Technology, Collection, and Budget Challenges of Growing Health Systems on Academic Health Science Libraries

The growth of health systems is having a major effect on academic libraries. The aim of this project is to survey academic health sciences libraries to learn about the challenges they face when they are part of a growing health system. In 2021, the Association of Academic Health Sciences Libraries (AAHSL) published a white paper on this issue, it did discuss the challenges of providing library services and resources to affiliated health systems, it did not describe in detail the specific challenges related to funding, collections, and technologies that this survey aims to do. Introduction: Previously published papers, have studied the relationships between academic health science libraries and hospitals, health systems and how to work with growing systems. However, they usually focus on best practices. These papers acknowledge the challenges in general but don't take time to acknowledge the specifics. This survey aims to help further understanding among academic health sciences libraries and librarians about the specific issues that are faced related to library collections, budget, and technology. Methods: A 15 question Qualtrics survey was sent to the AAHSL members' listserv. It was requested one completion per US based institution. It is a mixed methods survey with IRB approval. The survey was open for four weeks and there were 56 respondents. Results: The results of the survey can be divided into three categories: technology, budget, and collections, and politics & unique circumstances. There were many responses regarding current IT support and technology systems. Topics of concern included systems for assigning access (which included or excluded from resources) and authentication. In exploring collections funding and contracts for institutions with growing health systems, not surprisingly there were a wide variety of funding models expressed in the survey. In most cases funding comes from multiple sources, some expected and some unexpected). It was also common for the answer regarding who has access to resources to be complicated and these issues around access often bleed into the technical aspects of proxy and identity management. Challenges faced by the responding libraries often included comments around collections and budget, specifically reduced or flat budgets in the face of increasing resource costs and access issues tied to contract limitations. More than expected, libraries discussed the challenges of identifying appropriate charge back system