Olympic sponsorships & Vancouver Public Library: Conflict of Interest?

Vancouver Public Library (VPL) in British Columbia, where the 2010 Winter Olympic Games are about to begin in a matter of weeks, has been in the news this past week. At issue are the instructions given to staff on how to handle branding, logos and sponsorship for events related to the Olympics.

In the biblioblogosphere, Jessamyn noted it “without comment”,  Rory thinks it’s “just too much,” noting that VPL was the site of history’s largest librarian’s strike in 2007, and LIS news quotes the union president speaking against the memo on the grounds of intellectual freedom. Tara, over at We Read banned Books, posts the memo in question, and highlights the irony of the instructions to put “a little piece of tape” over non-sponsor logos on electronic equipment.

A lot of people seem uncomfortable with this memo, but few seem willing or able to name exactly what the problem is, what rules or principles have been violated. What is it about this memo that strikes so many of us as “just too much?”

I’ve been talking with folks and thinking about it and I think it feels to many like a potential conflict of interest with our “basic responsibility for the development and maintenance of intellectual freedom.”

Conflict of Interest

In medical publishing, Conflict of Interest (COI) is a Big Thing, but I don’t think it’s as much discussed in the lower-financial-stakes world of public libraries. Bear with me for a moment while I call up some references from health information sources, and then discuss application to this public library/Olympic sponsor situation.

The World Association of Medical Editors’ (WAME) recently updated (July 2009) policy on “Conflict of Interest in Peer-Reviewed Medical Journals” states in part that:

Everyone has COIs of some sort.  Having a competing interest does not, in itself, imply wrongdoing.  However, it constitutes a problem when competing interests could unduly influence (or be reasonably seen to do so) one’s responsibilities

Okay, so if everyone has one or more COI, and they’re not necessarily a problem, what’s the big deal? Well, the devil is in the “unduly influence” part here, right? Having a COI can make it more difficult to prioritize your primary mission.

Notably, even if there is no actual COI, the mere appearance of COI can undermine credibility of an institution. On this point, WAME states:

In addition, the appearance of COI, even where none actually exists, can also erode trust in a journal by damaging its reputation and credibility.

The International Committee of Medical Journal Editors (ICMJE) – the people who created the “Uniform requirements” and related “Vancouver” referencing style – also have considerations regarding COI. This document leads off with what I think is a very helpful description/definition of COI:

Public trust in the peer-review process and the credibility of published articles depend in part on how well conflict of interest is handled during writing, peer review, and editorial decision making. Conflict of interest exists when an author (or the author’s institution), reviewer, or editor has financial or personal relationships that inappropriately influence (bias) his or her actions (such relationships are also known as dual commitments, competing interests, or competing loyalties). These relationships vary from negligible to great potential for influencing judgment. Not all relationships represent true conflict of interest. On the other hand, the potential for conflict of interest can exist regardless of whether an individual believes that the relationship affects his or her scientific judgment. (emphasis mine)

As a third and final example, the Institute of Medicine has a consensus report on COI, the abstract of which begins:

Financial conflicts of interest pose many challenges to health care professionals. They raise concerns about the objectivity and trustworthiness of research conduct and publications, the prudent management of scientific investigations and other activities in the public interest, and the commitment of health care professionals to the best interests of patients. In recent years the media has highlighted failures of individuals and institutions to disclose and appropriately manage financial ties with industry (including pharmaceutical, medical device, medical supply, and insurance companies). These failures contribute to questions about whether industry has undue influence in research and other activities. (emphasis mine)

Just to flog a dead horse here, COI raises concerns about objectivity, good management practices, and whether the user group is the true priority. Additionally, past COI management failures cause the public to be more suspicious about current COIs.

COI and the Public Library

I thing all the quotes excerpted above could be applied to a library setting with little modification.

For example:

Financial conflicts of interest pose many challenges to library managers. They raise concerns about the objectivity and trustworthiness of library programs and collections, the prudent management of information services and other activities in the public interest, and the commitment of librarians to the best interests of patrons.

I don’t think that’s a stretch at all, do you?

Speaking specifically about the VPL/Olympics situation, I think it’s been difficult for external library-world folk to comment upon because we don’t really know whether there is an actual COI at play here.

