Reaching Those on the Move

Health information for the uprooted or displaced

Last month I was privileged to visit the Phillips Collection, the new Smithsonian National Museum of African American History and Culture (NMAAHC), and the White House. (I know, quite a month!) Each place was inspiring, but I found an unexpected thread linking them: the concept of migration.

At the Phillips, I viewed all 60 panels of Jacob Lawrence’s The Migration Series, reunited for a special exhibition. (The Phillips owns all the odd numbered panels in the series, the Museum of Modern Art in New York the even ones.) These colorful block images depict the migration of African Americans from the rural South to the industrial North, showing men and women in the fields, families at train stations, workers in steel mills, and a changing home life.

Later, at the NMAAHC, I traversed 500 years of African American history and culture, from the enslaved Africans to the first African American president. Then just before Christmas I toured the current home of that president. In the Green Room of the White House, I saw another Jacob Lawrence painting, “The Builders.” At the end of the migration, a chance to build a new life!

Busy workmen on an active construction site, painted in browns, reds and blues.
“The Builders.” This painting of a group of men constructing a building was done by Jacob Lawrence in 1947. It hangs in the Green Room of the White House. (The White House Historical Association)

Those art pieces and museum exhibits inspired me to think about an important way NLM serves the health information needs of the public: how we reach people on the move.

We need to provide health information—often specific and potentially unfamiliar—to people when they are not in their usual, stable places, whether they’re traveling, in the hospital, or uprooted due to war or natural disaster. To do that successfully, we need to explore new ways to get our information out.

Our consumer health website, MedlinePlus, is fully responsive. As a result, it’s easy to use whether viewed on a full-sized monitor or a smartphone’s small screen. The full NLM website is responsive as well. But providing dynamic mobile content takes us only part of the way toward serving people on the move.

NLM’s Disaster Information Management Research Center (DIMRC), within our Specialized Information Services Division, travels that road even further. Our staff focus on maintaining access to health information at all phases of disasters and public health emergencies, circumstances which create their own unique challenges for staying connected and staying informed. Most recently, this impressive team set up websites to aid people in the path of Hurricane Matthew and to provide up-to-the minute information on the Corpus Christi water emergency.

On a larger scale, they have developed apps that serve the specific needs of first responders and emergency personnel, folks who are regularly on the move and encountering unexpected, shifting conditions. These apps—WISER, REMM, and CHEMM—help emergency personnel respond to hazardous materials (hazmat) incidents and chemical, biological, radiological, and nuclear events.

But Jacob Lawrence’s images depicting the terror and beauty of people on the move inspire me to do more. How can we build upon our services for emergency personnel? What else can we do to get health information to people on the move? How can we make sure those uprooted or displaced can readily access information and make sense of it despite the strains of being in unfamiliar locations or unstable circumstances?

I invite you to share your thoughts below.

Leading in Transitions

Maintaining continuity in a time of change

Those of you watching the calendar have probably figured out that I’ve been on the job as the NLM Director for just about five months. My past 30 years were spent in academe, and I figured the biggest transition I would be facing was from academic to Federal employee—daunting but doable, I thought!

I had not figured on the difference between my transition from academic to fed and THE TRANSITION, the change brought about when a new president takes over for a sitting president and the reshuffling in the House and Senate that accompanies it. The logistics of a presidential transition are many—with a good percentage actually completed by October—including preparing briefing books for the incoming administration.

This task is more challenging than it might sound. Putting together a briefing book means distilling this $400 million operation down to a 3.5-page summary detailing our goals, staffing, and key actions for the near future. None of this would have been possible for a newbie without the diligence and insights of Betsy Humphreys, our NLM Deputy Director.

Beyond NLM, it seems to me that the NIH and the entire Department of Health and Human Services (DHHS) is experiencing a mixture of business-as-usual, excitement about change, and curiosity about where a new DHHS Secretary and a whole new administration (with 4,000 new political appointees) will take us.

So what is my role in all of this?

