William F. Garrity

My current, principal projects include (but aren't limited to) the following (in no particular order):

Rheumatology fellowship internal review.  I've been asked to serve on the committee doing an internal review of DHMC's Rheumatology fellowship.  In the role, I'm to interview several current faculty in and graduates of the program. 

The Institute for Health Policy and Clinical Practice (IHPCP).  Effective August 1, the Center for the Evaluative Clinical Sciences split from the Medical School and was renamed the Institute for Health Policy and Clinical Practice.  I am collaborating with IHPCP's leadership (and with DMS, DHMC, and College Library leaderships) to define support of library and information resources and services. 

Quality Literature Program.  An effort lead by IHPCP's Paul Batalden, MD (Pediatrics and Community and Family Medicine, and Director of Healthcare Improvement Leadership), Frank Davidoff, MD (Editor Emeritus of Annals of Internal Medicine), and David Stevens, MD (Vice President of the Association of American Medical Colleges and Editor-in-Chief of BMJ's Quality and Safety in Healthcare) seeks to change standards for quality improvement publication guidelines.  See this article.  The Dartmouth Biomedical Libraries are supporting the effort by having reviewed draft publication guidelines and will propose a regular "library column" in Quality and Safety in Healthcare about finding good evidence.

Dartmouth-Hitchcock Information Systems Steering Committee.  I've been appointed to an Information Systems Steering Committee for Dartmouth-Hitchcock (D-H).  This committee reports to the D-H Board of Governors and sets direction, budget, priorities, resource allocation, and polices for and provides oversight of information systems at D-H.

The Dartmouth Summer Institute in Evidence-Based Mental Health, Thursday-Saturday, August 9-11, 2007.

The course utilizes small-group sessions with hands-on, case-based training to introduce the evidence-based process using topics in the areas of child, adolescent, adult, and geriatric mental health.  The audience is all mental health professionals, including residents, trainees, and training directors.  The institute's ultimate goal is for patients to benefit from the most effective services and care.

The institute's directors are Robert E. Drake, MD, PhD (Director, Dartmouth Psychiatric Research Center), Matthew R. Merrens, PhD (Co-Director, Dartmouth Evidence-Based Practices Center), and myself.  Institute faculty include Pamela Bagley, Heather Blunt, and Karen Odato, each a Research and Education Librarian at the Dartmouth Biomedical Libraries, and Cindy Stewart, Associate Director/Health Sciences Library.

We are also offering a fully-funded "librarian internship" as part of the institute.  The goal here is to provide a (non-Dartmouth) librarian the opportunity to expand his or her evidence-based medicine instructional skills and knowledge.  After a competitive application process, we have selected Tagalie (Tag) Heister, MSLS, from the University of Kentucky Medical Center Library.  She is a medical librarian working directly in Kentucky's Department of Psychiatry.  Tag will receive all instructional materials, participate in the small groups and exercises, assist institute faculty members, and socialize with the faculty and participants.

Tag will work with the institute faculty ahead of time to determine in which topic areas she should participate with the small groups and which areas she will be assisting the faculty. 

Also, Matt and I have agreed to coordinate writing about the institute) for submission to the journal Academic Psychiatry.

Science-in-Sight.  The to-be-constructed Life Sciences Building is thought to have a "virtual life sciences library presence," likely via interactive, multi-media displays.  I'm to spec the idea, and then assist Dartmouth's building planners implement it.

Vietnam.  In early March 2007 (3-19), I went with a group of plastic and craniofacial surgeons, and "informaticists" from industry and university to consult with Hanoi-area hospitals about ICT and healthcare.  The surgeons did clinics.

See this site (specifically, http://www.william-garrity.com/vietnam/) for more information, including a travel journal.

I'm writing a trip report, including a proposal for continuing future work, and will publish it here when I' done.

NAHSL 2007.  The University of Vermont's Dana Medical Library is planning this year's conference, with considerable support from the Dartmouth Biomedical Libraries.  In addition to being co-chair of the conference planning committee, I'm chair of the sponsorship committee.  In the latter role, I solicit conference support from information vendors and businesses, and from New England health sciences libraries and medical centers.

