# Presentation: 085817

## NLM Update: Part II

- Deputy Director, National Library of Medicine
*National Institutes of Health*
*U.S. Department of Health and Human Services*

- Medical Library Association
- Annual Meeting
- Tuesday, May 17, 2005 ~ San Antonio, TX

## New Opportunities 

- NIH Public Access Policy
- PubMed Central
- Federal Health Information Technology Policy
- Commission on Systemic Interoperability
- UMLS, RxNorm

## House Appropriations Language

- “The Committee is very concerned that there is insufficient public access to reports and data resulting from NIH-funded research. This situation, which has been exacerbated by the dramatic rise in scientific journal subscription prices, is contrary to the best interests of the U.S. taxpayers who paid for this research.”  **(July 8, 2003)**
- “The Committee is aware of a proposal to make the complete text of articles and supplemental materials generated by NIH-funded research available on PubMed Central (PMC)... The Committee supports this proposal and recommends that NIH develop a policy, to apply from FY 2005 forward, requiring that a complete electronic copy of any manuscript reporting work supported by NIH grants or contracts be provided to PMC upon acceptance of the manuscript for publication in any scientific journal listed in the NLM's PubMed directory.” **(Sept. 7,2004)**

**Notes:**
Over the last several years Congress has indicated its interest in ensuring that the results of NIH supported research is made available to the public.

This language appeared in the FY2005 appropriations report for NIH, highlighting Congress’ concerns and encouraging NIH to move forward with the policy it was developing for depositing  manuscripts resulting from NIH funded work in PubMed Central.

## NIH Public Access Policy Goals

- ACCESS Provide electronic access to NIH-funded research publications for patients, families, health professionals, teachers, and students.
-  ARCHIVE Keep a central archive of NIH-funded research publications—for now and in the future, preserving vital medical research results and information for years to come.
- ADVANCE SCIENCE Advance science by creating an information resource that will make it easier for scientists to mine medical research publications, and for NIH to better manage its entire research investment.

**Notes:**
The NIH policy has three basic goals.  

Improving access via the Internet to NIH funded research results for health professionals, researchers, and the public.
Creating a permanent archive of these publications to  ensure that they will be available in the future.
Enabling scientists to more effectively mine both the literature and related data sets to make new discoveries and to strength NIH’s ability to manage its research portfolio.

## NIH Public Access Policy 

- NIH-funded investigators are requested to submit an electronic version of the author’s final manuscript upon acceptance for publication, resulting from research supported in whole or in part, with direct costs from NIH.
- Beginning May 2, Electronic submission will be made directly to the NLM’s PubMed Central (PMC) digital repository of full-text, peer-reviewed, biomedical, behavioral, and clinical research journals.
- At the time of submission, author will specify the timing of the posting for public accessibility.
- NIH strongly encourages authors to post for public accessibility as soon as possible (and within twelve months of the publisher’s official date of final publication.) NIH expects that only in limited cases will authors deem it necessary to select the longest delay period.

**Notes:**
These are the major elements of the final policy.

Note that NIH is strongly encouraging posting as soon as possible and expects that only in limited cases will the authors choose 12 months.

## NIH Policy – Coverage & Timing

*The policy applies to:*
- Peer-reviewed publications resulting from research supported in whole or in part with direct costs from NIH
- Investigators supported with direct costs from all research and career development award mechanisms, cooperative agreements, contracts, NRSA grants, and NIH intramural research studies
*The policy does *_*not*_* apply to:*
- Book chapters, editorials, reviews, conference proceedings
*Authors should submit publications resulting from:*
- Currently funded NIH research projects or previously supported projects accepted for publication on or after May 2, 2005
- Author’s final manuscript* = final version accepted for journal publication and includes all modifications from the peer review process*

**Notes:**
Again, the focus of the policy is on the peer reviewed literature.

It covers all individuals receiving direct NIH support.

