The Use of Social Networking in Managing a Consumer Health Information Service
Jeanie Straub, Reference Librarian
Douglas County Libraries: Parker Library
February 1, 2011
What's Happening Now
A short three years ago, the buzz at the Medical Library Association's annual conference was the social networking "revolution," where, according to medical librarian Maura Sostack in Information Today, attendees were chatting nonstop about blogs, wikis, Delicious, Furl, Flickr, podcasts, and, yes, MySpace, which back then was still a name in the burgeoning array of social networking sites.
But while the Web 2.0 revolution was all the buzz at the 2007 MLA conference, an informal survey of followers of the Consumer and Patient Health Information Section (CAPHIS) electronic mailing list from December 2010 to January 2011 showed that a square 50 percent were using no Web 2.0 media or social networking platforms to promote their libraries, reach patrons or to collaborate with other staff. This response is in keeping with the findings of a scientific sampling of health-science library representatives by researchers at the Health Sciences Library at the University at Buffalo, State University of New York (Hendrix et al, 2009). The researchers in Buffalo designed and distributed a survey to analyze the professional use of Facebook by libraries belonging to the Association of Academic Health Sciences Libraries. Respondents were reference or public services department heads, outreach librarians or library directors. Of respondents, 85 percent said their organizations did not maintain a library-specific Facebook page despite all respondents in the study being familiar with Facebook. At the same time, the authors noted that a 2008 study[i] of medical students and residents showed that 44.5 percent were using Facebook.
Use of Facebook
Of the 12 percent of libraries that were using Facebook:
Respondents were given the option to list multiple ways their libraries use Facebook. … [A]cademic health sciences libraries use their Facebook pages: mainly to market the library, to push out announcements to library users, post photos, provide chat reference, and have a presence in the social network (Hendrix et al, 2009).
Regarding the relative importance of the social networking site, the authors of the Facebook study noted:
As academic health science libraries explore social networking technologies to create and market library services, Facebook provides a flexible space to interface with a large number of students. Homegrown applications for Facebook have been created by libraries to answer reference questions, search online public access catalogs, and host multimedia collections. For health sciences libraries, whose users are often widely dispersed, Facebook offers several opportunities for outreach and instruction. For example, self-organizing groups of users (i.e., medical student class of 2010, pharmaceutical sciences undergraduates) afford targeted marketing opportunities despite their distributed locations (i.e. teaching hospitals, rural clinics, commercial pharmaceutical laboratories). Additionally, Facebook encourages developers to create applications that could be useful in a health sciences setting (i.e., PubMed Search application), form affinity groups (i.e., Medical Library Association Facebook group), and fashion library fan pages (Hendrix et al, 2009).
The Buffalo authors cited in their literature review a 2008 study[ii] by Mack, et al, in which Facebook was the primary means of answering research questions in a library: Out of 441 reference questions, 126 came through Facebook, followed by email (122) and then face-to-face (112).
The authors noted in their conclusion that the perception that the upkeep of a Facebook page would consume too much time was incorrect: Respondents spent under four hours a week maintaining their sites.
Use with a Passion
The largest majority of respondents in the informal 2010-2011 CAPHIS poll[iii] were the 66.1 percent working in a health-sciences library associated with a hospital; 16.1 percent were working in an academic health sciences library and the balance was evenly split between those working in a health-sciences library not associated with a hospital and those working in a public library with a consumer health emphasis. Respondents who were employing social networking could check more than one answer indicating what using social networking sites they were using: 35.7 percent said they were using Twitter, Facebook[iv] or other micro-blogging sites; 30.4 percent were using a blogging platform; RSS feeds were used by 26.8 percent; YouTube or other video-sharing sites were used by 16.1 percent; Google Docs or other collaborative sites were used by 12.5 percent; wikis were used by 8.9 percent; and Flickr or other image-sharing sites were used by 5.4 percent. (Please see charts at end of text.)
