Marking an Anniversary

It’s Tuesday, which means it’s time for Musings.

It’s also time to celebrate! Musings from the Mezzanine is now 3 years old, and we’re marking the occasion with a new masthead, and some reflections.

When I began this blog three years ago, I wanted to use it to reach NLM stakeholders and offer them a chance to get to know me better. Over time, it’s evolved into an important vehicle for communicating advances in the NLM portfolio, describing key policy issues, and highlighting events and other perspectives. To my great surprise, Musings has become a powerful tool for advancing the work we do every day at NLM.

Last year, I decided to direct more of my attention in this blog toward the science of NLM — computational biology, biomedical informatics, and data science. I promised more posts about basic biomedical informatics, data science research, and new partnerships with domain scientists who are building tools that are accelerating discovery. In addition, I wanted to discuss in detail some complex policy issues, such as the data life cycle and the Library’s responsibility to support rigor and reproducibility within federally funded research.

Focusing on the science of NLM, we’ve reported on the work of some of our intramural scientists. For example, Teresa Przytycka introduced the Musings audience to network biology, characterizing the complex way that cells interact with each other as a suite of networks and nodes. Utilizing data from high-throughput experiments, Teresa’s research group has shown how those interaction networks can be leveraged to identify disease-associated groups of related genes.

We’ve had many articles featuring data science this year — from David Hale’s discussion of the innovative NLM Data Discovery portal to Jim Ostell’s announcement of the launch of NLM’s Sequence Read Archive (SRA) in the cloud, making SRA the largest database of publicly available high-throughput accessible via the cloud. We also addressed whether our data are ready and fit for artificial intelligence, and Susan Gregurick described how the National Institutes of Health (NIH) enhances data sharing through NIH-supported repositories, PubMed Central’s data deposit, the Science and Technology Research Infrastructure for Discovery, Experimentation, and Sustainability (STRIDES) Initiative, and a pilot with the generalist repository Figshare.

I’m proud of how we expanded the focus on public policy germane to NLM. Earlier this year, Dina Paltoo, along with Jerry Sheehan and Rebecca Goodwin, updated us on public policy initiatives affecting NLM, including data sustainability, net neutrality, and open science. They reported on the work of an NLM policy team that brings experts together to deliberate on how NLM should address such issues. And, just last month, I shared the congressional testimony that I submitted to the U.S. House Congressional Subcommittee on Appropriations for NIH Investments in Medical Research.

My blog has also become a place to showcase important events and a variety of perspectives. In February, we celebrated the contributions of African American scientists at NIH. Guest bloggers have periodically provided insights into new developments, such as the introduction to authority-based security by Kurt Rodarmer and the overview of NLM’s new Office of Engagement and Training by Amanda Wilson, and shared their thoughts on important issues, such as the discussion of data reuse by Melissa Haendel of the Oregon Health & Science University.

And, true to the blog’s name, I’ve continued to share my own musings as I’ve matured as an NIH director, including on communicating and leading in a time of change and on my role as a nurse who directs a national library, in response to the oft-asked question, “Didn’t you used to be a nurse?” I was delighted to highlight the 10 women who lead institutes and centers at NIH, which has become my most popular post. I also made a plea for the appropriate use of sick leave — please stay home when you’re sick, if you can.

It’s a privilege and a pleasure to develop this blog and to work with NLM Office of Communications and Public Liaison staff to bring these posts to you. Please let me know your thoughts and ideas — and maybe consider contributing something yourself!

Thanks News Outlets for Getting the PubMed Central Word Out!

How do people find out about PubMed Central?

Some people access NLM’s vast bibliographic resources through our website. Others arrive after a Google search or through platforms such as Ovid MEDLINE. But recently I was reminded that news outlets help people find articles in PubMed Central, too. 

While reading an article about consumer electronics and consumer health, I noticed a link provided by the reporter, which I followed to find the original source material. Low and behold, the link took me back home — to PubMed Central (PMC).