I’m willing to give Jean Kavanaugh, VPL’s marketing & communications manager (n.b. a PR manager, NOT a librarian, as some commenters have alleged) the benefit of the doubt and assume that she issued memo(s) about Olympic sponsorships and branding in an effort to keep VPL employees from accidentally acting in a way that would raise the ire of VANOC (the Vancouver Olympic organizing committee, which has shown itself to be quite vicious when defending branding or sponsor affiliations). I’m willing to assume that Kavanaugh just got overzealous with the instructions in (ironically) an attempt to keep VPL out of the media and out of the courtroom. Kavanaugh herself  “said neither the city nor VANOC asked her to send the memo,” and both the city of Vancouver and VANOC appear baffled at her apparent need to send such a memo at all. I could be wrong here, but I’m willing to assume this was just a well-intentioned but botched communication on the part of Kavanaugh. Admit it here: we’ve all made messaging errors; we just don’t all have the pleasure of the Olympic spotlight on them!

That said, even if the intentions behind the memo(s) to VPL staff were perfect in integrity; even if no actual financial COI exists between VPL and VANOC/Olympic sponsors, there remains the problem of the appearance of COI that these rules have created – both within library staff and now with the public at large.

VPL could be completely conflict-free here, but in absence of an official statement from the library, the following remains the case:

1. It’s unclear what the relationship (financial or otherwise) is between VPL and VANOC
2. The leaked memo information instructing library staff on appropriate sponsorship behaviour creates the appearance of COI
3. The potential COI in question is the hypothetical conflict between the interests of Olympic corporate sponsors and the intellectual freedom of the population.

What a Public Library can learn from Medical Publishing

If VPL were run like a reputable medical journal, we would see a disclosure statement as to the funding of the library, and whether the library or any of the trustees or top library management had in the past or will in the future stand to benefit financially from the success of VANOC and/or the Olympic sponsor companies. We would also have information as to which decisions were more and less likely to be influenced by such relationships. The analogue to the way medical journals send research articles out for blinded peer review in order to attempt at objective review of the paper’s merits might be a description of what does the library do to ensure balanced collection management and reference service.

VPL already has the building blocks from which it could create a cohesive response that would go a long way toward restoring the public’s faith in the library’s role as a protector and promoter or intellectual freedom (rather than a promoter of selective corporate interests). To begin with, there is the Collection Development Policy.

Additionally, as Tara points out, VPL has a sponsorship policy, which clearly states that “Sponsorships must not undermine the integrity of the non-commercial public space that the Library provides.” (Of course the same policy also does “not allow direct marketing of products to children”…which is interesting given the leaked memo’s instructions as to which fast food outlets to approach for sponsorship of kids’ activities.) Clearly, a memo about sponsorship and Olympic programs should have referenced the existing organizational sponsorship policy!

All to say that while it appears that VPL is hunkering down, not “dignifying” the media hubbub with a response, and hoping all of this brouhaha dies down under the desperate situation in Haiti and the frenzy over the actual Olympics, I wish the library would stand up and make an official public statement clarifying what, if any, COI exits here, and how it will be managed.

To paraphrase the ICMJE, Public trust in the library and the credibility of librarians depend in part on how well conflict of interest is handled. Ignoring allegations of COI are not, in my opinion, handling them especially well.

-Greyson

Sex, Gender & Librarianship

This is likely just a brain-dump of a teaser post, as it’s a topic I’ve just gotten started on, which could really grow into multiple posts as I explore it further in the future.

I ran into Dean at my favourite local coffeeshop the other day and we got talking a bit about gender issues and librarianship. Given that I’m a gender studies teacher, and a librarian, it didn’t take much prodding on his part to get my head spinning in that direction. It’s actually more surprising that – while certainly I talk about gender isues, pay equity, library cultures, and the like a lot – I hadn’t sat down and seriously thought about the intersections in a methodical way before. And wow, once you start thinking there’s a lot of interesting stuff to explore in terms of sex, gender and LIS, isn’t there?

Here’s my brainstorm list of topics to play with, as of this morning. All of these thoughts are themes to explore with an eye to sex & gender, race & ethnicity, socio-economic class, and ideally also attributes such as age, dis/ability, sexuality, etc.