## NIH is Not a Publisher

- NIH supports the current publishing process by providing direct costs to its funded investigators for publication costs.
- The Policy is compatible with any publishing model that authors and journals choose to employ.
- The Policy creates a stable archive of peer-reviewed, research publications financed with NIH funds
- NLM’s statutory mandate to preserve the biomedical literature
- PubMed Central as NIH’s institutional repository

**Notes:**
NIH is creating an archived of published material; it is not acting as a publisher.  We believe this is an important distinction.

Because the goal is to create an archive and the policy allows flexibility on the timing of public access, any publishing model that authors choose is compatible with the policy.  NIH is not dictating that authors must choose open-access publishing approaches.

## Copyright Issues

- The NIH policy explicitly recognizes and upholds the principles of copyright.
- Authors/journals can continue to assert copyright in NIH-funded scientific publications, in accordance with current practice.
- NIH encourages authors and institutions to sign agreements that specifically allow the manuscripts to be deposited with NIH for public posting on PMC as soon as possible after journal publication

**Notes:**
One of the main legal concerns was that NIH was taking away authors and/or publishers’ copyright.   The policy explicitly states that existing copyright agreements will be upheld.

NIH expects that authors will inform publishers of their intentions to deposit their manuscripts and make them pubic at a specific time.  NIH will not get involved in negotiating copyrights, but here is some sample language that could be used by authors. 

## Advantages of Depositing in PMC

- Fulfills a grant progress reporting requirement
- Ensures that the article is available for cross-linking to many related resources and databases, such as: DNA, protein sequences, protein structures, chemical structures, ClinicalTrials.gov, MedlinePlus, etc.
- Heightens the visibility of the research and enhances the likelihood of early and increased citation
- Ensures permanence of the record of science

**Notes:**
As I will demonstrate, once a manuscript is in the system we are able to link it to multiple resources.

## May 2, 2005 - http://nihms.nih.gov

***May 2, 2005 - *****http://nihms.nih.gov**

## Slide 11

## Slide 13

**Notes:**
Author manuscript available for public viewing in PMC. Links to the final version of the article will be active once the final version is available in PMC.

## NIH Public Access Working Groupof the NLM Board of Regents

- Tom Detre, MD, Chair, NLM Board, Univ. Pittsburgh
- Deanna Marcum, Ph.D., Member, NLM Board, LC
- Susan Buchanan, Ph.D., NIDDK
- Jeff Drazen, M.D., *NEJM*
- Harvey Fineberg, MD, Ph.D, IOM
- Mark Kamlet, Ph.D., Carnegie-Mellon
- T.J. Koerner, Ph.D., Am. Cancer Soc.
- Brian Nairn, Elsevier
- Mark Sobel, MD, Ph.D., Am. Soc. Investigative Pathology

- Michael Stern, Fisher Center for Alzheimer’s Res. Found.
- Sharon Terry, Genetic Alliance
- Pat Thibodeau, MLS, Duke
- Annette Thomas, Ph.D., Nature Publishing Gp.
- Donald Tykeson, Tykeson Associates
- Gary Ward, Ph.D., Am. Soc. Cell Biology
- Ann Wolpert, MLS, MIT
- Jim Williams, MLS, Univ. Colorado, Boulder, *ex officio, Chair, PubMed Central National Advisory Committee*

## What you can do

- Promote and facilitate participation
- Review policy and FAQs and sign on to listserv
- Watch for more explanatory and educational materials from NLM/NIH, MLA, and AAHSL
- Be *the *source of information – and inspiration - in your institution

## PubMed Central in March 2005

**178** journals
**373,000** items (> 50% from digitized back issues)
- includes some pieces (e.g., book reviews) not in PubMed
- Users: **1,073,689** unique IP addresses. Actual users estimated to be **2.5 times** this number.
- Retrieval: Over **4.78 million** full-text (HTML or PDF) articles

**Notes:**
I thought it would be useful to give you a picture of what is currently in PMC.

Our back issue scanning project is vastly increasing the material in PMC and making this critical information available electronically for the first time.

