Betsy L. Humphreys, MLSBetsy L. Humphreys, MLS National Library of Medicine, National Institutes of National Library of Medicine, National Institutes of HealthHealth

U.S. Department of Health and Human ServicesU.S. Department of Health and Human Services

http://www.nlm.nih.govhttp://www.nlm.nih.gov

Prologue to the Future:Prologue to the Future:50 Years of Medical Librarianship 50 Years of Medical Librarianship

North Atlantic Health Sciences Libraries, Inc.North Atlantic Health Sciences Libraries, Inc.5050thth Anniversary Meeting Anniversary Meeting

Lowell, MassachusettsLowell, MassachusettsOctober 20, 2008October 20, 2008

Medical Library Association – 1958Medical Library Association – 1958est. in 1898 by librarians and physiciansest. in 1898 by librarians and physicians

• Members: 1,362 (558 institutional)Members: 1,362 (558 institutional)• Programs and Services:Programs and Services:

– Annual meetingAnnual meeting– MLA Exchange, CertificationMLA Exchange, Certification– 2 Awards (Noyes & Gottlieb)2 Awards (Noyes & Gottlieb)– Bulletin of the MLA, Handbook of Medical Library Bulletin of the MLA, Handbook of Medical Library

Practice Practice – Regional and Subject Groups, 1948—Regional and Subject Groups, 1948—– CE Courses, 1958– CE Courses, 1958–

1958 – MLA “Refresher” Courses1958 – MLA “Refresher” Courses• Acquisition – Acquisition – Louise DarlingLouise Darling**• Administration – Administration – Mildred JordanMildred Jordan**• Architecture – Architecture – William PostellWilliam Postell**• Binding – Binding – Paul BerrisfordPaul Berrisford• Cataloging & Classification – Cataloging & Classification – Mary Louise MarshallMary Louise Marshall**• Equipment – Equipment – Scott AdamsScott Adams**• Medical Nomenclature – Medical Nomenclature – Frank B. RogersFrank B. Rogers**• Medical Writing – Medical Writing – George G. StilwellGeorge G. Stilwell• PeriodicalsPeriodicals – Eleanor Steinke – Eleanor Steinke• PhotoduplicationPhotoduplication – Mildred Walter – Mildred Walter• Rare Books Rare Books – Gertrude Annan– Gertrude Annan**• ReferenceReference – Bertha Hallam – Bertha Hallam* *

*Past or Future MLA President*Past or Future MLA President

National Library of Medicine – 1958National Library of Medicine – 1958est. in 1836, as Surgeon General’s Library, U.S. Armyest. in 1836, as Surgeon General’s Library, U.S. Army

Moved to DHEW by NLM Act, 1956Moved to DHEW by NLM Act, 1956

• Budget: $1.49 millionBudget: $1.49 million– $1.49 million – Intramural$1.49 million – Intramural

• Included: NLM collection ($82K!!), ILL, NLM book catalog, Current Included: NLM collection ($82K!!), ILL, NLM book catalog, Current List of Medical Literature, few subject bibliographies, NLM interns List of Medical Literature, few subject bibliographies, NLM interns (1958- )(1958- )

– $ 0 – Extramural $ 0 – Extramural • Staff: 217 employeesStaff: 217 employees• Facilities: Facilities:

• Army Medical Library & Museum, Army Medical Library & Museum, Wash.,DC; History of Medicine Division, Cleveland,OHWash.,DC; History of Medicine Division, Cleveland,OH• NLM Bldg. to be constructed at NIH in Bethesda MDNLM Bldg. to be constructed at NIH in Bethesda MD

1958-2008 - What Happened?1958-2008 - What Happened? People with VisionPeople with Vision+ Legislation/PolicyLegislation/Policy+ Technology/Standards/Digital Information+ Technology/Standards/Digital Information+ Networks/Outreach + Networks/Outreach + Professional Development+ Professional Development+ New Opportunities/Roles for Librarians+ New Opportunities/Roles for Librarians

= = Huge Improvement in Access to Huge Improvement in Access to Biomedical & Health InformationBiomedical & Health Information

((+ Continuous Change + New Challenges)+ Continuous Change + New Challenges)