I’m super interested in poking my mind down these paths, so if you’re reading and thought on these bullet points, or other suggestions for related topics, I’d love to hear them:

1. Pre-Dewey librarianship, and the historical Western masculinity of literacy
2. Melvil Dewey& the feminization of library education & professions
3. Modern (past 100 yrs) images & protrayals of librarians
4. Studies of library cultures/subcultures (including “guybrarian” “gaybrarian,” the systems vs public services great divide, corporate librarianship vs non-profit, school teacher-librarians, IT in libraries, etc.)
5. LIS research and gender/race/class assumptions and approaches
6. Information behaviour & user groups
7. Technology uptake & influence among user groups
8. Social issues in design of info & communications systems
9. Techie & g33k culture(s) and accompanying masculinities and semi-masculinities (this can probably be divided up into eras, like the library bullet points above, but I’m not yet knowledgable enough to brainstorm how – other than to say that:
10. OSS and other “open” movements should probably be their own bullet point here

Dean suggested this topic area might make an interesting grad course, and I have to completely agree. With the right framing (including critical sex/gender 101 for LIS folks and LIS 101 for non-LIS folk), it could be cross-listed between LIS and gender studies at any given institution with both grad programs, as a “sex, gender and information issues” or “gendered aspects of information” or some such.

Why would this be important? Well, to me it’s clear that diversifying LIS work is essential. I don’t mean “attract more men to librarianship” because if that was the only goal, we could probably do it by raising salaries and changing language. I mean real change, that will make libraries representative of the populations we serve, and help information services or various types understand user needs as well as employee strengths and needs.

And in order to make change we have to understand what’s going on now and how we got here. Anyone who supervises other workers can really benefit from a critical analysis of race/class/gender issues in their profession. Anyone who is setting the agenda for the future of a profession must understand such issues, or their agendas will lead down the path of diminshing returns.

More on this topic after I’ve had time to explore further. Feedback is welcome.

-Greyson

CMAJ “No longer free for all”

I’ve been thinking about the Canadian Medical Association Journal (CMAJ)’s decision to convert from being 100% free to read online to only partially so, come January.

Access Change

The Canadian Medical Association Journal (CMAJ) has been entirely free to read, online, since it first went digital in the mid-1990’s.

This is about to change.

Letters from the publisher and editor inform us that, beginning in January,

“Editorials, news, clinical images, abstracts and previously published articles will also remain accessible to all readers. Access to reviews, analysis, practice, commentaries, humanities and supplements will be restricted [to CMA members and journal subscribers]…although these items will become free of charge 12 months after publication.”

Funder OA Requirement Implications

Research – of key concern to any researcher holding funding from CIHR or the many other research funders who require OA to publications before a year’s embargo is up – will remain free to access. However, authors should be advised that publishing in the “Reviews” or “Analysis” sections will not meet the CIHR OA requirement - and there is no pay-for-OA option to remediate that.

Bucking the Trend?

The reason given for the CMAJ’s access change is that:

We must now adapt our business model to respond to current economic conditions and can no longer provide free access to all of our content.

I think this is interesting, given all the journals that have recently been deciding they cannot afford NOT at least offer an OA option. Is there some sort of OA “sweet spot” that is most profitable in 2009/2010? Or is CMAJ just panicking and hoping to get a bit more cash in a recession here?

I’m also curious as to why CMAJ decided to restrict access to readers, rather than charging publication fees to authors. Author-side fees seem to be the current dominant method for publishers attempting to move from subscription to free-to-read models in biomedicine. (Will this be a later phase for CMAJ, post re-institution of subscriptions, effectively making an early adopter of OA end up as also a late adopter of OA?) My guess is that CMAJ authors are generally better funded than the readers. If anyone reading this has insight in to why CMAJ decided to charge readers rather than authors, I’d love to hear it!

Institutions or individuals requiring immediate access to the entire online journal will need to purchase subscriptions unless they are CMA members. (Haven’t heard much buzz on the library wire yet as far as how this $690/yr is going to affect already-shrinking serials budgets in libraries…maybe there’s nothing to say?)

The journal is also planning to publish more frequently online, and less frequently in print, to speed up publication timetables and save on postage. Wish they could scrap the print all together, but I’m not intimately familiar with the reading habits of practicing Canadian MDs, so maybe there is a reason they haven’t done the obvious yet?

