- Email: [email protected]
Beyond networking
ht.
Libr.
Rev.
(1981) 13, 231-243
Beyond Networking* MICHAEL
CARMELt
INTRODUCTION
This paper invites librarians to look at some of the established trends in our working environment and to ask where, collectively, they are taking us. It is argued that several current trends are converging to erode the concept of the library as a distinct institution, and thereby diminishing the administrative role of the librarian. At the same time they tend to increase the demands placed upon the information handling and coordinating skills of the librarian. Above all these trends demand a clearer understanding of human and organizational relationshipsbetween individuals, between institutions and between professions. If this analysis is correct then a far reaching re-appraisal of the librarian’s role is required, with consequent changes in the education, qualifications, and self-concept of the profession and a restatement of professional objectives. None of the specific trends mentioned is unfamiliar to readers of this journal. They are international in scope, for they can be clearly seen in North America, Europe, the Third World and the Western Pacific. Certainly there are extreme differences in scale, especially between the United States and the least developed countries, but the same tendencies can be seen, sometimes in quite striking forms, in the poorest as well as the richest nations. We are all going through the same process, and it is essential for our future that we find a way of facing the problems and opportunities together. The examples quoted in this paper have been drawn mainly from the field of medical and health librarianship, simply because this is the area best known to the author. It may be that special features of the * Paper based on an address given at the Fourth Librarianship, Belgrade, l-5 September 1980. t Regional Librarian, South West Thames Regional Guildford, Surrey, GUI 3NT, UK. 0020-7837/81/030231+
13 $02.00/O
(0
International Library
1981 Academic
Congress
Service,
Press
Inc.
on
Medical
St. Luke’s
Hospital.
(London)
Limited
232
M. CARMEL
health care environment, such as the pace of change in clinical practice, the dispersal of health professionals in small groups around the globe, and the small size of the medical libraries from which a big service is demanded, have contributed to unusually rapid developments in this field. If so (and I am not sure that it is so!), those areas which have been less radically affected can look forward to similar changes in the near future. Most visible and perhaps most fundamental among these trends is the growth of library networks. This phrase itself masks a variety of different relationships between libraries, which it will be worth while to distinguish. Concurrent with the growth of large regional, national and international networks is the extension of micro-networks in the form of health district library services, library consortia, circuit riders, etc. The specialized services of information brokers and clinical librarians may have equally radical consequences for the relationship between the librarian, the library and the user. Similarly, the recent growth of research into users, their needs and information seeking habits much of it conducted by users themselves, must affect our way of looking at our relationships, as must the growth of information services right outside the library environment, of which the services of information pharmacists and statisticians may serve as examples. NETWORKING
Co-operation between libraries is almost as old as libraries themselves. In the earliest times this may have taken the form simply of scholars being sent from one library to another, but the exchange of catalogues and indexes, and lending of documents between libraries, has been established for over a century. Copying has been simple and commonplace for over forty years, and the exchange of copies has grown apace. In talking about networking, do we mean anything more than this established practice of co-operation and sharing? I believe that there are four significant differences between the concepts. Firstly, the growth of interactions between libraries has greatly exceeded the growth in either the size or the number of libraries. This quantitative/cumulative growth eventually tips the balance between the different activities of the library radically enough to alter our perception of the primary function and nature of the library. Formerly a place for the storage and retrieval of documents, with occasional access to other resources, the library has become primarily a place of access to information resources, irrespective of where they are held, supplemented by a core of locally held documents.
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NETWORKING
Secondly, networking implies an organizational commitment to resource sharing going beyond the concept of co-operation. The individual library surrenders the right to refuse to co-operate, in return for receiving a similar commitment from others. There also has to be some commitment to standardize procedures, which further diminishes the independence of the individual library, in return for a share in wider decision making. Thirdly, library networks can co-ordinate more of their activities than informal groups of co-operating libraries. Besides exchanging information and documents, libraries organized in networks can interchange scarce skills, undertake joint activities and share responsibilities. Finally, the development of networks has made feasible a new ideal of library service. In its extreme form, one might say that if any idea or piece of information exists, anywhere, in recorded or communicable form, then it is feasible for any library, anywhere, to obtain that information when it is required for use. This is the concept of “the 100% library”. A related concept is the phrase coined by Tony Harley, “the virtual library”.1 This concept is based on an analogy with timesharing computer systems where the user interrogating the system has no indication that the computer is not wholly concerned with his enquiry, the system appearing to him as a “virtual computer”. (The limitation of the analogy is that existing computer systems, however large, are closed systems while library networks are open and indefinitely extensible, at least in theory.) In the virtual library the user chooses a library to suit his own convenience, in the confidence that he will obtain the same quality of service and the same information wherever he “accesses the system”. In the field of health care this concept has special significance. For the key problem of health libraries has always been the rapid communication of knowledge to practitioners, who, in distinction from researchers or academics, are of necessity widely geographically dispersed, who tend to require their information quickly, and who are neither able nor willing to invest large efforts in information seeking. DEVELOPMENT
OF LIBRARY
NETWORKS
Although networking has grown out of co-operation, a degree of formal organization is essential for a high level of co-ordination. Historically, this has come in a number of ways. Among public and academic libraries, the amalgamation and concentration of parent institutions 1 A. J. Harley Conference.
The
virtual
library.
Title
of paper
to be given
at 1980 Library
Association
234
M.