PMC is a free, full-text archive of biomedical and life sciences journal literature here at the National Library of Medicine at NIH. Since its inception in 2000, PMC has grown from comprising only two journals, PNAS: Proceedings of the National Academy of Sciences and Molecular Biology of the Cell, to an archive of articles from thousands of journals.

Today, PMC contains more than five million full-text records, spanning biomedical and life science research from the late 1700s to the present!

PMC supports the NIH Public Access Policy, ensuring access to publicly-funded biomedical research. It also helps NLM meet one of its fundamental responsibilities, outlined in our 1956 enabling legislation, “to preserve permanently the content of books, periodicals, and other library materials pertinent to medicine.”

PMC is not a publisher and does not publish journal articles itself. Instead, content is added to the archive through collaborations with publishers, scholarly societies, research funders, and international organizations.

In December 2017, we reported that more than one billion articles had been retrieved within a single year. Since then, more than 300,000 articles in PMC now have associated supplemental material, frequently including the data to support their research findings.

Almost two-thirds of the articles come from journals that automatically deposit any article reporting on NIH-funded research or from journals that fall under PMC’s full-participation category. Another 25% or so represents “digitized content,” an important collection of articles that, through a collaboration with the Wellcome Trust, provides online access to thousands of complete back issues of historically significant biomedical journals. And about 10% of the articles are “author manuscripts,” which have been peer-reviewed and accepted for publication in a journal. These manuscripts are deposited directly by authors complying with their funders’ public and open access policy to make funded research results available widely, sometimes after an embargo period.

We’ve long known that PMC is a boon to scholarship and clinical practice, yet I’ve wondered how the general public would find articles in PMC.

Now I know.

Journalists who want to direct readers to the authoritative source of their reporting use PMC to provide the full text of the journal article, bringing the power of NLM to an even wider audience. I’m proud that PMC is viewed as a trusted resource and delighted that we’re reaching the public in this way.

Hispanic Heritage Month: Improving Access to Health Information

Hispanic Heritage Month (September 15 to October 15) celebrates the many contributions to U.S. society of people originating from Spain, Mexico, the Caribbean, and South and Central America.

Today, there are almost 60 million Latinx-identifying or Spanish-speaking people in the United States (about 18% of the total U.S. population). Representing our nation’s largest ethnic or racial minority, the median age of the Hispanic population is 29.5 years, which is younger than the median age of about 38 years for the overall U.S. population. About 50% are female, almost half are married, and, unlike their non-Hispanic counterparts, they tend to live in households with children. The number of U.S.-born Hispanics is growing faster than the number of Hispanic immigrants.

The Centers for Disease Control and Prevention reports that people of all races who identify as Hispanic are more likely to develop chronic conditions such as cardiovascular disease, type 2 diabetes, and obesity. Each of these conditions can be managed, or even delayed or prevented, by engaging in healthy lifestyle behaviors that include physical activity, healthy eating, and regular check-ups.

So, the health and the health information needs of Hispanics in the United States, and the well-documented disparities that exist between the Hispanic population and other populations, is of critical importance to NLM.

Our powerful consumer health information resource, MedlinePlus, and our Spanish-language version, MedlinePlus en Español, are trusted sources of accurate health information, and we strive to make them culturally sensitive, relevant, and accessible. Our amazing PubMed literature citation database promotes access to research literature in both English and Spanish, and our molecular resources allow for exploring the intersection of genetics and nationalistic identity.

In addition to these online resources, NLM supports Hispanic individuals, families, and groups through our National Network of Libraries of Medicine (NNLM). Serving diverse communities, the NNLM provides another pathway for providing linguistically and culturally relevant health information.  

