Disruptive technology and medical librarians.

My grandfather had a Royal typewriter. It was mechanical—he could be click-clicking away on the keys even if the power was off, and it did not even need batteries. Royal was a leader in the typewriter market, except during 1942–1945, when it produced machine guns during the war. The typewriter market was huge and secure…until it got disrupted by technological innovations, first by stand-alone word processors, then by ubiquitous computer processing connected to printers. Typewriters were not so much needed anymore. Factories and stores were closed; jobs were lost. The newspaper industry has also been disrupted by technology. In our town, we used to have an afternoon newspaper. The reporters were competent; the managers worked hard. My father looked forward to reading the evening paper after coming home from work. But the newspaper industry was disrupted by technology, television. Dad's afternoon paper quit publishing, as newspapers started to decline across the country. Now, there are virtually no local afternoon newspapers in the United States. Because of the new technology, companies went bankrupt, printing presses went idle, and jobs were lost. Postal mail has been disrupted by new technology. Email can send messages over great distances and quickly, without the cost of a postage stamp. Likewise, Kodak cameras using only film are relics now, as the film camera industry has been disrupted by digital imaging technology. And the list goes on. Technology disrupts an industry, shops are closed, and jobs are lost. The library industry is on the list of those disrupted by technological innovation. Not too long ago, a typical librarian sat at a wooden desk, surrounded by thousands of hardcover books, some popular, others just on the shelves gathering dust. The traditional librarian was the shepherd of the books, tending and protecting them. People went to the library to borrow books, if they had a library card. And the traditional librarian would be available to help them. In medical libraries, located in or near a hospital, the medical librarian was not much different. Medical librarians collected books and cataloged them, subscribed to journals and manually checked each issue into a log, and answered their customers' questions using the books, journals, and printed indexes. Innovation hit us too. And it hit hard. Lots of disruptive technology. The Internet search engine and electronic journals and books are technologies that disrupted traditional library work. Physical books and bound journals have disappeared from medical library collections. Librarians and end users alike search online databases for information on topics. At the same time, the number of users of our physical medical libraries have decreased. They get their information online, offsite, at their work desk, at the point of care, and in the research lab. Libraries are closing, and jobs are lost. Disruptive innovation or disruptive technology is an important academic field of study. “No matter the industry, a successful company with established products will get pushed aside unless managers know how and when to abandon traditional business practices,” according to Clayton M. Christensen's classic paper on this topic 1. Basically, the principle is that industries decline when they fail to adapt innovations to meet customer needs. In most cases, it is argued, industry gets blindsided by sticking to its (successful so far) practices. The industry fails to incorporate the innovation into its operating model. Recently, the concept has been criticized as overly applied 2, but it cannot be denied that innovations can disrupt an industry and can even wipe it out. Not gloom and doom This is not a gloom and doom piece. Disruptive innovations can lead to successful change. The Royal company still exists. It looked at what it could do and looked at market needs. Now, it produces cash registers, shredders, and other devices. Yes, you can even buy a new Royal typewriter. It can have battery backup and spell check, if you want. News is now reported more widely and quickly than before (USA Today, a newspaper, has a print circulation of over one and a half million, and a total daily readership of over three million). For libraries, information is more accessible than ever before. Our industry, medical and health care librarianship, is challenged by disruptive innovations, but we are meeting the challenge. It is not just that we all use computers. We have become recognized players in informatics (King and Lapidus, this issue). We can evaluate information systems such as VIVO, a semantic approach to scholarly networking, not just use them (Eldredge et al., this issue). We understand and participate in the data lifecycle (Goben and Raszewski, this issue). We can create gold standard search filters used to retrieve high-quality information (Frazier et al., this issue). We can devise a better way to evaluate the impact of scientific publications (Sibbald et al., this issue). We can survive and even increase services in spite of budget cuts (Martin and Delawska-Elliott, this issue). We can understand our users' needs to create effective ways to get information to them (Ports et al., this issue, and Bradley et al., this issue). As Margaret Moylan Bandy, AHIP, FMLA, points out, we need to pivot, to turn on our heels and move forward (Doe lecture, this issue). And we are doing that. We are going to our customers, and we are using new technology. We are reacting well to the disruptive innovations that are affecting us. We pivot, we turn, and we go forward. I think we are doing okay.