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Transcripts: Voyaging to the Future Symposium Videos


Transcript: Symposium Overview

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I think we've been extremely fortunate in not only the leadership of the Library but in the quality of the personnel of the library, and the vision that they've shown along with the Board of Regents in working together. I Donald Lindberg...

[Betsy Humphreys:] And the notion that we should build computer systems that could understand medical meaning is an idea that Don Lindberg came to the National Library of Medicine with in 1984. AI-Rheum...SNOMED...PubMed Central One of the first things we had to solve with IAMS was how you could knit together separate email systems. Can you imagine worrying about that in a post-internet world? The Library of Medicine is really an international library. Most of the information we bring is published outside the United States. NLM is the place to go. I go there myself many times a day. Five books -- they were extremely important. There wasn't anything that you could do or put in a budget that didn't have to cite one of the points in those five books. The most under-utilized resource in health care today is the engaged patient. As you pass from the scientist and the doctor to patients, families, and the public, the latter three groups really want to improve their understanding of some situation.

[Dr. Collins:] Much credit to NLM for making sure that when you did jump onto the internet and you asked a question you got the answer in a fashion that was readily understood by the average person who's asking that question. That's not trivial. We started with the librarian. The librarian is the key. One of the big issues is organizing the disaster information which is a very diverse, very disparate body of information. Hey how are you on Medline searches? Medline become very helpful... MedlinePlus...Mobile MedlinePlus Well the MedlinePlus magazine... What he was envisioning 30 years ago is just now taking place in terms of the use of computers in clinical care.

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PubMed and Docline and MedlinePlus ClinicalTrials.gov Unified Medical Language System I think UMLS clearly filled a void. And you wisely said this is a language problem and even more wisely and a benefit to me is you decided you needed a linguist to actually do this work. Absolutely, just exactly what we needed. Exactly. We are actually in the future that the UMLS was designed to help. It's quite human in our attempt to simplify things to bifurcate things. So we would say it's this or that. We say it's bricks and mortar or the digital library and I'm here to tell you it's bricks and mortar and the digital library. Telemedicine... GenBank... Visible Human Project...

I recall the conversations about the Visible Human Project where the concern that you voiced that we would have anti-vivisectionists camping out on the lawn because the National Library of Medicine was slicing up cadavers and you know, none of that ever materialized. The images are exquisite. I mean unbelievable that this is available for free, just the most beautiful, beautiful detail. Every day people download me, download me. It's starting to hurt in parts. Music playing I'm a fan of these shows and the History of Medicine Division. They've done a great job. I love the exhibit. It's great. It's great interactions. You can show how things are identified spectroscopically and under the microscope.

Hokulea is a symbol for the pride and integrity of Native Hawaiians. In all of this, the message is individuals make a difference. Don, I want to congratulate you for always your talented ability to communicate and all of your team as well.

InformationRX... This represents an adjunct that will help both physician and patient going forward into this new millennium. There's disaster information... Profiles In Science... So it is not just about science. It's about being a scientist in the human world. I think the National Library of Medicine is just an incredible creation. We're really lucky that we have something like that in the United States. The National Library of Medicine has been a critical funder in our development of Health Map and other technologies that support public health efforts. The National Center for Biotechnology Information NCBI The Friends of the National Library of Medicine During your tenure, you have really expanded this activity beyond anything that we had envisioned for the Library. It's really extraordinary. It's a great place, great people. [Musical tones]


Transcript: Seeing Genetic Sequences

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[Narrator:] The NLM long-range plan of 1986 endorses the concept of the Library taking an active role in biotechnology information.

[Dr. Collins:] We have tens of thousands of genomes, not just one and all of that has to be assembled in a place where people can compute on it and learn from it and that's where NLM is just a central hub of information that we all depend on. We did introduce some complicated new ideas like DNA is not just a string of letters. You actually have to put it together in pieces and assemble it into chromosomes.

[Dr. Roberts:] The resource itself is now one that one could not do without. I think for those of us who are out in the trenches still doing biology without NCBI we simply couldn't do it.

[Rep. Obey:] Researchers are downloading data equivalent in size to the contents of the entire Library of Congress every week. That's amazing.