You may find it amusing to note the title of the most accessed article in the last month.

## 2004 Agreement to Expand PubMed Central 

- Wellcome Trust and U.K. Joint Information Systems Committee (JISC) to fund an additional 1.7 million pages of backfile scanning for PMC
- New titles include:
-    *Annals of Surgery, Biochemical Journal, Journal of Physiology, ****Medical History****, Journal of the Royal Society of  Medicine, British Journal of General Practice*

## Slide 19

## Portable PubMed Central (pPMC)

- Provides a local mirror of PMC content
- Updated daily from NCBI
- Multiple site archiving
- Provides rendering of PMC XML into HTML
- Provides searching through NCBI **EUtils**
- Provides for controlled local content in presentation
- Provides first step toward collaborative archiving
- Collaboration with Microsoft on support

## Slide 21

## pPMC Modules

## Browsing by Journal

## Slide 24

## U.S. Health IT Activity - FY 2004

- Medicare Modernization Act – 2003
- E-prescribing standards
- Commission on Systemic Operability established – to report Oct. 2005
- NIH RoadMap –Re-engineering Research Infrastructure
- Emphasizes use of health data standards
- Presidential Executive Order – April 2004
- EHRs for the majority of U.S. population within 10 years
- HHS National Coordinator of Health Information Technology  (ONCHIT)
- SNOMED CT released in UMLS – May 2004
- SNOMED CT, RxNorm, etc. designated as target U.S. government-wide standards - May 2004
- HHS Health IT Framework for Strategic Action–July 2004
- Secretary’s Summit - “Woodstock” for U.S. Health IT
- Several “National Health Information Infrastructure” Bills

## Slide 26

## Commission on Systemic Interoperability   - appointed late 2004

- Scott Wallace, JD, Chair, National Alliance Health IT
- Simon Cohn, M.D, Kaiser
- Don Detmer, M.D., Pres & CEO, AMIA
- Vicki Gregg, CEO, BlueCross BlueShield TN
- Gary Mecklenberg, Pres. & CEO, Northwestern Memorial Healthcare
- C. Martin Harris, MD, CIO, Cleveland Clinic

- Herbert Pardes, M.D., Pres. & CEO, NY-Presbyterian Hosp
- Thomas S. Priselac, Pres. & CEO, Cedars-Sinai
- Ivan Seidenberg, Chm. & CEO, Verizon of NY
- Frederick Slunecka, CEO, Avera McKennan Hosp
- Bill Stead, M.D. Assoc. Vice Chancellor for Health Affairs, Vanderbilt

## UMLS as common distribution vehicle for standard vocabularies –New Features in 2004

- Enhanced UMLS Knowledge Server, with new Developers Guide
- DVD replaces CD as alternate distribution format
- MetamorphoSys now the UMLS install program
- Choice of 7-bit ASCII or Unicode UTF-8 character set
- Enhanced features for customizing the Metathesaurus
- New Documentation,Website, Materials – *a start*
- _[http://umlsinfo.nlm.nih.gov](http://umlsinfo.nlm.nih.gov/)_
- Online licensing and registration
- New Rich Release Format (RRF) for Metathesaurus
- New RRF Browser, which allows users to view their subsets

## Beta version viewable at NLM booth

***Beta version viewable at NLM booth***

## Put RxNorm in Search box on NLM website

***Put RxNorm in Search box on NLM website***

## RxNorm:  What is a Clinical Drug?

- Level of Clinical Discourse - Standard Needed
- For order entry and decision support
- For medical records
- For linking to knowledge
- Active ingredient + Strength + Dose Form
- UMLS Semantic Type