19581958 19681968

19671967NMAC to NLM

AACRAACROCLC

1st RML-NE1st RML-NE1st Janet Doe

LectureLATCH

19661966NLM Tox Info Pgm

TWX for ILLTWX for ILLUCMPUCMPISBNISBN

NELINETNLM Associates

Resource, Training,

Construction,R&D Grants

19641964Civil Rights Act

Lib. Serv. Constr. ActMEDLARSMEDLARS

IBM 360IBM 360

MLA-NLMLiaison

Committee

19631963PHILSOMPHILSOM

MLA FederalRelations

Committee

19651965Medicare

Medical LibraryMedical LibraryAssistance ActAssistance Act

Regional Medical Programs1st decentralized

MEDLARS Center

19681968Lister Hill Center;Williams & Wilkins

Copyright CaseSUNY BCNSUNY BCN

1st Int’l MEDLARSCenter

19581958NASA

IndexIndexMechanizationMechanization

NE NE RegionalRegional

GroupGroup1st MLA CENLM Interns

NFAIS

19601960MeSHMeSH

Med LibrMed LibrCenterCenterNYCNYC

19611961NLM

To BethesdaScience Science CitationCitationIndexIndex

19591959XeroxXerox

MachineMachine

Irwin Pizer, Bertha Izyk, Richard Fenzi, Ph.D., SUNY Biomedical Communications Network, 1968

1963- Frank B. Rogers, MD and Thelma Charen receive MLA’s Eliot Prize (est. 1962) for an article on Journal Title Abbreviations.

Thelma will later co-author the ANSI Standard – and also teach MeSH and Indexing principles to generations of searchers

19681968 19781978

19711971 National Cancer Act

MEDLINEMEDLINE UCLA OnlineUCLA OnlineSerials SystemSerials SystemOnline TrainingOnline TrainingExpert SearcherExpert Searcher

“ResourceImprovement”

GrantsClinical Medical Clinical Medical

LibrarianLibrarian

19721972TOXLINETOXLINE

InformaticsTrainingGrants

AHECs

19731973 Online Charges

CATLINECATLINESERLINESERLINE

MLA Minority Scholarship

Circuit Circuit Rider Rider

LibrarianLibrarian

1975197511stst CONSER CONSER

Record in OCLCRecord in OCLCISSNISSN

HSOCLCUGConsortia

Grants

19761976Copyright ActCopyright ActNLM MasterNLM Master

Serials SystemSerials SystemApple ComputerApple Computer

1st Hospital Librarian MLA Pres.

19771977LHC ILSLHC ILS

1st SCAMC

19781978“Bethesda 11”

AACR2AACR2AAHSL

19691969MARC MARC

ARPANETARPANETProblem-

based Curriculum

19741974Research

Libraries Group

19701970AIM-TWXAIM-TWXPDP-11PDP-11

MinicomputerMinicomputer

Early MEDLINE Training Class (1972)

1977 - MEDLINE Training Class

19781978 19881988

19811981OTA, GAO

StudiesSERHOLDSERHOLD

IBM PCIBM PC

19821982IAIMS ReportMiniMEDLINEMiniMEDLINE GenBankGenBank OctanetOctanet 7 Region7 Region NetworkNetwork

19831983 InternetInternet GaINGaIN1st IAIMSAwards

19851985NLM Preservation Plan DOCLINEDOCLINE

1986 NLM Long Range Plan

Grateful MedGrateful MedMEDLINE CD-ROMsMEDLINE CD-ROMs

UMLS ProjectUMLS Project

19841984“Train theTrainers”Classes

19871987 PermanentPaper Campaign HL7HL7Plain Paper FaxPlain Paper Fax QuickDocQuickDoc MLA Strategic Plan

19881988NCBIAHIP

19791979NLMNLM

RetroconRetroconProjProj

PaperchasePaperchase

19881988 19981998

19911991HPCC Act

IOM Comp.-BasedPatient Record Rep.

Physics Pre-PrintPhysics Pre-Print ArchiveArchive Ariel Region 8Region 8 NN/LMNN/LM

19921992 Genbank at NLM 1st Solely 1st Solely Electronic Electronic Biomed. JrnlBiomed. Jrnl Woods Hole CourseMLA Education Policy Internet“Connections” Grants

19931993NICHSR1st Web1st WebBrowserBrowserCochrane

Collaboration

19951995 Free AIDS Databases MLA Research PolicyLibrarian Education Challenge Grants Bioinformatics Bioinformatics SpecialistSpecialist

19961996Telecomm. ActTelecomm. Act

HIPAAInternetInternet

Grateful MedGrateful MedEFTSEFTS

Clinical Clinical InformaticsInformatics

Consult ServConsult Serv.