Consumer Health Librarians who do use social media and other collaborative Web 2.0 technologies do so with a passion. In an email interview, Angela Arner, John Moritz Library Associate at Nebraska Methodist College, Josie Harper Campus, said:
I use Facebook, LinkedIn, have a blog, have a library wiki, utilize YouTube, have a Delicious account, have tag cloud through Delicious and my blog; have a Flickr account, use Google Reader, LibGuides, LiveBinder, LibraryThing; have a Diig account; view podcasts; iGoogle; e2Campus; TeacherTube; Shelfari; Netvibes (just discovered this morning).
In an article in Information Today, Darren Chase, an informatics librarian at the Stony Brook University Health Sciences Library in Stony Brook, N.Y., had a similar list and a cut-and-dry explanation for why the list is so important:
[S]tudents, faculty, clinicians, and residents at Stony Brook University expect the cutting edge – the latest refinements – and look to us to deliver the goods. I developed an instant messaging reference service, implemented an interactive directions map, created a Flickr image bank, and as part of a team … built a wiki intranet for my library. I did these things in response to users' changing expectations as a technology-enhanced progression of traditional library services and goals (Chase, 2007).
The Library's Place in the Social Sphere
In the American Library Association's guide to social networking, Doing Social Media So It Matters: A Librarian's Guide, author Laura Solomon gives librarians a heads up that they will be expected to abandon the traditional role of librarianship:
When a library involves itself in social media, it first and foremost has to understand that it's going to be expected to interact. To do otherwise is to fail. Let me say that again: To do otherwise is to fail. By failing to participate in conversations and relationships, the library is essentially declaring that it will simply maintain its traditional role as a depository of knowledge (Solomon, 2011).
Among Solomon's advice is to write a social media policy for staff and understand social capital on social networks: "Gaining social capital really means becoming a strong, consistent member of the online community," she says. In practice this can mean things as simple as thanking people for contributions such as a comment on your blog, asking for opinions, linking to others, giving credit and encouraging others, and forging relationships with followers. Solomon cautions librarians to answer this question when posting advertisements for library programs or services: "What's in it for me?"
Advertising a service or program with promoting its benefits is counterproductive and can actually hurt your library's social capital. It's very likely that your patrons are generally overwhelmed with input from various sources throughout their day and are suffering from information fatigue. Most have learned to be picky and are likely to tune out things that they find irrelevant or equivalent to pure advertising (Solomon, 2011).
A common failure in social networking, Solomon says, is the misconception that it is merely a way to broadcast messages or promotions.
Another common problem I've encountered (especially on Twitter) is the library that follows no one back. These are likely libraries that believe social media is just another way to broadcast their message and indicates a tremendous failure to understand the potential of the medium. Not making any connections also indicates the library has no interest in listening to its patrons – not a message any institution would want to send, even inadvertently. Make sure your follower ratio is somewhat even; your library should be following back roughly the same number of people following it (Solomon, 2011).
How a Consumer Health Librarian Uses Twitter
Abigail Jones, Consumer Health Librarian at the John A. Prior Health Sciences Library, Ohio State University Medical Center, said she uses Twitter and Delicious mainly but also has used Facebook and "experimented" with a volunteer staff wiki for training purposes. The Twitter account she has been maintaining since July 2009, http://twitter.com/libhealthinfo, has 64 followers, and appears in six lists, including two described as "OSU" lists – one that has almost 360 followers – and one described as health news list that has 96 followers. Typical posts by Jones include:
- OSU faculty=Best docs:http://go.osu.edu/bestdocs. Here's the list:http://go.osu.edu/ColsMoThursday, January 13, 2011 10:11:06 AM via web
- Road construction will mean extra travel time to the library:http://medicalcenter.osu.edu/maps/Pages/index.aspxMonday, December 06, 2010 8:41:28 AM via web
- Cell phone rash. Who knew?http://go.osu.edu/rash.
Wednesday, November 17, 2010 8:13:50 AM via web
Jones says she has changed the way she uses Twitter "only slightly" from when she first began posting. Originally she referred to materials in the collection, which she may return to in the future. Now she primarily uses it as a news forum for consumer health information and as a marketing tool for the library. "To get our name out there in the noise," she says.Jones says she is trying to cultivate a certain brand of followers -- health information consumers, professional librarians, and health educators. "Tweeting is fun," she said, "and can be a manageable way to 'get the word out.'" Her recommendations for those new to Twitter include the following:
- Decide what your focus is and if Twitter is the best use of your time. For me, it was the best choice among several social networking tools … because of the limited characters. I'm in and I'm out -- quickly.
