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The Graduate and Professional School Libraries

Countway Library of Medicine

Report of Isaac Kohane, MD, PhD, Librarian

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The Francis A. Countway Library of Medicine, one of the largest medical libraries in the world, serves the Harvard Medical School (HMS), the Harvard School of Public Health, the Harvard School of Dental Medicine, the Boston Medical Library, and the Massachusetts Medical Society. The Countway Library holds more than 630,000 volumes, subscribes to 3,500 current journal titles, and houses over 10,000 non-current biomedical journal titles. The library houses one of the world’s leading medical history collections and provides access to many electronic information resources. Additionally, it hosts an archives and records management program for the schools of the Harvard medical area and houses the Warren Anatomical Museum.

In 2005, Harvard Medical School, together with its affiliated institutions, recognized that it had an extraordinary opportunity to conduct groundbreaking research in biomedical informatics. Already, Harvard investigators had made numerous important contributions to the field of biomedical informatics, which may be broadly defined as research at the intersection of biomedicine and the computer and information sciences. Successful investigations have been conducted in bioinformatics, functional genomics, real-time public health surveillance, clinical monitoring, knowledge management, decision support, and medical education. Until recently, research and educational activities have been carried out by individual investigators, by individual laboratories, and, in a few cases, by small groups of investigators organized around specific collaborative grants. Often, collaboration occurs with investigators at outside institutions, when equal and sometimes superior opportunities for collaboration may exist within the HMS community.

To foster a spirit of collaboration across the Medical School community, HMS Dean Joseph Martin established the Center for Biomedical Informatics (CBMI) in the fall of 2005. He asked Isaac Kohane, MD, PhD, Lawrence J. Henderson Associate Professor of Pediatrics and Health Sciences and Technology, and Alexa McCray, PhD, associate professor of medicine, to be co-directors of the new center. CBMI provides an organizational and administrative structure for participating faculty from across the broad HMS community to seek biomedical informatics grant and foundation support, enabling more effective competition for large-scale governmental, industrial, and philanthropic initiatives. The CBMI has its organizational and scientific hub in the Countway Library. This allows the center, first, to take full advantage of the outstanding resources and capabilities of the library and its staff, and, second, to strongly support a collaborative environment at HMS—one that includes researchers, librarians, clinicians, and other professional staff at HMS and its affiliated institutions.

The missions of the Countway Library and the HMS Center for Biomedical Informatics are tightly integrated, though each has its own focus as described below.

The mission of the Countway Library of Medicine is to foster the advancement of education, research, scholarship, and professional practice in medicine, biological sciences, public health, and dentistry by

  • ensuring access and linkage to the world’s literature in the biomedical and relevant social sciences;
  • exploring and promoting effective utilization of information and knowledge;
  • educating library users in the principles and techniques of information management;
  • preserving an historical record through its scholarly, rare-book, and archival collection; and
  • creating a stimulating and synergistic setting for intellectual growth.

The Harvard Medical School Center for Biomedical Informatics promotes and facilitates collaborative activities in biomedical informatics research and education among faculty at Harvard Medical School and its affiliated institutions. In an era of biomedical knowledge overload, high-throughput biomedical data generation, increasing consumer knowledgeability through information access, and national needs for real-time public health, CBMI will convene and lead research and educational activities to meet these needs.

CBMI’s goal is to be the coordinating and administrative organization to support the above mission, and will be composed of faculty members who are active in biomedical informatics research and education defined broadly as the intersection of biomedicine and the information sciences. We plan to adopt an approach that we have successfully executed at other parts of the Medical School (i.e. the affiliated hospitals), and which has three components:

  • attracting world-class junior and senior faculty who come with their own grant funding because of the opportunities presented by CBMI leadership and the opportunity to collaborate and grow;
  • hiring biomedical informatics staff for large funded projects, such as the Clinical Translational Science Center that is centered at HMS but spread across its affiliated institutions and the informatics core for the Boston Autism Consortium, whose mission is to rapidly advance the understanding, diagnosis, and treatment of autism through collaborative research to improve the care of children and families affected by autism and related disorders; and
  • leading or catalyzing trans-HMS research initiatives of a scope that attracts significant extramural funding and allows for further growth of research and education faculty.

