My name is Liz Morris, project coordinator for Webjunction "Health Happens in Libraries" program.
We have been working over the last several months to support public library eHealth services as well as staff capacity to respond to information needs --
we know that in many libraries across the country have been taking a very proactive role in this, and we're excited to be able to share more information about this topic in our presentation today.
We have collaborated closely with a number of excellent partners in this work.
Including ZeroDivide, you will be hearing from two ZeroDivide team members today.
McCrae Parker, a Senior Program Manager there, and Vanessa Mason, a Senior Manager for eHealth at ZeroDivide.
We have also worked closely with the national network of libraries of medicine, pleased to be joined by Emily Hurst, Technology Coordinator in the South Central Region.
In addition to these organizations, we have benefited from the expertise of the centers for Medicare and Medicaid services in our projected -- projects, and supported by the institute of museum and library services.
Our goal is to share information about the growing intersection of health services and health information technology, and explore resources that may be relevant to your library as you support patron needs in this area.
So, with that, I will turn it over to ZeroDivide. 
>> McCrae, I think you might have just muted yourself again.
>> McCrae: Thank you, Liz, and thank you for the opportunity to share some of the work of ZeroDivide.
We hope to set context for the continuing work of libraries and their support of patron health information needs.
And we also will present what we feel are some leading edge practices from the field at large.
And hope that these examples will inform and inspire your practicepractice.
So, just by way of background, a little bit about ZeroDivide.
ZeroDivide is a mission-driven consulting organization that stays true to original philanthropic purpose of helping communities transform through technology.
We provide technology adoption and field-building services to clients and also design technology rich initiatives that hold promise for national impact.
We're located in the tech heart of San Francisco, but our projects and our work have a national reach and with more than 15 years of demonstrated success, we work with our partners to improve economic opportunities, civic engagement, and help for low income and culturally diverse communities.
Over the last few years, an emerging body of work at ZeroDivide has come about in the form of eHealth.
Through eHealth, we work with health care providers, health systems and community organizations to promote place-based health avocacy agendas, provide training to cultivate tech savvy workers and innovators and underserved communities together to develop culturally appropriate and accessible eHealth tools by reducing barriers to adoption of eHealth tools by medically underserved consumers and their providers, promote the design and development of appropriate patient-centered technology and establish a compelling foundation of evidence and expertise to build the field of eHealth.
As Liz mentioned, I'm joined today by Vanessa Mason, who is Senior Program Manager for our eHealth.
I'm going to pass it over to her and she is going to present us with just some background here on ACA, and eHealth.
>> Vanessa: Great.
Hello everyone.
I hope your day is going well.
The next slide you will see in front of you is just a quick overview, when we talk about the Affordable Care Act, what does that really mean on the ground?
Of course, first and foremost, Affordable Care Act is about expanding insurance coverage.
We're trying to capture the several million -- I think at last count, 47 million people uninsured to start expanding that level of insurance coverage.
So, what does expanding insurance coverage mean, the centers for Medicare and Medicaid services, really talk about the triple aim as the sort of benchmark for success in health care.
Increased patient satisfaction in the experience of care, and also patient outcomes.
So really focusing on increasing preventative care.
Getting people before they get sick and better able to manage people once they do have some sort of illness or condition that emerges.
And also that third piece is reducing the cost of care.
I'm not sure if you -- how many of you are aware of this, currently the United States spends about 18% of our GDP on health care and we don't necessarily have the health outcomes you would expect for spending that much money on care.
One of the real ways that the ACA has been helping to achieve that triple aim of better satisfaction and improved patient outcomes and lower cost of care is by supporting the adoption of eHealth tools.
So, we will transition into talking about what does it mean when we say eHealth? 
So, at ZeroDivide we look at eHealth in three key areas when we're talking about tools that are available.
We have the PHRs, personal health records and patient portals.
These are online basically web sites which people can use to access their health information.
So, for example, if you go to your doctor and you have lab tests done through a patient portal, your doctor can basically upload these results and you would be able to see them online at your convenience.
And it is also a way for you to be able to communicate with your physician.
Next disease management tools -- these focus on chronic disease.
