This project explored the literature regarding the mobile delivery of health care information and its impact on health sciences library collection management

1. The Twenty-First Century Black Bag:
Mobile Delivery of Health Care
Information and Implications for Health
Sciences Library Collection Development
Elizabeth Retzel Bucciarelli, MSLS
Eastern Michigan University

2. Elizabeth Retzel Bucciarelli
Michigan Academy of
Science, Arts and Letters
Annual Conference
March 22, 2013
Hope College, Holland, MI
ebucciare@emich.edu

3. “Mobile is very much a moving target.”*
“Nowhere has technology changed as rapidly
and consumer behavior as broadly.”*
This is a market in which new competitors come in a week’s time.”*
*New York Times, “Mobile Apps Drive Change in Searches”, Jan. 8, 2013
Google “…has 96% of the world’s mobile search market…”*
“…as people change their search habits on mobile
devices-bypassing Google to go straight to apps…
that dominance could wane…and knock Google
off its perch.” *

4. Higher Education
Student Technology Trends
• Nearly all students own a laptop - 86%**
• Student tablet ownership – 7% in 2011 and
25% in 2012***
• E-reader ownership – 12%**
• Portable devices are the academic favorites,
and they are diverse in terms of brands and
platforms**
• U.S adult population tablet/e-reader
ownership – 18% in 2011 but 29% in 2012*
o *Pew Research Center’s Internet & American Life Project
o **ECAR 2012
o ***Pearson Foundation Survey of Students and Tablets 2012

5. Mobile Technology
Popularity
• Mobility & flexibility of modern
devices
• Ubiquitous high-speed internet
• Moderate price-range of devices

6. Mobile Technology
Behavior Changes
•“People moving toward consumption-based internet
experience from a production-based experience”
Sue Gardner, Ex. Dir. of the Wikipedia Foundation
•Tablets are used for watching videos and surfing the
internet more so than typing text
•Expectation of academic library users that resources
will be available electronically

7. Mobile Technology in Medicine
and the Health Sciences
• Medicine has been an early adopter in the use of
telehealthcare, e.g., EKG via telephone modem
• Medicine has been an early adopter in the use of
mobile devices
• Medical residents and health care professionals show a
preference for using internet-powered mobile devices to
access information at the bedside
• Medical libraries provide more mobile services,
resources, and support than libraries in other disciplines

8. Mobile Technology Ownership
by Physicians and Nurses-2012
Nurses Physicians
Smartphone Ownership 71% 81%
Tablet Computer
Ownership
44% -iPad dominant 62% -iPad dominant

9. Mobile Technology
Health Care Applications
• Bedside access to:
o Drug handbooks
o Clinical textbooks
o Medical & allied health dictionaries
o Point of care resources, e.g., Up-to-Date, DynaMed
o Patient education materials
• Electronic medical records (EMR)
• Real-time alerts
• Useful at bedside of patients in critical care areas
where health care professional cannot leave

10. Mobile Technology
Health Care Applications, cont.
• Mutual management by patient and
health care professionals of chronic
diseases
o Cardiac management
o Smoking cessation support
o Asthma monitoring
o Blood pressure monitoring
o Diabetes management
o Weight management
o Drug & alcohol recovery support
o Grief support
o Psychological support
• Early detection of problems
• Periodic prompts and text messages to patients from
health care professionals

11. Mobile Technology Applications in
Health Sciences & Medicine – Early Uses
• Personal Digital Assistants (PDA)
o Care planning
o Pain tracking and documentation
o Medication & drug reference & administration
o Diagnostics
o Medical terminology
o Advanced practice nursing
o Medical and nursing students, and preceptors
• Pharmacological knowledge
• Contextual knowledge
• Clinical knowledge

12. Mobile technology Applications in Health Sciences/Medicine
Current Trends
• Tablet computers in rural health & medicine study –
2003
• Clinical portfolios for nursing students study - 2005
• Physician use of ‘handheld technology’ studies –
2000-2007
o Rapid response
o Error prevention
o Information accessibility
o Data management
• Kindle e-reader study -2009
o loaded with medical textbooks on primary care & family medicine