[Dr. Bryant:] The real heart of PubChem is the links from each chemical to other sources of information about its biological property. When we were formulating the Framingham Share Program in which we wanted to genotype the 10,000 participates in the Framingham heart study we wanted to put the genotypes and the phenotypes together in a common database and before we know it there was dbGaP Database Genotype and Phenotype.

[Dr. Masys:] Written by Herman Melville here "I thought I would sail a little about and see the watery part of the world." So, you know, if you view our internals, our molecular internals as the watery part of the world then I can only say thanks for the journey and sail on, NCBI. Sail on.

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Transcript: Raising The Floor

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I sense that our training pipelines are scaled for perhaps two decades ago and now this sudden importance of electronic infrastructure has led to this tremendous demand and very little supply for very well-trained individuals who have both the technical expertise implicit in informatics but the domain, depth and the semantics of the data and then good judgment of knowing among 100 things you could do, which ones you actually should do.

[Dr. Collins:] That has become an incredibly exciting field and I think it's all very clear how this arose from initial leadership within the National Library of Medicine making it possible to think of biology in this very computationally rich way.

[Dr. McCray:] NLM has been and continues to be a very warm and welcoming place. I would say that actually the entire field of informatics is that way and I think that's partly because it is so highly interdisciplinary, multidisciplinary.

[Dr. Corn:] From what used to be zero we're now up over 30 percent women in the field and I think that's been a very attractive evolution.

[Alvy Smith:] The idea all along was to take all that discrete raster data and extract geometric models from it to simulate a human body and build a virtual -- I think of it as a flight simulator for surgeons. What I watched the NLM do particularly under your leadership is start a program and then adapt to what we learned. UMLS -- the Unified Medical Language System -- maybe it in and of itself wasn't research. What it was was an unbelievable resource that has enabled all sorts of research.

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Transcript: Building New Informatics

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One of the really rapid trends now is the creation of new departments of computational biology and of informatics at the medical schools. [Dr. Florance:] With the Recovery Act money we could fund twice as much new research last year and this year as we could have without it, and that's fantastic.

[Narrator:] We have developed and installed a system to automate the production of Medline bibliographic records. This system that we call MARS for Medical Article Record System primarily relies on document scanning, optical character recognition, or OCR and most importantly our rule-based algorithms. This is a tremendous accomplishment. In fact, SNOMED is going to be distributed by the National Library of Medicine through its unified medical language system. Donald A.B. Lindberg came out to visit to give a talk, and he and his wife Mary and my wife Mary Helen and I hit it off and it wasn't too long after that that he was kind enough to invite me to join the Board of Regents of the Library so then I really was off and running in informatics.

[Dr. Stead:] I think that your leadership and the way the NLM is run fits Bill Stead's mantra of the way you do things no one has ever done is you try/fail, try/fail, try/fail and you succeed before you run out of time or money but that's just innovation.

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Transcript: Commitment to High Speed Communications

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High-speed computer networks are under development and the foundations for that network are already in place in a really global network called the internet.

[Dr. DeBakey:] You've got Medline and Medlars and you have Grateful Med and the public itself has all this knowledge available to it and they're responding to it more and more. We'll take a little adventure with your United States senator here and see what he can do by introducing the internet Grateful Med.

[Dr. DeBakey:] Ann Landers happens to be a friend and I wrote a letter to her to tell her about the National Library of Medicine's availability on the internet and she published it. That's an example of how the public can be educated.

[News Reporter:] Today on Capitol Hill the National Library of Medicine's Medline internet database is made free to the public. The superhighway on medical information will now become a freeway. This development by itself may do more to reform and improve the quality of health care in the United States than anything else we've done in a long time. I mean we, actually at NLM alone answer a million inquiries a day.

[Chairman:] A day? A day. It's a staggering amount. It's going on 400 million a year.

[Dr. Ackerman:] Telemedicine to rural areas? Absolutely. Telemedicine to the inner city? Yes. But the greatest opportunity for telemedicine is telemedicine right in your neighborhood right to your home. NLM has really provided the seed money for a project that's no longer a research project it's practice now for us.