And really managing life-style behaviors that are associated with minimizing complications and also trying to sort of reduce the severity of chronic disease, such as heart disease, asthma, and diabetes.
And then lastly are the SMS and mobile apps.
Refers to text messaging.
All of these applications, interventions are taking place on a mobile phone and -- why does eHealth matter to libraries -- for patients to be able to access that information, they need broadband access.
47% of Americans look for health information online at libraries.
So, libraries serve an important place to access that information.
With disease management, libraries serve as an important location to really understand what are the needs of the patrons, particularly with regard to health care as they are situated within their unique communities.
And with SMS and mobile because they're -- this is an opportunity to engage your patrons in another way, and also to help, you know, them have a better quality of life.
So, in looking at -- what are the barriers to eHealth adoption?
So, broadly ZeroDivide has identified these eight key barriers to adoption.
One being the digital divide.
And, so, I'm sure that many of you are aware that broadband access is pretty far-reaching in this country, but it is not available everywhere.
So, libraries serve as an important location within communities for people to be able to access the internet.
With design and usability, of course, linguistic barriers and cultural competency come into play.
One of the most -- best known patient portals offered by Kaiser permanente is not available in Spanish -- for a library to address those barriers in addition to tech literacy is particularly important.
Lastly, education and awareness.
Health literacy is a huge problem in this country.
There are a fair number of people who don't have sufficient health literacy to be able to understand the information that they're receiving from physicians to be able to manage their care.
And as libraries, experts in literacy, you're uniquely positioned to address many of these literacy issues. 
And, so, I'm going to turn it over to McCrae, who is going to talk more about how libraries fit in with the new landscape with growing new eHealth adoptions.
>> Some of you may recall with the initial roll out of ACA enrollment period, we presented this model called the ecosystem.
And encouraged libraries to think about their role as part of a mutually enforcing network of organizations that libraries were not alone in providing information and support of community members, and that libraries serve as important access points for this information.
They also can provide space for programming, and, most importantly, as we have heard, the technological access point.
The key library competencies, particularly around reference services and patron training include information literacy.
And when coupled with libraries being seen as trusted anchor institutions, this has allowed libraries to secure an ongoing and expanding role within this ecosystem.
Central to this role will be the ability of libraries to plan for emerging patron needs and technology.
So, at ZeroDivide and through our work with the digital bridge technology -- we have developed what we call the technology assessment and matrix.
This matrix serves as an important role -- an important role in allowing ZeroDivide and a given client to assess their current technology capacity in service to their missions and social impact objectives.
It provides means to clarify and accept and goals for increased capacity in terms of tech and services.
Regardless of the size and capacity of the CPO, technology can be leveraged to increase social impact for constituents.
We feel that this insight is important for libraries.
We recognize that capacity is diverse and each branch is diverse, but there is a way to support patrons at any level of capacity.
And, so, here on this slide, we have distilled our matrix to focus on aspects particularly relevant for libraries.
Leadership, communications, and program delivery.
Where these elements intersect with tech planning and infrastructure, there is a continuum created in terms of of the practice.
Those are listed there along the top, developing, aspiring, promising, and leading edge practice.
When we get to our case studies a little later in this presentation, we really will try to take a look at some organizations that are doing leading-edge practice.
We do want to remind, again, that any organization or library regardless of their size and capacity, can leverage technology to improve services and outcomes for their constituents.
We have supplied a link also in our resource guide for those of you who would like to take a closer look at this matrix and the assessment tool.
We have found that it is often very informative to simply take the assessment and see what is all covered and should be considered as part of technology planning and integration.
Some other considerations for development include broadband and digital literacy.
The good news here is that there is an increasing penetration of high-speed internet.
70% of Americans have connections in the home.
But currently, there are roughly 80 million people in the United States who rely on public libraries to provide broadband access.
In or just outside of one of the 16,000 plus facilities throughout the country.
Having broadband strongly affects how one uses the internet.
Pew data shows that you know dial-up users take part in average of three online activities a day.
While broadband users actually increase that to seven.
