Who Really Are Our Users, and How Can We Help Them?

Well, this is a question too big for even the largest biomedical library in the world to answer. Our users are everywhere, and in fact, the same user may approach us with very different needs or personas, such as the brilliant cell biologist who is also the mother of a sick toddler. Today, I am thinking of that huge army of applied clinical informatics specialists and how we might begin to help them.

Applied clinical informatics specialists form the technical workforce that make health information technologies work for patients and clinicians. These individuals often have a background in nursing, medicine, or another clinical specialization. Their advanced training and advanced certifications can attest to their understanding of how health care is delivered, the data and information resources needed to deliver that health care, the data underlying care, and the person-professional-technology engagement needed to better deliver care through effective use of information technology.

NLM is pretty clear about its role in supporting the enormous research and development efforts that design, deploy, and evaluate computer systems for health care and in making the basic and clinical biological and biomedical literature accessible to patients, clinicians, and researchers. To the best of my knowledge, NLM has not done enough to think about the applied clinical informatics community as a distinct stakeholder group, and it is now time to do so!

Applied clinical informatics professionals are skilled at designing, installing, and implementing electronic health records. Some of them specialize in evidence-based practice, bringing the research evidence into the point of care. Others focus on human computer interaction, striving to harness the power of computing to support practitioners and to avoid cumbersome or ill-designed clinical records systems. Still other applied clinical informatics professionals are crafting the decision-support tools that bring effective, ethical artificial intelligence into practice. Some serve key roles in their institutions’ value-based health care deliberations, bringing to light through data where health care interventions bring value to the patient and the system. And some applied clinical informatics specialists focus on translating science into care. These positions are critical to making sure that the advantages of information technology reach into the realm of clinical practice… and man oh man, are they busy!

This makes it hard for applied clinical informatics specialists to make use of NLM’s vast resources in the ways different from the typical researcher uses of these resources – as part of a larger process of building or evaluating research ideas, in a reflective manner, through exploration of several articles on the same theme, and with the time, the patience, and the purpose to discern lines of reasoning out of multiple articles. To best support the applied clinical informatics community, NLM needs to expand its ways of doing business, and find ways to make in-the-moment search for best practices or clinical guidance available. How can we do this?

Rethink the “typical library user” and be open to the atypical user. NLM also serves as the repository of record for biomedical knowledge. We have presumed that the synthesis and application of that knowledge is the responsibility of the reader. Perhaps now is time for us to find new ways to partner with outside organizations that can cast their special eye over our resources and to cull their knowledge for the applied clinical informatics specialist.

Work on translating our research findings into practical practices. NLM makes a substantial investment in developing new algorithms that find better ways to link clinical records together. We have a small but fledgling program, our tech transfer funding to stimulate new businesses relevant to the use of data in health care. Perhaps we should better advertise the availability of these funds and target the challenges experienced by applied clinical informatics practitioners.

Expand our abilities to cull basic science and clinical care innovations from the literature. Applied clinical informatics professionals have, as part of their job, the building of the information tools to bring science into practice. We need to learn from them so we can better expose our literature for their needs, keeping them abreast of new and emerging findings in the literature that will someday make their trajectory into practice.

Partner with specialty organizations to make sure that the important lifelong skill development of being an applied clinical informatics professional becomes a realistic process in their career trajectory.

A few months ago, I spent a morning speaking with applied clinical informatics professionals to affirm their interest in NLM supporting them in their work and to listen to their needs, dreams, and demands. In a future blog, I will tell you more about what I learned from them!

NLM’s Library Operations is Reimagining to Better Serve You

This blog was authored by staff who serve on the National Library of Medicine (NLM) Library Operations (LO) Strategies Working Group.

NLM is nearing its 200th anniversary in 2036, and NLM’s Library Operations (LO) is reflecting on its continuing mandate to acquire, organize, preserve, and disseminate biomedical information. LO is one of NLM’s largest divisions and comprises over 400 talented staff committed to furthering NLM as the world’s largest biomedical library and a leader in research in computational health informatics. We are re-envisioning our products, operations, and services for NLM’s diverse users around the world.