 

Organizational Structure 

The Office of the Director includes the director, the deputy director, and a small team of support personnel that work closely with the directors and with the leads of the cells in the matrix shown below. These include a department administrator (coordinates office administrative matters), a staff assistant (manages office calendars, travel, event planning, space requirements), and a grants coordinator (identifies and oversees extramural funding).

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Very clearly, the most frequent visit to the library will be via web searches bringing users to various parts of the Countway web site. This site, which is being implemented as a multiplicity of interrelated sites, provides access to all tools and contains the full content of all open-access materials, digitized collections, and the digital content of community events sponsored by the Countway. Annotations regarding authoritativeness and reputation will be added through semi-automated techniques. Working together with other library staff, Informatics Technology staff lead the design and development of these and the other online resources for each of the four focus areas. The head of Informatics Technology also serves as the primary liaison to senior HMS IT staff.

The Bioinformatics team meets the community need for apprenticeships and short courses for the most efficient use of existing bioinformatics tools. This requires bioinformatics specialists and librarians who are both knowledgeable in the use of the current tools and able to teach others, as well as to help customize these tools for particular uses by the apprentices.

The wide variety of bioinformatics tasks, data types, and analyses and tools available requires a team that is experienced and willing to provide the necessary infrastructural support to the community. This team is already constituted and led by Dennis Wall. The team will provide leadership across all Bioinformatics efforts in the four organizational units of the Countway.

Several departments at the Medical School Quad and the affiliated hospitals have expressed enthusiasm for the role of the Countway in maintaining and curating clinical databases (e.g., Medicare claims, HMO medication use). Under supervision of the team in Clinical Informatics, medical informaticians with training in the mining of large clinical databases will work with several “customers” at HMS to provide useful access to these data.

There is a core set of competencies required around the curation of clinical databases. Whether they are public health, health-reimbursement (e.g. CMS databases), or hospital databases, they will also require knowledge of informatics standards for nomenclature and data models. To this end, medical informaticians will develop and/or curate and maintain the necessary databases and provide decision-support functionality as needed. These individuals will work with the medical informaticians responsible for the databases used principally by clinical researchers in the HMS community.

Creating focused electronic and interactive educational offerings based on Countway resources, in collaboration with expert faculty and customized to a variety of audiences, will require a rapid cycle of engagement with the targeted community and design/redesign of these offerings. This requires reference librarians, application developers, and education specialists working together under the guidance of the lead librarian in Outreach and Education.

The broad portfolio of new user communities (patients, basic researchers, real-time epidemiologists) requires that we have ongoing efforts to customize all Countway content (both electronic and physical) to these diverse communities. To this effect, a lead librarian will coordinate all customization and resource management and will work with the Digital Library and Collection and Knowledge Management groups to ensure that these efforts are consistent and cost-effective, monitoring their use for future resource allocation.

Electronic resource management and integration of the various kinds of resources (e-journal subscriptions, bibliome network databases, clinical databases) requires a new set of skills that intersects library science and computing. To this end, librarians comfortable with electronic media, electronic resource administration, and electronic media business contracting will work with application developers to ensure that the appropriate content is made available to all users of Countway services. They will also coordinate their work with the staff in the Center for the History of Medicine.

Perhaps the most significant lacuna in the Center for the History of Medicine is that its curated resources are largely confined to the physical confines of the Countway and its repositories. For this reason, we are initiating an effort that will bring these curated materials to the broader external world via the Countway web portal to the Center for the History of Medicine.

The Bioinformatics team will work with the librarians in the Center for the History of Medicine to work on curating bioinformatics databases that are of archival interest as well as documenting the pioneering work in bioinformatics arising from the HMS community.

Given the leadership since the mid-20th century of HMS investigators in clinical informatics, a perspective on recurrent themes in these investigations is of timely relevance, particularly given the large investments in this area now contemplated locally and nationally. To this effect, librarians at the Center for the History of Medicine will work with medical informaticians to identify relevant documents of early medical computing applications at HMS.

In order to make the Center for the History of Medicine an even more dynamic and relevant presence, locally and nationally, and to enable it to generate its own funding sources, we have recruited a faculty head for the center. The position includes an academic appointment in the HMS Department of Social Medicine. The new center head will work with staff to bring the treasures of the Countway to the view of investigators and beyond (through their interactions with the Digital Library team).

