William F. Garrity

The Biomedical Libraries' annual report for FY08 and goals for FY09 is available (pdf). My own performance review for FY08 is here (pdf).

Dartmouth College Web Strategy Advisory Committee. I am appointed to this group as the professional schools' representative. "WebSAC" thinks about and makes recommendations for strategic use of Dartmouth's web presence. Other members of the group include leaders from the offices of the Dean of the College, Development, HR, Admissions and Financial Aid, the Faculty of Arts and Sciences, Computing, Alumni Relations, and Finance and Administration. Currently, we're ruminating about what "the web"--particularly Web 2.0 and new media--really means for Dartmouth. For instance, we're thinking about the relevance and use of YouTube's channels and iTunes U. (Here are Dartmouth's YouTube channel and Dartmouth Medical School's YouTube channel.)

DMS Strategic Planning. I co-chair a small group steering the Medical School's strategic planning process. Here is Dean William Green's announcement. The strategic planning process will springboard the launch of a DMS collaboration web (intranet, portal) as a tool to support the school's work; when the site is live, I'll post about that. In the meantime, please do contact me if you have any thoughts about DMS's future.

The Bard Group. The College's Board of Trustees has retained a consultancy (The Bard Group) to focus on DMS governance (the school's relationships with the College and Dartmouth-Hitchcock) and funds flow (the financial flows among the entities).

As a member of the strategic planning steering committee, I am on the Liaison Committee overseeing the consultancy. The two processes are complementary, but formally independent. Other members of the committee are

• the rest of the steering committee--Joseph F. O'Donnell, James Geiling, Duane A. Compton, Christopher Lowrey, and Carolyn Kerrigan
• Leslie P. Henderson--Senior Associate Dean for Academic Affairs
• John F. Modlin--Chair of Pediatrics and Senior Associate Dean for Clinical Affairs
• Jay C. Dunlap--Chair of Genetics
• Adam M. Keller--EVP for Finance and Administration of the College
• Barry P. Scherr--Provost
• Thomas Colacchio--President of the Clinic
• Nancy A. Formella--President of the Hospital
• Robert Thurer-- Board of Trustees

Next-Gen Library Systems Taskforce. I was a member of a small, ad hoc group to help the College Library articulate how we need our "finding systems" to behave and interact to navigate the physical and digital information resources to which the Dartmouth communities have access. (Translation: should we replace "the catalog" with something else--different, bigger, better?) Our report is here.

The next generation library systems need to be nimble, personalized, relevant, and convenient. Our library organization needs to fully embody these traits too. The library should compete for attention through ease of use, excellence of content, and functionality of space. Our information services should allow one to discover knowledge rather than to search for information. And they should to be accessible from within whatever online place a user inhabits (iGoogle; Facebook; Blackboard), in whatever language one works in, and on whatever networked device.

CTSA (Clinical and Translational Science Award). Clinical research--also known as "translational research"--is the current emphasis in NIH-funded biomedical research. It's where the NIH is directing more of its funding and where DMS/DHMC and other medical schools/academic medical centers are positioning ourselves. See this June 12, 2008, feature issue of Nature on translational research.

Here is the overarching concept:

• "T1:" basic science and its translation into clinical research.
• "T2:" patient-specific evidence of clinical effectiveness; practice guidelines; tools to allow for the right treatment of the right patient in the right way at the right time.
• "T3:" reliable delivery of care to all patients, in all settings and to the population, based on measurement and accountability implementation, and system redesign.

I worked with folks from across the university and medical center to craft a grant proposal for a Clinical and Translational Science Award from NIH. Specifically, I was on the team writing about biomedical informatics, with Andy Gettinger (Anesthesiology, and Medical Director for Informatics) and Jason Moore, (Genetics, and Community and Family Medicine, and Director of the Bioinformatics Shared Resource in DHMC's Norris Cotton Cancer Center).

Helmut Schumann Lecture. The Hitchcock Foundation's Helmut Schumann Lecture since its inception in 1983 has focused on "studies in healthful living" for an informed lay audience. Speakers are nationally known and the lecture typically attracts hundreds of attendees. I chair the selection committee.

The purpose of the Hitchcock Foundation, as stated in the bylaws, is

 ... to aid and advance the study and investigation of human ailments and injuries, and the causes, prevention, relief, and cure thereof, and the study and investigation of problems of hygiene, health and public welfare, and the promotion of medical, surgical and scientific learning, skill, education and investigation, and to engage in and conduct and to aid and assist in medical, surgical and scientific research in the broadest sense.

2008's lecturer is JoAnn Manson, Professor in Harvard School of Public Health's Department of Epidemiology.

The Dartmouth Institute for Health Policy and Clinical Practice. Effective August 2007, the Center for the Evaluative Clinical Sciences somewhat cleaved itself from the Medical School and was renamed The Dartmouth Institute for Health Policy and Clinical Practice (DIHPCP, or, much more commonly, The Dartmouth Institute or TDI). I am collaborating with TDI's and DMS's leaderships to re-define support of and opportunities for library and information resources and services.

Quality Literature Program. An effort led by Paul Batalden (Pediatrics, and Community and Family Medicine, and Director of Healthcare Improvement Leadership, TDI), Frank Davidoff (Editor Emeritus of Annals of Internal Medicine), and David Stevens (Editor-in-Chief of BMJ's Quality and Safety in Healthcare) seeks to change standards for quality improvement publication. See this article. The Biomedical Libraries are supporting the effort by reviewing draft publication guidelines and are developing a proposal for a regular "library column" in Quality and Safety in Healthcare about finding good evidence.