CMAJ will continue to participate in the HINARI and AGORA initiatives to bring free or low-cost access to low-income international readership. They’re also giving “media” free access, and while I am really glad CMAJ’s not planning to limit journalists to lousy “press-release journalism,” I’d be interested to know who qualifies as “accredited” media in 2010.

Effect on Journal Impact?

CMAJ is one of the only Canadian biomedical/health journals to be a serious competitor in the Impact Factor rankings (ISI Journal Citation Reports). Since 1997, it’s IF has grown from 1.6 to 7.5, placing CMAJ within the top 10 general medical journals. This stellar climb in a non-U.S.American journal has frequently (but controversially) been associated with it’s wide availability – particularly since other OA journals – such as PLoS Medicine – have made similar sharp climbs. While research articles (upon which the IF formula is based) will remain free to read, it will be interesting to see whether the journal maintains its high IF ranking or slips in the years following this change. My guess is that it would take a long time to slip, if at all, because it is now fairly widely known internationally, compared with a decade ago.

Open vs Free

A couple years ago, back in July 2007, the editors of CMAJ published a commentary congratulating the editors of Open Medicine (OM) on establishing a new journal. While this congratulatory note was interesting in light of the historic editorial schism at CMAJ that gave birth to OM, the letter itself looked nice and innocuous enough. In said letter, CMAJ wrote:

Like CMAJ, Open Medicine is an open-access journal, available free to all who wish to read it and free for all who wish to contribute to it. As open access remains disappointingly rare among general medical journals (Table 1), this is both commendable and of great significance. The birth of Open Medicine thus provides us with a valuable opportunity to remind our readers why open access to the medical literature is important and necessary.

OM’s editors responded a few days later with their own letter, which struck some as less than gracious. In it, they wrote:

Although the endorsement by CMAJ’s editors of open access medical publishing is welcome, we would like to take this opportunity to clarify several points raised in their commentary.1 First, there is an important distinction between open versus free-access publication. Open Medicine has not only adopted the principle of free access, that is, making content fully available online, but endorses the definition of open access publication drafted by the Bethesda Meeting on Open Access Publishing.2 This definition stipulates that the copyright holder grants to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute works derived from the original work, in any digital medium for any responsible purpose, subject to proper attribution of authorship. Given that CMAJ holds copyright and charges reprint and permission fees, it is not in fact an open access journal.

It’s significant to note that these letters were written before the Suber-Harnad agreement on the terms gratis OA and libre OA to indicate free-to-read/access vs free-to-read/access/reuse/redistribute. There was more talk about what was and wasn’t “real” OA just a couple years ago. Even taking into consideration the context of the day, though, the OM response could be read as a bit snitty.

However, in light of this recent “Access change” by CMAJ, the OM letter suddenly seems more relevant, almost prescient. Another difference between gratis, free-as-in-no-money OA and libre, free-as-in-freedom OA emerges when journals highlight their ability to take their toys and go home. CMAJ is not saying they’re moving anything that is currently freely available back behind subscription barriers, and they are currently planning to make everything free to read 12 months after publiciation, BUT…we are reminded that CMAJ’s articles are CMAJ’s articles. Whereas Open Medicine’s articles are ours.

-Greyson

Online drug advertising & the regulatory challenge

Between the (minor!) bike accident , the kid’s birthday, and being out of town for a bit, blog posting has gone a bit by the wayside the past few weeks. However, something that’s been much on my mind lately, and which I’d like to discuss here, is drug advertising online.

I’ve written various posts before about DTCA – direct to consumer advertising of prescription drugs – which is legal in limited form in Canada, and in much greater form in the US. I think prescription drug promotion of all sorts is a big social justice issue, and that DTCA is a significant and oft-overlooked consumer health info issue that librarians should have on our radar. When we talk about the Pew research on online health info seeking, social media, and “e-patients,” we cannot forget that profit-motivated companies are as interested in our patients’ online information behaviour as we are, just for very different reasons.