My primary job is to ensure adequate resources for the men and women who work here to create and manage our products and services (such as PubMed, the Common Data Elements Repository, the UMLS, PubChem, ClinVAR, TOXNET, etc.), preserve our historical collections, conduct research, and develop new ways to document clinical trials. I also need to be an advocate for the NLM in NIH-wide discussions about how to foster discovery and support clinical practice in a time of uncertain direction. I must be mindful of my own tolerance for ambiguity, being sure to listen to the concerns of staff and colleagues, respond with confidence, and provide reassurance in a realistic manner.

No leadership job comes with a crystal ball, and my personal opinions about how the future will pan out do not serve as a guide for action. What does guide me is the wisdom arising from the strong NLM leadership team, formed prior to my arrival and now pivoting to guide me as I lead the Library not only in anticipating our third century but also in transitioning to a new administration. The NLM enjoys broad respect and acceptance, so I expect our core mission to persist, but frankly, I too am curious about what the future holds.

What do you think this transition will bring us?

One NLM

Weaving together all NLM resources to meet the challenges of the future

The strategic planning process is in full swing here. Our RFI is active for a few more weeks and getting a lot of attention from individuals and organizations. We’re seeking stakeholder input through four planning panels that will meet during the spring. Those panels will look at NLM’s role in the following key areas:

  1. Advancing biomedical discovery and translational science / Chair: Arthur Levine, MD, University of Pittsburgh
  2. Advancing data science, open science, and biomedical informatics / Chair: Russ Altman, MD, PhD, Stanford University
  3. Supporting the public’s health: clinical systems, public health systems and services, and personal health / Chair: Suzanne Bakken, PhD, RN, Columbia University
  4. Building collections to support discovery and health in the 21st century / Chair: Patricia Thibodeau, MLS, MBA, Duke University

We have also begun internal functional audits to examine the investment and impact in activities critical to our mission, such as public outreach and curation of the biomedical literature.

I have been encouraging our 1700 men and women to think of the strategic planning process as building a blueprint for “One NLM,” that is, to envision the entire NLM efforts aligned and integrated towards a common vision: the National Library of Medicine, in toto, as we prepare for our third century.

One NLM weaves the work of each division into a common whole.

One NLM emphasizes the integration of all our valuable divisions and services under a single mantle, and acknowledges the interdependency and engagement across our programs. Certainly, each of our stellar divisions–for example, the Lister Hill Center for Biomedical Communications, Library Operations, or Specialized Information Services–have important, well-refined missions that will continue to serve science and society into the future. The moniker of One NLM weaves the work of each division into a common whole. Our strategic plan will set forth the direction for all of the National Library of Medicine, building on and augmenting the particular contributions of each division.

So why do we need One NLM?

Achieving excellence as a resource for discovery and science demands that we efficiently leverage the work of each division toward common goals. Additionally, One NLM encourages sharing the expertise found in any one division across all our efforts. Finally, the idea of One NLM entreats us to bring together all the Library’s resources to meet the key challenges of the future across biomedical knowledge collection, curation, and dissemination–ensuring a talented workforce, enabling every staff member to work Six threads of different colors pass through the eye of a single needleat the top of his or her skill set, creating collections that accelerate discovery and address global health needs, and anticipating (and resolving!) the health information challenges of the future.

Take a minute to let me know how this One NLM theme strikes you, and how you think we can use this unifying concept to ensure the excellence of the NLM into our third century.

Holidays Greetings from the Mezzanine!

Like most busy and productive workplaces, the NLM celebrates those times when social events intersect with everyday work. Just now, we are pausing to celebrate the Judeo-Christian holidays of Christmas and Hanukkah. Decorations are up, treats are appearing, and everyday greetings are complemented with good wishes for the holidays and the new year.

Arising from my family traditions and beliefs, I take this time to extend my greetings for a Merry Christmas and a Happy New Year to you, your friends, and your families. In our large family of 10 children, Christmas was a time of giving and excitement, with crafts-leading-to-gifts, secret presents hidden till that special morning, and participation in the church traditions of our community.

