My name is Jennifer Peterson and I'll be helping host today's session. We're really glad you're here and we're going to go ahead and get started. We have a wonderful group of folks here today that come to us from the state of Utah. We have Casey Cox and Katie Larsen, who have come to us from the Tooele City Public Library in library. >> Erica Lake: -- -- Erica lake is from the health sciences library. And we have Liesl Seborg from the Salt Lake County Library Services. Congratulations to you Liesl, I know you're the winner of the library of the year. We're going to go ahead and get started. Welcome, to all four of you. And again, thank you so much. >> Casey Cox: Hi. So, this is Casey Cox and I'm going to get us started. So, our team was put together through ILEAD usa. It's a leadership institute that brings together librarians to bring together technology projects that identify a community lead. It stands for innovative librarians, explore, apply and discover. The primary goal of ILEAD usa is to implement national programs that develop the knowledge, skills and abilities why applying technology tools to understand and respond to user needs. ILEAD USA has a direct impact on end user to identify needs including community user representatives to provide critical feedback and using team products to identify needs and improve quality of life. Individual participants joined together in diverse teams, including public, school, and academic librarians, as well as specialized library staff members. Each team is assigned a community representative, as well as a qualified mentor who works with the participants throughout the program development process. The project has a quick turnaround time of 10 months. They apply for a $4,000 grant and all funds must be spent by the end of the 10-month period. That's ILEAD is. The four of us were recruited as a team by Jaime Carter. It has been observed that there's a need to improve health lit rueracy, in situations of isolation. Most communities have a library or are close to one, so this idea to improve health literacy is huge and has a really broad scope. We quickly realized we needed to narrow it down. Our team decided that it would be best to focus on just one help literacy group. We chose MS because one of our mentors has connections to Multiple Sclerosis. So what is Multiple Sclerosis or MS? It's a complex condition with a steep learning curve for patients. It an autoimmune condition where that attack the system and damage myelin and disrupts signals to and from the pain. There are long stretches of time between doctor appointments and are left with many unanswered questions. There is MS information and support online. Organizations like the National Multiple Sclerosis Society, maintain comp rehensive information. Many people living with the disease in rural and urban areas don't have access to a computer or internet service. Mobility constraints can limit some from accessing public computers. Others, who do have access to an internet-connected computer, lack confidence. As we move forward, we decided the how would be tablets. Tablet technology lends itself well, especially for people who are living with a chronic condition. Tablets are portable and have a low learning threshold. They can access the internet by WiFi. There are accessibility features and easily implemented privacy and security parameters. We had a meeting between us and the local MS chapter society. It overlapped on something they were working on. It was called the isolation initiative. It says to identify the groups of isolated individuals that we are not currently serving well and make a plan to better-connect them to current society programs that offer information resources and connections to others living with MS. Development and imLMENT plans. It was the perfect partnership with our team. According to the 2013 U.S. census bureau, 470,00utans live without high-speed internet. We want to provide technical skills. We entered into a partnership with the local MS chapter. So we had to figure out what our perspective participants want. We talked to the MS Society. Our team attended the 2015 MS Walk to find out with a customized tablet would be useful to people with MS. The survey also asked where patients went online when they had MS health questions. They went to Google for answers but were unsure if they could trust the answers they were finding. Armed with the answers from the MS Walk survey, we developed the customization of the tablet. We created the MS Buddy kit. They are killed with customized content that is relative to the individual, including hospital library. There are videos and apps and websites saved. A the check-out appointment, the MS Buddy libraryian provides one-on-one training and provides them with the vetted content. There are videos and documents. We point out the link to the online evaluation and ask that it is completed once a week to help us improve the product. And now Liesl will talk about some of the challenges we faced. >> >> Liesl Seborg: Boy, did we have some challenges. They fell into the categories of funding policy, technology, partners and just general delays. In every grant process, there are always the questions of funding. How much money is there? Where will it go? Who will administer and report? Most processes trend to the institution seeking the funds. In our circumstance, ILEAD grants were pre-approved and each team, which was composed of representatives from more than one institution, were able to receive and manage the funds so we had to decide which institution would receive the funds and that was our very first stumbling block. Funding concerns, not only because we needed to change our direction from one institution to another, to get the funds and have them manage the funds. due to our multi-organization composition