>> WELCOME ALL TO DAY TWO OF THE BOARD OF REGENTS MEETING. WE HAVE SEVERAL EXCITING EVENTS PLANNED. THE FIRST PART IS CONTINUING OUR DISCUSSION OF THE STRATEGIC PLAN. THEN WE'LL HAVE A COFFEE BREAK AND THEN WE'LL HAVE OUR GUEST SPEAKER, DR. NEIL SMALHEISER AFTER THE BREAK. IN OUR DISCUSSIONS YESTERDAY FAR-RANGING CONVERSATION, WE TALKED ABOUT WANTING TO ACHIEVE A COUPLE GOALS TODAY. ONE IS THE -- AND BOB YOU CAN SPEAK TO THIS, THE OUTLINE OF HOW WE ENVISION REVISING THE REPORT, THE KEY POINTS AND THE OTHER IS TO GET THE FIVE KEY POINTS FOR PATTY TO REALLY BE ABLE TO CONVEY THE EXCITEMENT OF THIS PLAN TO HER VARIOUS STAKEHOLDER AUDIENCES. THAT'S OUR SHORT LIST BUT I'M SURE WE'LL HAVE A FAR-RANGING CONVERSATION. DO YOU, DAN AND JOEL, HAVE ANY SPECIFIC QUESTIONS? JILL, I THINK YOU MAY HAVE HAD SOMETHING YESTERDAY YOU WANTED TO ADDRESS. >> ONE IS A QUESTION TO MIKE AND BARBARA TO SAY CLEARLY A LOT OF THE WORK IS GOING TO FALL ON NLM AND IF THERE'S ANYTHING IN PARTICULAR THEY NEED TO MOVE FORWARD. AND I GUESS I HAVE ONE OTHER COMMENT. I WONDER WHERE THE QUIET, CALM TONE OF THE WRITING RATHER THAN THE EXCITING COMES FROM THE FACT WE HAVE ALL BEEN WRITING. >> LET ME SPEAK TO THAT. IT'S ENTIRELY DUE TO THAT. THIS IS THE PRODUCT OF A LOT OF DISTILLATION AND I CAN SAY THAT BECAUSE I DIDN'T DO IT, THE COLLEAGUES IN MY OFFICE DID AND THEY'RE LIBRARIANS. THE GOAL WITH THE DRAFT WAS TO PRESENT THE IDEAS, NOT TO MAKE THEM NECESSARILY COMPELLING. THAT'S THE NEXT STAGE. WE HAVE A FANTASTIC WRITING STAFF AT NLM I'M SURE CAN HELP US PUNCH IT UP AND ONCE WE HAVE AN IDEA OF THE IDEAS GOING FORWARD. >> THIS SPEAKS TO, BOB, WHAT ARE YOUR IDEAS WE WANT TO HIGHLIGHT. >> WE HAVE A BREAKDOWN IN TERMS OF DISCOVERY, COLLECTIONS, OUTREACH AND THEN WORKFORCE. THAT MIGHT BE FINE BUT ONE POSSIBILITY WOULD BE TO THINK ABOUT A DIFFERENT ORGANIZATION. I DON'T KNOW WHAT THAT MIGHT BE. IT COULD BE THE PIPELINE WE TALKED ABOUT FROM DAY TO DAY AND THEN TALKING ABOUT HOW THE LIBRARY FACILITATES EACH OF THOSE OR SOME OTHER. I WONDER BEFORE WE SETTLE SHOULD WE MAYBE SPEND A LITTLE TIME TALKING ABOUT THE OUTREACH OR CIRCULATE IDEAS IN THE NEXT WEEK. I WOULDN'T GO LONGER THAN THAT. >> WELL, WE ONLY HAVE A COUPLE WEEKS TO PRODUCE THE REPORT. WE HAVE TO BE MINDFUL OF THAT. >> I WOULD LIKE TO BE ABLE TO GET IT DONE TODAY. ONCE WE ALL GET ON THE AIRPLANES IT'S NOT GOING TO HAPPEN. >> IF WE CAN AGREE ON WHAT IS THE FRAME -- AND THEN THE OTHER THOUGHT TO PUNCH IT UP MIGHT BE TO HAVE -- DEPENDING ON HOW WE ORGANIZE IT, SCENARIOS TO DESCRIBE WA -- WHAT WE HAVE IN MIND OF HOW THE LIBRARY DOES THINGS. >> WE HAVE FOUR CONSTITUENCIES. THE NIH, PUBLIC, RESEARCHERS AND HEALTH CARE PROVIDERS. AND I THINK EACH SHOULD KNOW WHAT WE'RE GOING TO DO. >> I'LL CRAM TWO THINGS INTO ONE. FIRST IS WE HAVE LIBRARIES AS A CONSTITUENCY AND AUDIENCE. THE SECOND IS I DON'T THINK AS A BOARD WE DON'T NEED TO WRITE IT. THAT'S THE JOB OF THE PROFESSIONAL STAFF. WE NEED TO