Academic journal article Journal of the Medical Library Association

The Virtual Naval Hospital: The Digital Library as Knowledge Management Tool for Nomadic Patrons*

Academic journal article Journal of the Medical Library Association

The Virtual Naval Hospital: The Digital Library as Knowledge Management Tool for Nomadic Patrons*

Article excerpt

Objective: To meet the information needs of isolated primary care providers and their patients in the US Navy, a digital health sciences library, the Virtual Naval Hospital, was created through a unique partnership between academia and government.

Methods: The creation of the digital library was heavily influenced by the principles of user-centered design and made allowances for the nomadic nature of the digital library's patrons and the heterogeneous access they have to Internet bandwidth.

Results: The result is a digital library that has been in operation since 1997, continues to expand in size, is heavily used, and is highly regarded by its patrons.

Conclusions: The digital library is dedicated to delivering the right information at the right time to the right person so the right decision can be made, and therefore the Virtual Naval Hospital functions as a knowledge-management system for the US Navy Bureau of Medicine and Surgery.

INTRODUCTION

The mission of the US Navy, which includes the US Marine Corps, is to maintain, train, and equip combat-ready naval forces capable of winning wars, deterring aggression, and maintaining freedom of the seas. The mission of the US Navy Medical Department is to support the combat readiness of the uniformed services and to promote, protect, and maintain the health of all those entrusted to their care, anytime, anywhere.

Navy Medicine can be considered a virtual academic medical center, with approximately 37,000 US Navy medical professionals working in hundreds of medical campuses and departments around the world, all operating under a single administrative structure. Like any academic medical center, Navy Medicine contains a large amount of knowledge [1]. This knowledge has traditionally been codified in the form of lessons learned and best practices in print textbooks. Unfortunately, Navy Medicine's mission is complicated by the fact that naval primary care providers are among the most geographically isolated health care providers in the world and rarely have convenient access to the authoritative operational naval medical information that they need to deliver optimal patient care.

The US Navy has a long history of using knowledge-management systems, taking the first such commercially available system to sea in 1983 [2]. Recently, the US Navy has defined knowledge management as the "delivery of the right information at the right time to the right person so the right decision can be made" and has dedicated itself to deploying knowledge-management tools to its personnel [3].

In 1996, Navy Medicine desired to digitize its knowledge and create a knowledge-management tool, using digital library technology, to provide primary care providers and patients convenient access to authoritative operational naval medical information at the point of care. The Navy approached digital library researchers at The University of Iowa, who, since 1992, had a history of providing digital library services to isolated rural primary care providers and their patients through the Virtual Hospital digital library [4]. The Navy wished to leverage The University of Iowa's expertise to deliver digital library services to isolated naval primary care providers and patients at sea and in the field.

Thus, the Virtual Naval Hospital(TM) was commissioned in 1997, with a mission of creating and curating a digital health sciences library to make the Internet a useful medical reference tool for naval primary care providers at the point of care, by helping them take better care of patients, and, as a health promotion tool for sailors and marines, to help personnel live healthier lives.

The Navy and Marine Corps are nomadic, spending much of their time at sea or in the field away from their bases, which adds to the complexity of the project. During these times, they have heterogeneous access to Internet bandwidth, ranging from no access (much of the time), to low-speed access, to high-speed access in exceptional circumstances. …

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