The Canadian “freedom of expression” lawsuit on this matter has been indefinitely adjourned, but I’ve come to wonder if perhaps debating the merits and perils of television and magazine ads may be rather passé in light of the Internet’s growing centrality as an advertising medium. Maybe CanWest was not just throwing in the towel on a lawsuit that was destined for failure (b/c the FOE argument was pretty weak), but also strategically abandoning old media. Nah, actually, I think CanWest is still pretty wedded to old media, but the rest of us aren’t. And we are the target audience for DTCA.

Now, I know some people (lots of them) still watch TV on TV, even with all this digital conversion business. But will they in a decade? Not so sure. Hulu has been such a huge success in the US, spawning constant rushes of hordes of international viewers to one proxy setup after another in order to see the latest episode of their favourite shows. It’s only a matter of time before online TV is de rigueur in any region with decent bandwidth & reliable connectivity.

The unofficial rules for online drug advertising have, to this point, basically been an extension of the TV advertising regulations. It’s debatable whether this is appropriate or not. I’ll take on whether the Internet is more like TV or more like the telephone in a separate post (soon! I promise!), but I think we can all agree that it’s not *exactly* like TV.

Many online ads, for example, require some active selection on the part of the reader/viewer, and are not necessarily as time limited as TV ads (and thus able to provide fuller information). Typical online drug ads today appear as advertisements in the margins of a website, and attempt to entice the reader into clicking them to go to a website with fuller information on whatever the condition/drug may be.

In a somewhat impressive attempt to be proactive (?), the FDA (US drug regulator) held a couple days of public hearings last month on the topic of online drug advertising. The 5-page list of speakers (pdf) was heave on pharma and health tech investors, followed by representatives of online services both general and health-specific, ranging from Google to WebMD. So that pretty much covers the people who want to advertise, and those who want the money from said advertising. Of note, there were reps of specific social marketing units within pharmaceutical companies on the docket, so Pharma is well aware of the stakes here (e.g. Sanofi-Aventis has a rep, and then the Sanofi-Aventis social media working group had a rep as well). Unfortunately, I could pick out only a very few advocacy/public interest groups, such as the Consumers Union.

To backtrack a bit, this hearing didn’t come out of nowhere, although it was not terribly well publicized.Back in April, the FDA issued warnings to some 14 pharmaceutical companies over their “misleading” online advertising. At issue was failure to fully disclose risks, and these letters focused on search engine ads (aka “sponsored links” in some search engine displays).

November’s hearings, however, were broader in scope, touching on not just search engine advertising, but also ads on websites, and – perhaps most significantly – in social media. This is excellent news, as we know that social sites are an ideal location for what I called “embedded DTCA with a social environment created to reach vulnerable and isolated populations” in my post about the “patient support” site RareShare a year ago.

So what? Where is this going? What does the Internet mean for drug advertising and patient protection?
Well, there some very interesting threads to watch as this policy story unfolds:

1. The Internet doesn’t do super well with national borders. If laws on DTCA are different in different countries, do they have to appear differently based on site host location? IP address of the end user? How? DTCA on television has taken advantage of lack of political will to enforce existing laws to broadcast US drug ads across the Canadian border. Will the Internet do any better? (Personally, I am doubtful.)
2. The Internet, however, does allow for end-user participation on a scale unprecedented by other media. Some people have voiced optimism regarding the potential for commenting and annotation to temper, force transparency upon, and generally “culture jam” drug advertising. Google’s SideWiki has received a lot of attention in this regard, but it remains fairly unwieldy to use and market saturation is quite low.
3. The whole net neutrality debate applies here, and the way this debate influences our view of the Internet will influence the way we feel about things like online advertising. Is the Internet a media for entertainment or communications? Is it a utility, which should be neutral and allow for participation from all, or is it a medium for consumption? We would feel quite different about picking up the phone and hearing an ad than we do about a commercial break from a TV show.
4. Social media can really blur the line between non-profit advocacy and for-profit promotion in a nasty way. It’s one thing to regulate what can or must be said inside a little “ad” box in the margin of a website. It’s quite another to regulate embedded personalities within a social media site, who are planted there to promote certain products. I will be quite surprised if these hearings/this process even touches on this issue, but variations on hidden advertisements are a phenomenon that’s well-known in the blogging world, maybe less recognized in some other social media fora (Facebook, where everyone is supposedly using their “real name”?)