In a recent study, pew research found that 15% of American adults who do not use the internet, and those that are least likely to use the internet include seniors, adults with less than a high school education, those living in households earning less than $30,000 per year and often folks are citing relevancy as a reason for not using the internet and expense.
This particular tool here is called the broadband penetration map.
A link has been provided in our resource guide.
It is a great resource for determining the level of broadband access in your community.
You can essentially enter in your zip code, and begin to pull back data about your patrons levels of access.
This particular map is detailing broadband penetration in accordance with particular demographics having to do with age and education and income.
A second consideration we wanted to take a look at was tech literacy.
The purposes of our discussion, tech literacy refers to the ability to effectively use technology, whether a desktop computer or mobile device to access and manage information.
You can see data points related to the use of that technology in the online world. 
It should be noted that there has been a surge of smartphone adoption and that the research is showing that more and more individuals are accessing health information through their smartphone devices. 
As noted, libraries have played and will continue to play a critical role in providing patrons with technology access and training.
And here we want to point out that part of that support has to do with a basic literacy, understanding how to get online, use various devices, softwares, and services to access information, and also in advance literacy, ability to do critical viewing and analysis of the information, and to discern what are the appropriate tools for any given activity. 
Health literacy.
Overall health literacy of adults in the states is somewhat limited.
36% of adults have limited health literacy at the basic or below basic levels.
And the implications of low health literacy have been articulated by the American medical association in their report health literacy and patient safety.
This report states that poor health literacy is a stronger predictor of a person's health than the age, income, employment status, education level, or race.
In the context of the Affordable Care Act, we have learned that many patrons, in addition to seeking information about their obligations as part of the law, need support in understanding and accessing definitions of basic health insurance concepts.
Again, information literacy, and -- fundamental components of health literacy.
Our work has surfaced the importance of these concepts for any library and community health endeavor. 
So, really quickly, I want to present this model called the 3 Ps.
What can we learn and possibly apply from leading practice interventions in libraries and other anchor institutions regardless of an existing capacity.
In our work with the "Health Happens in Libraries" project, we have viewed the work of libraries and their partners through a model called the 3 Ps.
Populations, programs, and partnerships.
For the purpose of this part of the discussion, the presentation of our case studies, we have grouped the studies by these categories that drive interventions and address barriers to eHealth.
These cases exhibit what we feel to be leading-edge practices, again, but we feel that they may contain illustrative lessons for libraries and staff with an eye towards innovation, and, again, regardless of an existing capacity. 
>> Great.
Let's start first with populations.
What you are looking at right now are two programs that ZeroDivide is implementing in partnership with another community-based organization.
Text for wellness and mobilize for fitness are text messaging interventions -- what is unique about these two interventions, messages being relayed by health ministers within faith-based communities.
What libraries can learn from a program like this, one is the lesson by focusing on another trusted anchor institution, such as a faith-based community, which of course libraries act similarly in that fashion as a trusted anchor institution, it is a way of you having access to and a unique understanding of what are the needs of the populations that you're serving.
There is also a lesson here in using text messages -- this is sort of an initial basic tool that we're excited to see the promise that it holds in extending text literacy for health care.
And, so, in libraries, this is also an opportunity that you, too, can look at.
What are the different sort of technological tools that you can use with your patrons to help get them sort of in the habit and also get the skills to learn how to leverage technology for their health.
And then there is also the additional lesson that in this program, we're using the health ministers, which are kind of already congregant within particular churches who are trusted advisors who have come forward to say that they want to offer their time and their expertise to really leverage their knowledge in relationship to do outreach for health promotion.
So, in the same fashion, librarians also act as trusted advisors and can offer targeted outreach to their populations in need.
So, a developing library definitely has the opportunity to have a lot of room to learn from this example and having that unique knowledge of your population and leveraging the relationships that you already hold to offer more targeted outreach.
So, moving into programs -- 
what you are looking at is a prototype of a web site that ZeroDivide has built with a collaborative of community health organizations as well as policy advocates that really focus on Asian American and Pacific islander populations.
And, so, this prototype, which is still in development, that will be launched later this year, is focusing on data-driven and collaborative mapping to support ACA enrollment -- the Asian Pacific island community very diverse linguistically.
