No matter where they live or work, health professionals, researchers and the public can access information from the National Library of Medicine thanks to its National Network of Libraries of Medicine (NN/LM), consisting of more than 6,000 libraries coordinated by the NLM and supported by eight Regional Medical Libraries (RMLs). NLM in Focus is showcasing the libraries awarded contracts to serve as RMLs for 2011-2016.  In this article we introduce you to the people and projects of the Middle Atlantic Region (MAR).

Pittsburgh, the 20^th largest metropolitan area in the US with 2.6 million people, is home to NLM’s Middle Atlantic Regional Medical Library (MAR) located at the University of Pittsburgh Health Sciences Library System (HSLS). Covering Delaware, New Jersey, New York and Pennsylvania, the region encompasses nearly 48 million people (15 percent of the US population) and two of the world’s most prominent cities in New York and Philadelphia, along with sparsely populated rural areas in upstate New York and central and northern Pennsylvania. It is simultaneously home to well-known medical centers, academic health sciences centers, and federally designated Health Professional Shortage Areas, where medical, dental and mental health providers are lacking. English is the region’s main language, but some 14 percent of the population speaks Spanish as their primary language, with smaller populations speaking other native languages.

The Middle Atlantic Regional network has more than 1,000 members and the support of 30 resource libraries. It provides collaborative training and funding opportunities for libraries, health centers, health departments, associations and community-based organizations. Since 2011, when the University of Pittsburgh Health Sciences Library System became the coordinating Regional Medical Library, membership in the region has increased more than 25 percent.

NLM in Focus spoke recently with MAR Director Barbara Epstein and Executive Director Renae Barger.

NLM in Focus: What makes your region unique and interesting?

We have only four states but serve a large, diverse population from metropolitan areas to remote, rural areas. In addition to small community hospitals and health centers, our region has 27 federally designated Critical Access Hospitals (CAHs), with fewer than 25 beds and located at least 35 miles from, or a 15-mile drive over secondary roads to, another hospital. These facilities have been a priority for us because their staffs have no access to medical libraries.

Through our involvement with CAHs, we have also developed a great partnership with the Office of Rural Health at Pennsylvania State University. Their Pennsylvania Rural Health magazine featured MAR, including our services and NLM resources, in its fall 2013 issue.

This partnership has opened doors for presentations and trainings about our services and NLM resources to CAH staff in New York and Pennsylvania.

NLM in Focus: Are there any challenges unique to your region? If so, how have you overcome them?

Similar to the other regions, we support hospital libraries faced with hospital mergers and library closures. We also provide outreach to a diverse population of public and school libraries, health professionals and community organizations across four states. We strive to find the best ways to reach all of these population groups.

We support hospital librarians through a number of training and funding opportunities to gain new skills, and we promote their visibility, since greater visibility leads to better understanding of their contributions.

On the recommendation of our Hospital Library Special Advisory Group, we helped fund and guide development of a six-hour course titled “Running Your Hospital Library Like a Business” that has been met with very positive feedback.

A partnership with the University of North Carolina at Chapel Hill and health sciences librarians in our region helped produce the Value of Libraries study showing the importance of health libraries. In turn, that study led to articles in JAMA, the Online Journal of Issues in Nursing, the International Journal of Health Care Quality Assurance, and elsewhere.

We also support the Health Sciences Library Association of New Jersey Group Licensing Initiative, which provides hospital libraries with negotiated, discounted pricing for licensed, evidence-based resources.

By exhibiting and presenting at conferences, we reach health professionals and the public health workforce, public libraries, school libraries, nurses, and educators and organizations that provide consumer health information. These connections have increased our visibility and have opened doors to relationships leading to additional trainings and outreach. Michelle Burda, our Network and Advocacy Coordinator, co-authored an editorial in the International Journal of Clinical Practice on NLM resources with a clinician she met while exhibiting at the American Psychiatric Association annual meeting.

Face-to face meetings really help establish relationships, so we schedule site visits with network members and potential members while we are at trainings or exhibiting. We typically visit 60 or more locations each year, meeting one-on-one with staff at the various organizations.

Also, we belong to and attend meetings of our regional and state chapters and associations, such as the state public health associations, state library associations and regional chapters of the medical library association.

NLM in Focus: What are your proudest accomplishments?

Establishing a new regional medical library program is our proudest accomplishment. At its inception, the regional medical library was located in New York City. But with the current contract, we now have the program at the University of Pittsburgh. It took us a lot of work over six to eight months to go from a staff of one and a single part-timer to being 100-percent operational with a team of enthusiastic, ambitious library coordinators and staff. But being part of the regional medical library program is more rewarding than we ever imagined.

Also, we started a new advisory group that convenes network members from all types of libraries, community-and faith-based organizations, and healthcare arenas. At virtual quarterly meetings, our advisers help shape our programs to meet network member needs. We also have a Regional Advisory Committee that includes the chairs of our four Special Advisory Groups, as well as representatives from our regional chapters of the Medical Library Association.