The NNLM is a powerful human network of over 7,000 academic health science libraries, hospital and public libraries, and community organizations that provide a point of presence in almost every county in the United States. Its eight Regional Medical Libraries (RMLs) make sure that up-to-date information about NLM’s resources are accessible to communities that are often underrepresented in biomedical research. Although all the RMLs provide access to information in English and Spanish, I’d like to highlight the efforts of two of our regions: the South Central Region, serving Arkansas, Louisiana, New Mexico, Oklahoma, and Texas, and the Pacific Southwest Region, serving Arizona, California, Hawaii, Nevada, and the U.S. Territories in the Pacific. Together, these two regions serve 28 million Hispanics — reaching almost half of the Spanish-speaking population in the United States.

The South Central Region supports the Spanish-speaking community specifically through many programs, including outreach to Presbyterian Española Hospital in Española, New Mexico, a special award to the University of North Texas Health Science Center to support a Library School student from a minority community, and emergency funding for Mobile Programming/Pop-up Program Resources & Tools to support disaster relief and response. The Pacific Southwest Region offers programs that engage community health workers/promotores through activities that address social determinants of health as an approach to health education and promotion in the Hispanic community.

But service to the Spanish-speaking public is not limited to the South Central and Pacific Southwest regions. The Middle Atlantic Region offers Spanish language health information resources on topics ranging from AIDS to cancer to diabetes. An interesting program from the Pacific Northwest Region is a grant to bring health information and access to MedlinePlus en Español over the airways from local public libraries to the region.

Because NNLM members are embedded in their communities, they can utilize NLM resources to meet the particular needs of that community. The professional librarians in these communities provide a feedback loop that helps NLM appreciate both the professional terminology associated with critical health concerns and the need to map local colloquial language for Medical Subject Headings (MeSH) to index the literature.  

The NNLM not only helps us extend the amazing federal investment from Washington, DC, to local communities, but also helps ensure that federal staff in Washington understand, in the vernacular, the health concerns of this important population.

During Hispanic Heritage Month — and throughout the year — it’s important to think about how NLM can better engage with the populations we serve. I welcome your suggestions to ensure that our vast and trustable resources serve everyone, everywhere.

Taking NLM’s Story to Capitol Hill

Last month, I had the honor of joining National Institutes of Health (NIH) Director Francis Collins, MD, PhD, and four other NIH Institute Directors to provide testimony before the U.S. House Congressional Subcommittee on Appropriations for NIH Investments in Medical Research. This was the first time in 12 years that NLM provided testimony to Congress.

Each of us was given the opportunity to deliver a three-minute opening statement. As you can imagine, distilling our many successes and contributions down to a three-minute statement was incredibly challenging. I wish that there had been more time because we have so many wonderful stories to share. We were also able to submit a written statement, which is provided later in this post.

It is my hope that NLM will have more opportunities to share with Congress further insights and details about how NLM’s biomedical informatics and data science research play an integral role in supporting the mission of NIH and how we — true to the NIH tagline — turn discovery into health.

Below is the written testimony that was submitted:

PREPARED STATEMENT OF PATRICIA FLATLEY BRENNAN, RN, PhD, DIRECTOR, NATIONAL LIBRARY OF MEDICINE

Madam Chairwoman and Members of the Subcommittee: I am pleased to have this opportunity to speak to you about the exciting work taking place at the National Library of Medicine of the National Institutes of Health (NIH).

ACCELERATING BIOMEDICAL DISCOVERY & DATA-POWERED HEALTH

The National Library of Medicine (NLM) plays an essential role in catalyzing basic biomedical science through its cutting-edge data science and informatics research, comprehensive information systems, and extensive research training programs. As the world’s largest biomedical library, NLM acquires, organizes, and delivers up-to-date biomedical information across the United States and around the globe. NLM operates some of the most heavily used Federal websites.

Millions of data scientists, health professionals, and members of the public use NLM’s electronic information sources every day to translate research results into new treatments, products, and practices and provide the foundation for clinical decision making by health professionals and patients.

Leveraging its 180-year history of organizing and disseminating biomedical literature, NLM is committed to the application of emerging data science capabilities to challenges in biomedical research and public health.