This tool addresses that need to find ACA enrollment assistance in the languages that the populations need to find that assistance in and locate it on a map.
This tool is also mobile enabled so people can pull out their phones and be able to find the assistance that they need to enroll in health insurance, and also to understand some of the fundamental concepts that McCrae mentioned before that health literacy isn't just about what goes on in your body, but also an understanding of how to navigate the health care system as well.
So, what can a developing library maybe learn from this leading-edge practice?
>> One, an organizational story here with this particular prototype.
This came about through the collaboration of three different organizations all serving the same population, but in different ways.
So, you as a developing library, maybe have the opportunity to kind of look at what are your skills and what are your assets and maybe thinking about a collaboration of your own to deliver a program that meets the needs of your patrons.
There is also a second story in how do you actually facilitate health care access to services, health care services, as well as the delivery of services on the front line.
As Library -- librarians, you have that unique position, when someone comes in looking for health information, you have the ability to access that navigator to the right resources that they need.
Lastly let's look at partnerships.
What you are looking at is the gigabit libraries network.
This is a pilot project that involves libraries with definitely directly applicable to your local branch, but it is a pilot project that started in Kansas and Colorado to leverage what is called TV white space.
TV, radio, telecommunication needs certain band width to transmit information.
This project is leveraging the fact that not all of the -- all of the band width is not currently being use, and this so called white space can be used to increase broadband access.
These libraries have been able to implement fiber networks to increase access to broadband in the small, geographically diverse communities, and increase their own capacity to understand what does it mean to have broadband access and the ins and outs of broadband access and how that shapes information you have access to.
Over 80 million Americans rely on broadband access at the library.
A key role that libraries can help serve as that community hub for information.
As a developing library, what can you learn from this example?
One is using one of the tools that we have sent out already, and then also McCrae will get into talking to later, but one tool is a broadband assessment.
What is the internal capability of your library with regard to broadband, sort of look at information?
What are your upload and download speeds?
Some of the eHealth tools talked about earlier today, personal health records, patient portals need certain technological specifications.
Maybe it is an opportunity to implement a new policy within your library to allow people to use mobile phones to be able to access their health information.
This also, this unique project positions library -- as trusted authorities for access to information.
So, if we're talking about partnerships here, what other organizations or sort of other entities within your communities could you be working with, collaborating with, to re-enforce your position as that trusted authority and really trying to expand your reach?
I will turn this over to McCrae so that he can talk about some of our resources.
>> McCrae: Thank you, Vanessa.
That was great.
As we mentioned, we did want to be able to present to the group today a series of resources and tools that we think would lend themselves to enhancing and supporting libraries abilities to plan for future health information needs of their patrons.
On this slide, I really want to pull -- point out and highlight a couple of these resources.
The first being an assessment that has been developed by the ALA, the library and a network pool world.
Really provides a framework for understanding what it means to be a 21st Century network library and provide categories for assessment, including benefits to the community needs and services, the role of the library, and the network world infrastructure policy and planning.
Again, a very powerful tool, and a great first step to begin really taking a look at how technology can be leveraged for greater impact with patrons, and, in particular, around their eHealth needs.
I will quickly move to our closing activity.
And to begin taking any questions that folks may have.
We would like to do a small polling activity.
And folks should feel free to use the chat room feature.
Based on what has been presented here today, what do you think you might begin planning for in the next enrollment period of ACA at your library, and in support of patron needs?
Would it be to increase promotion of existing or new library services?
Would it be to develop targeted programming for distinct populations in your community?
Or would it be to develop new partnerships to leverage those towards meeting the needs of, again, distinct populations in your communities?
So, I'm just going to take a minute here and look at what comes across the window. 
Developing partnerships and programs to increase basic understanding of health insurance.
That is a great one.
We have seen some of that definitely in the work where community-based organizations have partnered with other organizations to really do that work around that particular part of the literacy.
>> Sure, and to also sort of re-enforce, there is policy level support for this as well on one of the Federal Government agencies, I believe the office of minority health, a new funding announcement targeted towards that same question.
How did you -- very targeted outreach to communities around health insurance, both for enrollment, as well as for understanding how to navigate services.
