Clinical Digital Libraries Project: Design Approach and Exploratory Assessment of Timely Use in Clinical Environments*

By MacCall, Steven L. | Journal of the Medical Library Association, April 2006 | Go to article overview
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Clinical Digital Libraries Project: Design Approach and Exploratory Assessment of Timely Use in Clinical Environments*

MacCall, Steven L., Journal of the Medical Library Association

Objective: The paper describes and evaluates the use of Clinical Digital Libraries Project (CDLP) digital library collections in terms of their facilitation of timely clinical information seeking.

Design: A convenience sample of CDLP Web server log activity over a twelve-month period (7/2002 to 6/2003) was analyzed for evidence of timely information seeking after users were referred to digital library clinical topic pages from Web search engines. Sample searches were limited to those originating from medical schools (26% North American and 19% non-North American) and from hospitals or clinics (51% North American and 4% non-North American).

Measurement: Timeliness was determined based on a calculation of the difference between the timestamps of the first and last Web server log "hit" during each search in the sample. The calculated differences were mapped into one of three ranges: less than one minute, one to three minutes, and three to five minutes.

Results: Of the 864 searches analyzed, 48% were less than 1 minute, 41% were 1 to 3 minutes, and 11% were 3 to 5 minutes. These results were further analyzed by environment (medical schools versus hospitals or clinics) and by geographic location (North America versus non-North American). Searches reflected a consistent pattern of less than 1 minute in these environments. Though the results were not consistent on a month-by-month basis over the entire time period, data for 8 of 12 months showed that searches shorter than 1 minute predominated and data for 1 month showed an equal number of less than 1 minute and 1 to 3 minute searches.

Conclusions: The CDLP digital library collections provided timely access to high-quality Web clinical resources when used for information seeking in medical education and hospital or clinic environments from North American and non-North American locations and consistently provided access to the sought information within the documented two-minute standard. The limitations of the use of Web server data warrant an exploratory assessment. This research also suggests the need for further investigation in the area of timely digital library collection services to clinical environments.


Timely information seeking when using collections of online resources, including medical books, is crucial if they are to be routinely consulted during patient care. A previous study shows how clinical information needs are highly structured and points to the possibility of collection analytics that would provide a model for deep linking directly to parts of structured online resources. It also cautions about the problem of split files, a situation that arises when, for example, a clinician must use different book collections, such as MD Consult and Books@Ovid, rather than a single digital library collection of all of a library's selected online resources [1].

Any research addressing clinical information seeking must recognize the time constraints inherent in this work environment. Research has documented the need for timeliness in terms of clinical information seeking [2-7], with one study reporting that physicians spend on average less than two minutes pursuing answers during patient care [8]. While quality issues remain a problem [2], a growing amount of research addresses the use of online resources [9-15]. Health sciences librarians are well suited to address the problems of information quality through extending collection development practices to collections of online resources [16]. The challenge facing librarians is whether their digital library collections can be organized so that they can be used for clinical information seeking in a timely way.

This paper describes the Clinical Digital Libraries Project (CDLP) and its approach to providing access to information at a level of granularity that addresses the structural aspects of clinical information seeking, while also dealing with the problem of split files.

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Clinical Digital Libraries Project: Design Approach and Exploratory Assessment of Timely Use in Clinical Environments*


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