It does this by enhancing its data and information resources and providing leadership in both the acquisition and analysis of data for discovery. It continues to expand its core biomedical literature and genomic collections to include a broad array of health, clinical, and biological data types. It makes these data findable, accessible, interoperable, and reusable (FAIR) for research.

NLM is investing in new research programs to systematically characterize and curate data describing complex health phenomena and to devise new methods to uncover the knowledge held in data. It has restructured its 16 biomedical informatics training programs to address data science as they continue to foster excellence and support a diverse workforce. NLM is in the process of developing an efficient organizational structure to accommodate emerging directions in research and services.

RESEARCH IN BIOMEDICAL INFORMATICS AND DATA SCIENCE

NLM’s research programs support pioneering research and development to advance knowledge in biomedical informatics and data science. Its research portfolio spans such areas as artificial intelligence, computational biology, clinical decision support, public health surveillance, visualization, and discovery mining in digital data sets. This research encompasses areas of high importance to NIH and society at large, and for audiences ranging from clinicians and scientists to consumers and patients.

Research in data science produces novel analytical approaches and visualization tools that help scientists accelerate discovery from data and translate these findings to clinical solutions. It also aims to solve problems consumers face in accessing, storing, using, and understanding their own health data and to produce tools that make precision medicine discoveries available and more understandable to patients.

Biomedical informatics research is yielding advanced analytical methods and tools for use against large scale data generated from clinical care, leading to fuller understanding of the effects of medications and procedures as well as individual factors important in the prevention and treatment of disease processes.

Recognized as a leader in clinical information analytics, NLM supports and conducts research in areas such as medical language processing, high-speed access to biomedical information, analysis and use of high-quality imaging data, health data standards; and analysis of large databases of clinical and administrative data to predict patient outcomes and validate findings from clinical research studies. Leveraging extensive machine learning experience and field-based projects, NLM is now advancing analytical tools and deep learning techniques for application in image analysis research.

NLM’s biomedical informatics research also addresses issues in computational biology. Research creates new ways to represent and link together genomic and biological data and biomedical literature and produces analytic software tools for gaining insights in areas such as genetic mutational patterns and factors in disease, molecular binding, and protein structure and function.

Last year, NLM established a new partnership with the National Science Foundation to support research on advanced analytical methods specifically applied to health.

BIOMEDICAL INFORMATION SYSTEMS FOR RESEARCH AND HEALTH

NLM develops and operates a set of richly linked databases that promote scientific breakthroughs and play an essential role in all phases of research and innovation.

Every day, NLM receives up to 15 terabytes of new data and information, enhances their quality and consistency, and integrates them with other NLM information. It responds to millions of inquiries per day from individuals and computer systems, serving up some 115 terabytes of information. This includes genomic data, such as that contained in the Sequence Read Archive, as well as citations to more than 30 million journal article records in PubMed.

On any given day, more than 2.5 million people use NLM’s PubMed Central (PMC) to retrieve more than 5 million full-text biomedical journal articles. PMC serves as the repository for NIH’s Public Access Policy and includes more than one million articles summarizing the results of NIH-funded research. Additionally, ten other federal agencies use PMC as the repository for publications collected under their public access policies.

Recently, NLM enhanced the ability to connect articles in PMC to openly available datasets that support reported research findings. Currently, more than 300,000 articles in PMC include datasets as supplemental materials. Others link to datasets hosted in other trusted repositories. The addition of this information has resulted in a 30 percent increase in daily downloads of supplementary material from PMC.

NLM also offers sophisticated retrieval methods and analysis tools to mine this wealth of data, many of which grow out NLM’s research and development programs.

For example, NLM tools are used to mine journal articles and electronic health records (EHRs) to discover adverse drug reactions, analyze high throughput genomic data to identify promising drug targets, and detect transplant rejection earlier so interventions to help clinical research participants can begin more quickly. Data analysis tools also support complex analyses of richly annotated genomics data resources, yielding important molecular biology discoveries and health advances for applications to clinical care. Such applications demonstrate how the benefits of big data critically depend upon the existence of algorithms that can transform such data into information.

