SERHOLD and the public's access to health information

Health information demands by the public are steadily increasing. Health questions are proliferating in public libraries; health care institutions are setting up health information resource centers; and the National Library of Medicine (NLM) is embarking on a new consumer health endeavor. For the first time, the National Network of Libraries of Medicine (NN/LM) has “improving the public's access to health information” as part of the NN/LM mission [1]. Donald A. B. Lindberg, director of NLM, says, “Good information is the best medicine … Thanks to MEDLINEplus, and the Internet, people from all around the world can research information on nearly any medical topic from the comfort of their home or office” [2].

What is the problem?

Once those concerned people find citations in MEDLINE, they may not be able to get their hands on the articles. How should public, school, college, and other non-health libraries get copies of health articles for their patrons? How can the public library find out if the hospital libraries in the county own the needed articles?

What is the most obvious source of information? SERHOLD.

But where do most public, school, college, and other non-health libraries look to find holdings? OCLC. NLM has provided the infrastructure for an interlibrary lending system that is the envy of the world. Through SERHOLD, which has 1.3 million holdings statements for health serials, and DOCLINE, which processes 2.5 million document requests per year, more than 3,000 health libraries throughout the United States and Canada have a seamless (and free of charge!) means of identifying holdings and automatically routing interlibrary loan (ILL) requests. At the same time that health libraries are benefiting from continual improvements to the system, I believe that we need to consider the implications for other, general libraries who are our partners in the provision of health information to the general public.

The health serial holdings of the more than 3,000 libraries in SERHOLD/DOCLINE provide an incredibly rich and unparalleled resource. SERHOLD includes libraries small and large; east, west, and mid; urban and rural; United States and Canada; covering biotech's latest research and complementary and alternative medicine. SERHOLD is maintained by motivated librarians who want DOCLINE to work well.

Starting in 2000, NLM is improving SERHOLD by providing health libraries a chance to enter their serial holdings directly into the SERHOLD database, at no charge. Changes will be effective immediately for accurate routing of DOCLINE requests. Health libraries no longer need to go through OCLC or other coordinators, but can make immediate changes, at no charge, directly to the database of greatest import for their daily work.

Currently, 1,185 of the approximately 3,000 U.S. and Canadian DOCLINE/SERHOLD participating libraries also participate in OCLC [3]. Because OCLC has no mechanism to add serial holdings in a batch way, via tape or ftp, holdings must now be entered one by one. Therefore, SERHOLD holdings information, en masse, cannot simply be fed into OCLC, even though NLM is very willing to provide the data to OCLC.

Having worked in the Regional Medical Library (RML) program for twenty-one years, I respect both local and national objectives: the system must work easily for each individual health library, but the nation as a whole must also have access to information. I use the following guideposts:

1. Health libraries should be able to enter their holdings into the SERHOLD database as easily, quickly, and inexpensively as possible. The SERHOLD database, which supports automated routing in the DOCLINE ILL system, is the critical database for health libraries. Rekeying of data should be avoided; any data transfers should go from SERHOLD, the database of greatest import, to other databases.

2. Health libraries should share their holdings information with other libraries.

SERHOLD changes

Details of recent SERHOLD changes are available from NLM. Here I will mention only immediately relevant changes.

Fast, free access for all DOCLINE libraries. NLM introduced the Online SERHOLD Updating System in 1994, which allowed for free, immediate updating of SERHOLD. Because of system constraints only a couple of hundred libraries were granted direct codes. The processes used by other libraries to update SERHOLD were often expensive and/or slow. Many health libraries paid to go through OCLC or through state coordinators. By contrast, the new Web-based SERHOLD system is available to all DOCLINE libraries and changes to holdings immediately affect DOCLINE routing.

Better SERHOLD products. SERHOLD has admirably fulfilled its main purpose: to be the underlying database for DOCLINE. With the new SERHOLD, other needed products will be available to participants. For example, an up-to-date individual library listing will be accessible to each library to check for errors or changes more easily. NLM also plans to make consortial and state union lists available. The NN/LM Pacific Northwest Region (PNR) has asked NLM to offer a limited view of SERHOLD publicly; NLM is considering this request.