Last year, we created a “3Cs” framework—Collect, Curate, and Connect—to describe the work we do.

Each component represents the critical work LO performs, but the components do not function in isolation. They are interconnected and move together to achieve operational success.

Illustration shows 3 gears in the middle of various sizes. The gear on the left is titled “Collect” with text below that says acquire and preserve unique and trusted collection of biomedical information. The gear at the bottom is titled “Connect” with text below that says link our global audience to biomedical data and resources to make informed health decisions. The gear on the right is titled “Curate” with text below that says make biomedical information findable through data normalization, metadata, and data standards.
Embracing a Future of Data-Driven Discovery

Our 2021–2036 Long-Range Plan is strategic, thoughtful, and forward-thinking. It will address the challenges that come with the accelerated pace of changing technology, the rise and spread of health misinformation, evolving user expectations, and need for equal and inclusive access to unbiased information.

In support of the three pillars of the NLM Strategic Plan, LO will work collaboratively across NLM and the National Institutes of Health (NIH) to build a data-driven workforce and with global partners to ensure our work accelerates biomedical discovery while reaching as many people as possible.

The five goals of our long-range plan will enhance LO’s mission and prepare us for the future as NLM reimagines its work post-pandemic and moves into its third century.

Illustration shows a 5-step process with numbers on top, description of  steps in the middle, and simple illustrations at the bottom. Step 1 says create a modernized organizational structure. Step 2 says unify and transform NLM collections. Step 3 says support and promote the use of health data standards and terminologies. Step 4 says customer design experience support. Step 5 says know and equitably engage our users.

Goal 1: Create a Modernized Organizational Structure. We will focus internally on our organizational structure, work processes, and the workforce expertise necessary to meet the future needs and expectations of our global users.

Goal 2: Unify and Transform NLM Collections. We will redefine and manage NLM’s diverse collection of both historical and modern content as “one collection,” valued by the world for the knowledge it holds to advance data-driven discovery. We will accelerate digitization, increase digital acquisitions, improve the discoverability of collections data, and continue investing in the physical collection space for future preservation.

Goal 3: Support and Promote the Use of Health Data Standards & Terminologies. We will position LO as a centralized leader in the production of and access to the terminologies, policies, data, and tools needed for wide-scale public use and research.

Goal 4: Provide Customer Design and Experience Support. We will support customers’ needs and translate them into product development and life cycle management by putting the principles of digital government strategy into practice.

Goal 5: Know and Equitably Engage Our Users. We will engage stakeholders to facilitate access, delivery, and dissemination of NLM’s collection and trusted NLM/NIH health information resources through community-driven engagement, training, and capacity-building programs.

The first phase of implementation for all five goals is currently underway, and we plan to continuously measure and assess our progress, evolve as needed, and continue to engage our stakeholders.

Our Commitment to Our Users

The interrelated 3Cs and five goals will allow us to continue to collaborate across our institution to serve NLM’s diverse users, enhance our role as a national library, maintain stewardship of the world’s largest biomedical collection, and serve as a key NIH institute. LO is committed to our continuous improvement, innovation, and data-based decision-making to support biomedical research discovery and integrity. Our core values of user focus, service, knowledge sharing, quality, and trustworthiness continue to serve as our beacon to confidently deliver on the goals outlined in this bold 15-year plan.

Libraries continue to evolve as their users’ needs and expectations change. How are you responding to the changing needs of your users?

Top Row (left to right):
Dianne Babski, Associate Director for Library Operations
Amanda J. Wilson, Deputy Associate Director for Library Operations
Jennifer L. Marill, Chief of the Technical Services Division
Jeffrey S. Reznick, PhD, Chief of the History of Medicine Division

Bottom Row (left to right):
Margaret A. McGhee, Chief of the Public Services Division
Deborah Lockett-Jordan, Senior Administrative Officer for Library Operations
David Gillikin, Chief of the Bibliographic Services Division

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