As a major force in health data standards for more than 30 years, NLM’s investments have led to major advances in the ways high volume research and clinical data are collected, structured, standardized, mined, and delivered.

In close collaboration with other HHS agencies, NLM develops, funds, and disseminates clinical terminologies designated as essential for demonstrating meaningful use of EHRs and health information exchange. The goal is to ensure that clinical data created in one system can be transmitted, interpreted, and aggregated appropriately in other systems to support health care, public health, and research. NLM produces a range of tools to help EHR developers and users implement these standards and makes them available in multiple formats, including via application programming interfaces or APIs.

NLM is now providing support to develop tools to facilitate research use of the Fast Healthcare Interoperability Resource, or FHIR, standard that is being widely adopted for use in electronic health records.

ENGAGING THE PUBLIC WITH HEALTH INFORMATION

NLM uses multiple channels to reach the public with health information, including development of consumer-friendly websites, direct contact, and human networks that reach out to communities.

Direct-to-consumer information is made available in lay language through MedlinePlus, which covers more than 1,000 health topics. EHR systems can connect directly with MedlinePlus to deliver information to patients and health care providers at the point of need in healthcare systems. In collaboration with other NIH Institutes and Centers and other partners, NLM produces the print and online NIH MedlinePlus magazine, and its Spanish counterpart, NIH Salud.

The National Network of Libraries of Medicine (NNLM) engages more than 7,000 academic health sciences libraries, hospital libraries, public libraries, and community-based organizations as valued partners in conducting outreach to ensure the availability of health information and efficient access to NLM services. The NNLM provides a community-level resource for NIH’s All of Us program, ensuring a point of presence in almost every county in the U.S. The NNLM provides a robust network that reaches communities that are often underrepresented in biomedical research.

NNLM partners with local, state, and national disaster preparedness and response efforts to promote more effective use of libraries and librarians and ensure access to health information in disasters and emergencies. NNLM also plays an important role in increasing the capacity of research libraries and librarians to support data science and improve institutional capacity in management and analysis of biomedical data.

CONCLUSION

To conclude, through its research, information systems and public engagement, NLM supports discovery and the clinical application of knowledge to improve health. Its programs provide important foundations for the field of biomedical informatics and data science, bringing the methods and concepts of computational, informational, quantitative, social, behavioral, and engineering sciences to bear on problems related to basic biomedical and behavioral research, health care, public health, and consumer use of health-related information.

To watch the entire proceedings, click here: https://appropriations.house.gov/events/hearings/investments-in-medical-research-at-five-institutes-and-centers-of-the-national

Hear Ye, Hear Ye! NLM’s Summer Town Hall

Twice a year, leadership at NLM invites the 1,700 women and men who work for the Library to a Town Hall meeting. These meetings provide an opportunity for leadership to announce new initiatives and demonstrate accountability to our team, and for staff to ask questions and share ideas, concerns, and even words of appreciation.

I use a lot of channels to connect with my colleagues here, ranging from email updates to informal brown bag lunches with groups across the Library, casual conversations in the hallways, and Musings from the Mezzanine. But the NLM Town Hall structure is unique because it allows NLM leaders to receive valuable feedback from staff about how things are going and how changes are perceived, while we’re all in one place. I was happy to host one just last week.

First, we paused to remember Donald A. B. Lindberg, M.D., who served as the director of NLM for more than 30 years. As I noted in last week’s blog post, he was a visionary giant who lives on in the activities and legacy of NLM. We have lost a great treasure, but he would want us to keep investing in the future.

Our Town Hall meeting highlighted progress on many fronts. We reported on implementing NLM’s 2017-2027 Strategic Plan, discussed plans to stimulate innovation across NLM, and talked about employee engagement and the quality of work life.

As we put our strategic plan into effect, it’s important to me that every individual working at NLM knows that he or she plays an important role in the present and future of this great organization.