SAY THESE ARE THE IDEAS WE WANT STATED AND YOU MAKE IT A COMPELLING STATEMENT. >> I GOT MY CHANCE AND I'LL TAKE IT. >> HELL OR HIGH WATER. >> KEN'S COMMENTS ABOUT OUR DIFFERENT CONSTITUENCIES SEEING THEMSELVES IN WHATEVER THE STRATEGIC PLAN IS. I THINK I SAID IT IN DIFFERENT WAYS. AND I DON'T KNOW HOW YOU'LL DO THAT BUT SEEING EACH CONSTITUENCY SAYING WHAT'S IN IT FOR ME IN A STRATEGIC PLAN. >> YOU THINK IT NEEDS ONE STRATEGIC PLAN OR DIFFERENT EXECUTIVE SUMMARIES? >> HOWEVER, YOU DO IT. AND IT'S CLEAR HERE'S WHAT THE NLM IS GOING TO DO AND HEALTH CARE PROVIDERS AND LIBRARIES. >> WHO DID I MISS? >> THE NATIONAL SCIENCE FOUNDATION WILL BE RESPONSIBLE FOR THE END OF THAT? >> WHEN I READ THE DOCUMENT I FEEL THAT'S WHAT I THINK YOU'RE TALKING ABOUT IN TERMS OF HEALTH INFORMATION AND GOVERNMENT HAS TO PLAY A ROLE IN DOING THAT. INDUSTRY CAN'T DO IT. AND SO I THINK THAT'S THE ROLE OF WHAT YOU'RE TRYING TO DO AND YOU WILL SERVE ALL THOSE CONSTITUENTS BY GETTING A PLATFORM LIKE THAT UP AND SEPARATES YOU AROUND YOU HAVE INFORMATION TO POPULATE AND DISSEMINATE. AND I THINK YOU LOSE THE MOMENT IF YOU DON'T DO THAT. >> THAT'S A GREAT ANALOGY IS THE EQUIVALENT TO THE INTERNET INFRASTRUCTURE. >> THE STAFF NEED TO SEE THEMSELVES AS BEING STRONG PROVIDERS AND PRODUCERS. MANY SEE THEMSELVES AS MOVING INTO NEW OPPORTUNITIES. I WANT THIS TO BE AS EXCITING INTERNALLY TO SHOW PEOPLE LOOKING FOR AN ONGOING CAREER TRAJECTORY THERE BE A PLACE. IT MAY BE NEW BUT THERE'S A PLACE. AND HOW WE CONTINUE THE KNOWLEDGE OF OUR DATABASE AND EXPOSING THAT IN EFFICIENT WAYS THAT SCIENTISTS PUT THE PUBLIC. ONE OF THE TAKEAWAYS I GOT YESTERDAY IS WE NEED TO THINK OF THE TRANSLATION PART BETWEEN THE SCIENTIFIC KNOWLEDGE IN OUR REPOSITORIES INTO THE HANDS OF PEOPLE. I THINK U.P. WILL BE THE ONE TO TAKE US THERE. >> YOU USED AN INTERESTING TERM. THE PRIVILEGED KNOWLEDGE OF PROFESSIONALS. ISN'T THAT WHERE KNOWLEDGE IS POWER IN THE 21st CENTURY SO MAKING THE KNOWLEDGE ACCESSIBLE TO EVERYBODY. MAKING IT TRANSLATABLE TO THE LETS -- LITERACY LEVEL OF ANYONE. BECAUSE IT WOULD ONLY BE FOR THE EDUCATED POPULATION UNDERSTANDING THINGS WHERE OTHERS THINK -- >> I THINK WE'RE HEARING SUPPORT AND ERIC REMINDED ME YESTERDAY I HAVE TO REMEMBER I'M DIRECTING A BIG ORGANIZATION. I'M NOT RUNNING A LITTLE TEAM AND I MAY WANT TO DO WITH A SMALL TEAM. >> I REMINDED BY CELEBRATING YOU. >> BUT IT WAS REMEMBERING I CAN DO THIS WITH $1 MILLION PEOPLE BUT NOT 1700 PEOPLE AND THIS PRECIOUS RESOURCE. >> THERE'S A PROFOUND DANGER IN TRYING TO REACH EVERYONE AND REACHING NO ONE BECAUSE IT BECOMES SO CONVOLUTED AT EACH GOAL NOBODY ACTUALLY SEES THEMSELVES. I REALLY THINK STRATEGIC PLANS THAT ARE LONGER THAN HALF A DOZEN PAGES ARE ARCHIVAL MATERIAL. I WOULD PROBABLY TRY AND BOIL THIS DOWN TO A PARAGRAPH ABOUT EACH OBJECTIVE. AND AT LEAST ONCE IN EACH OF THE THREE GOALS I WOULD PUT SOMETHING FROM OUR INTERMURAL OR EXTRAMURAL RESEARCH PROGRAM THAT SHOWED HOW WE WERE