The National Library of Medicine: Accelerating Discovery, Delivering Information, Improving Health

For almost 200 years, the National Library of Medicine (NLM) and the institutions that preceded it acquired and disseminated the knowledge base that supports clinical practice, funded and conducted the research that made sure that knowledge was available at the point of need, preserved the trail linking medicine's past to its present, and ensured that people everywhere had free access to current and relevant health information in a vernacular familiar to them. The NLM plays an important role in biological discovery and the success of new programs, such as the Precision Medicine Initiative. Its efforts accelerate discovery, maintain the infrastructure for biomedical knowledge, and facilitate dissemination of accurate health information to clinicians and the public. The NLM can be viewed as a contributor to almost every significant biomedical discovery. It ensures instant electronic access to the world's biomedical literature stored in PubMed and indexed through a Unified Medical Knowledge System (UMLS), an integration of more than 2000 biomedical terminologies (1). Its sister resource, PubMedCentral, serves as a free archive of full-text biomedical articles. Within the NLM, the National Center for Biotechnology information (NCBI) not only houses gene sequence databases but also created the methods that link genomes and phenomic structures. Another resource of the NCBI, ClinicalTrials.gov, is a registry and results database of over 200000 publicly and privately supported clinical studies of human participants conducted around the world. Guiding researchers, clinicians, and the public to the right information at the right time rests on an efficient organizing structure. Three functions of the NLM are important here: indexing (creating standard methods of knowledge description and representation in machine-readable form, including indexing), computation (ensuring efficient searching algorithms, creating analytic interfaces and tools), and distribution (making results visible). The NLM does not conduct clinical and biomedical research, but it undertakes basic and applied informatics research, for example, to glean drug-related mutations from thousands of published articles (2), or to match terms used by clinicians with those applied by researchers to describe the same phenomena (3). The NLM is deeply involved in helping to shape public policies related to acquisition, sharing, and safe storage of datafrom ensuring access to research results to reuse of clinical data for research to leveraging big data initiatives for personalized medicine (4). The NLM works with stakeholders to make sure that policies support appropriate access; maintain reasonable privacy rules; and facilitate fair use of copyrighted materials, such as scientific articles. The NLM serves diverse constituencies, from scientists to clinicians to mothers caring for sick children. The bibliographic management resources that serve the health professional also are abstracted and presented in a way to serve the public, such as through MedlinePlus.gov. Partnerships between the NLM and other federal agencies make use of the NLM platforms to bring trusted, relevant health information to the public. Yet the NLM is so much more than computers; the almost 6500 academic and public libraries joined in the National Network of Libraries of Medicine serve as local outreach centers around the country, bringing the NLM resources to patients and providers. As the 19th appointed Director of the National Library of Medicine, I can draw inspiration from the tradition of commitment to scientific rigor, clinical relevance, and public service evidenced in the directors who have gone before me. Systematic strategic planning has ensured that the NLM anticipates future needs while responding to present demands. It is time again for a new strategic plan, and this will be my first priority for advice and counsel from the NLM Board of Regents. A strategic plan documents the aspirations of the moment while providing guidance for the steps necessary to realize those aspirations or reconfigure them in light of continuous learning. The heart of the NLM mission is ensuring access to information for health. Partnerships are key to ensuring that information reaches those who can use and act on it. Publication strategies and dissemination pathways will continue to evolve and change over the years. Not only will NLM continue to serve as the nexus for archival journals, it will also help shape the National Institutes of Health initiatives in data curation and developing the tools and infrastructure for gleaning knowledge from data. The NLM will also look to existing and emerging partnerships to disseminate the world's biomedical knowledge as broadly as possible. The decade-long role of Annals of Internal Medicine as mentor journal to the Ethiopian Journal of Health Sciences in the National Library of Medicine's African Journal Partnership Project is an example of one of those strategies. I invite you to get involved in the NLM strategic planning efforts that will unfold over the next several months. Work with the American College of Physicians to let the planners know what information investments are most valuable to you. Post comments to the draft plans as they are published online. Above all, share your experiences in providing care to peoplethese are the moments of practice that we at the NLM are committed to understand and support.