- Read the help on Twitter and ask questions. … .
- Check the profiles of your followers. A lot of online marketers use Twitter. … that can junk up your followers list. But it's a minor annoyance.
- To protect the library's/university's reputation, I have a prominent disclaimer …
Regarding tracking effectiveness and using third-party applications, Jones says she uses a custom URL shortener that helps in tracking. "The university has a home-grown shortening service that allows me to chart the number of hits my tweets get," she says. "I also casually note if I have any re-tweets."Twitter is different than Facebook for a number of reasons, she said. "For me, as a solo librarian, Facebook takes too much time. It has a place for libraries with staff who can dedicate their efforts to it. I just couldn't keep up. Recently, I have considered resurrecting my Facebook account for the library, designing it more as a non-dynamic webpage and then simply redirecting my tweets to it. That would work."While she continues to prefer Twitter because of the stated time issue, she believes consumer or academic health libraries need to have something. "Both are ideal," she said. "One is essential."
What Other Libraries are Doing on Twitter
Examining 433 institutional accounts from academic, public, state and national libraries, independent web analyst David Stuart, formerly a postdoctoral research fellow in Web 2.0 technologies at the University of Wolverhampton, said "not only are libraries gathering relatively few followers, but they are also making little effort to follow users in their communities" (2010). He also found that only 30 percent of the libraries in his study averaged one post per day.
In the Web 2.0 world, users have an expectation of a constant flow of new information. With everything automatically time stamped, it quickly becomes obvious when institutions are not fully partaking in the community. It is not enough for a library to have an account on Twitter; it is necessary for them to have an active account.
Stuart says librarians need to do more than just sign up for the hottest site of the day.
Delicious
Jones of the John A. Prior Health Sciences Library at Ohio State University Medical Center, uses Delicious "as a favorites repository – a type of online pathfinder to 'good health info websites.'"Jones further explains how she got started on her Delicious site, http://delicious.com/LHI, and why she likes Delicious: "I took the couple hundred bookmarks on our library's computers and entered them into a Delicious account so that anyone can access 'librarian-vetted consumer health websites.' I like it because it extends the reach of the library and offers a service to those who cannot physically visit us."She sees it as a way to provide links mainly to consumers. Something she has learned since starting the account is that it takes more time than she would like to monitor the URLs and keep them up-to-date. "Also, I did not have time at the start to enter notes describing the individual websites, but have learned that this is essential especially since I am promoting the account as trustworthy and informed," Jones says. "I need to explain what each site is to the user."As of December she was in the process of adding tags. There is some functionality Jones says she wishes Delicious had: "I don't like that the 'Top 10 Tags' cannot be hidden permanently from account settings. It's distracting. I don't like that I cannot set the Tag Bundle headings to stay open from account settings.
Use of Wikis
Jones also experimented with PBWorks, a wiki platform, to have an online training manual and news page for volunteers. "It was called Libatrium and was not useful to the volunteers," Jones says. "Many found the online nature of it difficult to manage."Jones adds that the problem was not the wiki itself. The problem was that the technology did not match the learning style of her volunteers, whose average age was 63. She has a volunteer transfer the entire wiki into a 100-page Word document that is now in a binder and readily used by volunteers on a daily basis. Arner of Nebraska Methodist College has been involved in two wikis: one for policy and procedure work and one to share information literary work among library staff. "It was fairly effective," she notes, "however no one has utilized it for about 18 months."
'Best suited to the outcome desired'
What Jones learned from this first experience was that wikis are easy to construct, fun to design, and easy to refresh. "One needs to consider if the thing itself is best suited to the outcome desired," she adds. "In our case it was not."She notes that the wiki was incomplete since she "abandoned" its design and maintenance once she saw how ineffective it was for volunteers, and she planned to permanently delete the account at the end of January 2011.To folks starting a wiki from scratch, Jones recommends that they be sure they have the time to devote to the design and editing process -- a wiki may not necessarily be the best idea for a solo librarian.