## Propranolol

- NDC: 48695117305
- NDC: 00047007032
- NDC: 00047007024
- NDC: 00223255002
- NDC: 00223255001
- NDC: 00364075690
- NDC: 00364075602
- NDC: 00364075601
- NDC: 52953000304
- NDC: 00378018210
- NDC: 00378018201
- NDC: 51432097106
- NDC: 00677104110
- NDC: 00677104105
- NDC: 00677104101
- NDC: 54569055650
- NDC: 00102333502
- NDC: 46193073810
- NDC: 46193073805
- NDC: 52544030505
- NDC: 52544030501
- NDC: 53633032116
- NDC: 53633032110
- NDC: 12071044010
- NDC: 54441004350
- NDC: 54441004325
- NDC: 54441004310
- NDC: 54441004305
- NDC: 54441004301
- NDC: 49884010610
- NDC: 49884010605

- NDC: 46193073801
- NDC: 00555046506
- NDC: 00555046505
- NDC: 00555046502
- NDC: 00054475833
- NDC: 00054475831
- NDC: 00054475825
- NDC: 54441019750
- NDC: 54441019725
- NDC: 54441019715
- NDC: 54441019711
- NDC: 54441019710
- NDC: 00182175810
- NDC: 00182175801
- NDC: 00228232796
- NDC: 00228232710
- NDC: 00046042199
- NDC: 00046042198
- NDC: 00046042195
- NDC: 00603548921
- NDC: 53258015313
- NDC: 54269010901
- NDC: 51813007299
- NDC: 51813007290
- NDC: 51813007260
- NDC: 53492301303
- NDC: 53492301302
- NDC: 53492301301
- NDC: 00591555404
- NDC: 00591555401
- NDC: 52493063960
- NDC: 00839711420

- NDC: 00615256113
- NDC: 40039006001
- NDC: 00025090152
- NDC: 00025090131
- NDC: 47202255103
- NDC: 47202255101
- NDC: 12027008902
- NDC: 12027008901
- NDC: 53487014510
- NDC: 00781134413
- NDC: 00781134410
- NDC: 00781134401
- NDC: 53978003410
- NDC: 00117134405
- NDC: 00117134401
- NDC: 51316009004
- NDC: 11146094210
- NDC: 52544030551
- NDC: 52544030510
- NDC: 00839711416
- NDC: 00536430910
- NDC: 00536430905
- NDC: 00536430901
- NDC: 35470050801
- NDC: 00143150225
- NDC: 51608042104
- NDC: 51608042102
- NDC: 10465042109
- NDC: 00721002301
- NDC: 54421011001
- NDC: 19458042007
- NDC: 19458042001

- NDC: 50053310901
- NDC: 47679070204
- NDC: 47679070201
- NDC: 46703009410
- NDC: 46703009401
- NDC: 52584018410
- NDC: 00363690810
- NDC: 53489045101
- NDC: 00157052610
- NDC: 00157052601
- NDC: 00054875825
- NDC: 00005310931
- NDC: 00005310923
- NDC: 00071007024
- NDC: 00046042191
- NDC: 00046042181
- NDC: 00046042180
- NDC: 00046042162
- NDC: 00046042161
- NDC: 00046042160
- NDC: 00814644630
- NDC: 54697006305
- NDC: 54697006304
- NDC: 54697006303
- NDC: 54697006302
- NDC: 49884010601
- NDC: 00686018201
- NDC: 51079027760
- NDC: 00349845190
- NDC: 00349845110
- NDC: 00349845101
- NDC: 50053310902

- NDC: 51285032190
- NDC: 51285032160
- NDC: 52985003606
- NDC: 52985003601
- NDC: 51285032112
- NDC: 51285032109
- NDC: 51285032105
- NDC: 51285032102
- NDC: 00555036505
- NDC: 00555036502
- NDC: 00308627099
- NDC: 00308627060
- NDC: 00308627030
- NDC: 54697006301
- NDC: 00302573210
- NDC: 11146091299
- NDC: 00719179413
- NDC: 00719179410
- NDC: 00904041180
- NDC: 00904041160
- NDC: 00894633104
- NDC: 00894633103
- NDC: 00894633102
- NDC: 00894633101
- NDC: 10647042101
- NDC: 50111046707
- NDC: 50111046703
- NDC: 50111046701
- NDC: 52555001010
- NDC: 52555001001
- NDC: 00093060010
- NDC: 00093060001

