MEDINFO 2004 M. Fieschi et al. (Eds) Amsterdam: IOS Press © 2004 IMIA. All rights reserved
Using Knowledge Management Practices to Develop a State-of-the-Art Digital Library Annette M. Williams a, Nunzia Bettinsoli Giuse a,b, Taneya Y. Koonce a, Qinghua Kou a, Dario A. Giuse b a
Eskind Biomedical Library, Vanderbilt University Medical Center, 2209 Garland Avenue, Nashville, TN 37232 USA b Department of Biomedical Informatics, Vanderbilt University Medical Center, 2209 Garland Avenue, Nashville, TN 37232 USA
Annette M. Williams, Nunzia Bettinsoli Giuse, Taneya Y. Koonce, Qinghua Kou, Dario A. Giuse Abstract
Background: Digital Library Approaches
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.
The history of digital library work encompasses a vast array of initiatives and research endeavors [3]. Much of the early work has, understandably, focused on solving fundamental problems of system interoperability. The six projects funded under the National Science Foundation’s Digital Library Initiatives Phase I (DLI-I) [4] pioneered scalable methods for organizing large amounts of diverse information to support intelligent retrieval [5]. Most existing research has centered on the levels Fox and Marchionini define as technical and informational interoperability [6]. Representative examples of projects that address this technical and informational operability include the DLI-I projects at Stanford University, the agent-based system at the University of Michigan, the Informedia project, the Alexandria Digital Library and the University of California at Berkeley’s Geographic Information Systems.
Keywords: Digital Libraries, Knowledge Management, Information Storage and Retrieval, Libraries Medical
Introduction
Expanding upon the base of work established by the Digital Library Initiatives Phases I and II projects, libraries have played an increasing role in digital library development. Contributing to the less explored levels of community and service, library involvement in digital library research has focused on current and anticipated practical challenges with user-oriented approaches [7].
The information explosion in the health sciences is well illustrated by the increase in the number of citations indexed in MEDLINE. The National Library of Medicine indexes 4600 journals and, as of 2002, MEDLINE includes over 12 million citations. As noted in several publications on information needs, it would take a lifetime for a clinician to read everything relevant to practice [1]. In his discussion of information economics and the Internet, Enrico Coiera mentions that this problem is compounded by the growth of health information currently available on the World Wide Web [2]. The resulting challenge to informatics professionals is to create high-quality portals to reliable, authoritative Web-based information resources and provide the medical community with tools to help manage knowledge at its origin. These digital knowledge systems must also function to acquire and conserve, organize and retrieve, and display and distribute information in a manner that informs, educates, and facilitates the
At the core of knowledge management is the desire to identify and share knowledge that may not otherwise be found and shared, such as tacit knowledge residing in a single individual or an organization’s grey literature usually accessible to only a few of its members. The theory behind knowledge management practice is that knowledge is not an end unto itself. When information and knowledge flow can be captured, organized and made accessible for reuse, there exists the potential for subsequent creation of new knowledge. Diffusing knowledge management practices within an organization encourages and facilitates reuse of the institution’s knowledge commodity [8;9].
discovery and creation of new knowledge. In answer to these challenges, the Eskind Biomedical Library (EBL), as one of the arms of the Informatics Center (IC), has over the past three years created a suite of tools targeted to promote knowledge management practices within the Vanderbilt University Medical Center (VUMC). This paper describes the technical framework of a state-of-the-art Digital Library, EBL’s attempt to best capture and organize institutional knowledge in the effort to impact clinical, research, and educational workflow processes.
The Integrated Advanced Information Management System (IAIMS) has been a key component of VUMC’s strategy for achieving the highest standards in education, biomedical research, and patient care in a changing health care environment [10]. The original idea behind IAIMS was that health science libraries should play key roles in using computers, communication, and strategic planning to address the information needs of health professionals. Digital libraries within academic healthcare are generally tied to development in four areas: Integrated
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The Digital Library represents EBL’s first example of an application using multiple knowledge management principles at all levels of project development. These principles governed the selection of project participants, guided the organization of the portal’s content, and provided the foundation for a reusable tool. The project team, representing a composite of the skills that the EBL lends to the institution, was developed via a skills matrix model, which brings together participants based on skills rather than traditional roles. Using this model the library brought together knowledge which had been fragmented throughout different areas of the library.
Advanced Information Management Systems (IAIMS), telemedicine, Continuing Medical Education (CME), and consumer health. IAIMS created environments which fostered research and development of digital library technologies, such as interoperability, user interfaces, and electronic publishing [11]. The IAIMS collaborative approach model that establishes effective partnerships between technology architects and groups needing to leverage off technology has been particularly effective for linking problem-solvers with problem-bearers, a paradigm which can ensure that programmers’ products address real life issues instead of addressing perceived needs, allowing initiatives to be executed at a faster rate. At VUMC, we have been successfully able to carry out the IAIMS initiative and continue to use the collaborative model for building long-lasting relationships among the different players. For instance, the Informatics Center’s current ”E3” project (“Eliminate all paper-based processes from outpatient clinics by 2003”) [12] largely builds upon a clinical environment already receptive to informatics as a mechanism for building efficiency and productivity [13]. Similarly, as knowledge management experts, EBL librarians in their role as informaticians, are extending their knowledge evaluation, organization and processing skills to the medical center community through the provision of EBL tools capable of capturing their collective skills and know-how. This approach leverages the inherent strengths of three disciplines: librarianship, computer science and medicine. Fundamental skills that librarians contribute include 1) locating relevant information sources for particular needs; 2) critically evaluating resource quality, and 3) processing resources in a manner that imposes logical order so new knowledge can be gained.
