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It is a truism that the universe of historical documentation in the health fields is expanding tremendously today, in a manner consistent with the bureaucratic expansion of the U.S. health-care industry itself. In all areas, new record-keeping requirements and new and increasingly sophisticated methods for creating data have resulted in a superabundance of complex documentation. Only some of this documentation will survive to constitute the archival legacy, and it falls on archivists to responsibly manage the accumulation of it. This responsibility, however, is compromised for several reasons: archivists entering the health fields are seldom sufficiently knowledgeable about their complex functional components, budgets in archival programs have not grown to meet the challenges of the new records and formats, and the approaches advocated in the traditional professional literature are typically not helpful for coping with the new realities in the health fields. Archivists, lamenting the inadequacies of standard professional tools for building and sustaining collections in the health fields, have long wished for a guiding light.
Not one but two guiding lights, in the form of these welcome new books, are now available. In Designing Archival Programs, Nancy McCall and Lisa A. Mix characterize the twelve chapters they present as “a guide to chart a course of change” (p. xix). Given the proliferation of modern records in the health fields, they are justified in asserting that archivists can no longer acquire and manage them according to the old methods. Although their book is addressed primarily to archival programs in academic health centers, its scope is sufficiently broad to remain relevant to the more narrowly defined missions of other institutions. The book’s “course of change” is predicated on the universal necessity of “doing more with less”: new realities force archival programs to limit their acquisition policies according to severely curtailed documentation plans. The supreme challenge in [End Page 174] the face of such constraints is to maintain a core of archival documentation that nevertheless remains highly useful for research and achieves a maximum of operational efficiency.
Part 1, “The Broadening Base,” is an overview of appraisal issues in the health fields. In their introduction, the editors presumably know whereof they speak: their knowledge of health-sciences documentation is derived from a five-year federally funded survey of U.S. academic health centers. Part 1 provides tools to assess the research value of modern health-sciences documentation, including patient records, scientific data, and electronic records. It clearly demonstrates, too, the fierce challenges inherent in preserving this material. Part 2, accordingly, suggests new archival strategies to respond to the changing documentation base. The authors ably demonstrate why archives need to become more integrated with other “curatorial jurisdictions” (p. 88) within the same institution (records management, manuscripts, library, museum) to collect records of the greatest possible research value and to minimize redundancies. This section, while unquestionably full of sage advice for strategic planning, also offers rather obvious recommendations that will frustrate archivists searching for the practical means to enact them. For example: “To guarantee the long-term survival of holdings, both the selection and processing of materials should be accelerated” (p. 94). Part 3 expands on earlier points about integrating curatorial jurisdictions and will perhaps be of the most practical value to archivists. Here one finds advice on computerizing archival functions, integrating an institutional records management program, and managing manuscripts, institutional records, and object collections. These chapters offer welcome guidance, since an archivist’s specialization is usually in records, historical manuscripts, or museum objects, but seldom in all three.
While McCall and Mix use the broadening base of health-care records as the basis for a discussion of a range of archival management issues, Joan Krizack in Documentation Planning for the U.S. Health Care System focuses on what archivists need to know about the functions of the record creators. Chapter...