CARMEL
has been a major force. Some consortia have been established, often with objectives which are technically very ambitious, but limited in organizational terms. Two major national networks of medical libraries, in the UK and the USA, provide interesting historical contrastsr,s. The principle initiative in the USA has come from the National Library of Medicinethe source of many major initiatives on the national and international level--and its federally sponsored Regional Medical Library Programme. The whole country is divided into eleven large regions, and individual institutions, both privately and publicly funded, have been assisted with advice, staff training, and cash to play a variety of roles in network operations within each region. Each region has a regional medical library which provides leadership and services under a contract with the regional medical library programme. In the UK, almost all health care is publicly financed through a single loose knit structure of authorities known as the National Health Service. Oversimplifying slightly, the whole service may be seen as being planned by fourteen regional health authorities in England, and in Wales, Scotland and Northern Ireland by their own government departments. It is at this “regional” level that most activity in the co-ordination of health library services has been concentrated, with very little central guidance or initiative. Just recently, national activity has increased largely at the instigation of the regions themselves, co-operating in the National Health Service Regional Librarians Group. The UK system operates on internal lines within the National Health Service, so research, planning, and finance can all be integrated. On the other hand, problems arise in relationships with institutions concerned with health care which are wholly or partly autonomous-such as medical associations or university medical schools. As in the US, therefore, there is a constant process of exploration and experiment in the development of relationships between the many institutions concerned-both at a personal and at an official level. There is a further contrast, less clear-cut, between the US and British models. This lies in the role of the “regional library”. In most UK regional library services, there is no “regional library”, although a co-operating university medical school usually acts as a bibliographic resource centre on some form of contract with the regional health authority. In a few regions the university medical library, in a teaching hospital, has certain regional co-ordinating responsibilities, but in 1 Regional Medical 2 National Library Bulktin of the Mediml
Library Systems (1977). London: Library Association. of Medicine regional medical library program policy statement Library Association 60 (April), 271-273.
(19723.
BEYOND
NETWORKING
235
general the health authorities administer and plan their services through their own library staff. In the US it seems that the situation is reversed, and that most of the regional networks are strongly led by major institutions. Organizational experiments in both countries have led to a very complex situation, which has an important bearing on the future of library networks generally. Many other countries are in the process of developing health library networks, some on a regional basis and some nationwide, with varying degrees of centralization of resources, authority, and leadership. To my own knowledge these countries include Sweden, New Zealand, Bangladesh, the Philippines, Canada and Mexico. Of still greater interest may be the development ofinternational networks, in which the World Health Organization has played the leading part. Here we may detect a trend away from the “regional library” model, exemplified by the work of BIREME in South America, towards a “distributed network” model exemplified in recent proposals for an African network, for a Western Pacific Regional Network, and above all for the Health Related Information System for Developing Countries (HERIS). NETWORK
MODELS
As a result of these variations in historical development, there have emerged several different intellectual models for library networks, which influence people’s attitudes and actions in various ways. The first and simplest model is hierarchical, with various levels of library being subordinated to one another. Its archetype would be a large public library system with a central library, district and branch libraries. Its managerial mode is authoritative and it may be diagrammatically represented as in Fig. 1. Alternatively, it is possible to see the principal library as being mainly concerned with providing services to the other libraries, with no great degree of authority over them but still with a high degree of ascendancy. This might be seen as a “star network”
Principal
library
Major
llbrories
Minor
service
points
FIG.
1. Hierarchial
network.
236
M.
CARMEL 0 0
0 \I/
0 ‘I’
0 0 0
FIG. 2. Star
network.
direct, as in Fig. 2. Such a model can be “filled in” by providing non-hierarchical links between the service points, to create a “hub and rim” network model (Fig. 3) as put forward by the staff of the British Library. Here the dominance of the centre is diluted by the concept of co-ordination. Finally it is possible, and increasingly necessary, to visualize a library network not only with no ascendancy, but with no centre-a distributed network (Fig. 4). In a distributed network all the libraries relate directly to one another, and central dominance is wholly replaced by participative co-ordination. The libraries in a distributed network are not equal in size or scope of services. They may be as strongly contrasting as in any hierarchical scheme. Large centres always will be required to carry out certain essential functions, and their administration will always require special skills. In the distributed network, however, there is functional equality between the participating libraries, in as far as they all have identical relationships with their users and all contribute resources to the total system as well as drawing upon it. These resources may include the document delivery role which has been the mainstay of most centralized networks, but may also go beyond it to embrace, for example, sharing the varied skills which special librarians acquire from working in widely differing environments in close proximity with their users. As document delivery becomes technically simpler and more efficient, emphasis is likely to switch to other skills, some of which are more readily acquired in smaller units. As a result we may see an end to the tyranny of size-the misguided but still prevalent practice of giving status and prestige to libraries, and to their staff, on the basis of the size of their collections.
/“\o P/l /\ O\,/O
FIG. 3. Hub
and Rim
network.
BEYOND
FIG.
237
NETWORKING
4. Distributed
network
model.
The most important feature of the distributed network model is its extreme flexibility. In particular it encourages in each library the maximum initiative and responsiveness to local user needs, while acknowledging the practical interdependence of the libraries. It provides for co-ordination without subordination. Its most serious difficulty comes in the management of the relationships between libraries-the major challenge of the next decade, perhaps. THE
MICRO-NETWORKS
These large networks, operating at regional, national and international levels are in general highly visible and fairly well documented. Equally significant, however are some widespread yet essentially local developments which I have dubbed “micronetworking”. Two phrases which have appeared frequently in recent medical library literature are especially significant: the circuit rider1 and the library consortium. 2 The former is a librarian based in a substantial library who regularly visits smaller health care institutions on a local “circuit” to provide services and advice. The consortium is a device to enable institutions which are too small to afford-or perhaps to need-their own libraries, to provide professional services for themselves. The concepts share significant value judgments and objectives which are worth spelling out. Firstly, they stress the importance of providing services for health care practitioners at their places of work, however dispersed or institutionally weak these may be. Secondly they are based firmly on the concept of shared resources and shared responsibilities. Finally, and most important, both are based on the idea that the primary requirement of the practitioner is for contact with a 1 S. Feuer (1977). The circuit rider 349-353. 2 W. R. Fink, H. Bloomquist & R. consortium in the national biomedical Library Association 62 (July), 258-265.
librarian.