Design and Implementation Traditional skills such as cataloging, indexing and abstracting were re-engineered to meet the new demands of the dynamic digital environment. As an example of the unique skills librarians contributed, metadata record structure and portal content organization were defined by catalogers experienced in the classification and categorization of information resources. To supplement the representation of the basic record elements, librarians with diverse sets of skills were asked to critically assess the types of information included thus far in the Digital Library metadata records and contribute additional information in light of personal and professional knowledge. Figure 1 shows an example of the richness of a metadata record, critical to both resource discovery and portal administration [16]. The Technical Services staff contributed fundamental bibliographic elements as well as information critical to resource availability and connectivity. Collection development staff select all formats of electronic resources in response to medical center programs and initiatives. Information and Education librarians’ resource knowledge was captured through in-depth descriptions aiding users to identify appropriate resources for their needs. These descriptions are enhanced with instructional information promoting effective use of resources. Capturing complex knowledge in an electronic format called for an extension of the Digital Library in the form of a knowledge management shell. .
Given their skills in organizing knowledge, librarians are ideally qualified to face the challenge of creating tools that capture knowledge in a non-intrusive manner and make it available at the right time and place, where its reuse can be maximized and facilitated. The codification and reuse of organizational knowledge (which is currently handled informally and stored mostly “in a few people’s heads”) will enable new ways to facilitate an organization’s handling of information [14].
Digital Library Libraries can play a key role in digital library development by weaving librarianship skills into the final design of digital libraries. This has the potential to facilitate knowledge management functions by enabling barrier-free access to materials and incorporating structured and unstructured information in a way that precipitates knowledge discovery [15]. To further the Informatics Center’s mission of delivering information, the Eskind Biomedical Library has applied knowledge management principles to create a portal that supports digital resources. The VUMC Digital Library improves organization and delivery of electronic information at the time and place of need, and plays a pivotal role in the Medical Center’s goal of transitioning from print to electronic resources. The Digital Library is the main information access point for Medical Center resources, and is predicated on a holistic approach combining information availability with librarians’ know-how and skills, yielding true integration of library explicit and tacit knowledge.
Figure 1 - Metadata Record
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Figure 2 - Digital Library Usage by Location level content; access to some supplemental data, however, requires users to authenticate.
With the help of library Web developers, a new tool called the Learning Module Shell (LMS) was created. The LMS makes it possible for Information and Education specialists to best represent their knowledge in an online environment. In-context use of resources came into play with this tool as appropriate resource usage was demonstrated via real questions gathered during interactions with clinical and research teams. The knowledge captured by the LMS tool created an immediate opportunity for reuse, as the applicability of the modules created by the Information and Education librarians surpassed its original scope of training library users and became important material for the training of EBL’s junior library professionals.
Discussion An important measure of the success of the Digital Library implementation has been the constant monitoring of usage statistics. Usage from the VUMC community and remote access are logged for each hit on a resource link. Perl scripts on the server are set up to run each month to process the usage data and the results are output to a spreadsheet which is automatically emailed to portal content administrators, as decisions about successful or unsuccessful implementation of resources are often gathered through these statistics.
At the technical level the Digital Library is designed to support fast access to known titles and provide the ability to identify resources matching particular information needs. A goal that shaped its creation was to transition from the library’s initial portal -- in which digital information was presented in a flat, linear approach -- to a multidimensional interface which keeps primary content visible while allowing access to successive layers of information. The EBL technical team supports an Apache Web Server and a MySQL‚ database server running on the Sun SolarisTM/SPARC‚ platform. The MySQL‚ 3.23 server powers the portal’s back-end relational database. PHP (PHP Hypertext Preprocessor), HTML and Javascript on the Web server interact with the database to create dynamic, platform-independent administrative and public-view front-end interfaces. The entity-relationship data model is used to describe the data and their relationships within the database design. Database content management is achieved through the administrative interface, accessible to authenticated librarians.
Figure 2 details the overall access and utilization of the Digital Library by user location, showing that most of the use occurs outside the library building. Currently in-library usage accounts for only 15% of the total Digital Library access, down from 40% reported five years ago and from 20% just one year ago. The increasing usage beyond the library walls can be interpreted as a measure of the Digital Library’s ease of use, a hypothesis that also seems to be supported by the increasing amount of off-campus (remote) usage over the past two years. Ease of interface use, combined with the wealth of instructional information contained in each metadata record, allow users to fulfill many resource-related questions immediately at their desktop, whereas previously such queries necessitated coming to the library building. To investigate the team’s hypothesis that metadata played a role in the successful implementation of the Digital Library, a detailed analysis was run on the metadata usage, as shown in Figure 3. This figure reveals that the primary users of metadata are individuals accessing the Digital Library remotely. In FY 2002-2003, 81% of metadata access originated from remote users, up 20 percentage points from FY 2001-2002. This data shows a clear correlation between increased use of metadata by remote users with an increase in the remote access to resources in the Digital Library.
