In 2010 Andornot was approached to develop a system to manage the patient education materials produced and recommended by Fraser Health Authority (FHA) staff. FHA serves over 1.6 million people and employs 26,000 staff spread out over 12 acute care hospitals and numerous other facilities.

The challenge was to identify and review all existing patient education resources both in hard copy and electronic formats. Types of material included general informational pamphlets or posters on topics such as smoking cessation or breastfeeding, plus procedure-based factsheets and discharge instructions. Add in to the mix the multiple language versions created to cater to the large Asian, Indo-Canadian, Korean, and Filipino populations, and the fact that there were multiple similar pamphlets on popular topics, as many hospitals had developed these on their own.

Andornot provides similar patient education resources systems to Vancouver Coastal Health and McGill University Health Centre and so had considerable experience in the workflow associated with managing these types of publication.

We chose to emulate various well-respected websites for patient health information and index every item by multiple categories, including Disorders & Conditions, Body Location and Demographic, as well as an uncontrolled Keywords field and MESH headings. In addition, fields were added for FHA Program information and site locations. Considerable planning went into the choice and values for each category in order to create facets to allow users to easily limit or expand their searches.

We prototyped the catalog aspect of the system using Inmagic DB/TextWorks, and a library technician with a medical transcriptionist background was hired to do the first pass of data entry. DB/TextWorks is a great tool for this, as inevitably the scope changed during the project as different types of resources were uncovered, and integration with the FHA Print Shop was added to facilitate the ordering of multiple copies. 

Once a thousand or so items had been catalogued and the system parameters finalized, we transitioned to a SQL Server database with a Solr based front end search using our Andornot Discovery Interface (AnDI). This allows us to better specify relationships between documents, i.e. for multiple language versions, plus it supports versioning.    Searching for medical terms can be challenging with acronyms and abbreviations, as as well as problems with correct spelling.

Apart from the refine by facets capability, the new system features automatic truncation and a Did You Mean capability, so for example if a user types “anasthesia” they will be directed to the correct spelling.

The collection includes full-text documents created by healthcare professionals in FHA, plus links to the URLS’s of full-text documents created by other reliable organizations. FHA professionals are reviewing each publication for appropriate content in compliance with plain language and formatting standards.

An authentication system is in place to limit who can see what, and from where, depending on the Status field of each item.  Many of the resources are best viewed with a health care professional, so access to these will be limited to PC’s within the IP ranges of the FHA facilities. The aim is that in 2013, the catalogue will also be made available to the public through a link from the FHA website. In the meantime this direct link shows just a small subset of materials already approved for the public at large. The default AnDI search results are displayed by relevance but we were able to boost certain parameters to display the active and English language items first.

FHA staff are able to submit new patient education resources for evaluation using the resource submission function. These show up immediately with an In Process status so that other FHA staff can see whether a similar publication already exists or is under development.

Behind the scenes is an extensive administrative interface to allow FHA authorized staff to edit records, make batch changes to lookup fields and export reports of downloads for statistical analysis. The system has only been launched officially to the ER departments but it already provides a fascinating snapshot of the most in demand resources, thus helping guide ongoing review and translation priorities.

“Emergency departments in FH are now able to access the patient education catalogue to download patient discharge instructions as they send patients home. Plus they are able to capture reports showing how regularly each specific item is utilized. FH physicians, staff and volunteers are looking forward to accessing and sharing their patient education materials from across the health authority, to enhance the experience of patients, clients, residents and the public served by FH.  [Kathy Scarborough, MSN, RN, Clinical Practice Consultant, Professional Practice and Integration, Fraser Health.]

This new system showcases Andornot’s expertise in both designing and implementing a custom, complex web application over a multi year period.

Please contact us to discuss how we can help you develop a similar patient education system or for any other projects.

Provincial and territorial medical associations (PTMA) in Canada set policies on various issues such as emergency room overcrowding, nurse practitioners, electronic medical record keeping, prescription drug usage, etc. for their particular jurisdiction. The Health Policy and Research (HP&R) department of the Canadian Medical Association (CMA) was asked to create a repository of these policy documents and make them available to all PTMAs. The library was already managing a database of CMA policies and was asked by HP&R to set up a similar database for the PTMAs.

Andornot worked with the CMA library team, led by Reference Librarian Elizabeth Czanyo, and the association’s IT department, to set up a password protected database using the Andornot Starter Kit (ASK), DB/TextWorks and WebPublisher PRO, with the following features:

• Full text document searching and display
• Link to PDF document
• Referring URL security
• Email, Save and Print cart
• Permalinks to each policy
• Search, display and cart all in same template
• Bilingual: English and French
• Search result sorting by Title, Date and PTMA Author

Now researchers at each PTMA can access and compare policies from various jurisdictions, assisting them in the creation of their own policies.

Elizabeth Czanyo says, “I think the database will be a useful tool for our provincial partners, and help them collaborate in policy creation across the country. Working with Denise Bonin and her team at Andornot was great – they were fast, professional and really knew their stuff!”

The Vancouver Island Health Authority (VIHA) Library recently switched from an in-house built library catalogue system to Inmagic’s DB/TextWorks and WebPublisher PRO, becoming the fifth British Columbia health authority to do so.  The new system provides staff in all the VIHA hospitals and health-related offices (and from their homes and elsewhere, too) access to more features than were previously offered.  Because the catalogue is on the Internet, the public can use it too, although requesting items is limited to staff only.  Several of the VIHA library staff have used Inmagic software in other library settings and were delighted to be using it again.

