CHRC News

Vol.2, No. 2, April 2002














INTRODUCTION

This issue of the CHRC News features 
reports by CHRC Project Manager Julie 
Whelan about the web’s role in a local 
pediatric practice as well as news from the 
Center for Information Therapy.  Reference 
Services Librarian Linda Rossman, from the 
Perkins Braille and Talking Book Library, 
describes their unique services in our 
occasional series, Massachusetts Models

In the News

Our thanks to the Editors of Boston Region 
BRiefly for their kind mention of CHRC 
services in the January, 2002 issue.  Please 
don’t hesitate to get in touch with us for 
assistance.  Our complete contact 
information is on the last page.

Treadwell Staff Notes
Remarks from Julia Whelan

Senior Outreach Librarian, Treadwell 
Library, Massachusetts General Hospital 
617-724-2781; jcwhelan@partners.org

Some health care providers are integrating 
the Internet and web based information 
resources directly into patient care. At the 
recent Health on the Internet Conference 
(February 2002, Sheraton Boston), for 
example, we toured the web page of 
Pediatric Health Care at Newton-Wellesley 
P.C., http://www.pediatrichealthcare.com/, a 
pediatric practice firmly committed to using 
web technology. Patients and their families 
can use the web site to query a doctor or 
nurse, request a school/camp form,  request 
a referral, renew a prescription or schedule 
an appointment. When patients join the 
practice, they can submit their medical 
history forms online.  Web site utilities 
allow them to store and access their medical 
records from the web site. Dr. Eugenia 
Marcus, a pediatrician in this group practice, 
listed the many advantages she has 
discovered in using the Internet as part of 
her practice: 
- It eliminates telephone tag.
- It increases communication.  E-mail 
makes it easier, especially for 
adolescents, to communicate directly 
with the doctor on sensitive issues. E-
mail is also self-documenting and 
facilitates education and follow-up.
- The doctor can keep in touch with 
families, even at a distance, while 
simultaneously increasing 
productivity.
- Internet use can decrease the number 
of office visits: it is estimated that as 
many as 20% of office visits could be 
shifted to the Internet.
- Because patients can e-mail or scan in 
documents such as school evaluations 
or pictures of a rash, the doctor knows 
patient questions ahead of time and 
her thoughts are more organized; her 
responses more complete.
Patients have recommended web-based 
consultations because they may eliminate the 
following chores: bundling children into the 
car, driving to the office and searching for a 
parking space, sitting in a waiting room full 
of sick children, and missing work.  (For this 
last reason, many employers are interested in 
supporting web consultations.)
 
Click on “Education” on the web site home 
page to see links to selected information 
resources.  Dr. Marcus either refers 
patients to a particular site or cuts and 
pastes information into her e-mail 
responses. Working with clinicians to 
determine how these information resources 
are selected and utilized seems a prime 
opportunity for medical librarians to 
participate in the process. There are many 
issues that must be solved before the 
practice of internet medicine can become 
more widespread. Currently, health 
insurance does not reimburse clinicians for 
these activities. Pediatric Health Care at 
Newton-Wellesley charges patients a web 
fee when they join. Future plans include a 
sliding fee for consulting the doctor via e-
mail which would vary depending on the 
complexity of the question. During office 
visits, Dr. Marcus takes time to 
demonstrate how to use the web utilities 
and clarifies what types of questions are 
appropriate for this service and which 
should always be handled by phone. One 
of the biggest problems is the slowness of 
the average Internet connection. Questions 
of access are crucial. Currently, such 
integration of the Internet into medical 
practice could only work in a highly 
educated, affluent community. The 
proliferation of cell phone use across all 
segments of society and increased cell 
phone access to the Internet may serve to 
broaden these services to larger segments 
of the population.  

Center for Information Therapy
http://www.informationtherapy.org

In a related news story, the Center for 
Information Therapy  was launched in 
Washington, D.C. The Center plans to lobby 
Congress to mandate that “information 
prescriptions” become part of standard 
medical care. The group also wants 
reimbursement for these activities from 
Medicare, Medicaid and HMOs. Patients 
would receive information before a visit, at 
the time of care, as part of discharge, and 
follow-up. Medical librarians have 
expressed concerns that Healthwise, the 
commercial founder of the group, is using 
this effort as a vehicle for self-promotion. 
Additionally, the process they are lobbying 
for does not include librarians as either 
information providers or evaluators. 

The integration of consumer health 
information into medical care, whether via 
the Internet or more traditional media, is a 
hot topic and certainly one that librarians 
everywhere will want to follow and express 
their opinions. 