The end result of the portal design was total flexibility and potential for customization of different elements, as resources can be grouped based on a variety of record parameters -- for example, title, subject, and format (journals, books, databases, etc.). This flexibility contributes to tailored interfaces and advanced searching capability. Levels of portal content access are dependent on user authentication, administered via a campus-based system. The program enables global access to the portal’s top-
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Figure 3 - Metadata Usage by Location More recently the project team has observed an impact of the Digital Library on variables such as shelving of journals, entrances into the library, use of photocopiers, and analysis of questions received by information specialists. While this impact will require a detailed analysis and study of all the implications and correlations among the variables, it seems to support the concept of a paradigm shift within the library and the view of the Digital Library as a true innovation.
Acknowledgements
Conclusion
[2] Coiera E. Information economics and the Internet. J Am Med Inform Assoc 2000; 7(3):215-221.
The authors gratefully acknowledge the assistance of Rachel Walden in the preparation of this paper.
References [1] Arndt KA. Information excess in medicine. Overview, relevance to dermatology, and strategies for coping. Arch Dermatol 1992; 128(9):1249-1256.
For knowledge reuse to be fully optimized, knowledge must be treated as a shareable commodity. EBL’s Digital Library has been built as a modular, reusable knowledge management resource that can be quickly adapted to a multitude of Medical Center needs. Customized digital libraries, created through the reuse of the main Digital Library data, help Medical Center departments to meet their own information organization needs while also serving the institutional objective of improved knowledge management. Further capitalizing on this technology as well as the ability to quickly manipulate data and resources, the EBL is currently engaged in a collaborative project to create a digital library for Tennessee public health partners1
[3] Borgman C. What are digital libraries? Competing visions. Information Processing & Management 1999; 35(3):227243. [4] Digital Library Initiatives [online]. 1999 [cited 2003 Aug 1]. Available from: URL: http://www.dli2.nsf.gov/dlione/ [5] Schatz B, Chen H. Building large-scale digital libraries. Computer 1996; 29:22-26. [6] Marchionini G, Fox EA. Progress toward digital libraries: augmentation through integration. Information Processing & Management 1999; 35:219-225. [7] Lakos A, Gray C. Personalized library portals as an organizational culture change agent. Information Technology and Libraries 2000; 19(4):169-174.
The state-of-the-art VUMC Digital Library was created under the auspices of good librarianship and biomedical informatics to facilitate the optimal use of biomedical knowledge. With the exponential growth of available explicit and tacit information, informaticians have an opportunity to exercise their talents and skills to create knowledge management repositories. Thus it seems natural that information professionals put effort and resources into developing knowledge management systems designed to provide key services to continuously support and improve medical education, research, and patient care.
[8] Strawser CL. Building Effective Knowledge Management Solutions. Journal of Healthcare Information Management 2000; 14(1):73-80. [9] Kim S. The roles of knowledge professionals for Knowledge Management. International Federation of Library Association and Institutions 1999 Bangkok Conference Proceedings [online]. 1999 [cited 2003 Aug 1]. Available from: URL: http://www.ifla.org/IV/ifla65/papers/042115e.htm. [10]Stead WW. The evolution of the IAIMS: lessons for the next decade. J Am Med Inform Assoc 1997; 4(2 Suppl):S4-S9.
1. Project supported by NLM Grant No. GO7 LM07720-01. (Giuse NB, Principle Investigator).
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[11]Braude RM, Florance V, Frisse M, Fuller S. The organization of the digital library. Acad Med 1995; 70(4):286-291. [12]Jirjis J, Patel N, Aronsky D, Lorenzi N, Giuse DA. Seeing Stars: The Creation of a Core Clinical Support Informatics Product. In: Salazar A, Hackney R, Howells J, editors. Innovation Management in the Knowledge (Digital) Age: Enabling Strategic Transformation in Healthcare Organizations. London: IOS Press, 2003. [13]Giuse DA. Provider order entry with integrated decision support: from academia to industry. Methods Inf Med 2003; 42(1):45-50. [14]Knowledge Management for the Information Professional. Medford, NJ: Information Today, Inc. for the American Society for Information Science, 2000. [15]Rydberg-Cox JA, Chavez RF, Smith DA, Mahoney A, Crane GR. Knowledge management in the Perseus Digital Library [online]. Ariadne 25. 2000 [cited 2003 Aug 1]. Available from: URL: http://www.ariadne.ac.uk/issue25/ rydberg-cox. [16]McCray AT, Gallagher ME. Principles for digital library development. Commun ACM 2001; 44(5):49-54. Address for correspondence Annette Williams, MLS
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