Dartmouth-Hitchcock Information Systems Steering Committee. I am a member of the Information Systems Steering Committee (ISSC) 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 ISSC's current principal focus is replacing our home-grown clinical information system with a market-place solution (the finalist being Epic).

The steering committee has also cleaved ourselves into multiple subcommittees; I chair the "Messaging, Collaboration, and ICT Support" subcommittee ("MCIS"), and am working there in collaboration with Bill Weyrick, Senior Manager of User Support for DHMC Information Systems. (I'm also a member of the "communication" subcommittee.) Our first big job is replacing D-H's email system and making sure it integrates with our calendar.

Track the ISSC's work here on the DHMC intranet.

The Dartmouth Summer Institute in Evidence-Based Psychiatry and Mental Health. 2008's institute, our third annual,was August 7-9. The course uses small-group sessions with hands-on, case-based training to introduce the evidence-based process using topics in various areas of mental health. The audience is mental health professionals, including residents, trainees, and training directors, and medical librarians. The institute's ultimate goal is for patients to benefit from the most effective services and care.

In 2006 and 2007, the institute's directors were Bob Drake (Director, Dartmouth Psychiatric Research Center), Matt Merrens (Co-Director, Dartmouth Evidence-Based Practices Center), and myself. Institute faculty have included Pamela Bagley, Heather Blunt, and Karen Odato, each a Research and Education Librarian in the Biomedical Libraries, and Cindy Stewart, Associate Director/Health Sciences Library. In 2008, Karen, Matt, and Steve Bartels (Psychiatry), were institute directors, while Bob Drake, Alan Green (Chair of Psychiatry), and myself were institute sponsors.

Supporting Clinical Care: An Institute in Evidence-Based Practice for Medical Librarians. With a lot of inspiration coming from our work with the summer institutes in Evidence-Based Psychiatry and Mental Health, we (the Biomedical Libraries) in late July 2008 offered a first annual institute specifically focusing on the librarians' role in evidence-based healthcare. See here for more information.

Evidence-Based Information. Clinicians at DHMC and we in the Biomedical Libraries know about the need to better and more seamlessly integrate information to the point of health practice, to the point of care, and in patient information. The Biomedical Libraries and DHMC Information Systems collaborated on a project to integrate evidence-based information/clinical decision support tools in the current and successor clinical information systems. We reviewed potential solutions and have provisionally identified Zynx Health as the best. A D-H wide "Evidence Based Order Sets" team (EBOS), which includes librarians, is assessing the feasibility of taking this interim step with Zynx, with an initial focus on mapping current DHMC order sets to best-practice orderset templates available from Zynx. The Libraries' specific work is developing nomenclature and taxonomy for new ordersets.

The Biomedical Libraries will also participate in an NIH-funded project, "the Librarian Information Tailoring Environment (LITE)," whose co-investigators are James Cimino; Chief, Laboratory for Informatics Development, National Institutes of Health Clinical Center; and Professor, Department of Biomedical Informatics, Columbia University; and Noémie Elhadad, Assistant Professor, Department of Biomedical Informatics, Columbia University. LITE will provide an IT infrastructure to allow health and life sciences libraries to customize "infobuttons" as web links between clinical information systems to digital biomedical information resources, including the multiple evidence-based resources already provided by the Biomedical Libraries, but not hard-wired to clinical systems. Integrating the Libraries and CIS would add value to the healthcare enterprise--and certainly further the Libraries' mission, as well.

Science-in-Sight. The under-construction Life Sciences Center will have a "virtual life sciences presence," likely via interactive, multi-media displays. I'm helping facilitate the planning process, along with Mark McPeek and Tom Jack (Biological Sciences) and Steve Campbell (Office of Facilities Planning, Design, and Construction).

Fiscal. The Dartmouth Medical School has very significant fiscal challenges, due to contracting research funding from NIH and the endowment's pummelling in the financial crisis. For FY09 (which started July 1, 2008), the Biomedical Libraries have already had to make some economies, including not filling the Associate Director/Research and Education Services position. I have to identify a new model for managing our education and outreach programs, and constrain operating expenses. On the other hand, information resources were protected status quo--given inflation in the cost of journals and databases, an awarded increase avoids net cancellations. 

In late calendar 2008, as we begin planning the budget for FY10 (which starts July 1, 2009), it is very apparent that more cuts are coming. 

Fundraising. A director/chair/etc. should always have a list in his/her pocket a list of projects and priorities for development prospects. I've got to update my list.

Library Space. Any library's space should be continually assessed and re-engineered to meet the needs of its clients. The less-than-optimal condition and ambiance of the Dana Library continue to be major concerns. The principal minor renovations that are still possible to make are installing a new service counter on the first floor (circulation and reference) and reconfiguring the Access Services staff area. Longer range, the Medical School, and Arts and Sciences (the College Library) have agreed that the facility will be needed for at least the next twenty-five years, and we have initiated a planning process for renovation and reconfiguration of the library.

Medical Informatics. I'm working with Andy Gettinger (Anesthesiology, and Medical Director for Informatics), Jason Moore, (Genetics, and Community and Family Medicine, and Director of the Bioinformatics Shared Resource in DHMC's Norris Cotton Cancer Center), and Jenica Nelan (manager of DHMC's informatics program) to heighten Dartmouth's awareness of the utility of an institutional medical informatics program. One of our prominent efforts is a speaker series. See here. 

DMS and Tuck. Many universities are fostering 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 have ramped up our collaboration to support joint programs.

We are also collaborating with the Tuck's executive education division and DHMC's clinical and CME leadership to launch a "mini-MBA" program for section chiefs and practice managers. The program began June 2008.

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 parsing the data. I'll report here and elsewhere.

October Conferences. See here for information about 2008's conference--"Space 2.0: Small-Scale Library Redesign Projects."