Background
The Health Canada Libraries Review, which took place during 1995-96, involved a study of the
impact of the libraries within Health Canada as well as key informant interviews with senior
officials in the department. The interviews covered a wide range of topics related to health
library and information services in the present and future. One of the interviews with Richard
Van Loon, then Associate Deputy Minister, resulted in the preparation of a concept paper by
Joanne Marshall on the development of a National Health Library and Information Network for
Canada (HealthLINC).
The original concept paper was submitted in December 1995 and funds for a feasibility
study were allocated to develop the concept more fully in collaboration with various stakeholders
and potential partners. After Mr. Van Loon left Health Canada in July 1996 to become President
of Carleton University, these funds were re-directed. Although there is continuing interest in the
HealthLINC concept by the original group involved in the Health Canada Libraries Review, the
group's current efforts are being directed towards internal matters related to the Health Canada
Libraries. This concept paper has been revised to reflect current thinking about the potential of
HealthLINC and its relationship to Health Canada's current Health Info-structure initiative.
What is HealthLINC?
HealthLINC is intended to support increased access by health care providers and consumers to
high quality print and electronic health information resources by leveraging the substantial
investment that has already been made in health libraries by educational institutions, government
and health care facilities across the country. Such access is a key element in evidence-based
health care, which is dependent for its evidence on the ready availability of the latest health care
research in the form of peer-reviewed scientific literature.
HealthLINC will provide the local access points, through the network of health libraries
across Canada, required to achieve equitable access to high quality health information. The
network will also facilitate cooperation among diverse institutions that currently control access to
information resources. Local access points and print collections are particularly important in the
present hybrid world or print and electronic health information resources. As technological
capabilities grow, HealthLINC will work with partners to develop leading edge technologies for
information access that can be shared on a national basis. Health libraries can provide not only
the access, but also the technical and reference support that information users need to seek and
use information resources effectively.
HealthLINC will also be a major player in health information policy development at the
national level and will complement the efforts of organizations such as the Canadian Institute for
Health Information (CIHI), which specializes in gathering health care data for use by policy
makers, and the Canada Institute for Scientific and Technical Information (CISTI), which houses
an internationally recognized collection of scientific literature and a state-of-the-art document
delivery service. HealthLINC will be the facilitating organization that will enhance the ability of
the participants to build and share information resources of all types most cost-effectively.
The Need
Canada has a worldwide reputation for its universal health care system; however the same cannot
be said about access to health information. In Canada there is no national network for the
coordination and provision of knowledge-based library and information services. Over the years,
the medical school and hospital libraries have done their best to meet local information needs;
however the institutional funding of these libraries often makes it difficult, if not impossible, for
them to meet the information needs of health care providers and consumers outside their own
organization. In some local areas, consortia help to meet these needs through resources sharing.
In other communities, special services or outreach projects have been funded by professional
bodies or government grants. Lacking provincial or national network coordination, however, all
of these efforts to improve local and regional access tend to be limited in scope, fragmentary and
unevenly distributed across the country.
By providing convenient and timely access to the peer-reviewed literature and other
sources that make up the knowledge base of the health professions, effective library and
information services can improve the quality of health care and reduce costs. Such access can
also reduce the sense of isolation of practitioners who are working outside of major centres. At a
time when there are increasing public demands for accountability and cost effectiveness, and
when a glut of print and electronic information of varying quality threatens to overwhelm us, the
need to provide well-planned access to the best quality information is more important than ever.
It is notable that Canadian health professionals have been world leaders in the development of
evidence-based practice and the critical appraisal of the literature -- approaches that rely heavily
on library and information services.
The Comparative Context
Canada's experience stands in contrast to that of the United States where a National Network of
Libraries of Medicine (NNLM) has been supported by the National Library of Medicine (NLM)
at the National Institutes of Health in Bethesda, Maryland. NLM is mandated by law to acquire,
organize and disseminate the world's health care literature for the benefit of American health
professionals, scientists and students. NLM also supports regional libraries, usually located in a
library that serves a medical school, as well as the networking capabilities of libraries in hospitals
and other health care organizations. The result is that virtually every health professional in the
United States has access to a local health library of some sort that is backed up by regional and
national resources. NLM also plays a leading role in developing electronic databases, training
materials, search tools and expert systems.
In England, the Minister of Health and the King's Fund for Health Care Research
sponsored a series of conferences on the development of a national health library infrastructure in
1993-94. In January 1995, the Minister appointed a Library Adviser to the National Health
Service to make recommendations on building a national health library network.
The Concept
Health Canada is in a unique position to provide leadership and to partner with other
organizations in the development of a national health library and information network for Canada
-- an initiative that will fill the need for universal access to health library and information
services. As direct responsibility for the provision of health services devolves to the provinces,
the development of HealthLINC offers Health Canada and other national groups an important
national coordinating and support role. Such a network will also strengthen the services that the
Health Canada Libraries are able to provide to ministry employees in the National Capital and
the regions.
The HealthLINC will be complementary to other national initiatives such as the Canada
Institute for Scientific and Technical Information (CISTI), with its national collection of
scientific journals and state-of-the-art document delivery systems, and the Canadian Institute for
Health Information, which provides access to health data and statistics. HealthLINC will also
improve access to library collections and services at Health Canada.
The principal areas of activity for HealthLINC will be:
The timing of the development of HealthLINC is corresponding with exciting and significant
developments in the electronic storage and transmission of full-text documents, making it
possible for the network to deliver not only bibliographic citations, but actual text as well.
HealthLINC will ensure equitable access to the best available health care databases and Internet
resources from around the world. HealthLINC will also be a vehicle through which Health
Canada can share its own knowledge base. HealthLINC may also be able to fund innovative
health informatics research that will lead to improved methods for creating and disseminating
information to health researchers, practitioners and consumers.
The key principle of HealthLINC is that it will build on and reinforce the strength of
existing health library and information services in Canada. By strengthening the existing network
through improved coordination, technological infrastructure, training and resource sharing,
HealthLINC will simultaneously improve access and optimize the use of existing resources.
Health Canada and its partners will be a catalyst for providing a level of comprehensive library
and information services nationally that current budgetary arrangements and jurisdictional
mandates at local and regional levels cannot support on their own.
Steps to Make it Happen
1. As part of the current Health Info-structure initiative, identify a team of individuals to refine the vision for HealthLINC. Consult on the vision with a small group of key individuals in Health Canada, the Canadian library community and other appropriate organizations.
2. Discuss the concept with potential stakeholders and partners including other government agencies, professional associations and granting bodies.
3. Explore the experiences of other countries, in particular the United States and the United Kingdom, in organizing national networks of health libraries. Explore Francophone initiatives in this area. An important part of this process will be a national conference that will bring together the key stakeholders, international representatives and potential participants in the network. The results will be published and circulated for comment as part of the planning process.
4. Based on the data gathered in steps 1 to 3, develop a detailed proposal for the HealthLINC. The implementation plan will identify core activities and services and set priorities for additional services based on input from potential participants and partners.