMRs, diagnostic images, pharmacy, etc. all on one platform or at least on platforms that seamlessly play well together. What does this mean for the library? Library resources, (electronic journal articles, textbook chapters, videos, etc.) must be equally accessible within the same platforms doctors, nurses, and medical students are using to treat patients. Think of everything your library has on its web page, many of those resources need to be and eventually will be seamlessly integrated into the hospital’s information platform. So a doctor seeing a pediatric patient with maple syrup disease can choose to look at articles, book chapters, etc. all from a link within the electronic medical record. We are beginning to see this type of library resource integration with EMRs, products such as iConsult link FirstConsult, Mosby’s Drug Consult, and MDConsult into the EMR. However, iConsult only brings MDConsult (Elsevier) products to the EMR. It does not integrate access to articles or texts from other publishers/products. Therefore you still have a dichotomy of library resources at the point of care, those that can work in the EMR and those that can’t. In the future look for company to step up and create product that would allow portal and links from the EMR to multiple library resources regardless of publisher/vendor.

2. Mashups: Mashups are blended applications combining two or more existing programs to produce a third program. Like all new technologies, the rules and standards have not quite kept up. There are ongoing issues and questions with data such as security, privacy, copyright, and licensing. However, mashups open up a world of possibilities through combining various products to provide better and different library services. For example, Umlaut-Winner of OCLC’s Research Software Competition, is a very cool open source mashup (so you can grab it tweak it and use it at your library) for finding full text articles, books, and information. It combines information from an OpenURL Link Resolver program, with web content from Amazon.com and WorldCat.org. Expect ILS systems to begin to license their code to enterprising library customers to create their own institutional mashup. Ooh perhaps a medical library might create a mashup bringing their information resources into point of care systems.

3. Wireless and portable wireless devices:Hospital employees as well as patients, families, and visitors will use and depend on these devices with greater frequency, creating an increased demand for access to WiFi networks. Portable wireless devices seek out the WiFi networks, once the network is activated in a hospital, users will demand to use it. IT departments already dealing with bandwidth and security will have to address issues regarding what is accessible and who can get on the WiFi network. Already hospitals’ Intra-Internet policies vary widely from one to another. While one hospital allows and even encourages patients and their families to use web mail or blog from hospital computers, other hospitals’ IT policies are more draconian. In an age where restaurants (Panera Bread Co.), automotive places (Lube Stop), and public libraries offer free WiFi users will expect the same from a hospital WiFi and the library will be involved.

4. Virtual reality: As computer graphics and technology improve exponentially, virtual reality becomes a increasingly more important tool in medical education. University of Buffalo researchers created a “Fingertip Digitizer,” which users wear on the tip of the index finger. Hand gestures can be used to precisely direct the actions of electronic devices. As the user touches objects with the finger, it and can transfer precise physical characteristics to a computer. It can even sense the shape and size of a human gland or tumor. Libraries work closely with medical education and it important for librarians to be aware of the possibilities of virtual reality education.

5. Multimedia and Streaming Media: Smaller, faster, more portable, more applications and usages are the names of the game. Radiology images can be downloaded to iPods, the University of Toronto students digitally record and critique simulated patient exams, and medical podcasts are everywhere. It is a potpourri of information scattered throughout the Internet. Just as hospital IT policies vary widely regarding Intra-Internet access, so do the hospital multimedia policies. Many hospitals IT departments already block access to sites such as YouTube, but there are many other sites that are legitimately for medical education, including but not limited to online meetings, continuing education, videos and podcast. Not only will IT and the library have to walk the fine line between providing access to medical multimedia verses Mentos and Diet Coke erruption videos, but libraries will be faced with how to find and access these multimedia files for users. That could be anything from indexing podcasts, videos, or programs in medical databases (such as MEDLINE) or participating in online repositories.

6. Cloud architecture: Social tagging has become quite popular on the Internet. Most people associate tagging with sites like Flikr (photo tagging and sharing), del.icio.us (tagging web pages) but CiteULike and Connoteaare two online reference management systems for academics, clinicians, and scientists that utilize tagging. While many librarians are leery of “cataloging by the People,” tagging is growing in popularity and can will have an effect in cataloging and databases. Expect more library cataloging systems and databases to incorporate some form of folksonomy into their system, possibly by allowing records to contain both the librarian generated controlled vocabulary and user generated tags. After all what did we all learn in our indexing and cataloging classes in library school? The more descriptive terms a record has means more entry points for a user to find the record. We want our users to find information.