Existing and new Countway personnel fit very well into the four infrastructural units. New staff members have been hired to head each of these units.

  • Douglas Macfadden heads the newly established Informatics Technology unit;
  • David Osterbur, PhD, oversees Access and Public Services;
  • Elizabeth Eggleston oversees Collections and Knowledge Management; and
  • Scott Podolsky, MD, heads the center for the History of Medicine.

With the overlay of the four focus areas, all personnel will have the opportunity to participate in the transformation of the library as it becomes a major player in this age of high throughput data and knowledge management.

Recent activities of each of the units are described below.

Informatics Technology

The Countway/CBMI Informatics Technology group supports both library operations and research activities. This group works closely with the HMS IT and AV groups, with the Harvard University Library’s Office for Information Systems (HUL OIS), and the University Information Systems (UIS) teams in order to efficiently develop and manage resources that are needed by the Countway Library, its patrons, and the CBMI research team. Delivered services include: desktop computing, classroom computing, class/conference room AV, public computing, public printing and scanning, research computing, and operational systems for the library.

In the past, the library has housed a server room that has supported both research and library operations. Over the last year this server room has been decommissioned, with services being moved to platforms supported by HMS IT and HUL OIS. This move has allowed the Countway/CBMI IT team to focus on improving library services and operations, along with developing the library’s capability to perform informatics research. Specific projects that are under way include

  • redesign of the Countway web site;
  • development of data resources for related consortiums (e.g., Boston Autism Consortium and Clinical Translational Science Center);
  • development of a state-of-the-art WAN-connected classroom;
  • development of new information search and retrieval tools (e.g., discovery via dynamic clustering and SFX automation); and
  • development of an open software architecture that supports quick and easy access to new data resources for library patrons and research teams.

It is the goal of this team to ensure the reliable operation of library services while developing new tools that increasingly improve the ability of the CBMI and the entire HMS community to perform sophisticated informatics research.

Access and Public Services

The Access and Public Services division of the Countway Library is composed of three library departments—Reference, Circulation, and Interlibrary Loan—the parts of a library that are the most visible to the library user. Under the purview of this division lies responsibility for educating library users to take full advantage of information tools that are made available through the library; answering the many questions that are directed to the library from research and clinical faculty, staff, and students of the Medical School; and ensuring that the multiple different sources of information from the Harvard libraries and elsewhere are easily accessible. The staffs of all three departments have been a pleasure to work with through a year of transition, with real changes in the direction of the library made manifest with the hiring of new leaders in Access and Public Services, Collections and Knowledge Management, and the Center for the History of Medicine.

Reference

Three new staff have been added to the Reference department this year. Although two of them (the new Access and Public Services librarian and the new Digital Resources and Services librarian) have major duties elsewhere in the library, these additions, along with the excellent work done by staff from throughout the library at the newly instituted service desk, have allowed the Reference department to expand the number and frequency of information literacy classes being taught. Three classes in Bioinformatics topics (“BLAST Tips and Tricks,” “Functional Discovery,” and “Genome Browsing”), three classes on drug database searching (“Natural Medicines: Researching the Literature on Herbs and Dietary Supplements,” “Beyond PubMed: EMBASE,” and “Clinical Drug Resources”) and a class on a new clinical medicine database (DynaMed) have been added to the offerings of the department. The success of these new classes is attested by the rising attendance in each session and by followup conversations with attendees who seek out the class instructor for further in-depth exploration of particular research questions.

Outreach efforts in the department have also expanded. One of the new reference librarians, Julia Whelan, has met with the medical student organization and discussed with them what the library can do that would benefit them the most. Several good suggestions were made, and Julia has been following up on those suggestions. She was given access to a group e-mail address for the medical students to keep them informed of new happenings at the library.

Members of the reference department have also taught classes in PubMed searching and EndNote to groups across the Medical School campus and affiliated hospitals; e.g., the anesthesiology residents of both Brigham and Women’s and Beth Israel Deaconess hospitals; the pharmacoepidemiology and pharmacoeconomics department of Brigham and Women’s Hospital; Harvard Medical International, a self-supporting not-for-profit subsidiary of HMS whose role is to extend internationally the School’s tradition of improving the quality of health care through excellence in clinical medicine, medical education, and biomedical research; the Osher Institute; and several others. We have also begun a consumer health outreach initiative with the librarians of the Boston Public Library.