13. Mobile Technology
Health Applications-Advantages
• Overall error reduction due to currency of all information
• Ease of access to current, best information for each
patient
• Home-based patient monitoring
• Ease of access to patient education information
• More time spent in patients’ rooms rather than at a
central computer station
• Patient-centered approach to care
• Time savings
• Overall ease of use
• Patients approve of the use for patient education

14. Mobile Technology
Health Applications-Disadvantages
• *Lack of a standard platform*
• Cost - hardware & software
• Security of the devices
• Security of patient information
• Screen clarity and size re: readability
• Short battery life
• Awkward virtual keyboard
• Perception that the health care professional is browsing
the web rather than working
• Feelings of unprofessional behavior on the part of the
health care professional

15. Collection Development
Considerations
• Know the direction of the teaching faculty or health
care professionals on your campus re: e-resources &
mobile use
• Understand the effect of Digital Rights Management
(DRM) (copyright protection technology) on the use of
the item
• Create methods for training library staff and users on
accessing and making full use of the mobile collections
• Use patron driven acquisition models
• Know the parameters of the vendor licensing
agreements
o Ownership vs. access
o Single user vs. multi-user
• Be aware of e-resource maintenance fees by vendors

16. Collection Development
Considerations, cont.
• Know if content can be:
o downloaded and used offline or if an active internet
connection is needed
o copied & used for educational purposes
• Understand the compatibility of e-resources with as many
operating systems as possible, e.g., iOS, Android, Windows
• Be aware of the user experience with various mobile
devices
• Understand that e-resource workflows will change the
entire ordering and cataloging procedure

17. Collection Development
Recommendations
“Mobile technology is transforming librarianship, the
nature of our collections,
and the services we provide” (Canuel, Crichton, & Savova, 2012)
• Know, understand and use the technology in order
to be and stay relevant
• Have mobile specific web presence for the library
• Develop Quick Response (QR) codes to link various
resources, e.g. books to subject guides

18. Collection Development
Recommendations, cont.
• Change OPAC display to highlight mobile
devices and e-resources
• Create a process & procedure for archiving
e-resources
• Ensure the collection development policy
includes:
o Data gathering, analysis, and management
schedule
o Short and long term view of the collection of e-
resources
• Understand the types of user authentication
that are necessary

19. Collection Development
Recommendations, cont.
• e-Books – Know if:
o The platform is an optimized mobile version or an app
o There is a difference in the vendors licensing agreement for accessing their electronic resources for an optimized web site vs. an
app
o Free or fee
o Compatibility across all tablets or specific to a certain brand
o Include tools that are requirements for courses
o Include tools used in-class as ‘text books’ or general resources
• Apps – Know if:
o The app is free or fee-based, or free with a subscription to the item
o It is compatible with all various types of platforms being used
• Create subject guides with mobile resources and
services, e.g. apps for the health sciences, instructions
for downloading e-books from specific vendors
• Create subject guides for specific user groups e.g.
PAs, nurses, OTs

20. Qualitative Comparison
of Mobile Tablets
Number of
Health
Care/Medical
Apps
Quality of
Health
Care/Medical
Apps
Screen
Clarity
Tablet
Navigation
Apple iPad,
v.2
VG E VG E
Apple iPad
Mini, v.1
VG E VG E
Microsoft
Surface, v.1
G VG E E
Android
Nexus, v.7
E G VG VG
Kindle Fire P P G G
Key
E=Excellent
VG=Very Good
G=Good
P=Poor