Care for the Patient with Cancer

Martha Stone, Treadwell Library’s  
Coordinator for Reference Services, 
presented “Using the Internet to Search for 
Cancer Resources” at MGH’s Center for 
Clinical and Professional Development 
forum, “Cancer Nursing:  Back to Basics” in 
March.  If you would like a copy of the 
handout, consisting of a two-page annotated 
list of both general and specialized cancer 
web sites, please contact us. 

American Board of Medical Specialties 
(ABMS) 
http://www.abms.org/

The ABMS now requires registration to use 
their "Who's Certified" search.  The site 
remains free but requires you to input your 
e-mail address.  A password is instantly 
generated and sent your e-mail address.  
However, the ABMS has imposed a limit of 
five free searches per 24-hour period.  Reuse 
your password at subsequent searches, but if 
you have forgotten it, click on Forgot my 
password and a new one will be issued 
immediately.

Consumer Health Information for 
California
http://nnlm.gov/psr/chic.html#trainingmodules

Developed by the Pacific Southwest 
Regional Medical Library (PSRML) in 
collaboration with other California libraries, 
the overall goal of the project was to 
facilitate the ability of public library staff to 
answer consumer health questions.  Three 
modules are available in PDF.  The 
information presented is straight-forward 
and well-written.  There are some excellent 
mock health reference interview scenarios 
using real-life examples, as well as 
information about the legal/liability aspects 
of dispensing health information in Module 
I. Module II covers use of print materials 
available in most public library collections 
to answer consumer health information 
questions, while Module III describes online 
resources available to answer consumer 
health questions, including those  made 
available by the National Library of 
Medicine.

Lab Tests Online
http://www.labtestsonline.org/

Lab Tests Online is the product of a 
collaboration among professional societies 
representing the clinical laboratory 
community, and organized by the American 
Association for Clinical Chemistry (AACC). 
This excellent web site allows you to search 
by name of test, by condition/diseases, or 
by age group.  For example,  choose AFP 
Maternal from the drop-down menu of tests.  
Synonyms and related tests are listed.  There 
is a brief summary of this blood test, used to 
assess the risk of carrying a fetus with 
abnormalities. Click on “Links” for a brief 
listing of web sites appropriate to the test 
being carried out.  In another example, 
choose Peptic Ulcer from the drop-down 
menu of Conditions/Diseases.  There is a 
brief, understandable description of the 
condition, pop-up boxes to define terms such 
as antigen or enzyme, and information about 
any related tests, which in this case is the 
Helicobacter Pylori Test.  

Massachusetts Models

By Linda Rossman, M.S., Reference 
Services Librarian, Perkins Braille and 
Talking Book Library.

Background: The Perkins Braille and 
Talking Book Library has been providing 
special library services since 1830.  In 1931, 
it became a founding member of the Library 
of Congress Program for the Blind and 
Physically Handicapped. The library is 
housed at the Perkins School for the Blind, 
the first school for the blind in the United 
States, chartered in 1829.  We currently 
provide services to libraries and schools that 
serve eligible individuals, as well as to 
18,000 residents of Massachusetts who are 
blind, visually impaired, or cannot read 
standard print due to a physical disability or 
reading impairment.

The library is a cooperating member of the 
National Library Service for the Blind and 
Physically Handicapped (NLS), which is a 
division of the Library of Congress and is 
composed of 141 network libraries 
nationwide. The program is administered by 
the Perkins School for the Blind with 
funding from the Massachusetts Board of 
Library Commissioners.

The audiocassettes recorded by the NLS for 
the talking book libraries differ from the 
standard commercial audiotapes that public 
libraries purchase.  These tapes are specially 
recorded on four tracks rather than the 
standard two tracks.  The four-track system 
enables compliance with the U.S. copyright 
law and minimizes the number of tapes 
needed for each title. The library lends, at no 
charge, four-track cassette players to play 
these tapes. All materials are sent to and 
from the library and its patrons postage-free,  
as mandated by an act of Congress.   
Between 1800 and 2000 books on cassette 
are sent out per day, to individuals and 
libraries.

Reference Service:  The reference 
department specializes in providing a wide 
array of information on disabilities in 
whatever format the patron prefers:  large 
print, braille, e-mail, diskette or over the 
phone.  Blind people who use computers 
receive an electronic version of the file and 
then use adaptive technology such as JAWS, 
screen reading software that allows the 
computer to “speak” to the user, and 
ZoomText, software that enlarges the 
computer image. 

The reference department publishes topic 
bibliographies covering titles in both 
cassette and braille format. About ten 
percent of the library’s users prefer braille. 
Librarians also serve as information 
clearinghouses to help connect people to the 
agencies and resources they need.   In the 
future, the library will be initiating an online 
“Ask A Reference Librarian” service, as 
well as distributing its newsletter, Dots & 
Decibels, to Massachusetts public libraries.