Amy Six-Means, HANESbrands Health Learning Center Librarian, Sara Lee Center for Women's Health at Forsyth Medical Center, also has a wiki: http://hhlc.wikispaces.com. Her wiki contains links to consumer health sites she recommends; she also uses RSS extensively to get her consumer folders updated as well as to keep her department informed about consumer health issues that are in the media.The wiki is for the Hanesbrands Health Learning Center, which is part of the Sara Lee Center for Women's Health at Forsyth Medical Center; it shows two logos at the top of every page. Notes Six-Means of her forays into the wiki space:
"I had created one for myself and my colleagues when I was a clinical librarian. We worked at different locations and it made some things easier as we collaborated on projects. By the time I started working as a consumer health librarian, I had tried two different wiki providers and had determined that I clearly liked one more than the other for ease of use, ability to incorporate things like logos, and for cleanliness of the page design. Our hospital's Internet site is not user friendly and the only ones who can access and make edits to the pages are a limited number of marketing and IT folks. So they might ask for our input, but they are not very responsive in incorporating our suggestions. I needed a place where I could put all the websites I was bookmarking so that I could easily locate them and share them with both patrons and colleagues who asked for a good site for a topic."
The wiki currently has 43 pages, including the main "home page," with plans to add more on a regular basis. Creation of a topical page is based on how often Six-Means does a search for a patron on a topic, how much interest there is in a topic from patrons and colleagues, or whether she can promote a particular service within the department – such as their Continence and Pelvic Floor Program.She tracks how it is used via the site's statistics section, where you can track unique hits, hits per day, hits per page, etc.Other than telling people when they visit the library, Six-Means said she does little advertising of the wiki at this time. "I have been able to do TV spots for a local program that highlights services and news in the Winston-Salem area a couple of times and tell viewers about it," she says. The station posts the link at that time, but it is mostly advertised when patrons are looking for information on a topic for which she has a wiki page created."I have shared the Diabetes page with the diabetes educators, the Stroke page with neurology, etc.," Six-Means says of potential users of her library's wiki. "I would also have to say that customers are people who find it online."As far as functionality, Six-Means wishes she could add inks to documents -- incorporate them into the page -- to promote services within the library or hospital that are highlighted on specific pages. "For instance," she says, "I refer to the application patrons can complete in order to check out items, but cannot download the application to the site."
Blogging
Arner of Nebraska Methodist College writes a consumer health-focused blog called Health Information Literacy -- for Health and Well Being at http://aa47.wordpress.com. She said she uses WordPress as her blogging platform because it has greater flexibility and more features than Blogger. "I try to post several times each week," Arner notes. "I will be out of the office next week and have several posts scheduled for publication while I'm gone. I really like that feature. I have a Cluster Map linked to the blog and I'm amazed about 'readership' and number of 'hits' since the blog was created through WordPress."
Marshall Breeding, director for innovative technologies and research for the Vanderbilt University Libraries, says blogs can help libraries fulfill strategic purposes as well as reinforce the value of libraries:
[A]n externally hosted blog should be rich with inward-bound links that connect users back into the library's essential services. By composing blog entries peppered with terms that attract search engine traffic and subsequently funnel visitors into library services, a blog can better fulfill its role as a successful promotional tool. But without consideration to the relative inward and outward traffic patterns, activities based on Web 2.0 concepts can just as easily hinder rather than help overall library goals. These issues likewise apply to other social networking applications (Breeding, 2010).
Flickr
Flickr is a photo-sharing site. Users can create a free account to store, index, organize and share images. Each free account has a capacity for 200 images, while an inexpensive professional account offers unlimited storage.
Darren Chase of Stony Brook University Health Sciences Library commented on his library's use of the site:
Our Flickr site is mostly visited by other librarians, but I share our pictures in a number of ways that are popular with Stony Brook students and faculty. Though I've used Flickr pictures to great effect in Web site logos and promotional posters for our instant messaging service, the most visible, popular application of our image bank is a revolving set of pictures on our main Web page. Not only do students (by and large) enjoy getting their pictures taken, but having their photos then shared via the library Web site brings a fun sense of pride. … In another instance, nursing faculty were impressed with the Flickr images I used in illustrating a jointly developed database tutorial. The pictures gave it a real and intimate quality that clip art doesn't deliver (Chase, 2007).