21. Examples of Free Health Care Apps & Optimized Web
Sites for Apple, Microsoft, and Android Products
• National Library of Medicine
o PubMed Mobile (o. web site)
o TOXNET Mobile (o. web site)
o MedlinePlus Mobile (o. web site)
o DailyMed Mobile (o. web site)
o AIDSInfo Mobile (o. web site)
o LactMed app
o Drug Information Portal Mobile (o. web site)
o Clinical Trials
• Free Apps
o AHRQ ePSS
o Epocrates
o iTriage
o Micromedex Drug Information
o Medscape
o WebMD
o CDC – general and MMWR
o Medical Formularies
o Medical Terminology & Abbreviations

22. Places to Find Health Care Apps
• iMedicalapps –
http://www.imedicalapps.com/
• Apple – Apps Store
Apps for Healthcare Professionals
• Microsoft App Store
• Android App Store
• Unbound Medicine -
http://www.unboundmedicine.com/
• Skyscape -
http://www.skyscape.com/index/home.aspx

23. Examples of Health Care
Research Guides for Mobile Devices
• University of Michigan, Taubman Health Sciences
Library –
o http://guides.lib.umich.edu/content.php?pid=116930
• Penn State Libraries –
o http://guides.library.upenn.edu/content.php?pid=284388
• University of Wyoming
o http://libguides.uwyo.edu/content.php?pid=414031

24. References
• Anderson, Max. (2012, March). Information anywhere: Mobile technology, libraries and health. Workshop
presented by the National Network of Libraries of Medicine, Greater Midwest Region, Detroit, MI.
• Bogossian, F., Kellett, S., & Mason, B. (2009). The use of tablet PCs to access an electronic portfolio in the clinical
setting: a pilot study using undergraduate nursing students. Nurse Education Today, 29(2), 246-253.
doi:http://dx.doi.org.ezproxy.emich.edu/10.1016/j.nedt.2008.09.001
• Bogossian, F., & Kellett, S. (2010). Barriers to electronic portfolio access in the clinical setting. Nurse Education
Today, 30(8), 768-772. doi:http://dx.doi.org.ezproxy.emich.edu/10.1016/j.nedt.2010.02.003
• Boruff, J. T., & Bilodeau, E. (2012). Creating a mobile subject guide to improve access to point-of-care resources
for medical students: a case study. Journal of the Medical Library Association, 100(1), 55-60.
doi:http://dx.doi.org.ezproxy.emich.edu/10.3163/1536-5050.100.1.010
• Brusco, J. (2012). Mobile health application regulations and compliance review. AORN Journal, 95(3), 391-394.
• Canuel, R., Crichton, C., & Savova, M. (2012). Tablets as powerful tools for university research. Library Technology
Reports, 48(8), 35-41.
• Educause Center for Applied Research. (2012). ECAR Study of Undergraduate Students and Information
Technology, 2012. Retrieved from http://net.educause.edu/ir/library/pdf/ERS1208/ERS1208.pdf
• Farrell, M. (2006). Focus: technology and its impact on nursing care/education, nursing and midwifery education
• using mobile technologies. Australian Nursing Journal, 14(1), 25.

25. References
• Fenwick, Clare. (2006). RDNS nurses use a world’s best practice system. Australian Nursing Journal, 14 (1).
• Hasman, L. (2011). An introduction to consumer health apps for the iPhone. Journal of Consumer
Health on the Internet, 15(4), 322-329.
doi:http://dx.doi.org.ezproxy.emich.edu/10.1080/15398285.2011.623567
• Hoy, M. B. (2011). An introduction to QR codes: Linking libraries and mobile patrons. Medical
Reference Services Quarterly, 30(3), 295-300. doi:10.1080/02763869.2011.590423
• Katz, Paul S. (2012, April). Mobile devices offer advantages, challenges. ACP Internist. Retrieved from
http://www.acpinternist.org/archives/2012/04/technology.htm
• Klatt, Carolyn A. (2011). Going mobile: free and easy. Medical Reference Services Quarterly, 30 (1).
doi: http://dx.doi.org/10.1080/02763869.2011.540214
• Mandarino, Courtney. (2012, Winter). Invasion of the iPad. MDMLG News, 39 (2).
• Manhattan Research. (2011, May 4). 75 percent of physicians own some form of Apple device. New Taking the
Pulse, 11.0. Retrieved from http://manhattanresearch.com/News-and-Events/Press-Releases/physician-
iphone-ipad-adoption
• Medical Library Association. ( 2012, April). Leveraging mobile technologies for health sciences libraries.
Teleconference presented by the Medical Library Association, Detroit, MI.
• Mihlrad, L., & Glassman, N. R. (2012). Institutional access to mobile resources. Journal of Electronic
Resources In Medical Libraries, 9(1), 77-86. doi:10.1080/15424065.2011.651383
• Miller, Claire Cain. (2013, January 7). Mobile apps drive rapid change in searches. The New York Times.
Retrieved from http://www.nytimes.com/2013/01/08/business/mobile-apps-drive-rapid-changes-in-
search-technology.html