One of the pillars of our strategic plan is to accelerate data-driven discovery. I was pleased to announce that Xiaofang Jiang, PhD, will be joining NLM’s Intramural Research Program (IRP) as a tenure-track investigator who will be accelerating data-driven discovery. Her research plans involve developing methods for computational microbiome studies, including refining the resolution of metagenomic sequencing to the strain level. She also proposes to design a tool to track the transfer of antibiotic resistance genes using metagenomic data. In other staffing news, the search for a new scientific director for the IRP is underway.

A key component of implementing our strategic plan is communication. Our new director of the Office of Communications and Public Liaison, Jody Nurik, delivered a compelling vision for harmonizing NLM’s public presence to build a stronger, more consistent central identity that will create and enhance engagement with our stakeholders. This effort includes better showcasing the depth and breadth of our work and the resources we make available to the many audiences we serve.

Our discussion of innovation included an announcement of the launch of NLM Labs, a think tank to stimulate new ideas, prototypes, and research that support the goals of the strategic plan. Valerie Florance, PhD, director of NLM Extramural Programs, is heading a committee comprising staff from across NLM that will issue calls for proposals. Any NLM staff member can apply for an NLM Labs award.

The third theme of our Town Hall meeting was ensuring that NLM is a great place to work, and we addressed this in several ways.

The leadership team at NLM has reviewed the responses to the annual Federal Employee Viewpoint Survey, or FEVS, which measures federal employees’ perceptions of their agencies and job satisfaction. Overall, most NLM employees reported positive feelings about the work they do and the quality of their work life, so this year we’re focusing on employee engagement and our commitment to diversity, excellence, and safety.

Like other Institutes at the National Institutes of Health (NIH), NLM is developing a formal anti-harassment plan. Central to this plan is engagement with the NIH Civil Program, whose mission is to foster civility throughout the NIH workplace. The program provides a way for staff to report concerns about uncivil behavior, such as harassment, inappropriate conduct, bullying, and other disruptive actions.

We announced next steps for creating an NLM anti-harassment plan, as well as an upcoming presentation by the NIH Civil Program to Library staff planned for the fall.

After the Town Hall presentations, we opened the floor to comments and questions from staff, whether they were attending in person or online.

Several questions addressed challenges and opportunities facing NLM as a 21st century research institute, ranging from workforce planning, best practices for data center security management, and what it means to have perpetual access to the biomedical literature. Staff also discussed how NLM shares its story with stakeholders across the globe, which served as a reminder of NLM’s responsibility as a custodian of centuries-old historical treasures and our leadership role in the acquisition and analysis of biomedical data and information.

I welcome your questions, thoughts, and ideas about NLM and where we’re going. Whether you’re a Library employee, stakeholder, or member of the public, I want you to see yourself as a part of NLM—now and in the future!

Remembering Donald A. B. Lindberg, a visionary giant with a personal touch

Along with the 1,700 women and men of the National Library of Medicine (NLM), I am saddened at the death of Donald A. B. Lindberg, M.D. (September 21, 1933-August 17, 2019), director of the NLM for more than 30 years.  

A world-renowned leader in applying computers to health care and a giant in the field of biomedical research, he was hailed for his visionary and transformative leadership. When people talk about people with such great influence, they often say that those who come after them stand on their shoulders. With Don, it was different. He made sure that we stood beside him.  

Like many of you, I believe I had a relationship with Don that had nothing to do with me as a person, but everything to do with the personhood of “DABL.” Don had a way of making each of us feel chosen to be in his orbit and making you feel as if he singled you out as a winner—and he thought we all were winners!

Throughout the years, Don reinforced the feeling that I stood beside a giant, not on his shoulders.

Let me share a few memories that illustrate this point.

In the mid-1990s, Don recognized the importance of the patient as part of the health information ecosystem. He realized that changing the health care system couldn’t only be the job of health professionals, but that patient engagement was key and that it involved many disciplines, so he created committees to guide NLM’s long range planning efforts. He made sure that young people like me, who had strong research programs to address patient engagement, were part of the process.