Social Networking: The Future
From a talk he gave at the 2010 Caltech / MIT Enterprise Forum, venture capitalist Mark Suster later published as a three-part series in TechCrunch, a leading technology media property. The following insights were mentioned in the third installment, called "Social Networking: The Future" (TechCrunch, 5 December 2010):
• Users will form "true" social networks: Suster cites what he calls "the Facebook problem" – that the site lumps everyone into one large social network. "Nobody exists in one social network," writes Suster. Users have one for friends, family, and business. He says "to get around all of this jumbling of social graphs they simply create multiple Facebook accounts under pseudonyms or 'nom du guerre' for their real discussions and more pristine Facebook accounts for their real names." People are forming "topical" social networks via sites such as HackerNews or Quora, Namesake, and StockTwits.
• Privacy will continue to be an issue: Says Suster: "I know most people aren't troubled by the loosening of their information – but I believe that's because most people don't understand it." He adds that privacy "leaks" will cause a longer-term backlash. "Diaspora was created in direct response to the growing concerns about Facebook privacy and lock-in," he writes. "Whether or not Diaspora will take off is anybody's guess. But a lot of people would love to see them or similar players emerge."
• Third-party tools will offer features to websites: "Third-party software companies will start to offer features to websites to actually drive social features," Suster writes. "This will take a few years but players such as Meebo are already innovating in this category though their toolbar."
• The need to manage data will lead to new sites: The volume of data has exploded and will create opportunities just in the management of that data with sites such as Klout, Sprout Social, etc. Says Suster: "Once we're uber-connected and getting information online from people we've only met online we need to know more about the 'authority' of the people we're following." A site such as Klout tracks the "influence" of people in social networks.
• Facebook will not be the only dominant player: Suster notes that while Facebook has "more page views than even Google" and more than 10 percent of what time people spend on the web is spent on Facebook, only the next decade belongs to the company. He points to the dominance of Microsoft and AOL as examples of once monopolies that later shared the stage with others.
"Other" responses:
- Consumer health library at a hospital
- Also a consumer health library
- Medical society- nonprofit educational cultural institution with consumer website PhillyHealthinfo.org
- Library in a non-profit organization with consumer health materials
- Library at community-based organization
- Consumer health and family library
- Family Resource Library within a Children's Hospital
- We are a teaching hospital associated with a university
- Cancer center library associated with a hospital
REFERENCES
Breeding M. Taking the social web to the next level. Information Today. September 2010:28-30.
Chase D. Sharing with instant messaging, wikis, interactive maps, and Flickr. Information Today. January 2007:7-56.
Hendrix D, Chiarella D, Hasman L, et al. Use of Facebook in academic health sciences libraries. J Med Libr Assoc. 2009; 97; 43-46.
Solomon L. Doing Social Media So It Matters: A Librarian's Guide. 1st ed. Chicago: American Library Association; 2011.
Sostack M. From Web 2.0 to Health Literacy: The Buzz at MLA '07.Information Today, Jul/Aug2007, 24;28.
Suster M. Social Networking: The Future. TechCrunch. 5 December 2010. Available at: http://techcrunch.com/2010/12/05/social-networking-future/.
Accessed December 5, 2010.
[i] Thompson LA, Dawson K, Ferdig R, Black EW, Boyer J, Coutts J, Black NP. The intersection of online social networking with medical professionalism. J Gen Intern Med. 2008 23:954–7.
[ii] Mack D, Behler A, Roberts B, Rimland E. Reaching students with Facebook: data and best practices. Electron J Acad Spec Libr [serial online]. 2007 Summer;8(2), [cited 1 Jul 2008]. Available at http://southernlibrarianship.icaap.org/ content/v08n02/mack_d01.html. Accessed January 5, 2010.
[iii] In the informal CAPHIS survey, 56 people responded. The list has 753 followers.
[iv] For an example of a consumer health library's Facebook page, please see the Sara Lee Center for Women's Health at Forsyth Medical Center page at http://www.facebook.com/saraleewomenshealth.