National Electronic Library for Health 2

A couple of weeks after the New Libraries for Old conference, I was invited to attend a colloquium of interested parties to hear short presentations about NeLH but mainly to provide a forum for questions, discussion and input from representative bodies. More than a hundred participants attended from libraries, pharmaceutical companies, publishers, research organisations, royal colleges as well as a good number of clinicians.

Michael Stein from Blackwell Science started the presentations by speaking about electronic publishing and the possibilities that the Internet opens up for updating, linkage, self-assessment, etc. Ben Toth, R&D Information Manager, NHS Executive South and West, is one of a very small group of people pushing forward the NeLH. Ben described a possible (but by no means decided) outline for the NeLH architecture which allowed for one click searching for, say, a condition, limited by age range and diagnostic or treatment options. Users could also select from clickable catalogues of information such as current guidelines, audit protocols, circulars, news clippings, etc. And/or under patient information e.g. NHS Direct, local GP information, guides to local health services, and so on. Other possibilities could be to browse library resources such as the full text of over 300 key journals. While these would not be the only options available, Ben was trying to illustrate the potential for the NeLH. The design principles would involve a three tier model with a browser (user interface), the NeLH "catalogue" as the middle layer and the various "information objects" as the third layer. The aim would be to standardise so that resources can be built into local local systems and specialist libraries using common formats. Desktop software should be as simple as possible and resources should be visible on both the NHSnet and the Internet.

Muir Gray Spoke about funding. There was no intention to take away any money from existing services but they were looking to raise about 10-20 million. Some organisations have already agreed to put up funds with no strings attached; it may also be possible to sell products/services to more affluent countries and provide them free to others. The NeLH will be project managed by a small development team of Veronica Fraser, Ben Toth, Muir Gray and Robert Ward from the NHS Executive Information Management Group. Alistair Liddell, Director of Planning for the NHS Executive, is also on the Project Board, so there is high level backing.

The tone of this meeting was a bit less positive than the earlier conference, perhaps because it was such a diverse group. Some people seized on issues like the 300 electronic journals mentioned by Ben Toth and questioned the need for this since one of the aims of the NeLH was to ensure that clinicians would obtain an answer within 15 seconds. Others questioned who would be responsible for deciding what was gold standard material and what wasn't. One delegate mentioned the need to involve those in the education sector at all levels. While they cannot be expected to teach everyone everything they are likely to need to know, they need to know about the NeLH and how to access the knowledge base. Another delegate was concerned about an approach which seemed to focus on a particular condition. Some people would need different types of information like protocols, information on discharge, etc which might not be condition specific. It was also stressed that locally developed resources should not be squashed by the NeLH. Ben Toth pointed out that it has been recognised that there is a need to make available national or even international information but that can be downloaded on to local networks. He also suggested that local information might be the key to getting local clinicians on board. Another delegate pointed out that there was also a real need for training the end user - it could not be assumed that everyone knows how to use a mouse or a browser or how to navigate a computer screen.

I came away from the day fairly excited about the prospect of the NeLH and about how fast things were intended to move. I also suggested to Muir Gray that a similar event should be arranged in Scotland since there was a risk that this will be seen as an English venture only but there was already a wealth of good material north of the Border which should not be missed out.

I understand that the Project Team has commissioned library consultants Hudson Rivers to set up meetings in each region (including Scotland) to seek views on the NeLH and how it might be taken forward. Watch this space for more information.

Maureen Thom
The Development Group