Advisory Groups have very strong views of the NN/LM mission, and many have been funded to do powerful outreach projects.

• The Northern New York Critical Access Hospital Project offered training sessions on NLM resources to staff members at four Critical Access Hospitals in rural northern New York. MAR plans to fund another CAH and provide Skype reference services to all five CAHs.
• The Health Education and Advocacy through Health Ministers program offered training sessions on NLM resources to health ministers and parish nurses throughout southwestern Pennsylvania. It is planning to extend to other parts of the state.
• We provided train-the-trainer mental health classes to area agencies, produced a train-the-trainer manual for mental health issues, and also produced a manual on NLM resources for seniors and caregivers throughout Pennsylvania.

Establishing partnerships with network members that open doors to outreach opportunities is very important. In this regard, we are now a partner in Pennsylvania Forward Health Literacy. That’s a new initiative by the Pennsylvania Library Association to redefine the library’s statewide role in basic literacy; information literacy; civic and social literacy; health literacy; and financial literacy. Other notable partners who have shaped our outreach include: the Office of Rural Health; Behavioral Health and Aging Coalition; Chautauqua County Department of Health and Human Services; Center for Rural Health Practice; our state libraries; and library resource councils.

NLM in Focus: How has technology impacted your work?

Technology is a part of everything we do, from offering regular webinars to online classes and presentations—even our quarterly advisory group meetings. Technology brings people and communities together who, because of time, distance or financial limitations, cannot make in-person trainings or meetings.

• Lunch with the RML is a monthly webinar forum on which we share ideas informally with MAR members. Our funding recipients love to talk about their projects and the lessons learned, and to share successful outreach ideas.
• Boost Box webinars are another monthly favorite to educate or “boost” knowledge of special topics or resources.
• Our quarterly Tech Time webinars aim to increase awareness of and discussion regarding information technology trends and advancements.
• In response to members’ requests, we have begun Focus on NLM Resources, a bimonthly webinar series highlighting the many sources of great information out of NLM. Like many of our webinars, these are eligible for one Medical Library Association Continuing Education credit.

Our communications depend on email, Facebook, Twitter, and our MARquee blog. On Fridays we distribute a compilation of upcoming trainings, news about NLM products, funding opportunities and other relevant topics. We also produce an online, quarterly newsletter called MAReport.

NLM in Focus: Tell us about your recent community outreach projects.

In addition to our Critical Access Hospitals effort, we offer outreach funding to health professionals and consumers for medical library projects, technology improvement, emergency preparedness, health information awareness, and exhibitor and professional development.

Data management is a hot issue for our academic health sciences libraries, so with a subcommittee of resource and academic librarians, we have designed and hosted three events to stimulate their involvement in research data management.

The first was a two-day research data management course at the University of Pennsylvania in Philadelphia conducted by MAR-sponsored experts from the Lamar Soutter Library at the University of Massachusetts Medical School.

Next we offered a two-day symposium on research data management in libraries, hosted by The Rockefeller University. The symposium focused on emerging roles for health sciences librarians and retooling library services to incorporate support for managing research data. More than 140 people from 23 states and Canada participated.

We also partnered with the Association of Academic Health Sciences Libraries to host a webinar series on research data management.

We’ve done a lot with the Affordable Care Act (ACA), including a webinar for state librarians on reliable consumer health information resources, and later a series of webinars and in-person trainings by MAR staff, invited experts from the Centers for Medicare and Medicaid Services, and federally funded ACA Navigators. In April we held a symposium in Philadelphia titled “Access to Care – Libraries Making a Difference” and provided travel support for our member libraries to attend.

When Superstorm Sandy hit our region in October 2012, we offered back-up information support services to severely damaged libraries. We provided funding to replace damaged computers and equipment so the libraries could help their patrons with Federal Emergency Management Agency forms and other necessary disaster information support. The storm led to a lasting partnership with the New Jersey State Library to stimulate library readiness, planning and partnerships with local emergency planners.

In a new collaboration with the Center for Rural Health Practice at the University of Pittsburgh-Bradford, we are providing training on evidence-based practice to nurses at rural hospitals in northwestern Pennsylvania.

Our K-12 outreach programs have taken off and are popular at school nurse and science educator association meetings. And, our relationships with public health training centers and public health associations have led to in-person and online trainings for this workforce.

Health literacy is another important focus. We’ve done presentations for patient education committees, regional health literacy coalitions, risk management groups, and health professionals and librarians.

NLM in Focus: Any further thoughts about your region and the work you do?

The ability to make an impact in the region is one of the most gratifying things we share as the regional medical library. We revel in being a field force for the National Library of Medicine and introducing NLM resources to a diverse population. It is rewarding to collaborate with network members, many of whom are public libraries, to design programs and direct outreach and funding that meet their needs and support our common goal: to advance the progress of medicine and improve health through access to information.

By Thomas Conuel, NLM in Focus writer