>> This is an interesting one here, too.
Developing new partnerships is a priority for me -- oh, developing partnerships to overcome fear.
I imagine that means fear in the community, like a kind of perhaps a distrust of the ACA enrollment process and affordable health care -- have you seen that in some of the other eHealth communities that you have done projects in?
>> Yes, definitely.
There is definitely some interesting kind of beliefs about what, you know, what's out there related to a number of different things.
And, so, a lot of what ACA enrollment -- as I talk to you about the prototyping tool, what does it mean to sign up for this?
What are people actually paying for?
What are they -- what is the value in getting health care coverage?
So, there is a lot of room to really, once again, address that health literacy piece and have people understand health care insurance and a lot has to do with addressing their fears. 
Oh, great.
That's fantastic.
Someone had navigates come in the library to help them sign up.
That is a very strong partnership and that obviously it going to be very effective in providing the broadband access to help sign up.
In terms of looking at who to partner with, reaching out to the local legislature is a great partner, if you have that opportunity and are willing to do that, to help kind of bridge that gap and getting people enrolled. 
Yes, I'm seeing some people are saying it is hard having -- 
that turnout mattersment and that might also be a case, too, this -- you know, with any sort of community outreach that you're doing, it is not necessarily going to be if we build it, they will come.
That also might be an opportunity to even talk with other community-based organizations that are working with the patrons that you're serving.
Looking at the faith based community -- that might be an opportunity to look at where other institutions that people are interacting with in your community -- maybe it is having -- if you have a church within your community with health ministers and invite them in and patrons use the broadband access within the library but have their trusted advisors within your space, that could be a potential partnership that could bridge that gap in between.
So, it looks like maybe we're running out of time.
I'm so glad to see that there is so many great comments and questions coming in.
Yeah, so I'm sure that we will have a way to capture all of these insights here and incorporate that into our resources as well.
>> McCrae: Thank you, Vanessa.
We are just about out of time.
We, of course, can continue to take questions through the chat window feature, so we would encourage folks to use that as a way to post questions.
But right now, we're going to be passing along the baton, and we've definitely enjoyed our time here with the group today.
>> Thank you everyone.
>> Thank you very much, Vanessa and McCrae.
It was great to see some of those excellent examples of the three Ps how to support populations, partnerships, and programming.
A A -- I think a lot of people shared great examples of partnerships in their communities and a assesssment to some of the challenges to maintaining or promoting patron interest in a topic that can be scary for some people and a little bit challenging.
So, one of the key things that we have heard both from library staff members as well as patrons and community members as we thought about supporting health information in communities is the need to ensure patron privacy and to build best practices around supporting privacy, specifically related to health information.
We are very happy today that Emily Hurst, who is a Technology Coordinator with the National Network of Libraries in medicine can speak to this topic and share resources related to privacy and best practices.
Emily thank you very much and we will turn it over to you.
>> Emily: Great.
Thank you for having me today.
And I do hope that this portion of the presentation does build off of exactly what was presented before, some of those areas where we are seeing that there are more questions around information online and privacy concerns, and hopefully we will have some ideas about how to build some of those technology literacy skills and information literacy skills with your patrons.
I just wanted to start off with some data, of course, from the pew internet and research project.
And this is very similar to probably what you have seen before, and this actually comes out -- this data is coming to us before the ACA was actually off of the ground.
So, we were already seeing that about one in three American adults have gone online to figure out a medical condition.
As you are already familiar, there is a lot of health information online, and people are going online to look for that information and to make diagnoses, to find out if they have a specific condition or even find a provider in their area.
So, there is an overwhelming amount of information online.
At the same time, of course, we're seeing reports about the information privacy, where it seems like every day there is something in the news about privacy concerns, either from people watching what you are doing online, or from accounts being attacked and information being taken there.
And when we start to talk about health information or any of this confidential information, this becomes something that we want to be concerned about and we also want to make sure that our users, our library patrons are able to access information in a secure manner. 
When we talk about privacy in health care, one of the big topics that hopefully you have heard about and your patrons or users that are coming in will have likely heard about as well a Hipaa, health insurance -- 
the link that I have provided there, we will have that for you in the chat or somewhere else, but this is a great resource to come to to get some information about Hipaa and what it means.