7. Open Source: Open source software offers programmers the opportunity to customize your library software, allowing for greater flexibility at a lower cost. Koha is a well known integrated library system using open source software which is used by libraries across the United States. Libraries who don’t have programmers can use companies such as LibLime that provide customization, support and training to libraries using open source software systems. While open source software systems have been around for a while, expect them to rapidly grow in popularity as mashups become more popular. Because libraries using open source software do not have to worry about the ILS’s propriety data they will be able to quickly take advantage of adding or creating library mashups to their systems. 8. Relationship searching: Medical librarians are used to and really good at finding articles on particular subjects that are already known. But is much more difficult to find information on the unknown relationship between various proteins, genes, and signaling pathways. Text mining allows searchers to findpatterns and trends to linking two otherwise unconnected articles to each other. An early example of text mining the medical research was Dr. Don R. Swansonwho was researching migraines in the 1988. Starting just with the term “migraine,” he downloaded and looked at the titles of 2,500 Medline abstracts. As certain concepts caught his attention he would subsequently search to see whether that term was in other articles related to migraines. This eventually lead him to the term “spreading depression,” which he discovered that magnesium as treatment for spreading depression. He began to discover links and connections of magnesium deficiency through the literature, leading him to hypothesize that magnesium deficiency might be a causal factor in migraines. The relationship between magnesium deficiency and headaches was soon substantiated through experiments. Prior to his research there were no articles in Medline containing both of the terms “migraines” and “magnesium” and only eleven articles with “dietary deficiency” and “migraines.” Databases such as Chilibot, XplorMed, BioIE Search, and iHop are making the kind of research Dr. Swanson performed much easier and faster. These databases seem to be primarily used by biological scientists and in no way replace the human factor, but they lead to another method of conducting medical research. Look for more researchers asking about text mining databases, and librarians should prepare themselves by being more familiar with these databases as compliments (not replacements) to Medline.Finally, while doing research for my top technologies I noticed a couple articles on technology busts and failures. Just something interesting to read while looking at prediction lists. Technology’s 10 most inexcusable failures Ten Failed Tech Trends for 2005–Interesting in that they list the iPod as a failure. Huh.

1. Cloud Architecture (Folksonomies and Tag Clouds)
The concepts of folksonomies and tagging will continue to affect the future growth of the Internet and Web services. The basic premise behind tagging is that users assign descriptors for a particular object (image, video, book, etc). This concept relies on the ‘wisdom of crowds’ which states that the combined knowledge of the ‘crowd’ is more accurate than any one particular expert. Tagging is essentially user based cataloging and that is enough to make even the most progressive cataloger cringe. However, there is an opportunity here to leverage the best of both worlds. Pairing the freedom of user based tags, with the structure of controlled vocabulary could help librarians understand user’s information discovery methods and at the same time, point users to more structured ontology will make for better cataloged records. After all, both librarians and users have a lot to learn from each other.

Links for more info
• http://en.wikipedia.org/wiki/Folksonomy
•http://en.wikipedia.org/wiki/Tag_cloud
• http://www.youtube.com/watch?v=6gmP4nk0EOE

2. Collaboration Tools (Google docs, Zoho, etc)
Collaboration tools on the Web are quickly emerging as ways for groups of people to work together on a document regardless of their proximity or affiliation. Generally these tools do not require any special software, work in most browsers, and are free. Google docs and Zoho allows multiple people to work on word process and spreadsheets. For medical librarians this may help facilitate collaboration in professional organizations or situations where colleagues are not centrally located. For example, a group of ten energetic librarians working on the local chapters strategic planning document. In the past they might email a draft back and forth. If two librarians made a change at the same time, then someone would have to figure out where the documents differed and combine the two. Document version names could be unruly and unhelpful (stratplan.doc, stratplan2.doc, stratplan_bob.doc, stratplan10122006.doc, and stratplan10122006b.doc). These documents might be emailed back and forth amongst all of the members causing a great deal of confusion. Collaboration tools such as Google docs and Zoho allow for multiple people to access a document from a single location and automatically saves all versions of the document so that nothing is lost. There are also no constraints on software, although they can export to major formats such as Microsoft Word.

Links for more info
• http://www.google.com/google-d-s/intl/en/tour1.htm
• http://www.zoho.com/

3. Mashups
Mashups lie at the heart of the Web 2.0 movement. Basically a mashup is when one data source is combined with a second data source so that a tertiary product is created. If the source of data is open to the world, then often products are made that were never even conceived by the original producers of the data. There are many examples of this, but the some of the more common involve the use of Google maps and a different data source such as the mashup between Google Maps and CraigsList. What is exciting about this for medical libraries is the possibility of connecting to our cataloging, databases, or journals and combining them with Library services. Potentially this could produce tailored services to our patrons and user groups.

Links for more info
• http://en.wikipedia.org/wiki/Mashup_(web_application_hybrid)
• http://pipes.yahoo.com/
• http://www.housingmaps.com

4. Open Source Software
The open source software movement has gained a lot of steam in the past few years. Off the shelf software is often limited to the amount of customization that is allowed. Today, open source software is not only free, but the code based is free as well. This means that programmers have access to the code and can alter it to specifically address user needs. Many open source projects are highly developed and supported by communities that care about the product. Look for more open source applications to be integrated with library services.