-Greyson

p.s. During composition of this post I cheked the CBC news online, and lo and behold there was an example of DTCA right on the site. So I snapped a screenshot, of course, to stick up here. This is an example of a currently-legal “disease awareness” ad for erectile dysfunction, from the Health News page of the cbc.ca:

Are you a social justice librarian?

If you’ve been reading this blog for a while, you may have noticed that it’s basically become, well, all me.

That was never the intent. I’m not THE social justice librarian, I’m just A social justice librarian.

I’d prefer that this blog have multiple voices, with different perspectives and interests. However, my former partners in crime have moved on to other adventures in their lives and aren’t sure if or when they’ll be back.

Which brings me to the question…do YOU want to write for the SJL blog? Are you a social justice librarian, archivist, or other information professional type?

Can you add coverage of topics I don’t discuss much? Or a perspective that is different from mine? Ideally (but not necessarily), you do something other than health librarianship and live somewhere other than Western Canada.

If you’re keen, drop me a line to discuss your interest. If it seems like a fit, I’d love to expand the author list here again.

-Greyson

ICANN’s non-Latin domain approval

I’ve been wanting to say something about the ICANN non-Latin script domain approval move for a bit now, but found myself unsure of what to say. “Yay,” seemed trite, and “It’s about time,” is just more of my usual snark.

I think it’s a no-brainer for people with any sence of global justice issues to agree that the US government should not be “running” or “ruling” the Internet. The details get a little hairy, but really, this is the Internet folks. The world wide web made possible approzimately a gazillion-and-eight things no one thought were possible before, so pretending that figuring out how to make right-to-left and left-to-right scripts play together is beyond all the world’s geeks today is rather silly.

Further, fretting that you might have to actually learn some multilingual skills just makes you look like an ignorant American, so please just stop embarrassing us both. (as I did grow up as an ignorant American and am now an only-slightly-less-ignorant Canadian-American trying to foster a considerably-less-ignorant next generation)

I’m optimistic about the (slightly) increased distance between the US government and ICANN. I’m really interested to see where this goes, and what kind of representation non-Eurpoean countries (besides Japan) end up getting.

Finally, if you missed it, Xeni from Boing Boing did a great brief interview on this topic (the ICANN non-Latin domain ruling) on the Rachel Maddow show, and I encourage you to watch it (and not just b/c Maddow is my smarter, slicker twin!). You can link to it from this boing boing post.

-Greyson

Sometimes a mug is just a mug

I have two blue travel mugs, both conference giveaways. One is from the NLM and the other is from the CHN.

The NLM mug stinks. I hate to say it, but it has never sealed tightly. It leaks soffee subtly down one’s front while you’re sitting in a meeting trying to be professional.

The CHN mug, on the other hand, is lovely. Simple, no handle to fall off or anything, the top is one of the best travel mug tops ever. No leaking, no whistling, nada.

Of course, the CHN was shut down a year and a half ago. And the NLM apparently god some extramural funding boost in Obama’s stimulus plan.

I’ve been searching for a metaphor for months now…did CHN pay attention to the wrong details? Is NLM somehow “leaky”?

I’ve come to the conclusion that there is no metaphor here. Sometimes, a mug is just a mug.

Now I can finally toss that lousy NLM mug and enjoy sipping from my CHN mug while I browse the new PubMed. *sigh*

-Greyson

CRTC issues net neutrality ruling

And here it is.

I won’t have time to fully parse the policy decision till tonight, but my initial impression is that it’s a feeble gesture in the right direction (that being net neutrality), clad in nationalist bombast (“Canada is the first country to develop and implement a comprehensive approach to internet traffic management practices”).

At a glance, it seems that ISPs are still allowed to “traffic shape” but out and out throttling is discouraged unless the ISP feels it’s really necessary. Consumers are now supposed to be informed if their ISP is going to change traffic shaping practices, and consumers can complain, which will then possible trigger an investigation that will ask the ISP to explain what and why. There are also some new privacy guidelines for deep packet inspection.

So ISPs are still allowed to throttle, and to conduct deep packet inspection, but they have to jump through a few more hoops to do so now than they did before. There are also some new restrictions about wholesale ISP services, which I hope will help small ISPs remain competitive and viable.

Any other thoughts on the ruling would be very welcome.