Bulfttin
of fht
Medical
Library
Association
65 (July)
G. Allen (1974). communications
The place network.
of the
Bulletin
hospital
of th
library
Medical
238
M. CARMEL
librarian-a fellow professional skilled in handling and obtaining information from a variety of sources. These concepts are in fact based upon that perception of the library as an access point to the world of information, rather than a passive store of documents, to which we have already alluded. Both circuit rider and consortium concepts have been developed in North America, but they have been subsumed in several regions of the UK, and probably elsewhere, in the role of the health district librarian.1 Health care districts of between 150 000 and 300 000 population are generally expected to be self-sufficient in primary health care, district hospital services, and major specialties. Where district librarians have been appointed their responsibilities are perceived to include investigating the information needs of all health practitioners in the district and developing outgoing services to meet those needs. THE
NETWORK
LOOKS
OUTWARD
Organized library networks are limited in membership, but they are not closed systems. The search for the lOOo/o service in the supply of information continues beyond the boundaries of the network. Among libraries wider groupings grow in two main ways. Specialized regional services co-operate to create national and international networks such as we have discussed. In parallel, local co-operatives develop to embrace libraries differing in character or subject interest, to supplement one another’s resources of documents and skills and to fulfil shared responsibilities, for example in the provision of health related information to the general public.s,s By these two processes, we are building a series of interlocking library networks which can bring us closer to the ideal of the “lOOo/o library service”. It is, however, outside the field of librarianship that the most intriguing relationships can be seen. Still in the pursuit of a truly comprehensive service, many librarians have begun to look to other professions for help. Two important examples from the health field are statisticians and pharmacists. Statistical information is required for many purposes in health care, varying from the evaluation and monitoring of established services, through forward planning at both local and strategic levels, to research 1 J. Mayhew (1978). In R. B. Tabor (Ed.) Libra&for Health: the Wmex Exfierience. 2 D. Eakin, S. J. Jackson & G. G. Hannigan, (1980). Consumer health information: libraries as partners. Bulletin of 6he Medical Library Associafion 68 (April), 220-229. 3 R. B. Tabor, (1981). Information for health: informing patients and public. In M. J. Carmel (Ed.) A Handbook of Medical Librarianship. Library Association.
BEYOND
239
NETWORKING
and epidemiology. Librarians are in a particularly strong position to perceive the need for this type of information, and how it fits into the other information requirements of their users. On the other hand, librarians do not have the skills required to compile, interpret and evaluate data, any more than do the ultimate users. There is therefore increasing pressure, especially in countries with national health services, for a fully professional health statistics service.1 How will librarians relate to such a service? Both professions have a common interest in the dissemination of statistical information. Clumsily handled, this situation can lead to interprofessional rivalry and even hostility, yet a too careful demarcation of responsibilities may merely lead to bureaucratic stalemate. The answer seems once again to lie in the concept of an open-ended distributed network of services. The fundamental understanding must be that whether users initially contact a statistician or a librarian, they will have the pooled resources of both at their disposal. The sharing of skills in such a situation is especially important, but may be difficult for those brought up in a strong “professional” tradition. Both statistician and librarian must share their insights and methods freely if co-operation is to work, and there must be full mutual trust and respect. Each must know enough of the other’s professional skills to recognise the errors and pitfalls which await an overconfident venture into even a related professional territory. The librarian must be willing and able to advise the statistician on the organization of his information materials and on the means of access to library networks. Conversely, the statistician must impart enough understanding of the function, nature, form and value of basic relevant statistics to enable the librarian to handle them with confidence. A similar situation arises in the increasingly complex and vital area of information on drugs, drug effects and interactions. Here the special subject knowledge of a pharmacist is often essential in handling enquiries and advice, yet may sometimes be too limited to cope with even simple-sounding enquiries fully. On the other hand, the librarian alone can be trapped into providing superficial replies to deceptively complex questions. All important to the user is getting an accurate and reliable reply, and for that he must depend upon the relationship between the librarian and the pharmacist. This situation is intensified by the emergence of a new and dynamic sub-profession of information pharmacists who specialize in the advisory and information role, and who have quickly established a very effective 1 K. M. A Handbook
Morton, (1981). An information of Medical Librarianship. Library
network for health Association.
care.
In M. J. Carmel
(Ed.)
240
M.
CARMEL
pattern of networking among themselves. This has the possibility of a very fruitful relationship, with exciting prospects for co-operation and sharing through interlocking networks-provided we can overcome the mistrust and anxieties over professional roles which sometimes afflicts both sides. There are many parallel situations. Health educators are often rich providers and sources of information. An individual researcher, or indeed almost any individual library user, may at sometime become a supplier of information and hence a part of the network, at least momentarily. The common factors in all of them are the shared objective of providing a complete, reliable, and accessible information service to the user; the interdependence of the professions; the necessity to respect one another’s expertise without being overawed by it; the need for insight into one another’s professional perspectives; and the pursuit of co-ordination without subordination.
NEW
ROLES
FOR
LIBRARIANS
One of the most widely discussed developments of the past few years has been the introduction of clinical librarians. These librarians work with the members of the clinical team, and use the services of the library and information network on their behalf (or advise them on how to use it). The librarian has come right out of the library. The concept strongly resembles that of the information broker, which received a good deal of publicity a few years ago in various special subject fields but especially in management and planning. Some very useful research into this type of service was conducted at the Wessex Regional Health Authority in 197 l-72, and it is not wholly coincidence that one of the people involved in that project is carrying out a fulltime two-year evaluation of the clinical librarian project at Guy’s Hospital. There are also striking parallels between this work, and that of the “Action research” teams currently investigating the information needs and behaviour of social workers in the UK.1 Current investigations into the information seeking activities of general practitioners also owe a great deal to this work. In the earliest form, the clinical librarian seemed a very distinctive person, accompanying clinical teams on ward rounds, attending meetings, and dashing into the library on rare visits to carry out computer 1 B. Blake, titioners and
T. Morkham & A. Skinner their information needs. A&b
(1979).
Inside information: 31 (6), 275-283.