[Dr. Gupta:] Oftentimes, it's the National Library of Medicine that I turn to and not just as a reporter but also as a doctor. There are 23 million citations on PubMed. ClinicalTrials.gov is a place that I often send my patients.

[Dr. McCray:] The national importance of that resource for patients and families and really for the world continues to make a difference, I think. I push MedlinePlus. I eat, breathe MedlinePlus. It's just amazing, you know, the amount of information that they have on the website.

[Dr. DeBakey:] So today there's virtually no lag between new knowledge coming out of any kind of research activity, and its clinical application. The basic reason for that is what the National Library has done taking advantage of the new technology for the transmission of information.

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Transcript: Reaching the Underserved

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Good information is the best medicine. As health care consumers you and your health care professionals should have the most recent medical information at your fingertips.

[Rita Smith:] We love our National Network of Libraries of Medicine Southeastern Atlantic Region. They are just terrific, and that is due to the National Library of Medicine and the support that they give us which is invaluable.

[Narrator:] In 1993, the very first DeBakey Library Services Outreach Award was given to Mary Jo Dwyer a circuit rider librarian who traveled the back country bringing medical information to rural Texas.

[Dr. Lipman:] Every day, NCBI gets close to four million users coming to our website and many of them come from all over the world so we see international outreach as being really critical to the mission of the National Library of Medicine.

[News Reporter:] Satellite technology provided by the United States National Library of Medicine is being employed in the fight against malaria by providing internet access to research sites in 19 African countries.

[Martha Sczcar:] WISER is a tool that was really developed for first responders to use when there's a hazardous material spill or an incident. There were people, for instance like EPA who actually called us a day or so after Katrina saying, gosh, can you get this downloaded on some Palm Pilots send them off to us. So we did that right away and sent it down to them.

[Over Radio:] Rescue Squad 1 to Hazmat 34

[Dr. Bowles:] Medical emergency sometimes results after human exposure to toxic substances. In many instances emergency personnel not familiar with the chemistry of the offending agents need help in treating the victims. This medical information is available through the National Library of Medicine in Bethesda, Maryland. The Library maintains a computer access database called Toxnet.

[LaCher Napeatti:] When we first started out with our project, our building here was dilapidated. We had some broken windows. We did not have electric. We did not have the connectivity that we do have now. Recently we had the satellite internet input and, of course, our generator. Our facility is now able to plug in.

[Dr. Lindberg:] It's really regaining a sense of pride and importance and a sense of history.

[Dr. Lindquist:] The potential of what this is going to do in educating the American public about American Indian, Alaska Native, Native Hawaiians -- we're still here. We're still alive and well. There is great beauty in our respective cultures.

[Dr. DeBakey:] Immediate access to current medical research is as critical as a biopsy and x-ray have been in the diagnosis and treatment of disease. Your health care professional should have access to the National Library of Medicine and so should you.

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Transcript: Look Back Move Forward

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People had associated the National Library of Medicine perhaps with the adjective venerable but a little staid and conservative and we took it right to the other end of the slider bar in terms of adventuresomeness and doing things that we didn't quite actually know how to do with Unified Medical Language System and creating NCBI and new avenues of digital imaging and new services in an internetted world. That was a very heady time.

[Dr. Stead:] My dream world is one where the individual has enough information about what's going on in the world around them and in their own life that it helps them make decisions helps them identify trends and then connects them to the health system if they need help or connects them to something else in a way that doesn't require the health system to have access to all that information. It actually becomes my own personal life management environment that can connect out when I want it to. I think that kind of thing is actually quite doable now.

[Dr. McCray:] Since you are always a forward looking person where do you see the National Library of Medicine going forward in the next decade?

[Dr. Lindberg:] Well, I think our investment in information for patients, families, and the public is properly placed and I think that is going to be what reforms modern medicine and what makes the Affordable Care Act actually work. I mean it isn't going to be the magic in the laboratory. It's certainly not going to be the magic in computers. It's the patients taking responsibility for their health for their decision-making. Which I think they'll do. So I'm putting my nickle on the patients. I'll raise you a dime.

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