Four reader’s advisors are available to 
provide assistance to all library patrons.   
The library provides most of its services 
over the phone, but patrons are also 
welcome to come in and browse new braille 
and cassette titles in our drop-in facility, 
located next door to the library.  

How to register: Individuals unable to read 
print books due to a disability are eligible for 
services.  Hospitals, libraries, schools and 
other institutions that serve people who 
qualify are also eligible.  Libraries can 
arrange to have a deposit collection of 
braille and talking book titles on-site.  In the 
case of blindness, visual impairment or 
physical limitations, eligibility for service 
can be certified by any helping professional, 
including a librarian, therapist, or social 
worker.   However, in the case of a reading 
disability, a medical doctor needs to sign the 
form, certifying that the condition is 
organically based.  Call 617-972-7240 for 
more registration information.

Customized Service Plans: Registered users 
may set up automated preference profiles by 
subject or authors, and new titles will be 
automatically mailed on a regular basis in 
the format the user prefers.

Catalog:  Keystone Library Automation 
Systems (KLAS) is the online catalog, 
available for searching by the general public, 
although only registered library patrons can 
actually sign on and request books 
electronically.  The catalog can be searched 
by title, author, subject, or keyword, and 
results can be limited by media format.  It 
can be  accessed through the Perkins home 
page, http://www.perkins.org, or directly at 
http://www.klas.com/talkingbooks/mass

Collection: The Library holds 
approximately 65,000 book titles for adults 
and children and subscribes to 100 
magazines. Fiction and non-fiction 
bestsellers, biographies, westerns, mysteries, 
romances and how-to books are in high 
demand.

Children’s Services: The Children’s 
Services Department provides assistance to 
juvenile patrons, their parents, caregivers, 
teachers and librarians.  In 1999 a Summer 
Reading Program was inaugurated.  

Contact information: If you have any 
questions about our services or would like to 
sign up as an individual or institution, please 
contact us: 
General Information and Reader’s Advisors: 
617-972-7240; 800-852-3133
Fax :           617-972-7363
Reference:  617-972-7245
E-mail: rossmanl@perkins.pvt.k12.ma.us
(after late April, 2002 e-mail address will be:  
Linda.Rossman@perkins.org)

Location:  The Perkins Braille and Talking 
Book Library is located at 175 North Beacon 
Street, Watertown, MA, 02472-2790.  It is 
served by MBTA bus line #71 from Harvard 
Square and #70 from Central Square.

Hours: Monday-Friday, 8:30 – 5

Web site:  http://www.perkins.org

In Print 

The guide to living with bladder cancer / 
Mark P. Schoenberg and the faculty and 
staff of the Johns Hopkins Genitourinary                
Oncology Group / Baltimore : Johns 
Hopkins University Press, 2000.  This book 
is scientifically grounded, well-written, 
comprehensive, and includes a glossary.   
There are only a few illustrations. The 
author states in the Introduction that “this 
book contains very little information about 
[alternative or complementary] approaches.”

Instructions for geriatric patients / 
William A. Sodeman / 2nd ed./      
Philadelphia : W.B. Saunders, 1999.  
Includes CD-ROM.  These are generic, 
large-print, jargon-free instructions on a 
wide variety of topics ranging from 
dementia to insomnia, dry eyes, and edema.  
There are sample diets, when appropriate 
(e.g. lactose controlled, gluten restricted.)  
The CD-ROM can be used to create 
customized instructions.

Mayo Clinic guide to self-care : answers 
for everyday health problems / Philip T. 
Hagen, editor-in-chief / 2nd ed. / Rochester, 
Minn. : Mayo Clinic, 1999.  Covering 150 
common medical conditions, this book also 
includes sections on workplace health (e.g., 
coping with stress) and being a wise health 
consumer (e.g., a guide to home medical 
testing kits.)  Each entry, from tick bites to 
ankle pain to ear infections, is illustrated by 
a detailed line drawing.

What would you like to see covered in the 
CHRC News? Please don’t hesitate to tell us!



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CHRC Contact Information

Tel: 1-877-MEDI-REF (1-877-633-4733)
 or    617-726-8600

Fax: 617-726-6784

E-mail:    
    treadwellqanda@partners.org 
or treadwellqanda@partners.org

Consumer Health Reference Center
Treadwell Library 
Bartlett Hall Extension 1 
Massachusetts General Hospital 
Boston, MA 02114. 

http://www.mgh.harvard.edu/library/chrcindex.html

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