Re-Affirming the National Library of Medicine


William Hersh, MD, Professor and Chair, OHSU
Blog: Informatics Professor

Last week, National Institutes of Health (NIH) Director Dr. Francis Collins accepted a report from his Advisory Committee to the Director (ACD) that set forth a strategic vision that affirmed the National Library of Medicine (NLM) as a strategic leader in data science, biomedical informatics, and as a library resource. This report was prompted by the retirement of Dr. Donald A.B. Lindberg as Director of the NLM for over 30 years. I have written before on how important the NLM has been to my career, and I am sure many other informaticians, especially those in academia, can attest likewise.

Input to the report came mainly from a Request for Information (RFI) issued by NIH in February, 2015. My response was among the 650 received by NIH, and was reproduced in a blog posting. Like many of my informatics colleagues, I called on NIH to re-affirm the importance of NLM, and its underlying biomedical and health informatics (BMHI) research and education agenda.

The ACD report put forth six recommendations, which I will list here and interpreted by me in italics:

  1. NLM must continually evolve to remain a leader in assimilating and disseminating accessible and authoritative biomedical research findings and trusted health information to the public, healthcare professionals, and researchers worldwide. NLM should continue its role as the world’s premier medical library.
  2. NLM should lead efforts to support and catalyze open science, data sharing, and research reproducibility, striving to promote the concept that biomedical information and its transparent analysis are public goods. NLM should expand its library role to advocate for and lead efforts in open data and science.
  3. NLM should be the intellectual and programmatic epicenter for data science at NIH and stimulate its advancement throughout biomedical research and application. NLM should the NIH home for data science, including the Big Data to Knowledge (BD2K) program, and biomedical informatics research.
  4. NLM should strengthen its role in fostering the future generation of professionals in biomedical informatics, data science, library sciences, and related disciplines through sustained and focused training efforts. NLM should continue its robust education and training activities.
  5. NLM should maintain, preserve, and make accessible the nation’s historical efforts in advancing biomedical research and medicine, thereby ensuring that this legacy is both safe and accessible for long-term use. NLM should maintain its role in archiving all aspects of science, including data.
  6. New NLM leadership should evaluate what talent, resources, and organizational structures are required to ensure NLM can fully achieve its mission and best allocate its resources. NLM should seek out the most skilled and talented people to pursue its mission and activities.

While I am overall highly supportive of the report, I do have a few small quibbles with it. One is the decision to focus on “data science” as opposed to larger BMHI. Data science is certainly an important field, and I am pleased to see NLM recognized as its NIH home for it. However, it would have been more visionary to embrace the optimal use of information to improve individual health, healthcare, public health, and biomedical research, i.e., the larger discipline of BMHI, as the critical mission of the NLM. We cannot have good data science without attention to other aspects of informatics, including but not limited to usability of systems, workflow, and standards and interoperability.

A second concern, related to the first, is the report’s modest attention to clinical informatics. While clinical informatics does not represent the entirely of the larger BMHI, NLM is the only US federal research-related entity focused on basic research in clinical informatics, the branch of BMHI that focuses on the use of informatics for patients and in healthcare. The report does call for developing talent in research areas related to the electronic health record and analysis of biomedical text, but these do not represent the entirety of clinical informatics.

A final quibble, although I did not expect it to be addressed, concerns the name of NLM. While I recognize its library function as critically important, many who do not know the breadth of what NLM does may not fully appreciate the work it performs beyond its library role. While I understand it would literally take an act of Congress to change its name, I believe it would be much more logical for NLM to be called something like the National Institute for Biomedical and Health Informatics, with the NLM within it serving its critical library role.

These small issues notwithstanding, I am pleased to see the NLM, and its biomedical and health informatics research and training agenda, endorsed by the report. As such, I believe that the future of the NLM is bright, and now the NIH can get on with hiring the next NLM Director, who will hopefully be guided by the vision of informatics rightfully achieving its value in improving the health of the US and the rest of the world via its information ecosystem.

This article post first appeared on The Informatics Professor. Dr. Hersh is a frequent contributing expert to HITECH Answers.