Abstract
Objective:
This study was undertaken in order to determine how health sciences libraries in a ten-state region are using Loansome Doc, with an emphasis on whether this tool continues to be used to serve unaffiliated health professionals. Methods: Usage data were examined and health sciences libraries were administered a survey to determine how they are using this tool.
Results:
Loansome Doc usage across libraries is low and declining, and a number of libraries do not serve unaffiliated health professionals with this tool.
Conclusions:
Use of Loansome Doc is low and declining due, in part, to license restrictions, declining interlibrary loan, and the prevalence of alternatives, such as OCLC ILLiad, for document delivery to affiliated users.
Keywords: Loansome Doc, interlibrary loan, document delivery
Introduction
The Regional Medical Library serving the Greater Midwest Region (GMR) of the National Network of Libraries of Medicine (NNLM) is one of eight Regional Medical Libraries distributed across the United States and serves a 10-state region, comprised of Illinois, Iowa, Indiana, Kentucky, Michigan, Minnesota, North Dakota, Ohio, South Dakota, and Wisconsin. This Network of libraries, established by Congress in the Medical Library Assistance Act of 1965, was originally known as the Regional Medical Library Program, whose charge was to serve the health information needs of health care professionals. The mission of NNLM is to advance the progress of medicine and improve the public health by providing health professionals with equal access to biomedical information and improving the public’s access to information to enable them to make informed decisions about their health.(1).
The project described here concerns the primary mission of NNLM: to provide health professionals with equal access to information. This mission includes providing professional library services to unaffiliated health professionals, meaning those health professionals who are not served by a health sciences library through either faculty or staff status at an academic institution or by a health sciences library within their hospital or clinic network. Loansome Doc was designed to allow both affiliated and unaffiliated library users to order articles from a list of citations retrieved from PubMed®, the National Library of Medicine’s (NLM) online citation database of biomedical literature.
Loansome Doc allows individual library users to submit journal article requests without mediation by library staff. The request is sent digitally to a member library which supplies the articles from their collection; or it is sent to another library through DOCLINE (“Loansome Doc Transfer”), NLM’s automated interlibrary loan (ILL) request routing and referral system. Articles fulfilled through this system are sent directly to the individual library user and Loansome Doc patrons not affiliated with the DOCLINE® library supplying the article are charged a nominal fee.(2)
Much has changed since Loansome Doc was introduced in the early 1990s, in a pre-digital era when paper copies of articles were mailed or transmitted via facsimile. Loansome Doc was developed by the NNLM Pacific Southwest Regional (PSR) Medical Library in 1988, as an enhancement project to determine if a link could be created between DOCLINE libraries and health professionals using Grateful Med (1986) and then its successor, PubMed (1996) to order, send, and receive full-text articles via ILL. The project established a task force to make recommendations to NLM, which then developed and beta tested Loansome Doc in the PSR in 1990–1991.(3)
One of the obvious challenges to Loansome Doc in the age of electronic journals is the restrictive nature of license agreements for digital subscriptions from publishers. In today’s environment, where the majority of health science libraries’ collections are licensed digital content, many health sciences libraries are not able to provide document delivery to users not affiliated with their organization. Despite this change in the publishing environment, GMR libraries continue to offer Loansome Doc service. With this study, GMR staff librarians intended to determine how effective Loansome Doc is in meeting the information delivery needs of unaffiliated health professionals.
Methods
Data collected for this assessment consisted of the number of Loansome Doc patrons active within the past five years, the number of libraries within the region that list themselves as Loansome Doc providers in DOCLINE, and a survey of Loansome Doc contacts at partner Resource Libraries of the GMR. Usage data for active authorized Loansome Doc patrons in each state was obtained from the National Library of Medicine. Patrons are considered “active” if they have placed an order via Loansome Doc within the last five years or if they created a new account since January 1, 2016. A list of regional Loansome Doc providers, that is, libraries that indicate that they provide Loansome Doc services, was downloaded from DOCLINE in October of 2016.
Older Loansome Doc usage statistics are difficult to come by; a 1994 article written on the initiation of Loansome Doc reported 52,325 completed requests and 1,699 patrons for the first full year of implementation.(3) An article published by staff in the Southeast Region reported 251 active DOCLINE libraries and 867 Loansome Doc users in the region.(4) It is not known if these numbers include all users or just those that are actively placing requests within the system.
An online survey was developed by the authors, asking questions surrounding Loansome Doc usage, which was administered to Loansome Doc contacts at the Regional Medical Library’s thirty-three partner Resource Libraries. These Resource Libraries are a self-selected group of academic health sciences libraries that partner with the GMR through Memoranda of Understanding and agree to participate in DOCLINE and share interlibrary loan articles with health sciences libraries in the region on a cost recovery basis. A copy of the survey is contained in the appendix.
Results
The data collected indicated that there was a total of 4,949 active Loansome Doc patrons and 979 Loansome Doc providers within the Greater Midwest Region, distributed across the ten states. Beginning in 2017, Loansome Doc patrons reported out by the National Library of Medicine include only those who have been active within the past five years. There are 24,586 total active Loansome Doc patrons across the eight regions of the National Network of Libraries of Medicine, and the GMR ranks second in the number of active patrons.
Of the 32 libraries to whom the online survey was administered, 28 responded. Four libraries stated that they no longer used Loansome Doc, but had not updated DOCLINE to reflect that change. Responses to survey questions for the remaining 24 libraries are discussed here.