Links for more info
• http://en.wikipedia.org/wiki/Open_source
• http://sourceforge.net/

5. AJAX
AJAX stands for Asynchronous JavaScript and XML. Why would you need to know that? AJAX represents a change in Web services that will have a dramatic impact on Internet users. Javascript was once a gimmicky language that let you run a picture slideshow or create mouse trails on your website. Today AJAX allows for a higher level of interaction between the user and the webpage. An example of this is Netvibes where users can alter and save the information displayed on the webpage. Real-time interaction with a webpage and the ability to modify and save that information is a huge move forward. Imagine a library homepage where users can login and customize what is displayed and where it is displayed. This is MyLibrary 2.0 and data could be gathered to help libraries develop more meaningful web interfaces.

Links for more info
• http://en.wikipedia.org/wiki/Ajax_(programming)
• http://www.netvibes.com/

6. Electronic Medical Record
It is clear that the Electronic Medical Record (EMR) will have a significant impact on health care in the near future. What is unclear is the extent that library services will be integrated into the EMR. Certainly linkages between the EMR and library electronic resources will be important. Will literatures searches, consults, and other library services be made available? How can these resources be placed in the system so that they are at the point of need for the healthcare provider? I don’t know the answer to these questions, but I am sure that they will have a huge impact on our future.

Links for more info
• http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/
2005/07/24/EDGFVC9JFF1.DTL
• http://en.wikipedia.org/wiki/Electronic_medical_record
• http://dbmi.mc.vanderbilt.edu/trust/TRUST_for_patient_portals.pdf

7. Social Networks (MySpace, friendster, facebook)
MySpace, Facebook, and Friendster are examples of social networks that most librarians have heard of by this point. For many non-millennials these social networks may not represent a change in personal Web habits. However, how many medical and nursing students have MySpace or Facebook accounts? It is important for medical libraries to understand that these social networks are a means of communication and interaction for the millennial generation. In general, medical libraries have struggled to find useful ways to use of these sites to communicate with their patrons. From a larger perspective, is it appropriate for medical libraries create a Facebook or MySpace pages to communicate with their patrons. Or will this be seen as hooky attempt to “be cool”. Will this technology evolve into professional communities? Will there be a LibSpace community were library professionals connect and communicate with each other?

Links for more info
• http://en.wikipedia.org/wiki/Social_network
• http://www.myspace.com/
• http://www.facebook.com/
• http://www.friendster.com/

8. Streaming Media (YouTube, Podcasting, etc)
Both Podcasting and Youtube were buzz words in the 2006. Podcasting is already being integrated in many Library websites. Apple is partnering with iTunes to create iTunes University. YouTube has become the place where many Internet users begin to search for TV clips, music videos, almost anything that is video content. The lines between copyright and ownership are blurring. Many companies like Warner now allow mashups of user video content with their copyrighted music. Can libraries leverage the popularity and power of streaming media in 2007? This seems to have been on the library radar for several years now, but now the time seems ripe.

Links for more info
• http://www.apple.com/education/products/ipod/itunes_u.html
• http://news.digitaltrends.com/article11308.html

9. OS Wars
For years Microsoft Windows has dominated the computer market. However, recently Apple has dramatically increased its market share. Both companies have promising new products. For Microsoft there is the much anticipated new operating system Vista which is a huge shift from the XP OS. There is also a 2007 version of Office and a new tab-based Internet Explorer browser. Newer Apple Intel based computers can also run the Apple OS as well as Windows. Does mean ubiquitous computing for users in the future. Apple also made a huge splash by unveiling the iPhone at Macworld in January. The iPhone promises to be your iPod, smart phone, digital camera, and portable computing device. There is also a push by Apple to control your living room with iTV. The new Apple OS Leopard is said to be released in early 2007, but there is no exact date yet. What does all of this mean for medical libraries? Maybe not much in the short term, but certainly the technology that our users bring into their home will need to be supported for Library resources. One small impact that could affect medical libraries in the short term is the new file formats used in Office 2007. Older versions of Office need to have a compatibility pack download and installed to read the new format. Also, proxy servers, online journals, and CSS used on library websites could be impacted as libraries will need to consider and test for the new IE browser.

Links for More Info
• http://en.wikipedia.org/wiki/Windows_Vista
• http://office.microsoft.com/en-us/suites/HA101757691033.aspx
• http://www.apple.com/macosx/leopard/index.html
• http://www.apple.com/iphone/

10. Second Life (avatars)
This may be a low impact on librarians, but a site that every librarian should be able to speak about to some degree. Second life is a Mass Multiplayer Online Roll Playing Game (MMORPG) although it is not ‘played’ like a game. Inside of Second Life users create digital lives where they can build houses, have jobs, interact with people, even spend money. It is an advanced form of Web 2.0. The interesting thing about Second Life is Info Island. Info Island is library that provides real library services like reference and book discussions. There is even a Medical Library.

Links for More Info
• http://infoisland.org/

Other things I wanted to add to my list but didn’t have room for:

• Expanse of Wireless Ubiquity (802.11 Wi-Fi, WiMAX, VOIP)
• Federation (IM, Searching)
• Visualization
• Mobile Web 2.0 devices
• Dynamic Programming Languages (Ruby and Groovy)
• Blu-Ray – HD-DVD