HELILNET – The Case Study of a Regional Digital Library
Initiative for Networked Access to Health Science Information
Resources.
Dr.R.Rama Raj Urs and Mr.Hemanth Rao C,
Rajiv Gandhi University of Health Sciences, Bangalore, India
ABSTRACT
In this paper, we focus on a Digital Library Initiatives taken by India’s largest one of the six medical universities -- Rajiv Gandhi
University of Health Sciences (RGUHS). (Karnataka). The paper presents a brief background on the health science education in India,
and the status of IT and Internet access infrastructure in the health science colleges. The Digital Library resources and activities at RGUHS
are presented in detail. The paper underlines various WHO projects carried out in the Digital Library. The formation and role of HELINET,
the first resource sharing network and e-journal consortium in the medical education sector is discussed in details. The problems
encountered in the formation of the e-journal consortium and the strategies being followed for a sustained development of the consortium
are discussed
General Terms
Management , Economics, Experimentation, Standardization
Keywords
Digital Libraries – E-journals, Consortium, Resource sharing, Networking
1. Health Science Education in India
India is a centuries old civilization but an young Republic. In the 56 years of post-independent India, professional education in
health sciences as an essential sector to promote and achieve the “Health-for-All” goal of the Government has received significant attention
by the policy makers and the planners. The number of medical doctors per 10,000 populations has grown from 1.6 in the 1950 to 5 in
1992. There are 221 medical colleges currently offering graduate and post-graduate programs in the country.
The quality of medical facility in the country and the quality of education too has improved significantly over these years. Indian
Doctors represent a significant number in UK and USA. In the wake of the liberalization of Indian economy and its globalization over the
last one decade, the health education and service sector in the country is emerging as a major exporter.
The medical education in India is regulated by the Medical Council of India (MCI), a statutory body set up by the Indian
Government, through a process of setting quality standards and guidelines and ensuring compliances. Similarly, Dental Council of India
(DCI) regulates the functioning of the Dental Colleges. The All India council for Technical Education (AICTE) regulates education in
Pharmaceutical field.
1.1
Karnataka in the Forefront of Health Science Education
The State of Karnataka has always been in the forefront of providing quality education. The State has the distinction of
maximum number of health science colleges in the country – 333, covering all disciplines such as Medical, Dental, Pharmacy, Nursing,
Indian Medicine Specialties like Aurveda, Yogic sciences etc.
The State also enjoys the distinction of private sector participation in
promoting health education. Out of the total number of health science colleges in the State, more than 90% are in the private sector, entirely
run by student funding. Closely regulated by the State, these private colleges subsidize the education of merit and economically weaker
sections of the society through lower and special fee structure for them, which is less than US$ 200 per year in medical colleges. The
affordable segment of the society pay a significantly higher fee with a one-time capitation fee ranging between US$15,000 to 30,000 for
graduate and post-graduate medical education program.
The professional health education system in the State produces annually 15,450 health science professionals which includes
2,990 Medical Doctors, 2,159 Dentists, 3,381 Nurses, 2,368 Pharmacists, 1,217 Physiotherapists, etc. There is a larger number of colleges
offering graduate and post-graduate courses in Indian medicine like Ayurveda, Homeopathy, etc.
1.2
Health Science Universities in Karnataka
Until mid-80s, the health science education was managed by the general university systems in various States. The first Health
Science University was started by the State of Andhrapradesh in the year 1986. Following this a total of six new health science universities
have been constituted by various States through an Act of Legislation.
The State of Karnataka promoted Rajiv Gandhi University of Health Sciences (RGUHS) (www.rguhs.ac.in) in 1994 to focus
distinctly on a better planned development of health science education. The University rightly set its mission as – Right to rightful health
science education – to meet the health care needs of the country. Every development initiative of the University since its inception reflects
the spirit of this mission in practice. RGUHS was the second Health Science University to be constituted through an Act of Legislation by
the State. Currently there are six health Science Universities in the country. All the health science colleges in the State (with a few minor