In 2002, as I launched my sabbatical at NLM, Don and his wife, Mary, invited me and my son, Conor, to their home. I can still picture Don and my then-nine-year-old son splashing in their pool. The Lindbergs took the time to share their home with me, a kindness that my son and I will never forget.

When I became NLM director in August 2016, Don and Mary hosted a lovely party for me. They introduced me to so many people important to the Library with whom I wouldn’t have met so early in my tenure. Their warm welcome made me feel anointed as a person of importance to them and as a part of the next generation of NLM.

And as I prepared to attend my first Friends of the National Library of Medicine gala later that year, I told Don that I was looking forward to seeing him. His response was that he wouldn’t be attending; He said, “This is your time to shine. I will come back next year.” And so, he did—to the gala and to lectures, celebrations, and many professional events. He and his wife remained a strong presence in the life of the Library. Mary was not only Don’s wife, she was a hospice volunteer and a strong advocate in her own right.

Don left his legacy in so many ways, including the annual Donald A.B. Lindberg and Donald West King Lecture to be held September 11 at NLM. Edward Feigenbaum, a pioneer in the development of expert systems in artificial intelligence (AI) and in demonstrating its technological significance, will be speaking. I’d like to think Don would be pleased.  

As I sit in the same office where Don worked, I pledge to take forward the integrity and commitment that Don demonstrated in leading this great institution. It’s not only what he would want, it’s what he would expect.

Dr. Donald Lindberg with grandson, Martin, in his NLM office.
Dr. Donald Lindberg with grandson, Martin, in his NLM office, ca. 1999.

On the Importance of Mentors (and Mentors Who Become Friends)

The best mentors not only provide a sounding board to try out new ideas and thoughts, they also give you the confidence to ride new waves of opportunity. But sometimes mentors become something more: They become your lifelong friends.

That’s the way it’s been for me with Jon White, MD.

I’ve been blessed with many mentors and many friends, but this is a good time for me to reflect on my relationship with Jon because he just announced that he is leaving his post at the Office of the National Coordinator for Health Information Technology (ONC). Jon will become the associate chief of staff of research at the Department of Veterans Affairs Salt Lake City Health Care System.

I’ve known Jon for more than a decade, first in his role as the director of the Health Information Technology (IT) Portfolio at the Agency for Healthcare Research and Quality (AHRQ) and then in his role at ONC. We’ve served on committees together, pushed the national health IT agenda, and commiserated when the promise of automation fell short, once again, of what health care needed.

Jon was ONC’s lead for the Precision Medicine Initiative from 2014 to 2017, and he contributed significantly to the IT provisions of the 21st Century Cures Act. He solicited broad consultative input on the nation’s health IT agenda, engaging the JASON advisory group to inform the direction of artificial intelligence and patient participation, and served as co-chair of the Health IT Standards Committee, which was established in accordance with the Federal Advisory Committee Act.

It would take more space than this blog post to detail Jon’s accomplishments as a federal leader in the health IT space, which would detract from what I want you to know about Jon as a mentor who became my friend.

Like the best mentors, Jon challenged my thinking. During hallway conversations and AHRQ council meetings, Jon pushed me to consider how IT could better support patient participation in health care. He pointed me toward funding opportunities, and before the term “manel” was commonly used to describe all-male speaking panels, he invited me to participate on deliberation panels and key committees.

As I weighed the pros and cons of taking what turned out to be this outstanding opportunity to direct the National Library of Medicine, Jon provided me with sound advice, pointing out the opportunities and challenges I might find in a federal position.

My friendship with Jon is a special gift that reflects not so much the quality of his mentorship but an evolution of our relationship. And when you become friends, there is a mutuality that doesn’t really exist in a mentor-mentee relationship.

As Jon moves on, I hope he carries the gift of this mentorship that turned into a friendship into the next stage of his life, and I hope you’ll be inspired to reach out to the mentors and friends in your life.  

Click here for more Musings on mentors.