Proceedings,
social
welfare
prac-
BEYOND
241
NETWORKING
literature searches.1 Perhaps this accounts for the sometimes quite emotional opposition which was voiced. Fortunately, this opposition has subsided, and two developments have given particular cause for optimism. Firstly, the concept itself has been widely adopted, and consequently adapted, by librarians who have not the resources to become full time clinical librarians and who are therefore combining the new role with more traditional activities.2 It was especially heartening on a recent visit to Bangladesh to meet a librarian who has been accompanying clinical staff in their rounds for several years. Secondly the concept has been subjected to a comprehensive and detailed evaluative study by Jean Farmer and Ann Wilkin at Guy’s Hospital, London.3 The main value of all this work may turn out to be less the immediate service outcome than the exploration and development of relationships between the librarian and the library user. Nothing is so likely to improve the effectiveness and relevance of library services as an increase in mutual understanding. Closeness to, and awareness of the needs of users, is also the foundation for another role opening up for librarians-that of injbrmation consultant. There have always been full-time consultants advising large organizations on information systems. The development of new systems appropriate to individuals and small teams, however, presents us with a new set of opportunities-and problems. Most users in fact keep small collections of information, for which the most appropriate system may be by no means obvious, ranging from a minimal collection of cards and documents to a micro-computer based package. Judging from the number of requests for advice reaching health care libraries at a time when no such service has ever been advertised, there seems to be here a very large potential use for the librarian’s skills and knowledge. Perhaps the main significance of this lies in the fact that as a consultant the librarian has no administrative role in the development of the system, while remaining professionally responsible for the quality of advice given. In this context, research is never far from mind. Love4 has forcibly argued for a much more effective recognition of the role of research in the preparation of medical librarianship for the future. Given the 1 G. Library 2 S. hospital. 3 J. 81-85. 4 E. Library
G. Claman (1978). Clinical medical librarians: what they do. Bulletin of the Medical Association 66 (October), 454-456. R. Clevesy (1980). A modified clinical medical librarian program for the community Bulletin of the Medical Library Association 68 (January), 70-7 1. Farmer (1977). Full members of the team. Librarian Association Record 79 (February), Love, (1980). Research: Association 68 (January),
the third 1-5.
dimension
of librarianship.
B&fin
of the Medical
242
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CARMEL
central place of knowledge and communication in our society, this seems to be an area in which the choice before us as a profession is simple-conduct effective research into our own areas of responsibility, or lose control of our professional destiny. Fundamental research is required to improve our understanding of how information is used (or “processed”) by the individual-ourselves included, what provokes information seeking, and how information needs are perceived as existing or as satisfied. Of more immediate practical value is research into library use patterns and responses of various social and professional groups, and into this category falls some of the most widely discussed work of the last decade, including the clinical librarian services already discussed and some work on current literature services.l Studies on the evaluation of library and information services have in general been less successful, perhaps because of the difficulty of developing agreed and relevant criteria. Least glamorous, but at least equally valuable, is research into effective library practices and attempts to codify best current practices. All of these categories of investigation bear upon one another and relate directly and indirectly to practice, in a pattern too complex for easy analysis.2 Arguably, it is impossible to research into any one area without impinging upon all the rest. There is therefore a large range of potential starting points to begin the process of creating a researchbased profession. In looking at new roles for librarians, in a context of the growing importance of networks, one can scarcely omit the role of network co-ordinator. Increasingly this is a role divorced from the administration of any individual library, and is indeed scarcely administrative in nature at all, although wholly managerial. The network co-ordinator is principally concerned with managing the relationships between libraries within the network, between those libraries and other institutions and professions, and indeed between networks. Vern M. Pings” has analysed some of the problems attached to the role, although his views seem to me, as a practitioner, to have sadly underestimated the rewards and excitement which go with the problems. Certainly there are very few former network co-ordinators around. 1 A. Collins & R. Lever (1976). Oncology Information Service: Interim report. University of Leeds Medical Library. 2 A. Wilkin (1981). Library and information research in health care. In M. J. Carmrl (Ed.), A Handbook of Medical Librarianshif. 3 V. M. Pings (1979). Management conflict in network development. Special Libraries, 70 (February) 71-75.
BEYOND
THE
243
NETWORKING
NEW
LIBRARIAN
There are increasing numbers of full-time information brokers, library researchers, network co-ordinators and information consultants. They are unlikely ever to be more than a small minority of the profession, but the importance of the growth of these functions goes beyond the work of the individuals concerned with them on a full-time basis. For I would argue that all of these functions must in the future be seen as an integral part of the working life of every librarian, if librarianship is to make good its claim to be a profession in its own right. In the first place, we must clarify our relationship with information users, in ways explored by the clinical librarians in particular, but also by the information brokers and consultants. Too often our understanding of, and relationship with users-like their understanding of our skills and functions-is narrow and shortlived. Secondly, we must all become researchers, investigating the users-and the non-users-of our services to discover their information needs, exploring the best means of meeting those needs, and constantly evaluating the results of our efforts. Finally, we must all be co-ordinators, experimenting in the development of relationships with other libraries and networks and with other information providers and professions to develop a “lOO”/o service” or a “virtual library” for our own users. This is not to exhort the faithful to virtue, but to indicate that we are witnessing the emergence of a new core to the professional role of the librarian. This was in a large degree anticipated by Bundy and Wasserman1 in 1968 when they already concluded that there was a need to “forge a new professional identity”. Changes since 1968, many of them then scarcely anticipated, have given this need a new urgency. To some extent this history of development, undertaken often with great drive and enthusiasm shows that we are living up to Bundy and Wasserman’s call. Yet in a strict sense we have done very little to alter our professional identity, having been perhaps too busy with the pragmatic processes of developing new networks and services. To carry these processes further we have to adopt a new and more creative perception of ourselves as professionals. We have to leave behind the bureaucratic and institution-oriented value systems of the past. We have to escape from the tyranny of size in our assessments of prestige, status and value. The central place in our professional concerns must be occupied by the question of what kinds of relationships we are able to develop: among ourselves, with other professions in the information business, and above all with our users. 1 M. L. Rundy Rr P. Wasserman Libraries 29 (January), 5-26.