Some initial coverage:

CBC coverage here (CBC’s been hot on the NN file since the throttling of Next Great Prime Mnister).
Excerpt:

“Big telecommunications companies such as Bell and Rogers can interfere with internet traffic only as a last resort, the CRTC says. Instead, they should use “economic measures” such as new investment and usage limits to combat congestion on their networks.”

Michael Geist’s take is here (Geist obviously knew some things I didn’t know about what was coming down the pipe on this one!  <–Unsurprising):

Impressively optimistic excerpt:

“The CRTC’s net neutrality (aka traffic management) decision is out and though it does not go as far as some advocates might hope, it unquestionably advances the ball forward on several important fronts…Today’s CRTC decision signifies that traffic management is not a free-for-all and the days of ISPs arguing that they can do whatever they please on their networks is over.  That said, it also guarantees that traffic management practices such as throttling will continue and it is going to take more complaints to concretely address the issue.”

More to come, after I’ve had a chance to read & digest more.

-Greyson

Privacy vs. Data: Electronic Medical Records (EMR)

My province, British Columbia, is one of many jurisdictions currently in the process of implementing eHealth, which is basically a large scale, provincially-coordinated  implementation of the Electronic Medical Record (EMR).

And I’m gonna come out and say it: I’m a privacy advocate who is pretty much in favour of government-administrated EMRs.

(Of course, there is a catch…)

I work with health data. I mean, I don’t actually lay my own grubby librarian hands on most of it, but I work in a data-rich environment and with researchers who are analyzing lots of health system data. This stuff is highly privacy sensitive. There are parts of my office I’m not even allowed in without an escort, passing a security cam, and signing a log. And that is how it should be.

I sincerely appreciate the tension between

a) the researchers who want data access and linking in order to do good research and improve health and healthcare, and

b) data stewards and privacy officers who want to protect our privacy first and foremost.

Sometimes the privacy laws and regulations make it harder to do good research, but that’s part of the process.

For example: here, we’re not allowed to identify subpopulations with particularly diagnoses anymore, to survey them, because that’s considered invasive of their privacy. Fair enough – I wouldn’t necessarily want to be subject to lots of survey requests from people who somehow found out I had disease X. However, this also understandably makes it harder to research disease X, when we can’t just pull a representative sample (or all patients) to survey/study.

Both sides – the research/access and the privacy protection side – need good advocates in order to find the best (or at least an appropriate) balance. And I do believe in that balance.

It’s kind of like how in domestic violence shelters there’s often a staff member advocating for a mother who is in shelter, and another staff members advocating for the mother’s child. Usually what’s best for mum (the primary shelter client) is best for the whole family, and there’s no apparent need for the child’s advocate. But sometimes that’s not the case, and both mum and child deserve a strong advocate who is primarily concerned with their welfare, in order to strike a balance and find a solution that is in the best interest of most people.

I’m not a perfect privacy advocate.  I do not believe the government having any information on me is necessarily a bad thing. Sure, there are days when I dream of living off the grid and having babies who never get social insurance/social security numbers. Mostly, though, I think of myself as a realist whose goal is to help the government find an appropriate balance of privacy and data.

Why? Well, because I do have some faith in evidence based practice, despite the somewhat flawed way that medical evidence (the EBP “gold standard”) has been implemented. So I do want the government to have some data on me, because I certainly don’t trust private companies more than I do public institutions, and without data, there is no evidence.

So, when I think of EMR, I think first of the good that can come of it.

Yes, there is the clinical potential: possibly reducing adverse drug reactions/interactions, and the like. Yes, likely improving communication between docs working with the same patient. But beyond those (mostly unproven) claims of the potential of the EMR, the potential for research is phenomenal, really. Even the potential for a patient to finally have access to their own, fairly complete, medical records is pretty awesome.

THEN come the “buts”: the caveats, the necessary policies and procedures to ensure optimal stewardship of this type of linkable – and in some cases already linked – data.

I have to say, up front, that there is absolutely the risk of significant breach of privacy with EMRs.

BUT most of this risk already exists. We already carry electronic data. Several existing individual databases that will combine to form the EMR in this province are already personally identifiable and potentially incriminating. Take PharmaNet, for example. PharmaNet tracks every prescription dispensed in the province. It’s made possible some research in BC that hasn’t been done anywhere else (e.g., this cool stuff that some of my colleagues are doing). However, there is certainly a need for good data stewardship, as there’s a chockload of sensitive information in that database (and there have been some noted breaches – e.g. in this .doc from FIPA).

