
In February, I received the Miles Conrad Award from the National Information Standards Organization (NISO). NISO espouses a wonderful vision: “. . . a world where all can benefit from the unfettered exchange of information.” As the Director of the National Library of Medicine (NLM), this is music to my ears.
Standards are essential to NLM’s mission! Standards bring structure to information, assure common understanding, and make the products of scientific efforts—including literature and data—easier to discover. NLM’s efforts are devoted to the creation, dissemination, and use of terminology and messaging standards. These efforts include attaching indexing terms to citations in PubMed, our biomedical literature database housing over 34 million citations; using reference models to describe genome sequences; and serving as the HHS repository for the clinical terminologies needed to support health care delivery. NLM improves health and accelerates biomedical discovery by advancing the availability and use of standards. Standards are dynamic tools that must capture the context of biomedicine and health care at a given moment yet reflect the scientific development and changes in community vernacular.
By their very nature, standards create consensus across two or more parties on how to properly name, structure, or label phenomena. No single entity can create a standard all by itself! Standards are effective because they shape the conversation between and among entities, achieving a common goal by drawing on a common representation.
NLM alone cannot create, promulgate, or enforce standards. We work in partnership with professional societies, standards development organizations, and other federal entities, including the Office of the National Coordinator for Health Information Technology, to foster interoperability of clinical data. We support the development and distribution of SNOMED CT (the Systematized Nomenclature of Medicine – Clinical Terms) and the specific extension of SNOMED in the United States. We developed the MeSH (Medical Subject Headings) thesaurus, a controlled vocabulary used to index articles in PubMed. We also support the development and distribution of LOINC (the Logical Observation Identifiers Names and Codes), a common language—that is, a set of identifiers names and codes—used to identify health measurements, observations, and documents. Finally, we maintain RxNorm, a normalized naming system for generic and branded drugs and their uses, to support message exchanges across pharmacy management and drug interaction software.
Partnerships help us create and deploy standard ways to make scientific literature discoverable and accessible. To this end, we were instrumental in the adoption of NISO’s JATS (Journal Article Tag Suite), an XML format for describing the content of published articles, which we encourage journals to use when submitting citations to PubMed so users can efficiently search the literature and articles as they are described. MeSH RDF (Resource Description Framework) is a linked data representation of the MeSH vocabulary on the web, and the BIBFRAME (Bibliographic Framework) Initiative—a data exchange format initiated by the Library of Congress—adds MeSH RDF URIs (Uniform Resource Identifiers) to link data that will support complete bibliographic descriptions and foster resource sharing across the web and through the networked world.
Standards provide the resources necessary to understand complex phenomena and share scientific insights. Leveraging partnerships in order to develop and deploy these standards both allows efficiencies and produces a more connected, interoperable, understandable world of knowledge. Given the speed at which biomedical knowledge is growing, leveraging these partnerships assures that the institutions charged with acquiring and disseminating all the knowledge relevant to biomedicine and health can successfully and effectively meet their missions.

Patricia Flatley Brennan, RN, PhD
Director, National Library of MedicineDr. Brennan is the Director of the NIH National Library of Medicine, a leader in biomedical informatics and computational health data science research and the world’s largest biomedical library. Under her leadership, NLM has grown its intramural and extramural research enterprise, extended stakeholders’ access to credible and reliable health information, and acquired and preserved biomedical literature using cutting-edge digital research and outreach. Read more about Dr. Brennan.