(1968).
Professionalism
reconsidered.
College a& Research
Libr.
Rev.
(1981) 13, 231-243
Beyond Networking* MICHAEL
CARMELt
INTRODUCTION
This paper invites librarians to look at some of the established trends in our working environment and to ask where, collectively, they are taking us. It is argued that several current trends are converging to erode the concept of the library as a distinct institution, and thereby diminishing the administrative role of the librarian. At the same time they tend to increase the demands placed upon the information handling and coordinating skills of the librarian. Above all these trends demand a clearer understanding of human and organizational relationshipsbetween individuals, between institutions and between professions. If this analysis is correct then a far reaching re-appraisal of the librarian’s role is required, with consequent changes in the education, qualifications, and self-concept of the profession and a restatement of professional objectives. None of the specific trends mentioned is unfamiliar to readers of this journal. They are international in scope, for they can be clearly seen in North America, Europe, the Third World and the Western Pacific. Certainly there are extreme differences in scale, especially between the United States and the least developed countries, but the same tendencies can be seen, sometimes in quite striking forms, in the poorest as well as the richest nations. We are all going through the same process, and it is essential for our future that we find a way of facing the problems and opportunities together. The examples quoted in this paper have been drawn mainly from the field of medical and health librarianship, simply because this is the area best known to the author. It may be that special features of the * Paper based on an address given at the Fourth Librarianship, Belgrade, l-5 September 1980. t Regional Librarian, South West Thames Regional Guildford, Surrey, GUI 3NT, UK. 0020-7837/81/030231+
13 $02.00/O
(0
International Library
1981 Academic
Congress
Service,
Press
Inc.
on
Medical
St. Luke’s
Hospital.
(London)
Limited
232
M. CARMEL
health care environment, such as the pace of change in clinical practice, the dispersal of health professionals in small groups around the globe, and the small size of the medical libraries from which a big service is demanded, have contributed to unusually rapid developments in this field. If so (and I am not sure that it is so!), those areas which have been less radically affected can look forward to similar changes in the near future. Most visible and perhaps most fundamental among these trends is the growth of library networks. This phrase itself masks a variety of different relationships between libraries, which it will be worth while to distinguish. Concurrent with the growth of large regional, national and international networks is the extension of micro-networks in the form of health district library services, library consortia, circuit riders, etc. The specialized services of information brokers and clinical librarians may have equally radical consequences for the relationship between the librarian, the library and the user. Similarly, the recent growth of research into users, their needs and information seeking habits much of it conducted by users themselves, must affect our way of looking at our relationships, as must the growth of information services right outside the library environment, of which the services of information pharmacists and statisticians may serve as examples. NETWORKING
Co-operation between libraries is almost as old as libraries themselves. In the earliest times this may have taken the form simply of scholars being sent from one library to another, but the exchange of catalogues and indexes, and lending of documents between libraries, has been established for over a century. Copying has been simple and commonplace for over forty years, and the exchange of copies has grown apace. In talking about networking, do we mean anything more than this established practice of co-operation and sharing? I believe that there are four significant differences between the concepts. Firstly, the growth of interactions between libraries has greatly exceeded the growth in either the size or the number of libraries. This quantitative/cumulative growth eventually tips the balance between the different activities of the library radically enough to alter our perception of the primary function and nature of the library. Formerly a place for the storage and retrieval of documents, with occasional access to other resources, the library has become primarily a place of access to information resources, irrespective of where they are held, supplemented by a core of locally held documents.
BEYOND
233
NETWORKING
Secondly, networking implies an organizational commitment to resource sharing going beyond the concept of co-operation. The individual library surrenders the right to refuse to co-operate, in return for receiving a similar commitment from others. There also has to be some commitment to standardize procedures, which further diminishes the independence of the individual library, in return for a share in wider decision making. Thirdly, library networks can co-ordinate more of their activities than informal groups of co-operating libraries. Besides exchanging information and documents, libraries organized in networks can interchange scarce skills, undertake joint activities and share responsibilities. Finally, the development of networks has made feasible a new ideal of library service. In its extreme form, one might say that if any idea or piece of information exists, anywhere, in recorded or communicable form, then it is feasible for any library, anywhere, to obtain that information when it is required for use. This is the concept of “the 100% library”. A related concept is the phrase coined by Tony Harley, “the virtual library”.1 This concept is based on an analogy with timesharing computer systems where the user interrogating the system has no indication that the computer is not wholly concerned with his enquiry, the system appearing to him as a “virtual computer”. (The limitation of the analogy is that existing computer systems, however large, are closed systems while library networks are open and indefinitely extensible, at least in theory.) In the virtual library the user chooses a library to suit his own convenience, in the confidence that he will obtain the same quality of service and the same information wherever he “accesses the system”. In the field of health care this concept has special significance. For the key problem of health libraries has always been the rapid communication of knowledge to practitioners, who, in distinction from researchers or academics, are of necessity widely geographically dispersed, who tend to require their information quickly, and who are neither able nor willing to invest large efforts in information seeking. DEVELOPMENT
OF LIBRARY
NETWORKS
Although networking has grown out of co-operation, a degree of formal organization is essential for a high level of co-ordination. Historically, this has come in a number of ways. Among public and academic libraries, the amalgamation and concentration of parent institutions 1 A. J. Harley Conference.
The
virtual
library.
Title
of paper
to be given
at 1980 Library
Association
234
M.
