Late night chat set to save lives

Doctors in Australia and the UK now have a late-night "chat lifeline" that can save lives by providing them with immediate medical information.

The antipodean "Chasing the Sun" project is the first international virtual reference service for health professionals. It uses Internet chat to provide doctors and nurses working outside regular working hours with answers to late-night patient care queries from librarians in their sister city on the other side of the world.

Clinicians at the South West Division of the UK National Health Service and Royal Adelaide Hospital are using the service, launched officially last week, with plans to expand it to other states and countries.

"The service is targeted at junior doctors and nurses for situations where they can't wait for the library to open to seek reference material," said project coordinator, Mary Peterson.

The idea for the collaboration arose in 2001 during a visit to Australia by a representative of the UK National Health Service.

Using custom-designed chat software, a clinician can immediately notify overseas health librarians of a request.

The interface for librarians allows scripted responses to save time, as well as being able to see the status and previous responses to a request for information.

Chat sessions can also be transferred to another librarian more suited to the query.

The collaborative effort is possible due to similarities in the training of health professionals by UK and Australian health authorities.

However, it took several years to establish cooperative service levels, resources, and find appropriate chat software.

System administrators were appointed in both countries to oversee future development and training, and to ensure all requests were answered.

Memorandum of Understanding agreements, which govern service levels and usage for administrators and users of the system, were also enacted.

However, software selection was limited by the strong security provided by the firewalls in the hospitals' IT systems, according to coordinator colleague, Sue Rockliff.

The project team had investigated the use of remote access software for librarians to help clinicians search databases. However, hospital regulations deemed the approach too vulnerable to security and privacy breaches.

The project team then explored chat software, including free and commercial programs.

The free programs such as Yahoo Messenger were soon ruled out on the grounds of unreliable response times and their inadequate message archiving, Rockliff said.

Commercial packages were a stronger offering, but the licensing structure was expensive for the situation.

The project team had envisaged that each request would be seen by a group of librarians, with the most appropriate one then accepting the task.

The prospect of paying for a number of user "seats" when only one would be used to answer a question was not cost-effective for the project. A rostered seat or rotating seat around the libraries was not practical either, according to Rockliff.

The project team eventually decided on QuestionPoint, developed by Online Computer Library Center Inc. in the US.

Chasing the Sun had a "soft launch" in November, Rockliff said, to iron out bugs. But the challenge of training remained.

Such a chat program was easy to use, she said, but encouraging user "ownership" of the system was harder.

"Face-to-face training is really needed here to win over more users to the system," Rockliff said.

"We need log-on compliance, so that the librarians must log-in to the system first thing in the morning."

Chasing the Sun will push for training funding in future, she said, as the project has so far been unfunded in Australia.