exceptions) are now affiliated to RGUHS. Table-1 gives a statistical glance of the current status of health science education in the State
under RGUHS.
Table-1 : Courses and Student in Take in RGUHS - 2004
SN
Courses
Annual
Student
No. of
Colleges Admission
UG
PG
1 Medical
2 Dental
34 2934 1,407
40 2386 433
3 Pharmacy
4 Ayurveda
46 2537
47 2,070
295
192
222 5,925
10 654
202
62
5 Nursing
6 Homoeopathy
7 Unani
8 BNYS
150
110
28
-
9 Physiotherapy
10 Hospital Management (MSc.)
46 1,480
4
-
93
10
11 B. Sc. MLT
12 B. Sc. Radiography
19
11
329
118
-
13 B. Sc. Anesthesia Technology
14 B. Sc. Perfusion Technology
5
5
28
25
-
15 B. Sc. Renal Dialysis
M. Sc. Psycho-Social
16 Rehabilitation
B. Sc. Operation Theatre
17 Technology
2
10
-
2
-
21
8
24
-
18 B. Sc. Cardio Technology
B. Sc. Respiratory Care
19 Technology
2
14
-
1
4
-
Total
6
3
513 18,798 2,743
The State of Karnataka which pioneered private sector participation in health education also boasts of the first private medical
university in private sector called Manipal Academy of Health Education.
1.3
Medical Colleges in Karnataka
With 34 medical colleges, the State is the largest in the country for medical education. 30 of these colleges are in private sector,
managed by student-funding. These medical colleges have an annual intake of 4,700 students per year and command a total student
strength of 22,620 students. 22 of these colleges offer Post-Graduate programs. The net annual spending by all these colleges is estimated
at US$ 39 Mil. All colleges have a hospital attached to them for providing clinical-practice back-up to students and research.
1.3.1
Infrastructure for Internet and e-learning in Medical Colleges
E-Learning is a new concept in India and is expected to catch up with the growth and popularity of Internet. Computing and Internet
infrastructure in the medical colleges is currently at a very inadequate level. 9 of the 34 colleges have local area network. Only 5 colleges
have local Internet server connecting the campus LAN to internet through a dedicated low-bandwidth link. Rest of the colleges has
provision for dial-up/cable connections to access to Internet from various departments and the library. The per-capita PC population in the
medical colleges is still very small and estimated at 5 PCs per 100 students.
The IT and internet infrastructure in other health science colleges – Dental, Pharma, Nursing is much poorer, barring Dental which is
closer to Medical colleges in the infrastructure and facilities offered. Most colleges do not even have internet connectivity. PCs are largely
used in administration in most of these colleges.
2
Health Science Libraries in Karnataka
Every college is mandated to and has a library. The libraries have been developed conforming to Standards prescribed by the Medical
Council of India (MCI). The colleges offering only under-graduate courses focus largely on textbooks with subscription to a few foreign
and Indian medical journals. Those offering post-graduate programs have a better collection of medical literature with subscription to a
larger number of foreign medical journals. The library budgets for collection development range between US$1,000 to US$100,000, with
Medical and dental colleges spending larger sums.
2.1
Medical College Libraries.
The libraries in 34 medical colleges constitute less than 10% of Health Science Libraries under RGUHS, but is a favored group
accounting for more than 60% of the annual budget of all the libraries put together. The total current annual spending on journals by these
34 libraries is estimated at around US$1.1 million(Table –2). The number of international journals subscribed by these libraries ranges
between 50 to 300.
Table 2 : RGUHS Affiliated Colleges- Status of Journal Subscriptions – 2002
Affi
SN Faculties
liated
Colleges
No. of Subscriptions
Indian Foreign Total
Average
No. of Subscrip
Titles tions Per
Library
Annual
Journal
Budget
$ $ Per
Mil. Lib
134 1.12 37,330
36 0.63 15,366
1 Medical
34
1,143
2,880 4,023
798
2 Dental
41
367
1,128 1,496
164
3 Pharmacy
48
794
93
887
49
18 0.04
833
4 Nursing
67
381
518
899
126
13 0.10
5 Physiothera
py
44
25
185
211
69
5 0.03
1,493
682
(Note : 1US$ at Rs. 46)
3
Digital Library Initiatives at RGUHS
Started in the 90s, the library at the RGUHS planned its development on the advantage of going directly digital. Hence, the library was
named in the very beginning as RGUHS Digital Library (RDL) with resource allocation for developing a state-of-the-art digital library
infrastructure. The vision was to provide leadership to the libraries at the affiliated colleges in transforming their role and systems to the
demands of the e-age medical education. The Digital Library set a mission – to provide convenient and cost-effective access to global and
local health science literature for students and faculty of all the colleges affiliated to RGUHS. In moving with the spirit of this mission,
RGUHS has set the following goals.

