docMD: Eric H. Schnell Associate Professor Head, Information Technology Prior Health Sciences Library The Ohio State University (DOCument Mediated Delivery) docMD is funded through support by the National Network of Libraries of Medicine, Greater Midwest Region. Ohio State University project number

docMD Goal “ To establish an electronic document delivery service for hospital libraries that are unable to support such a service themselves due to limited human, financial, or technical resources “ “ To establish an electronic document delivery service for hospital libraries that are unable to support such a service themselves due to limited human, financial, or technical resources “

docMD Objectives Establish a mediated direct-to-customer document delivery service for hospital libraries Establish a mediated direct-to-customer document delivery service for hospital libraries Identify the costs involved in providing such a service Identify the costs involved in providing such a service Develop a model for use by other resource libraries in other regions of the country Develop a model for use by other resource libraries in other regions of the country

What is IDD/EDD? Internet Document Delivery / Electronic Document Delivery Internet Document Delivery / Electronic Document Delivery Reduces telecom costs (Landes ’97) Reduces telecom costs (Landes ’97) Reduces turnaround time Reduces turnaround time 1986: days (Budd) 1999: reduced to 2.52 (Sellen) Reduces supply costs (Weible ’02) Reduces supply costs (Weible ’02)

Barriers to Hospital Library IDD Implementation Firewalls (McKnight 2001) Firewalls (McKnight 2001) communication ports communication ports network authority network authority Workflow / staffing (Jackson 1993) Workflow / staffing (Jackson 1993) Access to technical staff Access to technical staff Fiscal resources Fiscal resources

How docMD Jumps these Barriers Firewalls Firewalls a common communication port is used (80) a common communication port is used (80) Workflow / staffing Workflow / staffing DOCLINE processing remains the same less physical processing of documents Access to technical staff Access to technical staff essential technical staff at mediation center little technical site support needed Fiscal resources Fiscal resources GMR supported

Timeline Approval July ‘02 Approval July ‘02 Planning Fall ‘02 Planning Fall ‘02 1 st test document December ‘02 1 st test document December ‘02 6 phase one sites online February ’03 6 phase one sites online February ’03 12 phase two sites June ’03 12 phase two sites June ’03 Through December ’04 Through December ’04

Participating Libraries Must: Be a DOCLINE ® library Identify the populations this project could potentially reach Provide a letter of interest Be willing to assist their users with local issues Implement and market the service locally Be willing to "go with the flow" Provide the project with feedback and participate in the evaluation process Provide the project with feedback and participate in the evaluation process

Current Direct to Customer Processing Model Local Library Customer OCLC / DOCLINE Ohio Lending “A”Ohio Lending “B” Scans/Sends though IDD EDD Web Server

docMD Delivery Model Local Library Customer DOCLINE Lending “A”Lending “B” Scans/Sends though IDD docMD Web Server with docID# Alert

docMD Client Demo

Survey Tools Project Librarian Survey Project Librarian Survey Attitudes Survey Attitudes Survey Technical Survey Technical Survey Turnaround Time Study Turnaround Time Study

Customer Attitudes Survey How confident in ability to get articles from your library:  Reasonably-totally: 91% How confident in ability to get articles not in library collection:  Reasonably-totally: 97% How satisfied with ability to get articles in timely fashion:  95%

Customer Attitudes Survey How often do you request articles:  weekly: 5%  monthly: 29%  every few months: 46%  Rarely: 20% How long does it take to get articles: How long does it take to get articles:  1 week or less: 48%  1-2 weeks: 44%  2+ weeks: 8%

Customer Technology Survey Computer in office:  97% (95% with Internet access) Computer at home:  94% (92% with Internet access) How often is web browser used:  65% daily How often is checked:  85% daily or constantly  84% sure they can check it

Customer Technology Survey Adobe Acrobat is a document viewer:  87%

docMD Statistics (as of Sept 2, ‘04) 406 registered customers 406 registered customers 3111 documents processed 3111 documents processed 15% have gone unviewed 15% have gone unviewed <1% posting failures <1% posting failures 44% sent to the librarian 44% sent to the librarian 1% required reposting 1% required reposting 1% alternative distribution 1% alternative distribution

docMD Statistics Turnaround time Turnaround time  Pre – docMD: 6.53 days (max 19 days)  Post – docMD: 3.11 days (max 9)

docMD Statistics Average document processing time: 1 minute Average number of documents requiring follow up: 2 per week Number of customers contacting docMD central regarding difficulty in downloading a document: 10 Percentage of documents arriving upside down: 15%  1%

docMD Statistics Documents without transmittal sheet: 2 per week Documents without customer address: 2 per week Documents ordered but never received: 1 per week