CARMEL
has been a major force. Some consortia have been established, often with objectives which are technically very ambitious, but limited in organizational terms. Two major national networks of medical libraries, in the UK and the USA, provide interesting historical contrastsr,s. The principle initiative in the USA has come from the National Library of Medicinethe source of many major initiatives on the national and international level--and its federally sponsored Regional Medical Library Programme. The whole country is divided into eleven large regions, and individual institutions, both privately and publicly funded, have been assisted with advice, staff training, and cash to play a variety of roles in network operations within each region. Each region has a regional medical library which provides leadership and services under a contract with the regional medical library programme. In the UK, almost all health care is publicly financed through a single loose knit structure of authorities known as the National Health Service. Oversimplifying slightly, the whole service may be seen as being planned by fourteen regional health authorities in England, and in Wales, Scotland and Northern Ireland by their own government departments. It is at this “regional” level that most activity in the co-ordination of health library services has been concentrated, with very little central guidance or initiative. Just recently, national activity has increased largely at the instigation of the regions themselves, co-operating in the National Health Service Regional Librarians Group. The UK system operates on internal lines within the National Health Service, so research, planning, and finance can all be integrated. On the other hand, problems arise in relationships with institutions concerned with health care which are wholly or partly autonomous-such as medical associations or university medical schools. As in the US, therefore, there is a constant process of exploration and experiment in the development of relationships between the many institutions concerned-both at a personal and at an official level. There is a further contrast, less clear-cut, between the US and British models. This lies in the role of the “regional library”. In most UK regional library services, there is no “regional library”, although a co-operating university medical school usually acts as a bibliographic resource centre on some form of contract with the regional health authority. In a few regions the university medical library, in a teaching hospital, has certain regional co-ordinating responsibilities, but in 1 Regional Medical 2 National Library Bulktin of the Mediml
Library Systems (1977). London: Library Association. of Medicine regional medical library program policy statement Library Association 60 (April), 271-273.
(19723.
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235
general the health authorities administer and plan their services through their own library staff. In the US it seems that the situation is reversed, and that most of the regional networks are strongly led by major institutions. Organizational experiments in both countries have led to a very complex situation, which has an important bearing on the future of library networks generally. Many other countries are in the process of developing health library networks, some on a regional basis and some nationwide, with varying degrees of centralization of resources, authority, and leadership. To my own knowledge these countries include Sweden, New Zealand, Bangladesh, the Philippines, Canada and Mexico. Of still greater interest may be the development ofinternational networks, in which the World Health Organization has played the leading part. Here we may detect a trend away from the “regional library” model, exemplified by the work of BIREME in South America, towards a “distributed network” model exemplified in recent proposals for an African network, for a Western Pacific Regional Network, and above all for the Health Related Information System for Developing Countries (HERIS). NETWORK
MODELS
As a result of these variations in historical development, there have emerged several different intellectual models for library networks, which influence people’s attitudes and actions in various ways. The first and simplest model is hierarchical, with various levels of library being subordinated to one another. Its archetype would be a large public library system with a central library, district and branch libraries. Its managerial mode is authoritative and it may be diagrammatically represented as in Fig. 1. Alternatively, it is possible to see the principal library as being mainly concerned with providing services to the other libraries, with no great degree of authority over them but still with a high degree of ascendancy. This might be seen as a “star network”
Principal
library
Major
llbrories
Minor
service
points
FIG.
1. Hierarchial
network.
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0 \I/
0 ‘I’
0 0 0
FIG. 2. Star
network.
direct, as in Fig. 2. Such a model can be “filled in” by providing non-hierarchical links between the service points, to create a “hub and rim” network model (Fig. 3) as put forward by the staff of the British Library. Here the dominance of the centre is diluted by the concept of co-ordination. Finally it is possible, and increasingly necessary, to visualize a library network not only with no ascendancy, but with no centre-a distributed network (Fig. 4). In a distributed network all the libraries relate directly to one another, and central dominance is wholly replaced by participative co-ordination. The libraries in a distributed network are not equal in size or scope of services. They may be as strongly contrasting as in any hierarchical scheme. Large centres always will be required to carry out certain essential functions, and their administration will always require special skills. In the distributed network, however, there is functional equality between the participating libraries, in as far as they all have identical relationships with their users and all contribute resources to the total system as well as drawing upon it. These resources may include the document delivery role which has been the mainstay of most centralized networks, but may also go beyond it to embrace, for example, sharing the varied skills which special librarians acquire from working in widely differing environments in close proximity with their users. As document delivery becomes technically simpler and more efficient, emphasis is likely to switch to other skills, some of which are more readily acquired in smaller units. As a result we may see an end to the tyranny of size-the misguided but still prevalent practice of giving status and prestige to libraries, and to their staff, on the basis of the size of their collections.
/“\o P/l /\ O\,/O
FIG. 3. Hub
and Rim
network.
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FIG.
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4. Distributed
network
model.
The most important feature of the distributed network model is its extreme flexibility. In particular it encourages in each library the maximum initiative and responsiveness to local user needs, while acknowledging the practical interdependence of the libraries. It provides for co-ordination without subordination. Its most serious difficulty comes in the management of the relationships between libraries-the major challenge of the next decade, perhaps. THE
MICRO-NETWORKS
These large networks, operating at regional, national and international levels are in general highly visible and fairly well documented. Equally significant, however are some widespread yet essentially local developments which I have dubbed “micronetworking”. Two phrases which have appeared frequently in recent medical library literature are especially significant: the circuit rider1 and the library consortium. 2 The former is a librarian based in a substantial library who regularly visits smaller health care institutions on a local “circuit” to provide services and advice. The consortium is a device to enable institutions which are too small to afford-or perhaps to need-their own libraries, to provide professional services for themselves. The concepts share significant value judgments and objectives which are worth spelling out. Firstly, they stress the importance of providing services for health care practitioners at their places of work, however dispersed or institutionally weak these may be. Secondly they are based firmly on the concept of shared resources and shared responsibilities. Finally, and most important, both are based on the idea that the primary requirement of the practitioner is for contact with a 1 S. Feuer (1977). The circuit rider 349-353. 2 W. R. Fink, H. Bloomquist & R. consortium in the national biomedical Library Association 62 (July), 258-265.
librarian.