MARC compatibility. NLM plans to accept holdings and provide output of holdings in USMARC format. This format makes the SERHOLD database more universally acceptable—a holdings blood type O+.

Pacific Northwest experience

Several SERHOLD and resource-sharing innovations have been pioneered in the Pacific Northwest, so we have already run across some of the advantages, problems, solutions, and decisions.

When available, public libraries make good use of health libraries holdings. Because of state and regional arrangements making it easy and cheap, for many years, even small health libraries in Oregon and Washington have contributed their serials holdings to bibliographic databases—OCLC in Oregon and WLN in Washington. Public libraries benefit by using their own communities' health library resources. The community cooperation has been so significant that the Oregon State Library and the Washington State Library are ringleaders in figuring out ways to continue the sharing.

Creative and guilt-free arrangements have been worked out between health libraries and public libraries. In Bellevue, Washington, the hospital librarian wants to help the community, but does not want to have the public physically in the hospital library. Instead, the hospital library offers free ILLs to the public library. Now, the hospital librarian can send people over to the public library with the confidence that they will be well served. Many health libraries face the situation of not being able to provide direct services to the public for a variety of excellent reasons (e.g., the hospital library is also the place where health professionals discuss patients). However, those same libraries still want to have a positive health influence on their communities! Equitable division of labor is a logical solution.

We know that much can be done with the SERHOLD data; it is a clean and rich database. For about fifteen years, the NN/LM PNR has used SERHOLD data from NLM to prepare a wide variety of customized products, including individual library listings and various union lists. We have found the data easy to work with and exceptionally accurate. For example, no serial title has duplicate records in SERHOLD. Starting in 1996, we offered customized SERHOLD products to the rest of the country—using any region's data to make individual library listings, state union lists, and any other requested union list. The programming, data transformation, and ftp availability cost only about $10,000 per year, which was allocated to us by NLM. Six of the eight regions took us up on this offer; the other two regions had a package of services offered by the Medical Library Center of New York. We made the lists freely and publicly available by ftp.†

We see that online SERHOLD updating is cost-effective. The NN/LM PNR tracked the costs of online SERHOLD updating [4]. We found that it cost the RML $6.72 to make updates for one year for the average health library in the Pacific Northwest! This cost was determined in a study with the 1995 SERHOLD updating system; we assume that costs would not be significantly increased (and may be decreased) with the new Web-based system.

Before 1994, when the Pacific Northwest needed to go through other bibliographic utilities to update SERHOLD, the NN/LM PNR saw time lags of up to eighteen months between the time of a serial holding change in a library and the reflection of that change in SERHOLD. Now, changes can be in effect the next day. We also improved the accuracy of our data; we were the first region to get all of our holdings in pure level three, the only level that can be used by DOCLINE for accurate automated routing. Our timely updating and clean data improved DOCLINE, saving library staff time and getting health information to our users more quickly. One measure was the fill rate (the percentage of requests fulfilled/requests received) for resource libraries in the Pacific Northwest before and after our adoption of online SERHOLD updating. In October to December 1993, the fill rate was 73%; in the same quarter of 1997, the fill rate was 84%. In other words, we wasted less time receiving and rerouting requests for materials we did not own. In addition, the unfilled requests did not have to be referred on to another library for an additional time lag.

Health libraries enthusiastically adopt the Web to update SERHOLD. In 1995, as soon as the Web became commonly used in health libraries, we replaced our old paper SERHOLD change request forms with a Web-based form, for an appreciative region.

Date: January 31, 1997

From: Roger Davis, Albany General Hosp, Oregon <davisr@peak.org>

To: pressno@u.washington.edu

Subject: Serhold

Nancy, I should be through with my updates now. I am really grateful to you and your staff for setting this up on the Internet. It makes it so much easier. I have been putting this off for about three or four years because I hated filling out those forms! Thank you.