A lot of people, as I mentioned, when you are coming into the health care environment, or you're meeting with your doctor, there is a lot of times this Hipaa is thrown around as a term that is the catch-all for protecting privacy.
And many people don't have a clear understanding of what Hipaa actually protects or who it covers.
Overall, three are three entities that are covered by Hipaa.
Those are listed there as the health plans, most health care providers, and health care clearing houses.
So, again, this has a lot to do with the individually identifiable health information, and information collected by your health care provider, or health insurance company.
What Hipaa does for patrons, or for your users or consumers, anyone looking at it, it does provide you with a protection so that if that information is divulged or linked, it gives your patients or consumers an array of rights with respect to that information.
But hopefully what you are seeing here is something that is not covered by Hipaa or libraries or the public places that people may be accessing information. 
When we start looking at what our users are doing when they come into the library or going online for information, they may be going to another site to look for information, to connect with others, to share information.
And this type of activity is actually not something that is protected under the Hipaa rights, but it is seemingly one of the most common ways that people are sharing information.
I have a statement up here from the privacy rights clearinghouse on medical records privacy, and I think this is a wonderful statement just to look at.
I have tried to highlight some of the important parts, but as you can see, a tremendous amount of information, health-related information online, but there is no guarantee that information U disclose to any of the forums that you may be using online is confidential.
And in italics I have put it is important that you always review the privacy policy of any web site that you visit.
And this is something that our consumers may not be -- our patrons may not be aware of.
People go online, just been diagnosed.
They want to connect with others, they may disclose health information on a variety of web sites to try to find out some new information.
And that's happening there is not going to be covered under those privacy policies of Hipaa.
And it is important that our consumers or patrons have the knowledge to go and check some of the privacy policies that are associated with these online resources.
The same goes for our mobile application, and that was something that was touched on.
We're seeing more smartphone users and more people accessing the internet and health information on these mobile devices.
And, as such, again, if this is not an app or if it is not a web site of some kind that's provided from your health provider, something they have downloaded or gone to on their own, it is important to review the privacy policies when looking for health information. 
But something that is often provided when our patrons come in, they may have just been released from the hospital or they may have seen their physician, and this was touched -- the personal health records, the PHRs.
And this is something that falls into two different areas.
There that is been new legislation that has come out with the ACA and some of the laws regarding it that do cover some of the PHRs, specifically those that are being provided to a patient from their hospital or their health care provider.
These do fall under Hipaa rights and policies.
And two of the icons that I have up there, hopefully you have heard about or if you haven't, your users who patrons that come in might be familiar with something called HealthVault from micro soft.
And Dossia another large PHR and both have become Hipaa compliant to their standards that they have to meet.
But that first little note I have up there, not all personal health records are mandated to be Hipaa compliant.
And this is because they are third-party vendors a lot of the time.
If someone does create a PRH and they are a third-party vendor, not associated with any of the Hipaa-covered entities, they may not have to be Hipaa compliant.
We are seeing the same thing come up.
I have tried to bold it here.
Individuals should evaluate privacy policies to determine if they are comfortable with the protections offered by the PHR.
It is falling back on to the consumers, to your library users.
Have they reviewed the privacy policies that these systems have?
So, it is something that they may not be aware of if they just signed up for a new PHR or started using something they may not be aware of how their data is being used by that system.
It is always important to look at those privacy policies. 
When we talk about libraries and privacy, especially related to health information, we want to make sure that we are creating a secure, comfortable location for our community to come to to look for and research health information.
We don't want anyone to feel that we are excluding them or that we have policies in place that will deter them from using our resources to look up health information.
As such, the ALA has a wonderful resource related to privacy and -- in public libraries.
I wanted to mention the medical library association as well has a resource related to ethics and just reading out one of the aspects of that ethical policy, health sciences librarians respect -- protect the confidentiality of that relationship.
Something Library -- 
libraries -- we will not broadcast that Mr. Smith has just been diagnosed with something.
We want them to feel comfortable and able to come in to the library and use our resources.
Those resources more and more are online.
