Barbara A. Epstein*, Nancy H. Tannery*, Charles B. Wessel*, Frances Yarger*, John LaDue*, Anthony Fiorillo + *Health Sciences Library System University of Pittsburgh +Ambulatory eRecord University of Pittsburgh Medical Center

 Setting  How it started  Snapshot of what was developed  Timeline to EHR  Challenges and Next Steps

 Large academic library serving University of Pittsburgh’s six health sciences schools, as well as the University of Pittsburgh Medical Center (UPMC)  UPMC hospitals contract with HSLS for access to licensed online resources.

 UPMC comprises 20 tertiary, specialty, and community hospitals, 400 outpatient sites and doctors’ offices, and retirement and long-term care facilities.  eRecord has over 3 million unique patient records and more than 22,000 active users, including more than 5,000 physicians employed by or affiliated with UPMC.  More than 196 UPMC physician practices use eRecord.

 June 2004 – Library director invited to participate in the eRecord Physician Advisory Committee (PAC)  investigated various tools  MLA 2006 Phoenix ◦ Integrating Reference Information into the EHR – Practices and Standards

 Fall 2006 partnered with key physician from PAC  Library development team initiated to work with key physician

 Identify appropriate technology  Identify full text information resources  Work with key physician to identify usability and work flow issues

 A meta-search engine that combines results from multiple sources into a single results list allowing users to search several resources at once  A search engine that clusters common terms from the results and creates “on the fly” groups to help narrow searches  Built on previous HSLS Vivisimo work

 Minimize dependence on any one resource  Take advantage of the wide variety of HSLS licensed resources  Find "the fewest number of resources that would still answer the questions"  Minimize repetition & redundancy

 Key physician ◦ Started with dx, disease and patient education tabs  Demo to IT Physician's Cabinet members ◦ EBM tab added; tab order changed  Demo to Enterprise-Wide eRecord PAC ◦ Drug tab added; tab order changed  Usability testing by volunteer group from Enterprise-Wide eRecord PAC ◦ Insert cursor in search box ◦ Resources changed

 Shoestring funding & operations ◦ Both good and bad  Scope of UPMC project dwarfs ours ◦ Difficult to find the right people ◦ We are a very small part of a very large project  Working across 2 organizations ◦ No direct access to EHR

 Licensed resources added and removed  Tab changes  Reformatted search box on results page  Behind-the- scenes Java changes to accommodate EHR technology

 Advisory Committee proposed ◦ evaluate content, access  Seek outside funding to do validation study & content analysis  Promote/market/educate/train  Integrate into dbMotion interoperability