of the team and the intended use by non-library card holders. We had to look at policies and have them evaluated unconjunction with the receipt and distribution of the funds. The application, grant award letter and additional documentation ended up going up the administrative ladder for approval and had to be reviewed and approved by the attorneys and the mayor's office, which is quite a feat. Such a process takes a lot of time and ended up causes an unanticipated six-week delay. Six weeks in our ability to access funds. The six weeks is key because normally such delays would not be a problem, since grants are awarded for one year. But these ILEAD grant funds were awarded and once they were awarded, they required to be used within three and a half months. So although casey eluded to a 10-month process, the portion of it was the last threeing months of our ILEAD project. We rebsolved yet another issue. Devices. Because of the unusual nature of the product, I.T. was brought in for discuss. They chose apple devices. And we were encouraged to use apple over android because of the security and privacy. This required the application to be amended and reapproved by the state library of Utah. We were able to embrace a different delivery platform and other apps. Overall, these delays meant less time to work with the devices and less time working with the MS patients to obtain feedback. The team was able to purchase devices, accessories and supportive materials. Set up the devices and create the infrastructure. There was also a sizable donation from oasis connections of some slightly older apple tablets that augments the iPads we planned to purchase so we had a larger group of devices to use for our project. And although the apple projects are very easy to set up and work with on an individual basis, it turned out to be much more complicated to set up multiple devices to use shared resources for an ease of maintenance and overturn for resetting them for additional users. Apple ids, emails and the establishment of data plan accessibility required individual setup but would enable the ease in resetting the devices after each use. Another consequence of the project delay was our inability to get the expected number of beta testers. We had planned on having at least 12, if not 15 or more beta testers for the project. We ended up having much fewer than that and many -- part of the reason being is many of the contacts we obtained were no longer interested in participating in the project or they'd given us phone numbers that were no longer valid and then of course, we had another issue when the local MS chapter, which had been on board to help refer patients to our project being unable to do so because they had so many staff turnover within the agency. Good news, we did obtain beta testers through some personal contacts and they were able to provide valuable information and help us with the beta testing. In the final evaluation of the beta phase, cultivated relationships would have helped with the MS Walk and we could have created a broader net to create beta testers. All right. So, this is where a sustained method of buy-in would have been appropriate. Maintaining enthusiasm with the MS Society may have resulted in a different response and turnout. In September, the MS chapter withdraw as our sustaining partner. They love the project and how it dove tails with their initinitiatives but couldn't carry the torch forward after our grant period was over. As you can imagine, this came as quite a blow to the team as we were nearing the end of the grant. We had planned ahead and submitted an moa that detailed the sustinbility plan. Once they reviewed it and they relized they couldn't sustain it, they let us know right away so we had time to change direction. So we have a couple of recommendations for implementing similar projects or if we were to do another project along these lines again. First, we'd want to make sure that we know the organizational policies and speak with administrators about potential delays in funding and policy that can be overcome ahead of time. Really, getting buy-in on an administrative level, which is one of the most important things. Second, we want to research whether the project needs to be vetted by more than one agency. You never know if it's the I.T. department that has to buy in or the fiscal department or the public services department. Which leads me to our third biggest issue, which is buy-in. Buy-in is probably one of the most important things to any project that is involving the public or multiple people. And some of the things you need to know are, if you want the keys to the car, you have to prove that you can drive the car safely and according to the rules of the road. Especially to those administrators out there, who really want to make sure that car comes back safe. So, there are lots of ways to create buy-in and many of you have may have wonderful suggestions you can share with us that we can reference later. There's tons of information on web. So I won't be making specific recommendations for resources there. But some of the things that I've thought about -- and our team has thought about -- as we've moved forward and looking back, what sort of buy-in we could do. So for future planning, we recommend these things. Encourage teams and administrators to share the vision or goal in such a way that everyone feels ownership with it. This can be accomplished through discussion of the idea and allowing team members to take on specific roles in the project. So we had our buy-in all set within our own ILEAD team and everyone in ILEAD that were excited about it. But we had to get the administrators and the other folks who might need to have a say involved and feel like it was part of their project as well, even though we'd be doing the