Q: I am adapting a Nova Scotia Health form and want to include an image that is used in the existing version of the form. The image is not cited, and I don’t know where it came from. Can I use it, since no one has ever complained?
A: Just because an image was used previously, it doesn’t mean it was used with permission. Even if you think the chance of someone complaining is slim, you must comply with copyright law.
Here’s what you should do:
- Try a reverse image search in Google Images to look for the source/copyright owner of the image. Watch the tutorial video below for tips on reverse image searching.
- If you find the image, review the terms of use to determine if your use is permitted.
- If written permission or payment is required, you must comply with those terms before using the image.
- Please submit proof of permission to our permissions repository.
- If the fee is too high or permission is not granted, look for a free-to-use alternative.
- Always cite the source of an image, even when it is not required. This will prevent having to repeat these steps the next time the form is revised.
If you are unable to find the image or need help with this process, reach out to Library Services: Copyright@nshealth.ca.
Q: I am developing a document for a clinical subject guide for staff. I found an image in a journal article that is perfect for my needs, but I must pay to use it. Since I don’t have a budget for this, can I create my own image that looks basically the same?
A: You can create something similar, but it cannot be identical or have only minor differences. Your image must be different enough to be considered an original work. You cannot trace or use photo-editing tools to manipulate the original image.
Consider:
- searching for a free-to-use or open-licensed alternative. Many of these images can be edited, but remember to check the terms of use. Visit the Using Images page of the Copyright subject guide for ideas.
- linking to the original image instead of copying it.
For more information, email Copyright@nshealth.ca or visit our Copyright subject guide.
Reverse Image Search Tutorial
Nova Scotia Health, 2024.

Lana MacEachern
Library Technician
Pictou/Colchester-East Hants/Cumberland Region

Roxanne MacMillan
Librarian Educator
Halifax Infirmary, Central Zone
For many Nova Scotia Health team members, sharing documents is an essential part of the workday. But as you may have noticed, there are many ways to link to documents or share URLs. In this post, we’ll share best practices to help make sure the links you share are inclusive, accessible, and most importantly, usable!
Before we dive in, let’s make sure we understand some key words:
Best practices
1. When adding a hyperlink, be sure the linked text appropriately describes what you are linking to.
Don’t hyperlink non-informative phrases like, “click here”, “read more”, or “view here”, etc.
Example:
Want to learn more about accessibility? Click here!
Do hyperlink the title or description of the link.
Example:
Want to learn more about accessibility? Check out: Best practices for accessible links
Why does it matter?
When we hyperlink instructions, like adding a link to the words “click here” or “read more,” we are not giving the user enough information about where the link goes. When these types of links appear one after one another, it’s difficult to differentiate between them, which can create a frustrating user experience.
This practice makes it more difficult for those using screen readers to identify the link’s purpose. When a screen reader comes across a URL, it reads the associated text aloud, as well as the written URL. Often, these URLs are lengthy and an unpredictable combination of characters and numbers. Appropriately labeling your URLs can help screen reader users know exactly what to expect when selecting your link (Microsoft, n.d.).
Descriptively naming your hyperlinks also allows search engines (like Google) to use your descriptive text as metadata to appropriately rank search results. This means you will get more intentional visitors to your content because the information stored about your URL is accurate.
You may have noticed that Microsoft Office 365 products have already started doing this for you. For instance, when you copy and paste a hyperlink into the body of an email, Outlook now automatically changes the visible text associated with the hyperlink to the title of the document (A) instead of the URL (B). The same is true when adding URLs within other Microsoft Office 365 products like Word or PowerPoint. These links look something like this:
2. For printed resources, include the written URL as well as your descriptive hyperlinked text.
If you are creating content that will be used both in print and online, including the descriptive link and the written URL ensures equal access for all users to the resource you are linking to. Those using the print copy may need to enter the URL manually into a computer, tablet, or smartphone, but having the written URL provides them with enough information to access the resource.
Don’t assume everyone is reading your content online. Be mindful of the digital divide and add written URLs for those using print resources.
Do add the written URL beside or below the hyperlinked descriptive text.
Why does it matter?
In this day and age, it’s easy to assume everyone has access to reliable internet. Unfortunately, a ‘digital divide’ still exists in many communities in Canada (Currie, Ronquillo. & Dick, 2014; Latulippe, Hamel, & Giroux, 2017). Researchers note that this divide “persists along lines of social inequalities (i.e., education, urban versus rural, income, age, and immigration status)” (Ismond et al., 2021).
When creating print resources for the public (like patients, families, and support persons), including a descriptive hyperlink and a written URL allows all readers to access the same information. The written URL (C) gives them sufficient information to find the resource at a later time, when they have access to the internet (like at a public library, community center, or loved one’s home, for example).
Remember, if you are creating print resources and the software you are using automatically changes the URL to match the title of the document (like Outlook, Word, or PowerPoint), be sure to add the written URL beside or below it so that your hard-copy readers can use your links, too.
3. Use ScreenTips
When hyperlinking within a Microsoft product, you can also change what text appears when the cursor hovers over a link (D). In the ‘Insert Hyperlink’ pop-up window, select, ‘ScreenTip…’ in the top right. Use this window to edit the URL addess, the descriptive text that will be hyperlinked, as well as what will appear when the user hovers over the link.
As technology evolves, there are bound to be new ways to share links and URLs. Keeping up to date on how to make your links usable and accessible helps ensure your intended audience can access whatever resource you’re sharing, reducing user frustration and broken links.
Happy sharing!
References
1. Currie, L. M., Ronquillo, C., & Dick, T. (2014). Access to internet in rural and remote Canada. Studies in Health Technology and Informatics, 201, 407–412.https://pubmed.ncbi.nlm.nih.gov/24943574/
2. Latulippe, K., Hamel, C., & Giroux, D. (2017). Social Health Inequalities and eHealth: A Literature Review With Qualitative Synthesis of Theoretical and Empirical Studies. Journal of Medical Internet Research, 19(4), e136. https://doi.org/10.2196/jmir.6731
3. Ismond, K. P., Eslamparast, T., Farhat, K., Stickland, M., Spence, J. C., Bailey, R. J., Abraldes, J. G., Spiers, J. A., & Tandon, P. (2021). Assessing Patient Proficiency with Internet-Connected Technology and Their Preferences for E-Health in Cirrhosis. Journal of Medical Systems, 45(7), 72. https://doi.org/10.1007/s10916-021-01746-3
4. Microsoft. (2024, July 25). Make your Word documents accessible to people with disabilities. https://support.microsoft.com/en-us/office/make-your-word-documents-accessible-to-people-with-disabilities-d9bf3683-87ac-47ea-b91a-78dcacb3c66d?ui=en-us&rs=en-us&ad=us
Kallen Rutledge
Librarian Educator, Patient Education Pamphlets Lead
Nova Scotia Hospital, Central Zone
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