Combining multiple database may raise the ease of identification, and give more information, but what my real concern is isn’t the linking and interoperabilityof the datasets (because, really, if PharmaNet shows an AZT script, does anyone really need corroborating doctor records to out you as HIV+?), but the privacy and security policies and procedures of the data stewards. This is the same concern today as it will be once the EMR is implemented in my province.

So no, I don’t want to Opt Out. Call me deluded, but I want all health care professionals who treat me to have access to appropriate data on my health history. I want the ER staff, when I arrive on a stretcher the day a crazy drive finally plows into my bicycle, to know about my life-threatening medication allergies ASAP.

And I’m not alone. Heck, there are people who want an EMR badly enough that they are trusting companies like Google and Microsoft with their medical information! I certainly can’t claim to fully trust my government, but I’ll take the Ministry of Health over a publicly traded company any day, when it comes to my health care and private information!

HOWEVER, I do want a Real Dialogue and some transparency about the handling of the EMR, as well as other government data. Because while I’m not signing on the Opt Out bandwagon, I do think the concerns about:

• lack of government transparency,
• lack of a publicly-available privacy policy governing EMR data sharing,
• selection of a US based company managing/holding the information,
• and lack of clarity regarding who will have access to which modules/portions of the EMR

are very valid and legitimately alarming.

We have some pretty good models of data stewardship here. Let’s learn from them, and listen to our privacy advocates and commissioners, as we move toward the inevitable EMR.

-Greyson

Academic librarians and research: a response

Before you read this post, go here and read Mark Rabnett’s blog post, ““For academic librarians what’s hard to reach is time for research.”

I started leaving a comment there, but soon realised that my comment was likely to challenge the original post in length. Thus, I figured I’d just post a response here and link back. What follows is my more fullsome response to Mark’s post. Feel free to join the conversation either in comments below, or on your own blog, linking back.

Mark, since I first read this post, it has kept coming back to the front of my mind. Very timely.

As you probably know, I don’t have faculty status, in my unconventional, embedded-librarian job. Ironically one of my hesitations when I consider applying for other, more traditional academic library type positions, is that I know that in order to obtain faculty status I will likely lose the research time I currently enjoy.

You really hit the faculty-status-but-not-really-faculty nail on the head when you point to the conflicting expectations on academic librarians to keep specific hours, far beyond what other faculty are obliged to do, like office staff, yet also produce independent research (some types of which necessarily take one out of the office).

I’m sure the degree of autonomy varies greatly among libraries, and perhaps even among individuals at the same library system, of course. I wonder, though, how many academic librarians have as few time-bound duties as a typical “teaching” faculty member (i.e. regular office hours, regular class times, but beyond that whatever you need to get the job done goes).

I would add to your post a degree of despair at the quality and amount of actual research training and experience I have seen library school and library jobs naturally providing. If we are to be a more evidence-based profession, the quality of research training and mentorship really must improve. In my opinion, that – not more workplace policies to look over our shoulders – is what will improve librarians’ research.

I’m sure you are aware of this, but Manitoba’s policy of 12 “research days” seems generous compared with many university libraries. I recently asked a high-level administrator from a university library acclaimed for reinventing their librarian jobs where research fell in the scheme of things (since conducting research was not apparent in the new job descriptions). Said administrator told me that while it was a critical part of T&P, librarians’ research would typically be conducted outside a normal 40-hour work week. She likened this to academic faculty who are not limited to a 40 hour work week, but as you point out these academic faculty do not typically have a prescribed 40-hour week at all.

I know there are librarians who do not want strict requirements to do research, and do not think it’s necessary to conduct research in order to be a good academic librarian. My own experience has been that unless I do research, faculty certainly do not see me as a peer, and that collaborating on research has helped me create valuable relationships with faculty members.

As far as academic freedom is concerned, apparently this is not just a Canadian issue, as John Buschman has just published an article on this very topic – the watering down of academic freedom for academic librarians – in the AAUP’s “Academe Online: (link here – which I should say I only know about from a tip on the Library Juice Press blog).

-Greyson