work. Secondly, maintaining enthusiasm across all levels of staffing, with specifics that include things that show what it looks like when accomplished. It should be a primary concern to maintain the buy-in on the shared vision over time. To be part of the initial strategic planning. Finally, which we embraced very, very heavily, was creating a pattern of celebration. When a project is complete or major steps have been accomplished, celebrate those successess. It gives staff the opportunty to reflect on where they've been and revitalize sagging enthusiasm. We were like, okay, one good thing and we'll move on to the next problem. So with staff and other members of your colleague team, once a pattern of celebration is established for the project, you can anticipate anticipate additional celebrations and you'll be more willing to buy-in because you'll know they'll be appreciated. Fourth recommendation is to try to find multiple partners who are able to support the project within their communities, that way the project is more broadly shared and strengthened because of the different perspectives being brought to the table. You want to maintain flexibility and the ability to revise the project as-needed. Some of you may look like this beginning flexor. [LAUGHTER] as she's stretching out, reaching. You need to be flexible not only for the needs of your partners, but for the project that was intended. We can stretch and strengthen ourselves to be more flexible and get better each time. Many of you are probably familiar with this envision -- this representation, shall we say, of success. So, most people think it looks like a straight line. What it actually looks like is a curvy, multi-routed line. Our line ended up being the path to success with terrain to be covered such as roadblocks, misdirection and even a ravine over a raging river without a bridge but we made it and we're so happy to be belivering our project. The MS Buddy team learned that challenging situations lead to real leadership skills. The team learned how to produce an excellent and outreach and customer model via the iPad, but how to handle setbacks, alternate plans. So our accomplishments were great. But our challenges were also great. I'm going to turn the time over now to Katie Larsen, who will tell us about the MS Buddy kit and our project's impact. >> Katie Larsen: Hello, this is Katie Larsen. The MS Buddy kit includes an iPad, bluetooth keypad, a zippered carry bag. The iPad itself has features that can be customized for accessibility for each individual. Optionally, you can include some books. We have included a copy of the first year Multiple Sclerosis, an essential guide for the newely-diagnosed and Marie Slusser -- Multiple Sclerosis, the questions you have. Many people are not sure which online sources they can trust so we collected information that are relevant to people living with MS. We preloaded the website link, apps and movies, as well as easy-to-understand iPad text and tutorials. Highlights of the resource package are online support groups, like my MS team. Informational video, like MS 101 and healthy living MS and the care zone app which is track nausea, headaches, sleep and pain levels. You can take a picture of your pill bottle and it'll automatically add it to your medication list. The app reminds you when to take your medication and when it's time to refill. The information tracked by the app is kept private, but it can be very helpful if you choose to do so, it can be shared with a family member, a friend or your doctor. And for someone who gets as little as one hour every six months to spend with his or her doctor, an app like this is very valuable. The resources can be delivered in other ways so I don't want anyone being discouraged if they're having trouble getting funding. You could print a distribution list, have classes in your lab or partner with local medical centers for a workshop. That said, the iPad is an effective -- it's extremely effective delivery system. There are a few reasons for this. It's easy to use. It's convenient and has the ability to generate a fantastic feedback system. So I'd like to go into a little bit more detail here. First, the iPad is easy to use when it's preloaded. Only the most basic skills are needed because the research has already been done. The website links, apps and videos are already loaded on to the iPad so using it becomes more of an exploratory experience. The little training that is needed can be provided at the check-out appointment. We have also added on device help in the form of easy-to-understand video and text iPad tutorials. And if the participant would rather get help from a real person, ongoing support is available, the local public librarian and the local hospital librarian. Next, the ability to check out the kit and take it home makes it much more comfortable experience. They can take it home to their safe space and try it out on their own time. They know the information is trustworthy and that alleviates a lot of anxiety. When a person is this relaxed state, they are more receptive to learning. In the 2014 publications, they reported that emotion plays a major role in learning. When students direct their own learning and can direct autonomy, they're more involved and receptive. Learning experiences were deeper. When they were able to make their own decisions about the direction of their learning process. Lastly, the iPad has the ability to generate optimal feedback. We created a short survey, using Google forms. We added the survey -- the survey's link to the iPad's homepage. We then set up weekly reminders in the iPad calendar so when using MS Buddy, a reminder pops up and the participant can quickly answer a few questions before moving on. This method of leaving feedback creates an emotional safety buffer and resulted