A Peek into the Inner Workings of NLM’s Health Information Services

Guest post by Dianne Babski, Associate Director for Library Operations at NLM

How does an organization like NLM build and deploy 21st century products and services to support a global user audience? I’d like to give you a behind the scenes glimpse into NLM’s ever-evolving operations, and how we continue to develop the health information resources that you know and love, such as MEDLINE/PubMed, Medical Subject Headings (MeSH), and MedlinePlus.

Agile Product Development

NLM continues to move towards agile product development and digital unification. Where we used to release enhancements and features once or twice a year, we now develop incrementally and release product enhancements frequently. NLM supports innovation in our workforce by empowering product owners to make data-driven decisions through usability reviews and analytics of features, page views, and user requests to inform future actions.

We encourage staff to ask, “Are we meeting users’ needs—now and into the future?”

We have seen the success of this approach in the rollout of DOCLINE, our interlibrary loan request routing system, and the redesign of PubMed. We are in the planning phase of modernizing our flagship clinical trials registry and repository, ClinicalTrials.gov, to deliver an improved user experience on an updated platform to accommodate growth and enhance efficiency. We also embarked on the recommendations of several studies to increase the automation of MEDLINE Indexing. This involves incorporating machine learning and computational algorithms to apply MeSH terms to PubMed citations. As a result, the time for MEDLINE citations to be searched as indexed with MeSH in PubMed will be dramatically reduced, and, more importantly, will better leverage NLM staff expertise around chemical and gene names to enhance discoverability.

Data-Driven and Data-Informed

NLM uses data to balance our portfolio of products and offerings. I like to use the analogy of thinning garden beds to make room for healthier and stronger plants.  We created evaluation measures to review our products and services, which allow us to make data-driven and data-informed decisions to streamline, simplify, and optimize NLM’s portfolio of offerings.

One key principle is to consolidate information into fewer platforms for improved user experience, discoverability, and efficiency. Pruning our garden allows us to focus on products that are unique, high-quality, and trusted resources. I think we can all agree that it’s more difficult to find what you need when information is scattered and disparate. This has informed the retirement of some products that are no longer sustainable or have a succession plan, or low or declining usage. And while a product may no longer exist as a stand-alone product, we have ensured that data and information from those products are integrated into others, made available for download, or both. For example, by integrating Genetics Home Reference and GeneEd data, we enhanced and made MedlinePlus more robust.

Other agencies or organizations sometimes have equally sufficient information and resources available that duplicate efforts. For example, this is true for the resources held in our Disaster Information Management Research Center (DIMRC), which we have begun retiring by limiting updates to select resources, such as Disaster Lit. This resource is currently only updated with COVID-19-related information as the product (or data) transitions ownership to other organizations. Meanwhile, much of the grey literature from Disaster Lit will remain available in the Digital Collections or the NLM Bookshelf.

To help users navigate NLM collections, we are upgrading our Integrated Library System infrastructure with a cloud-based library services platform. The new platform will allow for better systems integration, collaborative functionality, and community features to keep pace with the data demands of a digital ecosystem and enable better distribution to libraries worldwide. Stay tuned for a new and improved Catalog!

A Common Data Language

As a standards organization, NLM designs and integrates products to make information Findable, Accessible, Interoperable, and Reusable (FAIR). Following the FAIR data principles, an interconnected ecosystem of biomedical data, tools and software enables faster research conclusions and resulting publication(s).

NLM’s goal is to link different but related digital research objects, such as articles, data sets, visualization tools, and predictive models, to advance discovery within our vast collection and resources beyond NLM. For example, in response to the global COVID-19 pandemic, we quickly processed provisional out-of-cycle codes and terms from terminology sources in UMLS, RxNorm, SNOMED CT, and VSAC, added new MeSH and supplemental concept records, and new COVID-19-related Common Data Elements (CDEs) in the NIH CDE Repository. NLM also convened a trans-NIH team to identify NIH-endorsed data elements. We are extremely proud of the role we played in accelerating the interoperability and discoverability of critical COVID-19-related information to help solve a global health crisis.

Looking ahead to January 2023, NIH will adopt a new NIH Policy for Data Management and Sharing, requiring NIH-funded researchers to prospectively submit a plan outlining how scientific data from their research will be managed and shared. In response, NLM developed the Dataset Metadata Model (DATMM), designed to describe biomedical research datasets to drive discoverability and re-use of shared research data.

Serving Society

NLM connects globally to a large and diverse mix of stakeholders both in public and private sectors. Our products and services—no matter how agile, digital, or interconnected—would be nothing without our valued users.

We intentionally aggregate diverse data and analytical tools into our collections to advance research on factors such as biological, genomic, social, behavioral, and environmental impacts on health, and characteristics such as sex, gender, age, race and ethnicity. Working with other standards development groups, we are actively involved in efforts to represent sex, gender, race, and social determinants of health in their resources. We develop reliable health information in visual ways that are accessible to broad audiences, including users with low literacy. For example, MedlinePlus offers a series of brief videos (in English and Spanish) covering several popular health topics, and maintains a Health Information in Multiple Languages Collection featuring more than 60 languages to support the information needs of a global audience.

In its 2021-26 funding cycle, the NLM-supported Network of the National Library of Medicine has a new goal to “advance health equity through information”, and will focus on serving underrepresented populations. NLM remains committed to addressing the challenge of health disparities and seeks new ways to provide understandable and trusted health information resources in a variety of ways to support a broad spectrum of users.

I hope this peek inside of NLM gives you a sense of the ways that our dedicated staff are striving to meet the digital demands of the 21st century. Using our strategic plan as a roadmap, we continue to evaluate and develop products with our diverse user base in mind, and recognize that sometimes we need to rethink, rebuild, and reduce our presentation structures.

We’d love to hear how you are reimagining your services. Until next time, may your garden of health and knowledge blossom this spring!