Bulfttin
of fht
Medical
Library
Association
65 (July)
G. Allen (1974). communications
The place network.
of the
Bulletin
hospital
of th
library
Medical
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librarian-a fellow professional skilled in handling and obtaining information from a variety of sources. These concepts are in fact based upon that perception of the library as an access point to the world of information, rather than a passive store of documents, to which we have already alluded. Both circuit rider and consortium concepts have been developed in North America, but they have been subsumed in several regions of the UK, and probably elsewhere, in the role of the health district librarian.1 Health care districts of between 150 000 and 300 000 population are generally expected to be self-sufficient in primary health care, district hospital services, and major specialties. Where district librarians have been appointed their responsibilities are perceived to include investigating the information needs of all health practitioners in the district and developing outgoing services to meet those needs. THE
NETWORK
LOOKS
OUTWARD
Organized library networks are limited in membership, but they are not closed systems. The search for the lOOo/o service in the supply of information continues beyond the boundaries of the network. Among libraries wider groupings grow in two main ways. Specialized regional services co-operate to create national and international networks such as we have discussed. In parallel, local co-operatives develop to embrace libraries differing in character or subject interest, to supplement one another’s resources of documents and skills and to fulfil shared responsibilities, for example in the provision of health related information to the general public.s,s By these two processes, we are building a series of interlocking library networks which can bring us closer to the ideal of the “lOOo/o library service”. It is, however, outside the field of librarianship that the most intriguing relationships can be seen. Still in the pursuit of a truly comprehensive service, many librarians have begun to look to other professions for help. Two important examples from the health field are statisticians and pharmacists. Statistical information is required for many purposes in health care, varying from the evaluation and monitoring of established services, through forward planning at both local and strategic levels, to research 1 J. Mayhew (1978). In R. B. Tabor (Ed.) Libra&for Health: the Wmex Exfierience. 2 D. Eakin, S. J. Jackson & G. G. Hannigan, (1980). Consumer health information: libraries as partners. Bulletin of 6he Medical Library Associafion 68 (April), 220-229. 3 R. B. Tabor, (1981). Information for health: informing patients and public. In M. J. Carmel (Ed.) A Handbook of Medical Librarianship. Library Association.
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and epidemiology. Librarians are in a particularly strong position to perceive the need for this type of information, and how it fits into the other information requirements of their users. On the other hand, librarians do not have the skills required to compile, interpret and evaluate data, any more than do the ultimate users. There is therefore increasing pressure, especially in countries with national health services, for a fully professional health statistics service.1 How will librarians relate to such a service? Both professions have a common interest in the dissemination of statistical information. Clumsily handled, this situation can lead to interprofessional rivalry and even hostility, yet a too careful demarcation of responsibilities may merely lead to bureaucratic stalemate. The answer seems once again to lie in the concept of an open-ended distributed network of services. The fundamental understanding must be that whether users initially contact a statistician or a librarian, they will have the pooled resources of both at their disposal. The sharing of skills in such a situation is especially important, but may be difficult for those brought up in a strong “professional” tradition. Both statistician and librarian must share their insights and methods freely if co-operation is to work, and there must be full mutual trust and respect. Each must know enough of the other’s professional skills to recognise the errors and pitfalls which await an overconfident venture into even a related professional territory. The librarian must be willing and able to advise the statistician on the organization of his information materials and on the means of access to library networks. Conversely, the statistician must impart enough understanding of the function, nature, form and value of basic relevant statistics to enable the librarian to handle them with confidence. A similar situation arises in the increasingly complex and vital area of information on drugs, drug effects and interactions. Here the special subject knowledge of a pharmacist is often essential in handling enquiries and advice, yet may sometimes be too limited to cope with even simple-sounding enquiries fully. On the other hand, the librarian alone can be trapped into providing superficial replies to deceptively complex questions. All important to the user is getting an accurate and reliable reply, and for that he must depend upon the relationship between the librarian and the pharmacist. This situation is intensified by the emergence of a new and dynamic sub-profession of information pharmacists who specialize in the advisory and information role, and who have quickly established a very effective 1 K. M. A Handbook
Morton, (1981). An information of Medical Librarianship. Library
network for health Association.
care.
In M. J. Carmel
(Ed.)
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pattern of networking among themselves. This has the possibility of a very fruitful relationship, with exciting prospects for co-operation and sharing through interlocking networks-provided we can overcome the mistrust and anxieties over professional roles which sometimes afflicts both sides. There are many parallel situations. Health educators are often rich providers and sources of information. An individual researcher, or indeed almost any individual library user, may at sometime become a supplier of information and hence a part of the network, at least momentarily. The common factors in all of them are the shared objective of providing a complete, reliable, and accessible information service to the user; the interdependence of the professions; the necessity to respect one another’s expertise without being overawed by it; the need for insight into one another’s professional perspectives; and the pursuit of co-ordination without subordination.
NEW
ROLES
FOR
LIBRARIANS
One of the most widely discussed developments of the past few years has been the introduction of clinical librarians. These librarians work with the members of the clinical team, and use the services of the library and information network on their behalf (or advise them on how to use it). The librarian has come right out of the library. The concept strongly resembles that of the information broker, which received a good deal of publicity a few years ago in various special subject fields but especially in management and planning. Some very useful research into this type of service was conducted at the Wessex Regional Health Authority in 197 l-72, and it is not wholly coincidence that one of the people involved in that project is carrying out a fulltime two-year evaluation of the clinical librarian project at Guy’s Hospital. There are also striking parallels between this work, and that of the “Action research” teams currently investigating the information needs and behaviour of social workers in the UK.1 Current investigations into the information seeking activities of general practitioners also owe a great deal to this work. In the earliest form, the clinical librarian seemed a very distinctive person, accompanying clinical teams on ward rounds, attending meetings, and dashing into the library on rare visits to carry out computer 1 B. Blake, titioners and
T. Morkham & A. Skinner their information needs. A&b
(1979).
Inside information: 31 (6), 275-283.