19941994NLM WebsiteNLM Website 1st Visible1st Visible HumanHumanAIDS OutreachMLA Code of Ethics HPCC Projs1st “Magnet” 1st “Magnet” HospitalHospital

19971997Free MEDLINEFree MEDLINE PubMedPubMed PH Partners PH OutreachTelemedicine/ NII Projs

19981998SPARC

MEDLINEplusMEDLINEplusGoogleGoogle

Profiles in Profiles in ScienceScience

Public Library Outreach

19901990HumanHuman

Genome ProjGenome ProjLoansome Loansome

DocDoc1st UMLS 1st UMLS

releaserelease Grateful Med Outreach HBCU Outreach

CNIAMIA

19891989AHCPRAHCPR

NLMOutreach

Report

Information STAT! Rx for Hospital Quality1992 Satellite Broadcast

- Participants in the Green Room

19981998 20082008

19991999AHRQ

NLM Policy Consumer

HealthIOM Report“To Err is Human”

200120019-11 Attacks

RxNormRxNorm

20032003US-wide SNOMED License Go LocalGo LocalNLM Journal ArchivingNLM Journal Archiving DTDDTD

20042004 Executive Order re: Health IT PubChemPubChem

2007 2007 MandatoryNIH Public

Access PolicyMandatory

Clinical TrialsResults reports

REMMREMMIHTSDO formedIHTSDO formed

Disaster Information

Specialist

20022002M+ en espanol

ToxTown NLM-AAHSL Fellows Advanced Bioinformatics Training Frankenstein tours

20052005VoluntaryNIH Public

Access PolicyHurricane

KatrinaHITSPHITSP

DailyMedDailyMed

20062006NLM Long

Range Plan 2006-16NLM & NN/LMDisaster Mgmt

dbGaPdbGaPNIH CTSAs

20002000LC National Digital

Preservation Initiative

PubMed CentralPubMed CentralClinicalTrials.govClinicalTrials.gov

Consumer Health Outreach

“Informationist”

19

87% of DOCLINE ILLs delivered electronically in FY 200887% of DOCLINE ILLs delivered electronically in FY 2008(95% of NLM ILLs)(95% of NLM ILLs)

Electronic Full Text Access Electronic Full Text Access (10/14/2008)(10/14/2008)

Total citationsTotal citations # Linked to # Linked to full textfull text

% Linked to % Linked to freefree full text full text

All PubMedAll PubMed 18,316,26018,316,260 50%50% 14%14%

1990 on 1990 on 9,769,1029,769,102 72%72% 17%17%

2000 on2000 on 5,429,300 5,429,300 85%85% 20%20%

20

PubMed Central added 46% more articles in FY 2008PubMed Central added 46% more articles in FY 2008(now 1,685,498 articles from 444 journals)(now 1,685,498 articles from 444 journals)

““XML is, by and large, pretty easy, XML is, by and large, pretty easy, whereas semantic interoperability is whereas semantic interoperability is

insanely difficult.”insanely difficult.”

Tim Bray, co-creator of XML, Tim Bray, co-creator of XML, Nov. 7, 2005Nov. 7, 2005

Opportunities• Quality improvement• Decision support in electronic health records• Clinical and translational research• Problem based learning• Magnet hospitals• Evidence based practice• Patient centered care• Consumer empowerment• Distance learning• Clinical trials reporting• Et cetera

NLM Long Range PlanNLM Long Range PlanGoals for 2006-16Goals for 2006-16

• Seamless, Uninterrupted Access to expanding collections of biomedical data, medical knowledge, and health information

• Trusted Information Services that promote health literacy, improve health outcomes, and reduce health disparities wordwide

• Integrated Biomedical, Clinical, and Public Health Information Systems that promote scientific discovery and speed transition of research into practice

• A Strong and Diverse Workforce for biomedical informatics research, systems development, and innovative service delivery