Registered users of this site can see details about the entire conference planning effort (in the NAHSL folder).

FY08.  We're now waiting to know the actual budget. 

OASIS.  This is Dartmouth's new financial system.  Implementing it is a huge project and a fundamental restructuring of how the university works. 

Library space.

• Dana Library space: outlining the next round of possible improvements, and launching the arts program.
• Matthews-Fuller Library space: with Cindy Stewart, thinking about changes to that space.
• Define long-term needs for health and life sciences/sciences library space on the Hanover campus.

Evidence-based information and clinical information systems.  All of Paul Batalden, Joe O'Donnell, MD (Medicine and Senior Advising Dean, DMS), Joe Rosen, MD (Surgery), Andy Gettinger, MD (Anesthesiology and Medical Director for IS, DHMC), and we in the Biomedical Libraries know about the need to better and more seamlessly integrate information to the point of practice, to the point of care, and in patient information.  Paul has the context of improving clinical microsystems; Joe Rosen, putting information--likely via "smart phones"--in the hands of physicians in developing nations (see the Vietnam project); Joe O'Donnell and IS, making the medical record better; and Andy, enhancing the utility and value of DHMC's clinical information systems.

These are big, audacious projects.  Many people, at multiple institutions, are wrestling with the challenges.  (See this report from the American Medical Informatics Association.)  At Dartmouth, the Biomedical Libraries and IS are modeling a possible project.

The problem is obvious: Dartmouth has a great clinical information system (CIS), and rich Biomedical Libraries, but the two don't talk to each other in a coordinated fashion.  We make clinicians work in parallel, but separate, systems, with the result that the full promise of both CIS and the Libraries aren't achieved.

DHMC is doing a major, strategic review of its information systems.  There's opportunity to add value to our locally developed CIS or a potential vended successor clinical information systems.  Integrating the Libraries and CIS would add that value--and certainly further the Libraries' mission, as well.

Information Systems is right now implementing problem lists (http://cisweb2.hitchcock.org:596/cismain/help/training_materials/qrcs/problem_list_2006.pdf) linked to the SNOMED vocabulary (http://www.snomed.org/, http://en.wikipedia.org/wiki/Snomed, http://www.snomed.org/documents/snomed_overview.pdf).  This could be an ideal link between CIS and the Libraries.

The concepts include

• the problem list item in the patient record would be linked to appropriate evidence-based information--for example, a practice guideline.  Blair Brooks, my PCP, selects "dvt" in the problem list in my medical record and the relevant practice guidelines are provided.
• as relevant new information is published, it's pushed to the clinician.  So, for example, every time Blair views my record, any new practice guidelines concerning clotting are shown to him.

Right now, we're focused on discovering

• which information resources may be linkable to CIS, and
• what may be happening at other medical centers.  (The current sense: not much. I'll report here and elsewhere on findings.)

DMS and Tuck.   Many universities are fostering, or would like to foster, heightened collaboration between their schools of business and medicine.  Dartmouth itself sees synergy between DMS and the Tuck School of Business, and the Biomedical Libraries and Feldberg are ramping up our collaboration to support joint programs.  Right now, we're in the midst of assessing what is going on at other universities.  I'll report here and elsewhere on findings.

ACCME= the Accreditation Council for Continuing Medical Education.  Per my role as a member of DHMC's Continuing Medical Education Committee, I'm a member of an oversight group preparing for the institution's upcoming accreditation as a CME-awarding institution.

AAHLS's Future Leadership Task Force.  I'm responsible for the "workforce trends" effort, which seeks to quantify and characterize impending director retirements and recent director recruitments.  We've done a survey, and I'm to parse the data. I'll report here and elsewhere.

October Conference 2006.  I made a commitment to write about it for the literature--to spread the word about what we're doing.

October Conference 2007--"Surveys and Focus Groups: The Good, The Bad, and The Ugly.  We've issued the save-the-date and first call for presenters.