Proceedings,
social
welfare
prac-
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literature searches.1 Perhaps this accounts for the sometimes quite emotional opposition which was voiced. Fortunately, this opposition has subsided, and two developments have given particular cause for optimism. Firstly, the concept itself has been widely adopted, and consequently adapted, by librarians who have not the resources to become full time clinical librarians and who are therefore combining the new role with more traditional activities.2 It was especially heartening on a recent visit to Bangladesh to meet a librarian who has been accompanying clinical staff in their rounds for several years. Secondly the concept has been subjected to a comprehensive and detailed evaluative study by Jean Farmer and Ann Wilkin at Guy’s Hospital, London.3 The main value of all this work may turn out to be less the immediate service outcome than the exploration and development of relationships between the librarian and the library user. Nothing is so likely to improve the effectiveness and relevance of library services as an increase in mutual understanding. Closeness to, and awareness of the needs of users, is also the foundation for another role opening up for librarians-that of injbrmation consultant. There have always been full-time consultants advising large organizations on information systems. The development of new systems appropriate to individuals and small teams, however, presents us with a new set of opportunities-and problems. Most users in fact keep small collections of information, for which the most appropriate system may be by no means obvious, ranging from a minimal collection of cards and documents to a micro-computer based package. Judging from the number of requests for advice reaching health care libraries at a time when no such service has ever been advertised, there seems to be here a very large potential use for the librarian’s skills and knowledge. Perhaps the main significance of this lies in the fact that as a consultant the librarian has no administrative role in the development of the system, while remaining professionally responsible for the quality of advice given. In this context, research is never far from mind. Love4 has forcibly argued for a much more effective recognition of the role of research in the preparation of medical librarianship for the future. Given the 1 G. Library 2 S. hospital. 3 J. 81-85. 4 E. Library
G. Claman (1978). Clinical medical librarians: what they do. Bulletin of the Medical Association 66 (October), 454-456. R. Clevesy (1980). A modified clinical medical librarian program for the community Bulletin of the Medical Library Association 68 (January), 70-7 1. Farmer (1977). Full members of the team. Librarian Association Record 79 (February), Love, (1980). Research: Association 68 (January),
the third 1-5.
dimension
of librarianship.
B&fin
of the Medical
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central place of knowledge and communication in our society, this seems to be an area in which the choice before us as a profession is simple-conduct effective research into our own areas of responsibility, or lose control of our professional destiny. Fundamental research is required to improve our understanding of how information is used (or “processed”) by the individual-ourselves included, what provokes information seeking, and how information needs are perceived as existing or as satisfied. Of more immediate practical value is research into library use patterns and responses of various social and professional groups, and into this category falls some of the most widely discussed work of the last decade, including the clinical librarian services already discussed and some work on current literature services.l Studies on the evaluation of library and information services have in general been less successful, perhaps because of the difficulty of developing agreed and relevant criteria. Least glamorous, but at least equally valuable, is research into effective library practices and attempts to codify best current practices. All of these categories of investigation bear upon one another and relate directly and indirectly to practice, in a pattern too complex for easy analysis.2 Arguably, it is impossible to research into any one area without impinging upon all the rest. There is therefore a large range of potential starting points to begin the process of creating a researchbased profession. In looking at new roles for librarians, in a context of the growing importance of networks, one can scarcely omit the role of network co-ordinator. Increasingly this is a role divorced from the administration of any individual library, and is indeed scarcely administrative in nature at all, although wholly managerial. The network co-ordinator is principally concerned with managing the relationships between libraries within the network, between those libraries and other institutions and professions, and indeed between networks. Vern M. Pings” has analysed some of the problems attached to the role, although his views seem to me, as a practitioner, to have sadly underestimated the rewards and excitement which go with the problems. Certainly there are very few former network co-ordinators around. 1 A. Collins & R. Lever (1976). Oncology Information Service: Interim report. University of Leeds Medical Library. 2 A. Wilkin (1981). Library and information research in health care. In M. J. Carmrl (Ed.), A Handbook of Medical Librarianshif. 3 V. M. Pings (1979). Management conflict in network development. Special Libraries, 70 (February) 71-75.
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NEW
LIBRARIAN
There are increasing numbers of full-time information brokers, library researchers, network co-ordinators and information consultants. They are unlikely ever to be more than a small minority of the profession, but the importance of the growth of these functions goes beyond the work of the individuals concerned with them on a full-time basis. For I would argue that all of these functions must in the future be seen as an integral part of the working life of every librarian, if librarianship is to make good its claim to be a profession in its own right. In the first place, we must clarify our relationship with information users, in ways explored by the clinical librarians in particular, but also by the information brokers and consultants. Too often our understanding of, and relationship with users-like their understanding of our skills and functions-is narrow and shortlived. Secondly, we must all become researchers, investigating the users-and the non-users-of our services to discover their information needs, exploring the best means of meeting those needs, and constantly evaluating the results of our efforts. Finally, we must all be co-ordinators, experimenting in the development of relationships with other libraries and networks and with other information providers and professions to develop a “lOO”/o service” or a “virtual library” for our own users. This is not to exhort the faithful to virtue, but to indicate that we are witnessing the emergence of a new core to the professional role of the librarian. This was in a large degree anticipated by Bundy and Wasserman1 in 1968 when they already concluded that there was a need to “forge a new professional identity”. Changes since 1968, many of them then scarcely anticipated, have given this need a new urgency. To some extent this history of development, undertaken often with great drive and enthusiasm shows that we are living up to Bundy and Wasserman’s call. Yet in a strict sense we have done very little to alter our professional identity, having been perhaps too busy with the pragmatic processes of developing new networks and services. To carry these processes further we have to adopt a new and more creative perception of ourselves as professionals. We have to leave behind the bureaucratic and institution-oriented value systems of the past. We have to escape from the tyranny of size in our assessments of prestige, status and value. The central place in our professional concerns must be occupied by the question of what kinds of relationships we are able to develop: among ourselves, with other professions in the information business, and above all with our users. 1 M. L. Rundy Rr P. Wasserman Libraries 29 (January), 5-26.
(1968).
Professionalism
reconsidered.
College a& Research