Attachment 3 Background and Acquisition History.pdf

ATTACHMENT 3

BACKGROUND AND ACQUISITION HISTORY

With the rapid expansion of scientific knowledge in the years following World War II, it was recognized by the early 1960s that a vast amount of new biomedical information was not reaching those people who needed it: researchers, educators, and especially practicing health-care providers. Indeed, while many medical centers had developed into noteworthy generators of basic and clinical research, the health sciences libraries in many of these centers had been neglected. They were crowded and makeshift, with too few trained librarians, insufficient automation and too few programs for sharing resources.1

In 1965, the President's Commission on Heart Disease, Cancer, and Stroke, chaired by Dr. Michael DeBakey, set as a goal "to achieve fingertip control of the literature, of all that is known about the causes, treatment, and prevention of heart disease, cancer, and stroke, and to make this knowledge available to researchers, educators, and practitioners."2

The Medical Library Assistance Act (MLAA) of 1965 was enacted to help fulfill this responsibility. It established a program of grants and contracts to assist in developing services of medical libraries and in facilitating the dissemination and utilization of information related to the health sciences. Included in the original law and all subsequent amendments was a program to assist the development of a national system of Regional Medical Libraries, each of which would have resources of sufficient depth and scope to supplement the services of other medical libraries within the region served by it. It was determined from the outset that it was more desirable to utilize existing institutions for this purpose than it was to build separate institutions.

Accordingly, the first NLM grant for the establishment of a Regional Medical Library (RML) was awarded to the Countway Library at Harvard University in 1967. It was followed in 1968 by the University of Washington, College of Physicians of Philadelphia, and the John Crerar Library; in 1969 by Wayne State University, the University of California at Los Angeles, the New York Academy of Medicine, and Emory University; and in 1970 by the University of Texas at

1 Bunting A, DeBakey ME, Davies NE, Messerle J, Palmer R. Medical Library Assistance Act: a Twenty-year review. In: National Library of Medicine. Locating and gaining access to medical and scientific literature; report of NLM Board of Regents Long Range Planning Panel 2. Bethesda, MD, National Library of Medicine, December 1986; 32-49.

2 U.S. President's Commission on Heart Disease, Cancer, and Stroke.

Report to the President: a national program to conquer heart disease, cancer, and stroke, vol. 2. Washington, Government Printing Office, 1965; 326.

Dallas, and the University of Nebraska. From 1967 until January 1983, RML services for the Mid-Atlantic area were provided by the National Library of Medicine. In 1971 and 1972, non-competitive contracts to the same institutions were substituted for the grants in order to make the coordination of the national program more effective.

Pursuant to DHHS contracting requirements, in 1979 the Library issued the first three of ten Requests for Proposals (RFPs) for competitive responses from institutions capable of serving as Regional Medical Libraries to various regions of the country. During the next two years, all regions underwent contract competition when their current awards terminated. This process resulted in the decision to award a new RML contract in Region VII to the University of Illinois.

Other awards were made to incumbent RMLs except in Region VI where the incumbent's contract was extended.

In October 1981, the Board of Regents of the National Library of Medicine approved a reconfiguration of the RML Network, reducing the number of RML regions from eleven to seven in October 1982. The new configuration took advantage of the strong working relationships and programs developed over the previous 15 years. Its aim was to provide more cost-effective regional groupings while preserving the level of service to health professionals. RMLs were encouraged to develop appropriate programs on a fee-for-service basis. The Board also approved a revised mission statement. A revised set of program goals was implemented in the 1982-1985 RML contracts. Because of the major change in the configuration of the network, an RFP was issued for each of the seven regions, soliciting contract proposals from institutions wishing to serve as a Regional Medical Library.

Contracts were awarded for a three-year incrementally funded period to: the New York Academy of Medicine for Region 1; the University of Maryland Health Sciences Library for Region 2; the University of Illinois at Chicago, Library of the Health Sciences for Region 3; the University of Nebraska, Medical Center Library for Region 4; the University of Texas, Health Science Center at Dallas for Region 5; the University of Washington Health Sciences Library for Region 6; and the University of California at Los Angeles, Biomedical Library, Center for the Health Sciences for Region 7.