And we want to make sure our policies extend beyond that person to person contact and into the digital realm.
ALA has a wonderful resource if you need to redevelop or revisit your library privacy policies, there may be some things to add in related to online privacy to make sure that your patrons feel secure.
We, of course, don't want them to feel that they can't use our computers or our access points.
As you saw, that is a large number of people in the U.S. 
have to come to libraries to use the internet and we don't want them to feel that they can't search or can't look at health topics, if that is important to them.
Additionally, related to health information, the number one thing that we have been doing for years in libraries, especially with our consumer health collection, we have been putting up those disclaimers.
And there may be, again, something to add into the disclaimers that relate to your privacy policy for online use.
Are you -- hopefully not collecting data, that kind of thing.
There may be something to add in related to online resources and placing that on your LibGuide or your -- those disclaimers for online health information is one way to let your users know that the information that you are providing is for their benefit and it is something that you are not trying to track or keep up with.
The other thing that is very important, and it is an aspect of technology literacy that many people have seen, but they may not be as aware of as we would have hoped.
And that is the HTTPS, the hypertext transfer protocol secure.
Hopefully people have seen that in the URL bar, HTTP, and maybe the one with HTTPS.
HTTPS, something you would want to encourage your users if they are doing health information research or even financial, this is one way to make sure that the information that they're looking at is secure.
Basically with HTTPS, you are getting a secure loop from your computer system to the server that has the information on it, and, as such, you are excluded third parties that might want to be listening to in see what kind of information you are disclosing or get caught into a loop and maybe act as someone that they're not illegally there online.
HTTPS is a wonderful resource if you can encourage your users and educate them about the importance of this if they're sharing health information, they want to be using one of these secure systems.
Libraries can secure -- can enable HTTPS on their web site and, again, educating their users about its importance for use in online health communications.
Another online aspect to make sure that everyone is aware of, this comes out of the fact that when I go on the road as well, I teach, I visit libraries, and there has been, as I mentioned at the very beginning, a lot of publicity out there about government watching what you're searching for.
We hear a lot of times about search engines like Google and Bing and how they -- in our libraries, we want to -- three resources I have up, three search engines that if your users are weary of some of the big search engines, they can come to visit things like DuckDuckGo or startpage.
These web sites make it known that they are private and they are not going to track what type of information you are searching for or storing it.
Another search engine that is listed, it does track some personally identifiable information but it deletes it within 48 hours.
That's another tool that your users may be interested in using to make sure that they feel secure and private when they search for health information online. 
When we talk about resources, there is a lot that goes into looking for high-quality health information resources.
And this is actually the privacy policy from the National Library of Medicine related to the fact that the National Library of Medicine does not track personally identifiable information, PII, unless you write an email or something and disclose that.
We have resources that are sensitive topics, like genetics and clinical trials and looking at some things like this, looking at the privacy policy here, may be things you can implement on the web site and looking to evaluate the -- the privacy policy and reviewing the content creator are going to be important aspects of looking for high-quality health information resources. 
I do have resources at the end.
I have one more slide before we get through it.
I wanted to share a little about what else you can do, your library, if there are concerns related to privacy.
The number one thing I hope that all of your libraries have of course is an antivirus installed on the public computers, some type of antivirus software to make sure that malware or -- you want to be sure that you have an updated antivirus.
This will allow users to search online.
The information is no longer there.
The history is cleared.
We are not trying to track it.
We want our patrons to feel they can get up and leave once they're finished with their session and someone won't sit down and find out about the things they have been diagnosed with.
We have external devices, privacy and protection screens that make your screen darker so that people can't look over your shoulder and see what you are looking at.
You might consider a private review area or private viewing area for health information so that people can feel secure. 
And, finally, we have talked already and we have seen from ZeroDivide the information literacy and technology literacy are important skills, and there may be something to look for for user training.
In aspects such as online security, some things like HTTPS and antivirus software that people may be interested in learning about how to keep their data and information secure through training that your library could offer.
And, finely, teaching our users how to look for high-quality health information from reliable health sources.
They are not going to cite and be asked to disclose information and being tracked and having their data taken from them.