- 10Mg Tab

## RxNorm

- Aims for interoperability
- Equivalence at the generic level
- Connected to NDCs available from FDA
- Enables crosstalk between public & private drug information sources
- VA, FirstDataBank, Micromedix, Multum, Medispan ..

## U.S. Health IT Activity - FY 2005

- HHS “Request for Information” (RFI) on Nationwide Health Information Network (NHIN) – Nov. 2004
- Mike Leavitt becomes Secretary of HHS – Jan. 2005
- Secretary’s 500-day Plan – May 4, 2005
- Health Information Technology Leadership Panel Final Report  – May 11, 2005
- Several “National Health Information Infrastructure” Bills
- Coming VERY soon:
- Summary of Responses to RFI
- Multiple HHS Requests for Contact Proposals (May 13 announcement in FedBizOps)

## More at Legislative Update: Wed. 4:30-6 pm, Convention Center: River 008A

- More at*** Legislative Update: Wed. 4:30-6 pm, Convention Center: River 008A***

**Becky J. Lyon, MLS**
**Deputy Associate Director for Library Operations**

***NLM Update Part III***

**Medical Library Association Annual Meeting**
**San Antonio, TX**

**Tuesday, May 17, 2005**

## Futuro Magnifico!

- Provide more effective access to quality information
- Build collections and services to meet  information needs of
- Healthcare professionals
- Consumers
- Reach out to diverse groups
- Recruit the best

**Notes:**
Futuro Magnifico! Celebrating Our Diversity  (Joanne Marshall’s invitation to MLA 2005)
Presentation is organized following Joanne Marshall’s invitation to MLA 2005
Betsy, if this makes no sense to you, feel free to reorganize the slides—I was trying to come up with a structure that related to the conference theme—this is what Joanne wrote:
As health information professionals, we have an unparalleled opportunity to influence our individual and collective destinies and to improve lives by facilitating more effective access to quality information. In the information age, librarianship is being viewed with renewed excitement, as libraries become multimedia collections of print and digital information selected to meet the information needs of healthcare providers and consumers. We need to build greater awareness of coming demographic changes; recruit and retain the best people to the field; and find ways of tapping the wisdom of our elders who may retire, but who may also continue to have a vibrant interest in the field	

## More effective access to quality information

**Notes:**
A new and improved version of the NLM Gateway was released on April 4 with one-click access to each of the 15 NLM information resources the Gateway brings together.  Search results are presented in a consistent way and the basic search function is simple and intuitive.  We encourage you to give it a test drive!

## Slide 40

**Notes:**
Sept 14 launched NLM Catalog under Entrez retrieval system
Bib data for 1.2 million journals, books, avs, eresources, etc.
Supports explosions on MeSH terms
Alternate search interface to LocatorPlus with familiar retrieval and display features to PubMed users

## Click on Special Queries on PubMed sidebar

## Click on Special Queries on PubMed sidebar

## Slide 43

## DOCLINE 2.5

- Loansome Doc redesign
- Display library specific information to user during Loansome Doc registration
- Email registration confirmation to LD user
- LD Login ID will be user’s email address
- Password reset mechanism for LD users
- Warn LD user requesting duplicate articles
- Alert LD user to library’s holdings during order
- Serial Holdings output in MARC 21 format