in more open and honest responses than we received in the face-to-face conversations we had with our beta testers. The participants have made great achievements while testing the MS Buddy. The person who left this comment found an article about a new medication on one of the preloaded websites. She did research, took the information to her doctor and her doctor agreed it was a good choice to move forward with the new treatment. This is ashlee and her daughter, Paris. She is one of the first people who checked out an MS Buddy iPad. I met her at the MS Walk in 2015. When I asked her how often she had questions about her condition, between doctor visits, she said, oh, every day. She told me that she usually tried to look things up on her cell phone, any concerns that she had, but was not sure if she could trust the answers that she found. So, she was really excited to try out the MS Buddy. A month later, when I told her the iPads were ready to check out, she was so excited and she wanted to get started right away. When we met for her return appointment to return the kit, she was happy to get that printed list of resources. She had already installed some of the apps on her phone and she wanted to use the list to continue learning about her health. I talked to her recently and she told me that she is still using some of those apps every day. We keep finding new sources of information and support to include. This website has useful tips for every day life, written by people who are living with MS themselves. These people are some of the site's contributors. MS affects people of all ages, all over the world. The purpose is to empower by providing access to knowledge that can help them to live happier and healthier lives. And next, Erica Lake will talk about the future of this service. >> Erica Lake: Hello. Sorry. Am I connected now? We thought we had created something of value and we weren't sure. At this point, you might be thinking that you'd like to offer something like this at your library and one of the wonderful things about this service is that it can be implemented by any library, anywhere. Our intent right from the beginning was to create something that was going to be self-propagating so any librarian in any urban, rural or hospital setting could replicate this service. Another wonderful thing is its adaptability. We chose to focus on MS, but you don't need to. It is good for Parkinson's Disease, ALS, diabetes. It can easily be adapted to the health need that is the greatest in your community. There are terrific online health data and resources you can help to identify those in your community. So, to make this implementation as painless as possible, since we've jumped through all those hurdles, we know what the sticking points were. We created an online toolkit to save you time and brain cells. Rural librarians and hospital librarians, I'm talking to you. We know you're hard-pressed for time so we've done a lot of the leg work. The toolkit provides all the information needed. Step-by-step instructions for purchasing the devices and a datasheet for the contents. A list of suggested items to include in the kits. A sample promotional flier. A sample enrollment form. Guidelines during the check-out list. A final evaluation survey. So this toolkit and much, much more is available on our website, msbuddyproject.org. So, we, the team, are committed to maintain this website by keeping all the current content up-to-date and we've brainstormed how to expand the content. We'd like to add additional participant feedback to support the value of the service. We'd like to add additional sample budgets for the start-up cost. We have a couple right now that are already in place. We can share guidance for working together across different library disciplines and locations and we can provide assistance in connecting public and academic librarians. Partnering really is the key to building a team with a technical and a health expertise. Connections with national organizations, as we've discussed, are also really important. We stayed in contact with the Utah southern chapter of MS SU Society. We believe that participating at their events lends additional credibility. They've added MS Buddy to their provider's list that they share with their patients and caregivers. We introduced at the MS 101 nights. And we continue to be active at the annual MS Walk. On the left there, you see Katie and casey. They were out promoting MS Buddy at this year's walk in April and they had a great time. They spoke with 93 people and checked out five of our donated oasis iPads. Interesting development was they heard from some people that while they were really interested in the service and resources, they needed to check out an iPad because they already had one. This might be an alternate version of MS Buddy where we still meet with participants to have the one-on-one training time and then conduct a final evaluation but load all the content on to their personal tablets. We've been promoting MS Buddy to local healthcare providers. Dr. John Rose, he's the clinician and professor of neurology at the university of Utah. And he's one of the premier MS specialists in the country. He cares deeply about improving the quality of life and each person is going to need something a little bit different. He was immediately interested in talking to us because it offers a way to personalize and customize the health information for each individual. We've met with him and his staff several times and are in the process of setting up a trial. Lastly, we're busy spreading the word about MS Buddy to fellow librarians, like all of you who have joined us today. Last month, we gave a presentation at the Utah librarian association annual meeting. And then in August, we'll present at the 2016 international federation of