Although perhaps the most visible holidays mixing religious ideas and social events, Christmas and Hanukkah are but two of the range of holidays practiced by different cultures and religious sects recognizing the passage of time, preparation for the future, and attention to fundamental faith tenets. Here at the NLM we have staff from nearly every corner of the globe. In Library Operations alone, we have staff who, collectively, can speak 34 languages other than English, and across the Library my colleagues’ ages span from late teens to over 80. While we are united in the goals of our work, we recognize and respect that among us are people who hold a wide range of beliefs and adhere to different traditions that mark the passing of time and visions of the future.

So, as I extend and receive holiday greetings, I try to be mindful that to some, other times and other events provide more meaningful signals in their lives of what Christmas means to me. I encourage you to commit yourself, at least once in the next year,  to learn of the traditions of one of your colleagues–this will extend our holiday greetings year round!

Embracing the Future as Stewards of the Past

A View from NLM’s History of Medicine Division

Occasionally, I’ll be asking colleagues to offer their perspectives on the Library and what we do. In addition—given my particular interest in anticipating our third century—I might ask them to describe what that means for them, as Dr. Jeff Reznick, Chief of the NLM History of Medicine Division, so eloquently does below.

For several years now, the NLM’s History of Medicine Division has been embracing the future as we continue our mission to collect, preserve, make freely available, and curate for diverse audiences the NLM’s treasured historical collections, which span ten centuries. I’ve described this mission as stewardship of the past, and I have argued that it is not mutually exclusive of embracing the future, because to be the best steward of history during times of change, it is important to anticipate, explore, and chart the paths toward many possible futures. So what do I mean by embracing the future?

Embracing the future means facing change. It means engaging and grappling with it, because studying history can contribute meaningfully to contextualizing and shaping change.

Embracing the future means supporting open and “citizen-centered” government. It means enabling access to all, not just a few. It means engaging new audiences, not only the traditional ones. It involves engagement across the disciplines, and across the spectrum of the public, to ensure that scholars, educators, and interested people of today and tomorrow can have access to the world’s historical medical heritage for research, teaching, and learning.

A collection of headshots of those who have written for the Circulating Now blog in the past year
A Chorus of Voices. Through its blog Circulating Now, the NLM is giving voice to our patrons from a variety of disciplines and backgrounds, who—each in his or her own way and together—recognize the research and educational value of our world-renowned historical collections.

Embracing the future means embracing fair use and supporting robust digitization as a means of both access and preservation, and achieving these goals through mutually supportive public and private partnerships. Moreover, embracing the future means appreciating and understanding that digitized historical medical collections exist in a format appealing not only to those focused on deep reading and close study of individual works, but also to scholars and to entirely new audiences interested in mining these digital surrogates and their associated metadata data for more data-focused research. The evolving digital world is producing an ever-increasing volume of digitized physical material and born-digital resources. The worlds of “big data” and data science are meeting a longstanding world of persistent physical objects that contain records of the human condition. As these worlds collide and coexist, opportunities abound to advance interdisciplinary collaboration and expand cooperation among institutions and organizations that preserve history and support current and future medical research, and research in all disciplines.

Embracing the future means pursuing exhibitions and otherwise giving voice to the research and educational value of our historical collections as they speak to important contemporary and historical topics like domestic violence, AIDS, health care professions, and slavery.

And finally, from a leadership perspective, embracing the future means meeting individuals where they stand, treating them as colleagues and as part of a team. It means supporting mentorship to advance careers, continuous learning to advance interdisciplinary research, and teaching focused on historical and contemporary issues of health and the human condition. These initiatives are not only keys to embracing the future of challenges and opportunities. They are keys to succeeding in that future.

More by Dr. Reznick
Embracing the Future as Stewards of the Past: Charting a Course Forward for Historical Medical Libraries and Archives  Article | Lecture
Joining Together for a Win-Win (with co-author Simon Chaplin)