## Loansome Doc Login

## Collections and services to meet information needs

- http://www.nlm.nih.gov/tsd/acquisitions/cdm/

**Notes:**
Fourth edition published Oct 2004
Team of NLM staff led by Duane Arenales
Advisory Committee chaired by Alison Bunting worked for nearly 2 years
Reflects complex and changing environment of healthcare and biomed research
Sections on bioinformatics, molecular bio, plant science, toxicology and biol science describe incr emphasis on fundamental biol research in fields of biomedicine
New or rev statements on hsr, bioethics, ph, disaster mgmt, biotech, bioeng, biomed imag, neurosci reflect increasingly interdiscip and collab areas of research and practice in health
Elaborates on collecting policy for ptint, nonprint formats and lit types (e resources, avs, digital images, datasets)
Avail online in database to allow updating between revisions easier access for our selectors and contractors as well as for network libraries who may find it helpful

## http://www.nlm.nih.gov/nichsr/corelib/houtcomes.html

## Slide 49

## Slide 50

**Notes:**
In the summer of 2004, the History of Medicine Division's Prints and Photographs collections was enriched by the addition of a unique and extraordinarily fine collection of postcards on the subject of nursing.  Most of the cards come from the "Golden Age of Postcards," from the 1890s through the 1920s. The collection contains not only American cards but ones from around the world.  Some of the topics include nursing and war; nursing and childbirth; the nurse in the hospital; and nursing and romance.  The collection was assembled by Michael Zwerdling, who himself is a nurse and the author of Postcards of Nursing : A Worldwide Tribute (2004), based on this collection.

## Slide 51

## Slide 52

## phpartners.org

**phpartners.org**

## phpartners.org/tutorial

**phpartners.org/tutorial**

**Notes:**
For example, we provide a variety of training materials, increasingly in the form of online tutorials, so that they will be available at low or no cost to the widest possible audience.  Last May, NLM, NN/LM, U of Michigan and New York City Department of Health and Mental Hygiene colleagues published Public Health Information and Data:  A Training Manual, available on PHPartners.org.  Recently, an online tutorial based on the Training Manual was added to the Partners site. Each of its four modules (see colored tabs on the slide) includes an introduction and key concepts, lists of related websites, case studies, and exercises.

## WISER Wireless Information System for Emergency Responders

**WISER ****Wireless Information System for Emergency Responders**

- Critical Information tailored to the specific role of the emergency responder
- Information derived from TOXNET peer-reviewed Hazardous Substances Data Bank (HSDB)
- Support for identifying an unknown substance
- Developed with first responders on development team
- Available on PDAs (Palm and Pocket PC) and WindowsTM platforms

## Slide 56

**Notes:**
Finally, another recent SIS project is TOXMAP,  a web site developed by the National Library of Medicine to help users visually explore environmental health data with maps. It was officially released September 24, 2004. 

TOXMAP integrates the map display with access to bibliographic and factual data on certain hazardous chemicals and in that way serves as a GIS-based portal to these resources.

TOXMAP uses maps of the United States to show TRI locations where facilities are releasing specific chemicals
(such as benzene, Texas)

## US-Mexico Border – new Tox Town neighborhood

**US-Mexico Border – new Tox Town neighborhood**

- toxtown.nlm.nih.gov

**Notes:**
ToxTown is another different information resource produced by the Specialized Information Services  intended to provide for the general public information about hazardous substances found in every community.    This interesting graphical display has been expanded with a new scene – a US-Mexico border, focusing on the hazardous chemicals likely to be encountered in that setting. Previous scenes include a city and a rural setting.

## MedlinePlus

- 700 Health Topics in MedlinePlus
- 648 in MedlinePlus en español
- > 58,000 email list subscribers
- ~ 60 million page views/month
- 6.5 million unique users/month

**Notes:**
Here are the latest numbers for MedlinePlus ... and its growth over the last six years.

## Slide 59

## Go Local Status

_**NLM Hosted**_
**Linked today**
**Indiana**
**Massachusetts**
**In progress**
**Alabama**
**Arizona **
**Delaware**
**Maryland**
**Michigan**
**Nevada**
**Ohio—Southeast **
**Texas—East Texas**
**Texas—Gulf Coast **
**Tribal Four Corners**
**Utah**
**Wyoming**
**In approval**
**Alaska**