We want to make sure that we are sending them to reliable resources that have good privacy policies and good content for them.
And one wayway librarians can stay on top of health information, national network of of the library of medicine.
Medical library association, offering a consumer health and information specialist certificate.
There are classes that associate with this specialization and they do have to do with health information topics and many classes do include small portions related to privacy and security.
This is a wonderful resource to check out if you are interested and you work in a public library and you want to learn more about consumer health resources.
We have a number of things there as I mentioned that do have portions on online privacy.
And, finally, with my resources, there is a great many out there that have to do with your consumer health collections, and many of these have chapters or portions related to privacy.
I have provided some additional links here which I'm sure we will post online so you can get to these.
There are a lot of things related to ethics as well as resources from the National Library of Medicine that can help you point your users to reliable and security online information. 
I think my contact is the next information.
I have a 1-800 number there, national network of libraries of medicine.
The link is up there.
There are eight regions around the U.S.
If I am not in your region, you have someone -- that 1-800 number will contact your regional office where they can provide you with additional information and resources.
Thank you. 
>> Excellent.
Thank you very much, Emily.
That was a great overview of some of the privacy best practices that library staff members can keep in mind as they provide health information.
Emily I would like to clarify my understanding that services through the National Network of Libraries of Medicine, available to public library members at no cost, is that correct?
>> Emily: That is correct.
Our resources are available for free and we do have training opportunities around the country and there is also training online.
>> Great.
Thank you.
One other question, you spoke a fair amount of about quality and the fact that library staff members can help patrons assess the quality of the health information that they are receiving.
Are there any major red flags to indicate potentially low or poor quality or alternatively any kind of safe bets when it comes to quickly looking at and assessing the quality of health information online?
>> Emily: Sure, there is a lot of things that go into a high-quality health resource.
Some of the things to look for, you always want to have information about us, something where you can find out who the information is coming from, and hopefully find out a little bit more about that information or content provider.
Typically a red flag if you find a web site with health information and it may not be coming from a source.
There is no information there.
Or if it is just coming from you know, Jane Smith down the street.
How is she an expert?
How do we know what kind of information that she has?
There are little things the Hon code which comes up on many consumer health web sites that have been vetted as being appropriate resources.
But any of those resources from the National Library of Medicine or consumer resource pages that you will find from MLA, medical library association, are going to be vetted and especially those through MedLinePlus.
>> Great.
Thank you, Emily.
I have an additional question for the team at ZeroDivide.
McCrae and Vanessa, we spoke a little about the importance of partnerships and talked about libraries that have partnered with navigator organizations or have connected with local policy makers to support health information needs in their communities.
Are there recommended best practices for libraries that may be interested in approaching health care providers or facilities directly about building partnerships in their communities?
>> Hi, Liz, sure.
Thanks.
At this time I can't think of sort of an exact resource that outlines best practices top of mind, but one good resource in terms of thinking through how do you actually sort of partner for a community health outreach would be either your local, county, state kind of health department.
They tend to sort of look at how do they disseminate health information and just trying to get out that information.
They're a good resource to reach out to in terms of specific health information and kind of learning about what you can do with that.
It might be a great place to start.
And another resource that we were thinking about is given the federally-qualified health centers, sort of all of their sort of look-alikes located all over, using a resource that we outlined -- I think it is healthfinder.gov -- serving patrons in the communities where your libraries are located and their mission delivering primary care they often have -- folks that more interface with the community in a health literacy perspective as well.
They might be a good resource in terms of asking them and saying, you know, you're interested in serving the health needs of your patrons, how can you really sort of work with them to extend with what their reach is or sort of offer an additional resource once people have gotten maybe information within a clinic about something, and libraries can become the location to do a deeper dive into that information.
There is definitely -- I would say the kind of community health clinics located there are looking for all of the support that they can get because they're definitely underresourced and overutilized.
>> Great.
Thank you very much.
We have reached the top of the hour.
I want to again thank our excellent presenters for sharing their information with us today.
We will be posting all of the resources discussed online at the archive page and sharing that information back out with you.
Thank you for all that you do in your community to support health information and we hope you enjoy the rest of your day.