Libraries were asked if their journal licenses prohibited document delivery to individuals who were not affiliated with their institution. Responses were mixed. Of the 24 responses, the majority (46%) shared that they were unsure whether it was prohibited, and the remaining responses were nearly equally split between “yes” and “no.” This uncertainty is understandable when examined in light of the limited number of Loansome Doc requests that most respondents receive. Some of the comments regarding this include:
“We have only a few [patrons] who use Loansome Doc. We really have other, easier ways for our patrons to request an article.”
“Our Loansome Doc usage has decreased dramatically in the last five years. We currently have very few requests for this service.”
“We currently only have a few patrons who use the service….”
“Our [Loansome Doc] demand has decreased drastically over the last decade.”
“We have very few patrons/requests. There are not any current users.”
“We do very little, if any, unaffiliated Loansome Doc requests.”
“We still have users listed, but we have not received any requests for years.”
“We have only a handful of [Loansome Doc] users.”
“In my 8 years in this position, I have had only a handful of Loansome Doc requests.”
None of the responding libraries reported establishing language in their electronic journal license agreements to allow for Loansome Doc transactions to unaffiliated health professionals. When asked about other methods libraries use to provide document delivery to unaffiliated health professionals, respondents shared:
“Users are set-up with ILLiad accounts and billed for document delivery service.”
“We are happy to fill requests for unaffiliated health care professionals from our very small print collection.”
“We do offer an avenue for some non-affiliated users to submit requests using our ILL management software, ILLiad.”
“They can send us an email or fax…”
“Service is provided if they use the library in person.”
“Our library offers on-campus access to unaffiliated health providers via guest user kiosks…A user must be present in the library to use them.”
“We accept the ALA [American Library Association] ILL form from another library.”
“We have an internal system and we allow anyone to request, but they have to pay for the service if they are not affiliated with our institution.”
Finally, this survey provided some clues as to the use of Loansome Doc by member libraries. With the increasing prevalence of OCLC’s ILLiad product for document delivery among large libraries, Loansome Doc is not a common tool for document delivery to affiliated faculty, staff and students at library institutions. However, several interesting uses of Loansome Doc surfaced, and a trend was apparent in use by affiliated health professionals who were comfortable with the tool and its use for serving alumni.
“We do have some established doctors that still like to use Loansome Doc”
“[We] use Loansome Doc to fulfill ILL requests from our teaching hospital”
“We have our usual law firms that submit a few requests.”
“It is used by corporate members, certain faculty, and unaffiliated users to provide much needed information that cannot be obtained through other resources.”
“We have used Loansome Doc to provide document delivery to alumni who don’t have easy access to a home library than [sic] can make requests through.”
“We offer Loansome Doc primarily to alums who may not have any other way to obtain content.”
Discussion
This project was undertaken to determine how GMR libraries are using Loansome Doc, nearly thirty years after the tool’s release. While the number of Loansome Doc participating libraries and patrons appears to be strong, interlibrary loan departments report declining usage. The decline in the use of Loansome Doc by libraries can be attributed, in part, to the release and growing prevalence of OCLC’s ILLiad tool for document delivery. This and the technical advancement of integrated library systems and other sophisticated digital tools have provided alternate methods of document delivery to users. Another reason for the decline is undoubtedly the increase of freely available content online, due to the open access movement and the NIH’s Public Access Policy. Finally, those libraries whose journal licenses prohibit document delivery to unaffiliated users, the original purpose of Loansome Doc, may be contributing to declining usage.
While Loansome Doc activity in the region is low, some health sciences libraries found a distinct purpose for the tool. For those libraries without the resources to purchase ILLiad, Loansome Doc serves as a value-added tool to deliver documents from the library collection to their own affiliated users. Loansome Doc is free to use, although its usefulness is limited to the provision of biomedical documents indexed in PubMed, while ILLiad can be used for document delivery across subject areas. In addition, while some surveyed reported that journal license restrictions were a barrier to using Loansome Doc, other health sciences libraries continue to serve either all or a select group of unaffiliated users with Loansome Doc.
The future of Loansome Doc is unclear; as more advanced or comprehensive tools for document delivery are released, libraries with the resources to obtain these tools may continue to migrate away from Loansome Doc. Despite this, the fact remains that Loansome Doc is entirely free to use, with maintenance and support provided by the National Library of Medicine. It is possible that increased restrictions by journal publishers may result in libraries using this tool only for users affiliated with their institutions. If this is the case, a solution may take the shape of a model license agreement which allows for use of Loansome Doc with unaffiliated health professionals within the state. Responses from this survey indicate that not all libraries are facing this restriction, so a solution must be possible. One factor not examined by this study is the awareness of Loansome Doc among health professionals, but it is undoubtedly a contributing factor in the decline in usage. A more in depth look into awareness of Loansome Doc and the development of a strategy for marketing the resource may impact usage by individuals and libraries alike.
Figure 1:
Loansome Doc Patrons within the Greater Midwest Region
Figure 2:
Loansome Doc Patrons within the eight Regional Medical Libraries
Contributor Information
Elizabeth Kiscaden, National Network of Libraries of Medicine, Greater Midwest Region, University of Iowa.
Jacqueline Leskovec, National Network of Libraries of Medicine, Greater Midwest Region, University of Iowa.
Elisabeth Unger, National Library of Medicine.
Resources
- 1.National Library of Medicine. Fact Sheet: Regional Medical Programs May 18, 2004 [cited 2017 May 21, 2017]. Available from: https://www.nlm.nih.gov/pubs/factsheets/rmp.html.
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