The VIHA library catalogue on the web: http://viha.andornot.com is based on the Andornot Starter Kit and features Quick and Advanced search screens, a few popular topic searches – using canned searches.  The search results include Google book covers, which add both colour to the site and links to more details about each book; icons for quick material type identification; Permalinks to provide a link that remains unchanged over time (for sharing and bookmarking); and functions for Ordering requests and Email, Save and Print for sharing or personal use. 

They now join other BC Health Authorities, including Fraser Health, Northern Health, Vancouver Coastal Health, and Interior Health, and similar health organizations; all using the same backend Inmagic software.  As a result, this facilitated the inclusion of the VIHA catalogue into the popular Health Libraries Association of BC (HLABC) OneSearch where search terms can be entered into a single search box and all the  catalogues can be searched quickly at the same time.  Librarians from all the health authorities have commented how much they like to use the OneSearch system to locate items not in their collection, thus providing a time saving search mechanism and a wonderful resource sharing tool. 

Both the new features in the VIHA catalogue and the inclusion in the HLABC OneSearch system provide greater functionality to all the VIHA users, including both staff and public alike.   Cliff Cornish, Regional Manager, Library Services, comments:

“It is wonderful to finally have a modern OPAC, and it is great to be able to participate with the other Health Authority Libraries in the HLABC search.”

For further information, contact Andornot. 

Fraser Health, with its 13 hospitals and 5 main and 8 smaller library locations, is one of the largest Authorities in British Columbia in terms of population served and health and medical resources collectively held.  The web-interface for the library catalogue, which has been hosted by Andornot since 1999, has just been recently completely revamped. 

The new site, at http://library.fraserhealth.ca, uses the Umbraco content management system, allowing authorized library staff from any location to quickly add and change content on the site.  The new catalogue interface features quick and advanced search pages as well as an RSS feed for recent acquisitions on the Quick Search page.  Fraser Health staff can search the catalogue, add selected items to an ordering cart and send in a request for delivery to their nearest hospital library location. 

One of the fabulous new features of the site is the Subject Guides.  Fraser Health Librarian Niki Baumann coordinates this area and has moved all the information from individual BlogSpot websites.  She has completely revamped the interface to this resource rich area of the website by dividing each Subject Guide topic into What’s New, Journals, Books, Databases and Websites and has used the catalogue’s permalink feature to link from the featured new books to the actual record in the catalogue.  The pages are kept constantly up-to-date with embedded RSS feed headlines from various journal websites, with the links to the titles available directly by IP address authentication if within the hospital locations or via a user name and password from outside the hospital.   These resources are now readily accessible to all Fraser Health professionals, from their offices, their homes or on the road. 

During the launch of the site the library staff encouraged users to “play” with the new site and designed a series of questions requiring users to search the catalogue database in order to find the answers.  Once the survey was completed, the user’s name was entered into a draw for a 4GB USB Drive.

“Staff are thrilled with the new catalogue and web site.  We all feel like proud parents who have collectively given birth to a beautiful new child.  The catalogue includes additional special features that allow the user to search for items by format or site with ease.  The site is more streamlined and cleaner, yet offers more content." comments Linda Howard, Interim Library Manager.

Andornot has hosted the Northern Health (NH) Library catalogue and website on the internet for almost 10 years.  During this time it has undergone many iterations.  The most recent is one located at http://library.northernhealth.ca.

Earlier this year a new design for the NH website was implemented using the DotNetNuke Content Management System (CMS).  So while Anne Allgaier, the librarian was considering how to deal with that change, she was concurrently being pressured to move the library presence off the internet and inside to the intranet.  The major concern being that the library services were meant for internal staff only. Anne knew however, that there were plenty of users who accessed her Inmagic-based catalogue and related information from their homes or from remote locations throughout the widely distributed region.  These users would be deprived of what had become a very popular service.  Anne asked Andornot to help her find a solution to keep the library presence on the internet and to incorporate the new website design and comments:

“Andornot’s has provided the Northern Health Library with exemplary service for the past decade, providing us with solutions that make it possible to provide the level of service that the library’s clientele requires, regardless of location.”

Website Template Linking

Andornot’s philosophy has always been that web-based databases should be integrated into the website template.  So while we worked with Anne to built up layers of content on the new site to go with the library catalogue, we also liaised with the NH website developers to implement a method that taps into the always-live site template on the NH server.  This was accomplished by having a content-free page on the home server within the NH’s CMS with a specific hidden comment tag in the content area (in this case, "<!—andornot -->").  This bit of text in the content area tells our system where to parse each page's content into the source site's template.

Library Portal

So while the template remains current on the hosted site, allowing users to quickly navigate to other areas of the NH website, the library content on the site continues to grow.  It includes: 

• the BC Ministry of Health News RSS feed
• access to e-HLbc databases (requires IP authentication or username and password login)
• access to thousands of online books (requires IP authentication or username and password login)
• links to other library catalogues
• Google Book Covers with links to Google Book Previews
• Ordering cart
• a canned search (one click) and an RSS feed for recent library acquisitions
• links to various other services (Tutorials, InfoBriefs)
• Patient information website links
• Professional information website links

… thus providing NH staff, University of Northern BC medical faculty, and patients with a single access point for all sorts of resources, whether they are in the hospital, on campus, in their office, at home or on the road.