DL Services Network - Schema and Scenarios

Bibliothecal versus Bibliographic Access in Collections

This graphic illustrates a digital library services network plan for providing support for medical libraries in their quest to provide bibliothecal access to the specific information contained in their collections of web-published clinical resources. Bibliothecal access pertains to the physical layout of resource links in a classified arrangement (e.g., a Yahoo-like directory), as opposed to bibliographic access, which pertains to the databases of surrogate records accessible by either a keyword search (e.g., a Google-like search engine) or subject search with controlled vocabulary (e.g., PubMed).

This approach is exemplified in the digital libraries of the Clinical Digital Libraries Project.

For additional information, please go to the Clinical Digital Libraries Project.

The integration of professionally-managed digital library collections with other systems is an important aspect of the DL Services Architecture. The exemplar for integration is with electronic patient record systems (EPRs), the intent of which is to facilitate the seamless integration of just-in-time context sensitive links between an institution's medical library's digital librariy collection and the EPR in use at that institution. The DL Services Architecture also serves as a standards-based web environment for publishers to place their resources so that medical librarians can easily select, purchase, and place key resources in relevant digital libraries for their clinical users.

The architecture facilitates the delivery of professionally-managed locally-specialized collections of relevant clinical resources in context.

The following are three clinical scenarios consisting of patients presenting with painful elbow. Each scenario is tied to existing DL Services Network libraries in different institutional contexts, each having varying sets of information resources according to budgets and needs of the respective clinical environments.

Clinical Use Scenario A - Capstone Clinic Digital Library at the University of Alabama College of Community Health Sciences, Tuscaloosa, Alabama containing a large number of information resources purchased by their library

  1. Physician is working up a painful elbow using institution's EPR.
  2. DDx engine suggests:
  3. Physician decides to check relevant digital library resources in real time during a patient visit. Context sensitive links are automatically conveniently placed for the physician to follow:
  4. With retrieved information, physician can more confidently follow up a diagnosis with appropriate treatment.
  5. Further, physician's diagnosis and/or treatment strategy is documented in the EPR and this will be augmented by the informational record retained in the digital library. In the future, this record might be exported directly to the EPR. This enables the potential for possible savings realized through the reduction in malpractice or other insurance premiums.
  6. Physician may also choose to follow links to Patient/Family Resources on the specified topic by following convenient and consistently placed links within the digital library.

Clinical Use Scenario B - Same as above in a different institutional context: Baptist Hospital Digital Library, Nashville, Tennessee  containing a medium number of information resources purchased by their library

  1. Physician is working up a painful elbow using institution's EPR.
  2. DDx engine suggests:
  3. Physician decides to check relevant digital library resources in real time during a patient visit. Context sensitive links are automatically conveniently placed for the physician to follow
  4. With retrieved information, physician can more confidently follow up a diagnosis with appropriate treatment.
  5. Further, physician's diagnosis and/or treatment strategy is documented in the EPR and this will be augmented by the informational record retained in the digital library. In the future, this record might be exported directly to the EPR. This enables the potential for possible savings realized through the reduction in malpractice or other insurance premiums.
  6. Physician may also choose to follow links to Patient/Family Resources on the specified topic by following convenient and consistently placed links within the digital library.

Clinical Use Scenario C - Same as above in a different institutional context: St. Vincent's Hospital Digital Library, Birmingham, Alabama

  1. Physician is working up a painful elbow using institution's EPR.
  2. DDx engine suggests:
  3. Physician decides to check relevant digital library resources in real time during a patient visit. Context sensitive links are automatically conveniently placed for the physician to follow:
  4. With retrieved information, physician can more confidently follow up a diagnosis with appropriate treatment.
  5. Further, physician's diagnosis and/or treatment strategy is documented in the EPR and this will be augmented by the informational record retained in the digital library. In the future, this record might be exported directly to the EPR. This enables the potential for possible savings realized through the reduction in malpractice or other insurance premiums.
  6. Physician may also choose to follow links to Patient/Family Resources on the specified topic by following convenient and consistently placed links within the digital library.