During the spring of 1984, a Working Group of NLM staff met to re-examine the existing program in order to formulate recommendations for the RML program under the next contract period. Input was received from the RMLs and other senior staff of the Library concerning the most critical aspects of RML programs and services. Based upon a projection of the state of the information environment for the next five years, the perceived needs of health professionals, and the input received from within NLM and the RML network, the Working Group revised the overall goals of the network and recommended core programs and services for the next contract period.

A new Statement of Work was prepared, reviewed, and approved by the Director of NLM. The seven-region configuration of the network was not changed, although the period of performance of the contracts was increased from three to five years in order to facilitate continuity and stability in RML programs. In late 1985, competitive contracts were awarded for a five-year incrementally funded period to incumbent institutions in all seven regions.

In 1987, Congress encouraged NLM to develop an active outreach program aimed at transferring the latest scientific findings to all health professionals, particularly those in rural and other underserved areas.3 In response to this charge, the NLM Board of Regents convened a Planning Panel on Outreach which met during late 1988 and early 1989. A special working group of the Panel was asked to look in more detail at the RML program and address a number of questions related to the role of the program in outreach activities. The Statement of Work for the 1991-1996 contracts followed the recommendations of the Panel and working group. The Panel also recommended that NLM consider modifying the seven-region configuration to better emphasize outreach efforts, and change the RML program name to reflect its national structure and direction.

In response to those two specific recommendations, an eight-region configuration was developed which divided the previous ten-state Greater Northeastern Region (Region 1) into two smaller regions (Region 1 and 8) to enable intensified outreach efforts in the ten-state area. The name of the network was also changed to the National Network of Libraries of Medicine (NN/LM).

As a result of the outreach efforts of network libraries during the past 15 years, there are now fewer U.S. health professionals who do not have access to health information. Although the number of health professionals without access to information has decreased significantly, there are still health professionals in rural and inner city settings whose access is not satisfactory.

In addition, an increasing number of individuals today are seeking information for themselves or family members. NLM responded to this interest by developing databases that encompass human genome information, data about hazardous substances and chemical spills, and a wide variety of other topics which can assist citizens in making decisions about their health. The thrust of NLM’s consumer health information program is to improve the national infrastructure that can make electronic health information more readily available to the public and to the organizations providing health information to the public.

In the development of programs to improve the public’s access to health information, the RMLs will work with network libraries, state library agencies, 3 U.S., Congress, Senate, Committee on Appropriations. Departments of Labor, Health and Human Service, and Education and Related Agencies Appropriation Bill, 1988: Report to Accompany H.R. 3058, 100th Cong., 1st sess., 1987, S.Rept. 100-189, p. 138.

state, public and school libraries, as well as other regional, state, and local organizations that provide health information to the public. Outreach efforts will focus on continuing to promote MedlinePlus PubMed, and other NLM databases as resources for locating health information, and on promoting MedlinePlus Go Local efforts.

Within the Statement of Work, each RML is expected to maintain a level of programs and services to continue supporting the infrastructure of the network.

Included are activities related to planning, promoting, and implementing services within the region; coordinating the activities of the region with other regions and within the national program; and serving as a contact point for the region in relation to other library and information networks or health organizations and professional associations. Network infrastructure efforts will also focus on supporting scholarly communication and facilitating access to electronic journals.

Although programs have historically been implemented on a regional basis, widespread use of computers, high speed connections, and the Web are eliminating the need for all programs to be regionally implemented or for regional boundaries to limit collaborative efforts to solve problems. The NN/LM contracts in 2001 expanded the ability to develop and implement a program on a nationwide basis through a qualified institution located anywhere in the network.

An NN/LM National Training Center and Clearinghouse (NTCC), an NN/LM Outreach Evaluation Resource Center (OERC), a National Outreach Mapping Center (NOMC), and a Web Services, Technology & Operations Center (Web- STOC) were implemented in previous NN/LM contracts.

In the 2006-2011 contracts the services offered by the NOMC were transitioned to NLM and the NOMC was discontinued. In the 2011-2016 contracts, NLM will partner with the Medical Library Association (MLA) to merge the clearinghouse component of the NTCC into the MLA Educational clearinghouse. The NTCC’s name will change to the NLM Training Center (NTC) to reflect the elimination of the clearinghouse function and to indicate the national scope of training provided by the NTC.