To continuously enhance the quality of access provisions to health science information

To network all the libraries affiliated to RGUHS and promote enhanced access through resource sharing models and programs.

To develop and maintain state-of-the-art digital library infrastructure as a common facility for all the colleges.

To provide training and development support to the libraries at the affiliated colleges.
3.1 Programs and Projects
The Digital Library at RGUHS is envisioned to act as a central infrastructure for all the colleges. Hence, its focus is to improve
the existing information resource base and to develop access infrastructure. The students and faculty at all the affiliated colleges constitute
the user group of this Digital Library. The following major activities are currently pursued by the Digital Library.

Development of HELINET, the resource-sharing network of libraries in all the colleges libraries affiliated to RGUHS.

Development of e-Journal Consortium for various groups – medical, dental, nursing, etc.

The following resources are developed with partial funding from WHO to support e-journal access.

A Web-based Union catalog development and hosting software is developed to enable participating libraries to contribute
their holding information to a centralized catalog. This software is declared as an Open Source software freely available for
any consortia.

A customized e-Journal Gateway called JCCC (J-Gate Custom Content for Consortia) has been developed to serve as a
resource-sharing platform and e-Journal gateway for access to all journal resources subscribed by the HELINET consortium
as well as individual libraries in both print and electronic versions

A White paper on the framework and guidelines for the development, operation and management of a library consortium for
resource sharing (HELINET) has been commissioned.

Digitization and hosting of Post Graduate Dissertations and Ph.D. Thesis. A bibliographic database of all the dissertations,
around 6,500, submitted by all the Post Graduate Students has been created. This forms the basis for providing access to the
future digitized content. The University has set the standards and guidelines for electronic submission of dissertations by
all the students beginning the academic year 2004, which has been made mandatory.

Development of e-learning Module for the users to self-educate themselves about the using Internet resources, databases and
e-Journals subscribed by the Consortium. (WHO funded).
4
HELINET
HELINET is a networking concept (1). It stands for Health Science Library and Information Network. The concept is adopted
by RGUHS in 2001 to network all health science libraries under its affiliation and develop a consortium for resource sharing. Following is
broadly the structure of the HELINET





RDL is the nodal library of HELINET, responsible for providing infrastructure and operative directions and to manage HELINET.
All the colleges affiliated to the university are the members of the HELINET
HELINET has a Board of Management constituted by RGUHS with –
o The Vice-chancellor as its Chairman of the Board
o The University Librarian as Co-coordinator
o The Registrar and the Finance Officer as ex-officio members
o Members from the Deans of faculties nominated by the University.
Faculty Committees are constituted by the Board for each discipline to guide the HELINET in the selection of resources for the
consortium.
The University has created a HELINET Fund. Each member library contributes an annual membership fee to this fund.
The e-Journal Consortium is the first major program initiated by HELINET. The program is in its third year of operation.
5
The E-Journal Consortium
Journals being expensive resources and their collection size being inadequate in most libraries as revealed in section 2.1 above,
the earliest initiative of HELINET was to develop adequate resource base and access infrastructure through consortia model of
purchasing/licensing shared access to journal literature. The process of developing an e-Journal consortium was thought to be initiated for
the Medical Colleges as the first test case, and extended to other faculties on the demand and success.
5.1
Policy Decisions and Directions
Consortia purchase of e-journals is publisher or aggregator specific and largely involves negotiating big deals. Based on the
experience of libraries around the world in general and a few consortia deals in India, we were conscious and concerned about the
limitations and disadvantages of big deals. Hence, HELINET set the following ground rules as the basic policy direction for initiating the
e-Journal consortia.






5.2
The consortium will go for e-only model. But, a model should be developed not only for providing shared e-access to consortia
subscribed journals but also for sharing print subscribed journals that do not form part of e-journal consortia subscription.
Since nearly 90% of the medical colleges are in private sector and operate on student-funded model, the funding for the consortium
should come from the College Managements in a participatory model.
The University will fund the infrastructure development for e-Journal access as part of its mission to develop state-of-the art digital
library infrastructure.
The selection of journal-publisher combination should be judicious, need based, and based on the current spread of the existing
journals.
The licensing model for e-journals should provide for perpetual access and local archiving rights.
A detailed study should be conducted to assess the state-of-the journal collection and e-readiness among the medical colleges to
provide relevant inputs for developing the e-Journal consortium
Feasibility Study and Observations.
A detailed study of the status of the journal base and access provisions in the medical colleges was conducted. The study
revealed that 
The journal literature base in most of the colleges and particularly in those, which did not have Post Graduate programs, was far below
the need. Most libraries subscribed to international medical journals largely to conform to the mandatory guidelines of the Medical
Council of India (MCI), which prescribed minimum 100 journals out of which 30% should be International journals.