Oregon health libraries have been facing the same decision that their colleagues around the country will come up against: whether to continue with OCLC. For many years, Oregon health libraries entered their holdings in OCLC in order to participate in an Oregon Union List of Serials and to update SERHOLD. In 1995, Patrice O'Donovan of Oregon Health Sciences University and the NN/LM PNR streamlined the process so that Oregon health libraries only had to fill out one simple Web form, and their holdings were immediately entered in SERHOLD and shortly thereafter keyed into OCLC. With the new SERHOLD system, those libraries would enter their own holdings into SERHOLD, but have to fill out yet another form to stay current in OCLC (for which they also have to pay). The Oregon Health Sciences Library Association has been considering dropping costly OCLC participation.

We know it is possible to batch load SERHOLD data into another bibliographic utility. In 1994, the NN/LM PNR collaborated with the Washington Medical Librarians Association and WLN to filter Washington SERHOLD data through a tailored program and to load it into the WLN database.‡ The Washington State Library judged it to be in the interest of the people of Washington to have the rich holdings of health libraries viewable by all libraries. The program-writing and first-year processing cost less than $7,000. When OCLC purchased WLN, the program would not work with OCLC, and OCLC has no batch loading program to replace it. Right now, the thirty participating Washington libraries are facing the question of whether to pay to participate in OCLC, where they will have to rekey all of their holdings changes.

We are actively pursuing the option of batch loading SERHOLD data to OCLC. The Regional Medical Library in the Pacific Northwest invited an ad-hoc group of librarians from various constituencies in the Pacific Northwest—health, academic, state library—who have been discussing relationships between serial holdings data in OCLC and SERHOLD. We have been talking with OCLC staff and with the chair of the OCLC Users' Group about potential utility and possible methods. We encountered lively and surprising support from non-health academic librarians who wanted to have a batch-load program so that they could load other databases into OCLC without rekeying.

Possible solutions

1. A program could be written to batch load SERHOLD data into OCLC. This does not have to be limited to the current 1,185 libraries in both SERHOLD and OCLC. Why not add all of SERHOLD, so that our phenomenal geographic and topical distribution can be appreciated? OCLC's database would be profoundly enriched. Also, remember, the batch loading program for SERHOLD to WLN cost less than $7,000. Individual health libraries could choose not to participate; the choice mechanism could be as simple as a yes or no answer in a library's DOCUSER profile.

2. If NLM provides a public view of SERHOLD, non-health libraries could check SERHOLD for health titles and request ILLs through traditional means (paper forms, Ariel, fax, etc.). This solution requires non-health libraries to check an extra union list. Again, individual health libraries could choose not to have their holdings viewable.

3. Public, school, college, and other libraries with substantial health needs could apply for SERHOLD and DOCLINE participation—an idea acceptable to NLM. The non-health libraries would have to work with two separate ILL systems—whatever they currently use plus DOCLINE.

4. NLM and OCLC could jointly implement the ISO ILL protocol that permits libraries to exchange ILL requests electronically. NLM is very willing to work with OCLC to explore this option.

Support for any of these solutions is possible from a variety of sectors:

1. In order to increase the value of its own system and database, OCLC could support batch loading of SERHOLD data or ILL interfacing with DOCLINE. NLM has expressed its willingness to help support this endeavor, as well.

2. Non-health libraries wanting access to health serial holdings might be charged, either directly or indirectly (i.e., through state libraries), to have batch loading of health holdings or reciprocal ILL.

3. Under the auspices of its new consumer health information endeavor, NLM has shown interest in sharing between SERHOLD and OCLC. NLM could pay for an examination of the practicability of the above-mentioned solutions.

Conclusion

I urge health libraries to:

1. take advantage of NLM's improved SERHOLD capabilities, but, at the same time, work together with the RMLs and NLM in ensuring that health serial holdings information is available to non-health libraries.

2. lobby OCLC to load SERHOLD data simply—through a batch method. Health libraries should not be charged for this load, because it enriches the bibliographic databases primarily for other users.

3. lobby OCLC to work together with NLM to get the ISO protocol ILL-sharing mechanism going.

Once the public can cheaply and dependably get full-text articles from the Internet, either at home or in public libraries, we can stop worrying. Until then, we have a gap to fill.