I have read about librarians playing a major role in information resource at the point of care and patient records being linked to knowledge networks.  The ability of the librarian to be an expert searcher and the use of the library as a third space are exciting dimensions to traditional roles.  This approach also deals with some of the hierarchies I am talking of and allows knowledge flows and knowledge dissemination. Librarians are hopefully becoming more interactive with the clinical environment and multi displinary teams are developing.