Medical College Libraries had a total of 2,177 subscriptions to international journals, constituting 674 titles. The average number of
subscriptions per college was 87. The duplication was minimal. 348 of 674 titles were subscribed by only one of the 25 Libraries.
10 or more libraries subscribed 75 Titles. There was not a single title found to be subscribed by all the libraries. Average number of
subscription per title was found to be 3.2. Based on the analysis of the spread of 674 titles across the 25 libraries at this rate of 3.2
subscriptions per library, it was evident that a good resource-sharing platform for all the subscribed journals would increase the
potential of access by nearly seven times.

Journals are used primarily by Post Graduate Students. Graduate students are hardly encouraged to read journals and they largely limit
their studies to books.

None of the libraries had subscription to any e-Journals. A few libraries (less than 20%) were found using the available Internet
connectivity for accessing PubMed and any other resources. Most of the libraries were not even aware of many open access journals
and publishers offer free online access against print. This situation of low awareness of e-Journal availability and advantage was
largely due to inadequate Internet and IT infrastructure in most of the colleges as described in section 1.3.1 above.

A publisher-wise popularity ranking of journals was prepared based on the subscription density of the title-spread. This density was
measured as the ratio of number of titles of a publisher subscribed by all the colleges and total number of subscriptions to these titles.
Table-3 indicates this ranking. This ranking was used to identify the publishers who could be given priority for e-journal consortium
licensing.
Table -3 : A publisher-wise popularity ranking of journals
SN
Publisher (P)
Titles Subscrip
(T)
tions(S) T:S
1 AMA
11
94
8.5
2 BMJ Publishing
18
116
6.4
3 American Physiological Society
7
38
5.4
4 American Academy of Pediatrics
3
16
5.3
5 University of Chicago Press
4
20
5.0
6 Oxford University Press
7
34
4.9
7 Cambridge University Press
5
22
4.4
13
57
4.4
8 Annual Reviews
American Society for
9 Microbiology
6
26
4.3
10 W B Saunders
Lippincott, Williams & Wilkins
11 (LWW)
86
319
3.7
54
200
3.7
12 Blackwell + Munksgaard
41
145
3.5
9
30
3.3
14 IJCP Group
10
31
3.1
15 Mosby
13 Mediworld Group
33
91
2.8
16 Churchill Livingstone
9
24
2.7
17 American Heart Association
4
10
2.5
18 John Wiley
17
41
2.4
19 Elsevier Science
34
71
2.1
8
12
1.5
379
1,397
3.7
20 Springer Verlag
TOTAL
5.3 Marketing the idea of e-journal consortium
Series of awareness seminars were held to the Principals of the medical colleges and the librarians to introduce the concept of ejournals and resource-sharing consortia. Experts and vendors were invited to demonstrate and convey home the utility and benefits in
terms of expanded access to journal literature by breadth and depth. These seminars were used to –

Present the consortia dynamics and imperatives, their advantages, and cost implications.

Explain the consortia funding models evolved by HELINET

Educate the college principals and the faculty about the kind of internet access infrastructure they need to develop in their campuses