Circulation

The Countway Library is fortunate to have an efficient and stable staff working in the Circulation department. The fact that there has been no turnover of personnel in circulation for the past 2.5 years has given both the library and the Circulation staff the ability to undertake new initiatives. One example of this is the service desk, staffed by people from throughout the library, but with the majority of the coverage by members of the Circulation staff. With periodic training by members of the Reference department, the Circulation staff has been able to relieve the Reference staff of answering many of the simple access questions that arise in the library every day. Thus, the Reference staff has more time to teach and to do research consultations. The training that the Circulation staff has received also allows them to answer questions asked by library users more satisfactorily at night and on weekends when Reference staff are not available.

Circulation has instituted the use of a new system that will be used by faculty in the Harvard School of Public Health to facilitate electronic reserves for teaching. This system was designed by the Instructional Computing Group of the Faculty of Arts and Sciences and adapted by the HUL Office for Information Systems for use Harvard-wide. Unfortunately, the “My Course” part of E-Commons precludes the use of this new tool across the Medical School curriculum.

Interlibrary Loan

The staff of the Interlibrary Loan department has also been quite stable and is experienced with all aspects of interlibrary loan software and operating regulations. The level of interlibrary loan activity fell dramatically when a fee was instituted for loans that originated from outside of Harvard, but, unlike what many may think, not everything is available online and the demand for materials not available at Harvard has remained strong. However, one frequently asked question in Reference is, “How do I get this article/book that Harvard does not have?” People frequently are not aware of the services provided by interlibrary loan departments. David Osterbur, head of Access and Public Services, has been charged by the Public Services Committee to look into ways to make these services more visible. A committee of the heads of interlibrary loan departments from libraries across the University has been formed for this purpose and the work is ongoing.

Collection and Knowledge Management

The Collection and Knowledge Management group has been involved in several major projects aimed at making the collections more accessible through digitization, making space for new programs, and focusing collection development policy on meeting the needs of current users. The projects included clearing the library’s fourth floor of its non-circulating, pre-1960 collection of monographs; planning for the Google scanning team, the University Library’s Open Collections Program, and NEH-supported digitization projects; and de-accessioning duplicative and out-of-scope material. Work was also done on drafting an update of the library’s collection development policy, and on providing online access to a broad range of resources.

The Harvard Libraries have embarked on initiatives to enhance collaboration in collection development. There has been a University-wide survey, to which the Countway responded. Because Countway currently collaborates not only within Harvard, but also with other institutions (through the New England Research Libraries consortium and with the hospital libraries), the library was selected for a follow-up interview, which was completed. Collaborative collection initiatives have been identified as a very high priority within Harvard libraries, and it is highly likely that Countway’s participation in future initiatives will be solicited.

The collections of the former Biological Laboratories Library in the Faculty of Arts and Sciences are being dispersed, though many monographs will remain on site in Cambridge, at least temporarily. A group of science librarians, including representatives from Countway, met and agreed on where the various journal holdings would go.

Countway entered a collaborative agreement with the hospital libraries to purchase a subscription to AccessMedicine, providing online access to a variety of standard medical texts and reference works. Negotiations resulted in a two-year contract supported jointly by the library and by affiliated hospitals.

Work has been ongoing on a re-draft of the Countway’s collection development and management policy, which was last revised in 1995. The new draft takes into account the shift in user expectations with regard to online access and other changing priorities of our user base.

Countway accepted a donation of approximately 1,100 books from the Center for Population Studies Library in the Harvard School of Public Health, as that library was closing. At Countway, these books will be cataloged and added to the collection.

The Health and Human Rights departmental library also closed, and Countway accepted five boxes of AIDS reports from the collection. This material will also be cataloged and added to the library’s collection.

Work has been ongoing on a project to transfer library material printed in Cyrillic script to the National Library of Medicine. Though the work has slowed, due to the need to focus on other projects and to the lack of staff with expertise in this area, we will continue to work to effect this transfer.