library association in Columbus, Ohio. So, in reviewing the health literature, we've discovered that this really is an innovative service. There are numerous studies that utilize tablets. We haven't found any that focus on delivering customized contents or on building community connections. This enables information equity, which I'm really passionate about and provides access to technology and tech instruction to those who don't know how to use it and vetted information. Even more importantly though, this service enables connections to community members who participants can turn to for future support or assistance once that 30-day iPad loan of the MS Buddy is over. They can call casey and Katie to ask a question when he isn't feeling well enough and a woman can pop in and see the librarian the next time she's in for a doctor's appointment. It's expanding their whole support network. Working in a hospital, many patients desire high-tech services and high-tech personal interactions. They want contact with people and the face-to-face connections. We can bridge these wants by providing services that connect patients and caregivers to information at the time and place they need it while being at their virtual sides for them. This is the three-minute video we created to help you share this with your community. You can find it on our website. Please feel free to use it as often as you'd like and please contact us if you do adapt and implement this service because we'd love to hear about your experiences. Before we wrap up today and open things up for questions, we would like to acknowledge a few really important people. MS Buddy wouldn't have been possible without the incredible support of our mentors. Trish, the director of the library and Jaime Carter, director of the Tooele city public library and the support of our three employers, Salt Lake County Library Services, Tooele City Public Library and university of Utah. Thanks so much for joining us today. We'd love to have your feedback and have some discussion going on and answer any questions from any of you. >> Jennifer Peterson: Thank you so much, all four of you. It's so exciting to hear about this a little bit more. Certainly I can tell that wheels are spinning for folks. We have a hospital librarian in the house who's interested in finding public libraries in the Baltimore area. Another person brought up how this approach could be used to support community members with other conditions, diabetes, for example. And my dad had alzheimer's, I think this would be brilliant for alzheimer's caregivers. Have other people approached you or if there are other folks in networks related to other conditions and have you heard of people beginning to maybe replicate it? I don't know who wants to answer that first. Erica? >> Erica Lake: We've had interest from university of Utah, healthcare. Parkinson's. One we were presenting this, one of the book mobile drivers new people on his route with MS and he was interested in delivering it that way. It's a different way of collaborating that with others. I don't know if any of the rest of my team wants to chime in with some other different health conditions that have been brought up? >> Jennifer Peterson: Don't forget to unmute yourself. >> Katie Larsen: This is Katie. I wanted to elaborate on that situation with the book mobile driver. If they need any help, we are happy to help and work through providing you with the information that we have already created. Printables and the content of the tablets. We worked with Lee, the book mobile driver, and were able do give him a lot of that so that he didn't have to do all that work that had already been done here. >> That's a fantastic idea. I'm so glad that that's developed. Someone has a question. Once someone has had a tablet for a month and returned it, can they check it out, again, at a later time? >> We haven't had a repeat request yet. As I -- this is Liesl. As I mentioned earlier, we had very limited beta testing and so we didn't have a lot of opportunities to go through one round of turnover and then another round of turnover to see if someone might. We have had a lot of interest from folks who -- as was mentioned at the MS buddy walk. They have the device so sometimes maybe wanted to purchase a device after they've sampled the one that we've created and loaned to them. So, that's a possibility, as well. Just for people to go on and purchase a lower-end one for their own personal use, perhaps an android device or a Kindle fire. They were $49 at one point, just recently. So, our list of apps and things like that, for any of our users who have tested it out, were definitely able to help them get set up with their own device, as well. But going back to the original questions, we haven't had anybody request a repeat but we haven't had a broad collection of folks using it, at this point. >> We have applied for a couple grants that we hope to be able to expand the survey here at the university healthcare system. We'll have to limit everybody's turns, I'm sure. >> Right. >> We're building to that. [LAUGHTER] >> Right. >> You know, it's interesting because I've heard of similar -- something done similar with young -- parents of younger children, you know, whether it's related to early literacy approaches. I think this could work certainly, especially parents -- as a parent -- for parenting at different points. There could be a collection of resources and suggestions, you know, preloaded -- I mean, my kids also used Kindles even in school, that the librarian had preloaded a set of recommended reading. I think this approach certainly can be adapted in many different ways and depending on the popularity, as you said, or the topic, it would depend. But I really am fascinated by the traction that you got with the connection of the MS