_**Locally hosted**_
**Linked today**
**North Carolina**
**Missouri **
**Texas—So Texas**
**In progress**
**California—LA County**
**South Carolina**

***MedlinePlus Go Local ****Open Information and Discussion Session: Wed. 12:30-2:30 pm, Convention Center: River 001A*

## Slide 61

## Slide 62

## Reach out to diverse groups and communities

## Information Rx Project

**Notes:**
We have been pilot testing the Information Rx project in several parts of the country.  We began in partnership with the ACPF—the goal is to get physicians to write a prescription for information for their patients.  The ACPF project launched nationally in April of last year and we appreciated the enthusiastic participation of librarians in the states of IA, GA and VA throughout the pilot.  Now we have begun working with the AMAF and the Fisher Center for Alzheimer’s research, to focus on information prescriptions for Alzheimer’s patients and their caregivers and are involving community organizations that provide services to them.  Earlier this year this pilot launched in 5 counties in western FL; this coming Friday we will be expanding the pilot to include 4 more counties in eastern FL.

## http://www.informationrx.org

**Notes:**
We encourage libraries in these counties to become involved by ordering free materials, talking with physicians in the community about the project and distributing materials to them, working with physicians, patients and families to introduce them to MedlinePlus and making certain they know what services your library can provide.  The website to order materials is www.informationrx.org.

## Slide 66

## Slide 67

## http://medstat.med.edu/symposium/index.html

**Papers coming in Supplement to **
**October 2005 JMLA**

## Time flies... 

- Time flies...
- NN/LM RFP issued in April 2005

## Recruit the best

**Notes:**
NLM continues to work with the Medical Library Association, Association of Research Libraries, American Library Association, and AAHSL to recruit and train the next generation of health science librarians.  We feel these efforts have been very successful.  We have recently funded 3 additional years of the NLM/AAHSL Leadership Fellows Program and have expanded our support of the ALA’s Spectrum Scholar program to provide, in conjunction with MLA, funding for an additional Spectrum Scholar through 2010.

## 2004/2005 NLM Associate Fellows

**2004/2005 NLM Associate Fellows**

**Notes:**
Our own Associate program continues to be one of which we are extremely proud.  Here is a photo of this year’s group

## 2005 – 2006 NLM Associate Fellows

**Mellanye Lackey, University of Michigan  **
**         **
**Marianne Reynolds, San Jose State University         **
**Lisa Massengale, University of Pittsburgh**
**Oscencio Tom, University of Arizona  **
**          **
**Amy Harper, University of Washington        **
**   **
**Elizabeth Whipple, Indiana University **
**Cristina Horta, International Fellow from Mozambique, SUNY-Buffalo, 1991**

**Notes:**
And we have just completed recruitment of next year’s class. Since 1963, more than 200 librarians have participated in the NLM's Assocaite Fellowship Program.  In addition, more than 20 have participated in the 2nd year component of the program.  This year we are beginning an evaluation of the program to look at outcomes, assess how well we are meeting our goals, and guide our program planning. Those of you who have been Associates will be hearing from us...

## ...And retain them if you can

- ...And retain them if you can

**Notes:**
Our outstanding staff, of course, are the reason why we are able to do so much in so many areas.  We have had some changes in key LO personnel in the past year.  Fortunately, only one Section Head retired—Ken Niles, the person who had responsibility for getting those ILLs to you in record time.  Ken made many improvements to the ILL process and we certainly miss him.  In the “Plus” column, we were able to get Dianne McCutcheon, a former Associate, back from the Library of Congress to head TSD and we’re very happy to have her back; Joyce Backus was selected Head of Reference and Web Service in the Public Services Division; and Diane Boehr, who has been a unit head in the cataloging section for several years, was selected to Head the section.

## Slide 74