A New Era of Health Communications

Large phone in the foreground in front of four pay phones that gradually fade into the background

I’ve been reflecting on how communications has transformed our lives, particularly since the COVID-19 pandemic radically changed our ability to interact with others.

Before NLM’s physical workspace shifted to maximum telework, I was walking to work when I passed a strange sight — the last vestiges of pay phones on the National Institutes of Health campus! Those decommissioned pay phones got me thinking about how technology changes over time, how essential communication technology has become, and how NLM’s approach to providing trustworthy biomedical data and health information must evolve as methods of delivery change. As technology advances, we have more choices and greater sophistication in the methods we use to meet our responsibility to deliver biomedical data and health information, as well as in the tools we use to interrogate that information.

Payphones sit outside of the National Library of Medicine, having been removed from use in the building.

The Lister Hill National Center for Biomedical Communications (LHNCBC), now more than 50 years old, provides a case study of how NLM’s efforts to communicate information have been transformed.

LHNCBC was established by a joint congressional resolution in 1968 to stimulate the application of modern communications technologies to the challenges of delivering health information worldwide to support health care services and enhance medical education.

In that same decade, push-button telephone pads were replacing rotary dials, and the Trimline telephone, with the earpiece, mouthpiece, and dial pad in the handset, was introduced. The ARPANET, the early version of the packet-switching internet, appeared soon after. Just as the Trimline phone presaged the design of mobile phones, the early design of LHNCBC laid the foundation for robust innovation in the use of telecommunications tools, computer networks, and high-performance visualization to deliver health information and ensure its use.   

An intramural division of NLM, LHNCBC develops advanced health information resources and software tools that are widely used in biomedical research and by health information technology professionals, health care providers, and consumers. As it seeks to improve access to biomedical information for individuals around the world, LHNCBC conducts and supports research and development on the dissemination of high-quality imagery, medical language processing, high-speed access to biomedical information, intelligent database systems development, multimedia visualization, knowledge management, data mining, and machine-assisted indexing.

In 1994, it launched the Visible Human Project, a landmark accomplishment that made a complete, anatomically detailed, three-dimensional representations of a human male body and a human female body publicly available. 

Current LHNCBC researchers come from a variety of disciplines, including medicine, computer science, library and information science, linguistics, engineering, and education. The Biomedical Informatics Training Program brings together talented individuals to learn from and collaborate with research staff.

Research and development conducted by the interdisciplinary teams across LHNCBC has led to many advances in biomedical communication and information dissemination, such as:

  • Consumer Health Question Answering — This project involves research on both the automatic classification of customer requests and the automatic answering of consumer health questions.
  • Discoveries from Mimic II/III and Other Sources — This effort examines and attempts to validate controversial findings from smaller-scale clinical studies through the interrogation of de-identified medical records and information from health information exchanges. Researchers also conduct retrospective epidemiological studies in areas that lack clinical trials.
  • Open-i — This experimental multimedia search engine retrieves and displays bibliographic citations and their related images by linking to images based on image features.
  • Unified Medical Language System® (UMLS) — This tool integrates key health care terminologies, classifications, and coding systems used by clinicians, billing systems, insurance companies, and researchers. Sources developed include the Metathesaurus®, Semantic Network, and SPECIALIST Lexicon. The UMLS supports health care communication through interoperability, specifically, the mapping of key terms from one vocabulary system to another.

The changes to LHNCBC since its creation in 1968 parallel changes in telecommunications over the past 50 years. Early work at LHNCBC demonstrated how technological advances such as fiber optic networks and semiconductors could be put to best use by the health care sector. Today, LHNCBC continues to improve health through methodological advances in clinical data science and health informatics. We recognize that contemporary communication relies on interoperable data, scalable methods and translation of discovery into operations.  

As health care becomes more highly distributed and NLM resources are increasingly used by individuals around the world and beyond, LHNCBC will continue to be a partner in accelerating health communication.

What trends in health communication do you see ahead? How do you think COVID-19 will shape health communications?

Author: Patti Brennan

Director, US National Library of Medicine

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