Feedback “Our docs are always so delighted when personalized mail arrives for them.” one has a “raft of administrators tooling past his office wanting to know how his articles were retrieved electronically. They believe that he magically pulled them up all by himself. “ “Our docs are always so delighted when personalized mail arrives for them.” one has a “raft of administrators tooling past his office wanting to know how his articles were retrieved electronically. They believe that he magically pulled them up all by himself. “ “another test subject… has been running around Nursing telling people…” “another test subject… has been running around Nursing telling people…”

Feedback “The hardest part of this project has been getting addresses from people. Everything else has been very easy so far.“ “The hardest part of this project has been getting addresses from people. Everything else has been very easy so far.“ “I think that it might be an age thing. The younger, more computer savvy docs are ready to try anything new. Some physicians just haven't found the time to utilize computers. We're working on it, though. “ “I think that it might be an age thing. The younger, more computer savvy docs are ready to try anything new. Some physicians just haven't found the time to utilize computers. We're working on it, though. “

Issues How do we make sure the librarians “really” understand the project? Lending libraries often do not follow delivery instructions Some sites the feel docMD is at fault if a document is not posted.

Issues: Geography Geography I: Project leaders / librarian face-to-face contact difficult Geography I: Project leaders / librarian face-to-face contact difficult Geography II: Difficult if not impossible to organize group training Geography II: Difficult if not impossible to organize group training Geography III: helps. The phone is more effective, however, more time consuming Geography III: helps. The phone is more effective, however, more time consuming

Issues: How docMD is implemented at a site is dependent on the hospital librarian How docMD is implemented at a site is dependent on the hospital librarian Level of participation is dependent on the marketing performed by the hospital librarians Level of participation is dependent on the marketing performed by the hospital librarians Too much hand-holding or separation anxiety? Too much hand-holding or separation anxiety?

Issues: Funding Pay-to-Play (1) Each hospital pays a fee based on scale determined by the number of documents they normally process through DOCLINE in relation to other participants in a tiered fee schedule. Pay-to-Play (2) Each hospital pays a per-document fee based on the actual number of documents they process using docMD and is billed on a quarterly or annual or per-document basis. Subsidized (1) Each NNLM region establishes funding opportunities for resource libraries to support a docMD service for their resource area. Resource libraries apply for the available awards. Subsidized (2) Each NNLM region provides a funded mandate to each resource library to establish a docMD service in their area. Benevolent Any library can provide the service but supports it using their individual operating funds and can pursue reimbursement from the participants.

Issues: Standards GEDI: Generic Electronic Document Interchange Established in early 1990s Ariel 1.x Odyssey Open Standard Ariel 4.x ????proprietary

Issues: Standards Question: Is Ariel 3.4 compatible with all other versions of Ariel? Answer: Yes. Ariel 3.4 is able to send and receive documents with Ariel versions 2 and 3. However, Infotrieve has in important announcement about Ariel: Infotrieve continues to improve and upgrade Ariel, which will greatly change Ariel’s technology (especially with an eye to building a networked version of Ariel 4.0). We foresee that future versions of Ariel will no longer be technically compatible with older versions. We anticipate that Ariel 3.4 will be the “cut off” version for future compatibility. Hence, we encourage all 3.x users to upgrade to 3.4 for free, to be prepared for this future change. We also encourage Ariel 2.x users to take advantage of our upgrade discount and get current to prevent incompatibilty with future releases of Ariel. Infotrieve will continue to communicate about this important issue so that our customers can plan and budget accordingly. When we release the next version of Ariel, we will provide Ariel 3.4 users with a patch that will ensure compatibility with the next version, Ariel 4.0. It is important to take advantage of this release now.

Issues: Standards Lack of IDD standards will result in the pilot project ending in December 2004 Lack of IDD standards will prevent a wide scale implementation of the concept

Thanks! docmd.med.ohio-state.edu docmd.med.ohio-state.edu