New Electronic Resources

In addition to adding 50 online serial titles during 2006, the following digital resources were purchased:

Elsevier ScienceDirect Backfiles

  • Lancet (back to Volume 1, Issue 1)
  • Medicine and Dentistry (350 titles)
  • Pharmacology, Toxicology, and Therapeutics (57 titles)

Oxford University Press Medicine Archive (39 titles)

Springer Historical Archive Collection—Medicine (127 titles)

Wiley Backfiles

  • Journal of Pathology
  • General Medicine (22 titles)
  • Cell and Developmental Biology (13 titles)
  • Neuroscience (14 titles)

New Additions to StatRef Package:

  • Pickard’s Manual of Operative Dentistry
  • Red Book: 2006 Report of the Committee on Infectious Diseases
  • R2 Medical E-Book Collection (96 titles)
  • Pan-American Health Organization E-Book Collection (11 titles)
  • Faculty of 1000 Medicine
  • Clinical Pharmacology
  • RefWorks Bibliographic Management Software (partial contribution, with other Harvard Libraries)

Center for the History of Medicine

The Center for the History of Medicine and its staff took a larger role in the work of the library this year. The Archives for Women in Medicine staff planned and executed five events in March and April 2006 while the library hosted “Changing the Face of Medicine,” a traveling exhibit from the National Library of Medicine. Staff curated an exhibit drawn from the Hyams Collection of medical Judaica and assisted in the associated symposium; and the center hosted the exhibit of its first artist in residence, Dorothy Simpson Krause. Center staff took on less glamorous roles as well, covering shifts at the service desk on the library’s first floor and helping to review books from the fourth-floor collection as that floor was cleared for construction. These activities, while reducing time available for more traditional work, brought the center greater visibility within and outside the library, building relationships among colleagues, community members, and partners that will benefit the center and the library in the future.

Acquisitions

Archives

This year 220.8 cubic feet of records were accessioned into the school archives. Among the notable accessions were records of the HMS Dean’s Office created during Daniel Tosteson’s tenure. This completes the archival record of the Dean’s Office to the current administration. Highlights include:

Harvard Medical School: Office of the Dean

  • executive files, 1977–1997 (54 cubic feet)
  • speeches, 1977–1997 (1.8 cubic feet)
  • transition files, 1976–1977 (2 cubic feet)
  • long-range planning records, 1992–1997 (2.4 cubic feet)

Harvard Medical School: Office of the Dean for Academic and Clinical Programs

  • executive files, 1970–2000 (44 cubic feet)
  • orrespondence, 1978–2003 (4 cubic feet)
  • centers, divisions, and institutes records, 1978–2003 (4.8 cubic feet)

Harvard Medical School: Office of Educational Development

  • AIDS curriculum records, 1990–1991 (2 cubic feet)

Harvard Medical School: Department of Cell Biology

  • collected papers, 1871–1993 (7 cubic feet)

Harvard School of Public Health: Affirmative Action Committee

  • committee records, 1972–1988 (1 cubic foot)

 

Manuscripts

Acquisitions comprised 84 cubic feet and included significant collections added to the Archives for Women in Medicine, such as those of surgeon and scientist Patricia Donahoe, MD, and pediatric pulmonologist Mary Ellen Wohl, MD. Highlights include:

  • Theobold Smith papers, 1886–1934 (7 cubic feet)
  • Miles F. Shore papers, 1980–2004, (11 cubic feet)
  • Patricia Donahoe papers, 1972–2002 (22 cubic feet)
  • Lisa Iezzoni papers, 1975–2004 (22 cubic feet)
  • Caroline Chandler Murray papers, 1965–1993 (6 cubic feet)
  • Mary Ellen Wohl papers, 1972–2002 (6 cubic feet)

Warren Anatomical Museum

  • The museum accessioned 57 items in FY 2006. Highlights include:
  • Maurice Tillet’s death mask—donated by Patrick Leonard
  • collection of early intrauterine contraceptive devices (IUDs)—donated by Priscilla Tait
  • Civil War–era Leach and Greene surgical set belonging to Charles Thatcher Hubbard (a Civil War ship’s surgeon aboard the Union ship Hiradilla)—donated by Charles Hubbard, second cousin, once removed, of original owner.