Walk. I think that model of really getting out into the community and making those connections around, you know, this annual event that happens with many, many different conditions and builds connections to community, that model in and of itself, I think it could be huge for libraries to really -- to find partners. To create partnerships, as well as bring visibility into the community. So I'd love to hear a little bit more about what that looks like when you've been at the walks and how -- just even in general, the awareness of not only the MS Buddy, but just how you built awareness about the work that your library's are doing. >> Katie Larsen: This is Katie. When we -- casey few people that year, but when casey and I went back for the 2016 walk, the MS Society had set up a booth for us, a table and we were able to put out a much more official projection of our product and it really helped with people coming over and talking to us and feeling comfortable that we were someone that was -- that was approved of by the MS Society. There were a lot of people that were wondering what we were selling or how much it cost. We've had that question many, many times and they're always surprised to hear that it's a free service. We don't charge for time and we don't charnel for the device or any of the benefits that people get from using them. >> Yeah, I think -- obviously, the booth can help in a way so that people can find you. But, yes, it's always interesting how to frame -- we experience that when WebJunction is at conferences when we say, yeah, it's all free. There was a question, I would love a verbal response to this. Are there any apps loaded on the iPad that allow for peer to peer connections? Is there a way for them to connect to each other? >> I'll go ahead and field that one. This is Liesl. Our resource list we posted earlier in the chatbox, there's social media connections and support and Facebook and twitter. There is my MS team for folks living with MS and their address is www.mymsteam.com. There is msconnections. That's www.msconnection.org. And patients like me. This was one of the slides that Katie mentioned and I'm not seeing that we've got the direct link. It's patients like me and so that's a really great resource and those are all -- they have permanent, like, icons on the tablets that we're loaning out so those are preloaded. >> Okay. So it's not necessarily other MS Buddy users connecting through that way but they connect to each other perhaps on a Facebook group or other MS groups, they can identify themselves as MS Buddy users. >> Yeah, for the future, that might be nice, if we have multiple iPads checked out at once and if we have permission from the participants to share their contact information to other participants, that would be really nice for local connections. >> Is Dr. Rose the only physician's office partnering with us? Yes. We're just starting down that road now. He and his clinic staff, Katie and casey did a great presentation to them explaining the concept and getting their feedback about the best way to initiate a trial and Dr. Rose has a patient who's ready to try this out. So then it's just a matter of going on from there. We know there are different areas within Utah that have a high MS population that we'd really like to get to, to expand this service to. For instance, don't in the saint George area, four hours away from Salt Lake City, we need establish connections with the providers down there and the librarians. >> Excellent. Yeah, definitely room to grow. For sure. Can you just tell us how many participants you've had so far? >> Casey Cox: This is casey. Katie and I were counting and we were thinking somewhere between 10 to 15-ish. We don't have a list with them listed, at the moment. >> Excellent. That's great. And I just want to give a plug to -- I posted a link to our health happens in libraries resource area because many of the projects that we've -- the libraries we've worked with, there certainly have been -- has been work done around libraries Curiateing and others who have connected to partners that are working with those through other health providers so I want to encourage folks to explore all the great work that libraries are doing that we've discovered through the health happens and libraries project. And this is such a great exciting example of ways that public libraries and special libraries and health libraries are able to work together. We're excited to show the cross-collaboration and kudos to your mentor and to all of you for making that realized. And, we're really excited to hear that you're continuing to explore more avenues and more options. Again, thank you, both -- thank you to both of your mentors and, Jaime, we are such big fans of Jaime Carter and all the great work she's doing in her library community, as well, and impacting even out further in the community. She is now the current library Utah association president. And, again, we'll be sure to post the recording and all of the great resources. I know there were a few more links that got pushed out on chat that aren't on the event page. We'll add those, as well. And, I'll be sending an email to all of you here today, once the archive is posted and I'll send a certificate within a week. Thank you for creating the guide. It's a great way to start the conversation and to take steps to a similar project like this. So, thank you, again, for creating that. And are there any other final comments from any of you that come to mind before we wrap up? Okay. Hearing none, thank you, again, to all of you who joined us today and everyone, have a fantastic day. I'll also mention, as you leave, you're going to be sent to a survey and we appreciate the feedback and we'll share that feedback with our pre presenters and it'll help. Thank you so much to all of you.