26. References
• Miller, J., Shaw-Kokot, J., Arnold, M., Boggin, T., Crowell, K., Allegri, F., & ... Berrier, S. (2005).
A study of personal digital assistants to enhance undergraduate clinical nursing
education. Journal of Nursing Education, 44(1), 19-26.
• Miller, R. K., Moorefield-Lang, H., & Meier, C. (2012). Introduction. Library Technology
Reports, 48(8), 5-10.
• Pappas, C. (2012). Medical librarian rounding with an iPad. Library Technology Reports,
48(8), 22-27.
• Patrick K, Griswold WG, Raab F, Intille SS. (2008). Health and the mobile phone. American
Journal of Preventive Medicine. 35(2):177-81. doi: 10.1016/j.amepre.2008.05.001
• Pearson Foundation. (2012). Pearson Foundation Survey on Students and Tablets.
Retrieved from http://www.pearsonfoundation.org/great-learning/Survey-
Students-and-Tablets.html
• Pew Research Center. (2010). Mobile Health 2010. Retrieved from
http://www.pewinternet.org/Reports/2010/Mobile-Health-2010.aspx
• Prgomet, M, Georgiou, A, Westbrook, J. (2009). The impact of mobile handheld
technology on hospital physicians' work practices and patient care: A systematic
review. Journal of the American Medical Informatics Association 16(6):792-801. doi:
10.1197/jamia.M3215
• Salem, L., Cronin, B., & Bliss, L. (2012). Smarter Together. Library Technology Reports, 48(8),
17-21.

27. References
• Shurtz, S., Halling, T., & McKay, B. (2011). Assessing user preferences to circulate iPads in an
academic medical library. Journal Of Electronic Resources In Medical Libraries, 8(4), 311-
324. doi:10.1080/15424065.2011.626342
• Shurtz, S., & von Isenburg, M. (2011). Exploring e-readers to support clinical medical education:
Two case studies. Journal of the Medical Library Association, 99(2), 110-3.
doi:10.3163/1536-5050.99.2.002
• Slater, R. (2010). Why aren't e-books gaining more ground in academic libraries? e-book use
and perceptions: A review of published literature and research. Journal of Web
Librarianship, 4(4), 305-331. doi:10.1080/19322909.2010.525419
• Springer Publishing Company. (2012). 2012 Nursing eBook and Smartphone Survey. Retrieved
from http://www.springerpub.com/content/downloads/2012-Nursing-eBook-
Smartphone-Survey.pdf
• Thomas, L., & Tomren, H. (2010). Ebooks: Think mobile. Computers in Libraries, 30(10), 36.
• University of Central Florida, College of Medicine. (2013). Physicians tell how much time tablets
save them. Retrieved from http://ucf-rec.org/?news=physicians-tell-how-much-time-
tablets-save-them
• Walker, Rob. (2013). Are smartphones and tablets turning us into sissies? Yahoo! News.
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• Waton, K. (2006). Going mobile. A tablet PC is the core patient care device at a new digital,
wireless hospital in Wisconsin. Health Management Technology, 27(7), 28.