Educate the Librarians about the kind of training and internal marketing they need to be doing in their colleges to create e-readiness
and promote the usage.
A Memorandum of Understanding (MOU) was presented to the Principals and Managements of the colleges and their concurrence and
funding commitment was obtained.
5.4 Selection of journals and publishers for consortia licensing
The analysis shown in table-3 formed the basis for selection of journals and publishers. A further study was made about the
availability of consortia model by several of these publishers and aggregators. It was found that a combination of publisher, aggregator
models are required to have a wider coverage of journals that were currently subscribed. The vendors were invited to make commercial
presentations to HELINET’s Board of Management.
5.5 E-Journal Access and Resource Sharing Platform
As an imperative of e-journal access, HELINET required an e-journal access gateway to act as a common search and access
interface for all the e-Jouranals that HELINET would subscribe as part of its consortia licensing and the libraries might
independently subscribe for the titles not available through consortium. Further, HELINET required a mechanism to develop and
maintain a common database of journal literature for all the subscribed journals of 30 medical libraries which were largely in
print subscriptions. HELINET adopted an indigenously developed and locally available e-Journal gateway technology called J-
Gate, and commissioned the development of a customized gateway for its need, called J-Gate Custom Content for Consortia
(JCCC). JCCC enables online access to all the consortia members for the e-journals subscribed by the consortia. It further
enables shared access to printed journals through its customized database service. This project was partly funded by WHO.
6.
Impact of HELINET
6.1
Usage & Usage Promotion
The consortia took off during first quarter of 2003. HELINET organized traveling workshops in various colleges. Considering the fact that
infrastructure for Internet access from the colleges has not seen significant improvement as yet, the usage level was encouraging. The
consortium was extended to all health science colleges from the year 2005. The following fig. shows the usage ascent.
e-articles downloaded(Yearwise Statistics)
55698
60000
40000
32687
21591
Articles
20000
0
Articles
2003
2004
2005
21591
32687
55698
It is felt that usage promotion requires aggressive and sustained internal training and promotion activities within the college campuses. The
college libraries in the respective campuses need play a pro-active role in this. HELINET is evolving strategies to activate this process. A
few e-learning modules are under development for this purpose.
6.2
Increased Awareness
As HELINET approached the point of renewal there were demands by users to add more journals to the e-Journal basket of
HELINET. Most of those journals were those that the users were getting in their colleges but did not find the e-version access. This clearly
reflect the gaining momentum in the popularity of e-journal as preferred medium over print.
6.3
Catalyzing Effect
The popularity of HELINET consortium of medical colleges had its influencing impact on other groups and RGUHS expanded
HELINET consortium to other health science disciplines such as dental, pharmacy, nursing, physiotherapy etc., from the January 2005
onwards.
7
Lessons from HELINET experiment
In 2003, although there was an MOU in place, and the University had funded the development of internet access infrastructure,
the colleges could not contribute the consortia fee for the resources on time. The University had to pay the publishers from its internal
resources in anticipation of the payment form the colleges. Hence, from 2005 a different revenue generation model was adopted. The
University decided to fix a mandatory HELINET fee for institutions and students. Accordingly, an ordinance was passed by the syndicate
of University for prescribing annual institutional and students fee as follows:
Students annual fee structure for University Library towards e-journals and e-books under HELINET consortium
Faculties
Medical
Dental
Pharmacy
Nursing
Physiotherapy
Ayurveda/Homoeopathy
/Unani/Yoga
Others
UG
Rs. 1000
Rs. 1000
Rs. 500
Rs. 500
Rs. 500
Rs. 300
PG
Rs. 2000
Rs. 2000
Rs. 1000
Rs. 1000
Rs. 1000
Rs. 600
Rs. 250
Rs. 500
Institutional annual fee structure towards HELINET consortium of RGUHS
Faculties
Medical
Dental
Pharmacy
Nursing
Physiotherapy
Ayurveda/Homoeopathy
/Unani/Yoga
Others
Annual fee.
Rs. 1,00,000
Rs. 1,00,000
Rs. 25,000
Rs. 25,000
Rs. 25,000
Rs. 25,000
Rs. 10,000
The Institutions offering Post-graduate courses along with Under-graduate courses shall pay an additional 30% of the above annual fee.
7.1
Message to Publishers
Due to an existing low-base of journal literature through print subscription model, lack of infrastructure and its slow growth in
the campuses, and lack of curricular demand on the usage of journal literature by graduate students, the usage promotion will be a long
drawn battle. The current level of usage does not justify high-level of investments on content in the immediate term. We expect a
gestation of 3-5 years for the usage to develop through sustained access acting as a catalyst in usage promotion. Hence, it is important for
the publishers of e-journal to look at our market as a joint development partnership with consortia like HELINET with long-term
investment goals. A country-specific affordable pricing model is a must.
8.
Future Vision and Plans
HELINET has already caught the attention of other Health Science Universities in the country. As its effort mature within RGUHS,
HELINET will launch its HELENET Extended version to other Universities and Health Science institutions in the academic sector. The
goal is to make HELINET a national consortium for health science education and research sector.
References
[1] Goel S.L. Health Care System and Management, Deep & Deep Publications, New Delhi, 2001;p13.
[2] Urs, Rama Raj R. Networking of Health Science Libraries: Resources and standards, Jaypee Brothers, New Delhi, 2000; p147.
[3] http://www.mciindia.org
[4] http://www.rguhs.ac.in