Access

Materials processed this year comprise 59.75 cubic feet and include collections in reproductive health, dermatology, and endocrinology.

  • Irvin Haas Blank (1902–2000) papers, 1927–1992 (10 cubic feet)
  • Lydia M. Gibson Dawes papers, 1896–1990 (2.3 cubic feet)
  • Ethel C. (Ethel Collins) Dunham (1883–1969) papers, 1952–1965 (3 cubic feet)
  • Anne Pappenheimer Forbes (1911–1992) personal and professional papers, 1930–1991 (6.2 cubic feet)
  • Alan Frank Guttmacher (1898–1974) papers, 1860s (19.75 cubic feet)
  • Harvard Medical School: Office of the Dean, committee files, 1965–1976 (7 cubic feet)
  • Roy G. (Roy Graham) Hoskins (1880–1964) papers, 1907–1965 (1 cubic foot)
  • Abraham Stone (1890–1959) personal and professional papers, 1916–1959 (13.5 cubic feet)

Grants

The 2005 NEH grant project to microfilm resources in science to preserve and provide access to them was ongoing in FY 2006. The library provided some 1,000 titles from the Rare Books collection as well as those from the general collection in the subject areas of communicable diseases such as smallpox, cholera, tuberculosis, etc.; quarantine; and vaccination, as well as pamphlet collections, including those on the ether controversy and biographies.

Warren Museum staff oversaw the implementation of the Conservation Assessment Program (CAP) grant from the Institute for Museum and Library Services (IMLS) to review the condition and propose care, handling, and treatments for museum holdings.

Exhibits and Public Programs

The center’s artist in residence, Dorothy Simpson Krause, staged an exhibit of her work, “Ars Longa—Vita Brevis,” early in the fall, the product of her study of the Warren and rare book collections in the spring and summer. Her oversized digital prints and mixed-media artwork was shown both at Gordon Hall and on the first floor of the library.

In addition to the annual “Human Body” exhibit staged by the staff for the undergraduate “Human Body” class, the center participated in two major exhibit programs this year. In the fall, “Sages, Scholars, and Healers: Judaica from the Solomon M. Hyams Collection of the Boston Medical Library” highlighted the incunables from the Hyams Collection that were cataloged with support from the University’s Library Digital Initiative.

On March 1, 2006, a full-day scholarly program brought physicians, historians, and antiquarians to the Countway to study the role of Jews in the history of medicine.

In March and April, the center hosted the National Library of Medicine’s traveling exhibit, “Changing the Face of Medicine: Celebrating America’s Women Physicians.” The exhibit, which focused on the entry of women into medicine and their contributions to research, clinical care, and public health, featured a number of Harvard women in medicine, past and present (see the complete list at http://www.hms.harvard.edu/coewh/ChangingFaceofMedicine.html). The center staged two exhibits in conjunction with the traveling exhibit: “The Stethoscope Sorority: Stories from the Archives for Women in Medicine,” drawn from a selection of collections and curated by Leslie Schoenfeld, and “Refocusing Family Planning: Selections from the Abraham Stone and Alan Guttmacher Papers,” based on two of the center’s many collections in reproductive health, and curated by Jennifer Pelose.

The “Changing the Face of Medicine” exhibit provided the opportunity for the Archives for Women in Medicine and center staff to develop partnerships with a dozen organizations in the Harvard and medical communities to offer a program of varied and dynamic lecture events. These programs leveraged interest in the exhibits and were attended by more than 700 members of the community and the general public.

The exhibit opening on March 23, 2006 included a keynote by Tenley Albright, MD, and a panel discussion, “On Being a Woman in Medicine,” featuring Eleanor G. Shore, MD, MPH, Harvard Medical School; Paula A. Johnson, MD, Brigham and Women’s Hospital; Lynne M. Reid, MD, Children’s Hospital; Patricia Donahoe, MD, Massachusetts General Hospital; Joan Whitten Miller, MD, Massachusetts Eye and Ear Infirmary; May Pian-Smith, MD, Massachusetts General Hospital; and Maureen Connelly, MD, Harvard Medical School. The standing-room-only crowd included faculty, staff, medical and graduate students, and other community members. Four other programs studied women’s leadership in medicine, gender equity in medicine and global health policy, women’s history, and institutional culture and women’s success.