LEADING THE WAY AND WE HAVE A PLATFORM BASE TO CARRY THIS FORWARD WHETHER IT'S NCBI OR THE INFORMATICS RESEARCH TO RELAY PERSONAL HEALTH INFORMATION AND REPORTS FROM THOSE KINDS OF PEOPLE IN THE LAST SEVERAL YEARS. I THINK THERE ARE SOME PARAGRAPH-LINKED NUGGETS THAT CAN BE PUT IN BOXES TO DEMONSTRATE THIS IS A TRAJECTORY WE ARE ALREADY ON. AND DATA SCIENCE IS THE CLEAR NEXT STEP IN ALL THESE CONSTITUENCIES. IT'S GOING TO BE DIFFERENT FOR EACH ONE. AND MONDAY AFTERNOON WE MIGHT PRODUCE A PAPER FOR EACH COMMUNITY. MAY PRODUCE AN APPENDIX WITH A SIX-PAGE REPORT AND SAY THIS IS WHAT WE'VE DONE. >> OR TAKE THE GOALS AND SAY GOAL ONE FOR LIBRARIANS TRANSLATES TO THIS KIND OF A RESEARCH. I WOULDN'T DO IT AT THE OBJECTIVE LEVEL. >> THAT'S NOT IN SIX PAGES. >> UNDERSTOOD. >> I THINK IT'S THE READERSHIP IMPACT WHETHER IT'S ACADEMICS WE KNOW IT OR NOT WILL GO SKYROCKETING UP WITH THE LINK COMING DOWN. I JUST STARTED THIS WITH MY OWN TEAMS AT MICROSOFT RESEARCH. FOR ANY DECISION I ASK FOR A SIX-PAGE, NO MORE, DOCUMENT. THIS COMES FROM JEFF BEZZOS PERSONALLY IN HOW HE RUNS AMAZON AND AS MUCH AS APPENDICES AS YOU'D LIKE. >> I LIKE THE IDEA OF CALLING OUT EXAMPLES. CONCRETE EXAMPLES OF STUFF THAT ALREADY EXISTS AS AN EXAMPLE OF WHERE WE CAN TAKE IT OFF. WHAT DO YOU THINK? I THINK AS LONG AS THE EXAMPLES AREN'T A 20-YEAR PORTRAYAL OF WHAT SOME HAVE PARTICULARLY RELATED TO HEALTH CARE ATTEMPTED THREE TIMES AND THEY HAD INADEQUATE AND RAW DATA FROM 20 YEARS PAST. ONE DOES POINTED PREDICTIONS AT ONE'S PERIL. MY RESEARCH MENTOR SAID IT'S BETTER TO BE CONSUMMATELY RIGHT THAN PRECISELY WRONG AND THE DOCUMENTS IN THE PAST HAVE BEEN PRECISELY WRONG. >> WHAT YOU'RE SUGGESTING IS NOT PREDICTING PUT SHOWING WHERE WE ARE NOW AND WHERE WE CAN TAKE OFF. IS THAT WHAT YOU'RE SAYING? >> WE'RE DOING INFORMATICS. WE'RE BUILDING TOOLS INTERMURALLY AND EXTRAMURALLY SO IT'S A LOGICAL EXTENSION FROM THE WORK OF BUILDING TOOLS ALREADY. WE LECTED WE COLLECTED DATA AND CREATED STANDARDS TO MAKE METADATA MORE USEFUL. I WOULDN'T CORRELATE WITH ANY PRECISION ANY HISTORIC EXAMPLE WITH WHERE THE GOAL MIGHT END UP. SIMPLY SHOULD OBVIOUSLY RELATE TO OUR ABILITY TO WORK IN THAT REALM. >> I LIKE THE IDEA OF ONE TOOL AND TAKING THE BEAUTIFUL DOCUMENT WITH ITS ROUGHNESS IN LENGTH AND PUTTING IT IN SIX PAGES THAT WILL LARGELY BE PRESENTED ONLINE AND TAKE THE REST OF THE MATERIAL AND STRUCTURE IT IN A WAY SO YOU HAVE A LINK WITH EVERY SESSION AND GO OUT TO THE PIECE AS PART OF A LARGER DOCUMENT AND INDEX IT TO THAT PIECE. THAT WOULD BE A GREAT WAY TO PRESENT IT. >> YOU ASKED WHAT'S MISSING AND YOU HAVE A MESSAGE STATEMENT BUT I DON'T SEE A VISION STATEMENT. THE VISION STATEMENT CAN ACTUALLY BECOME A MARKETING TOOL. USUALLY THE VISION STATEMENT IS ONE SENTENCE, IT'S VERY STRAIGHTFORWARD. YOU CAN USE THAT AS YOU REACH OUT TO YOUR CONSTITUENTS. >> THAT'S A GREAT IDEA. >> WHAT YOUR TITLE IS MISSING IS THERE'S NOT A LINK TO THE USERS FOR DATA POWERED HEALTHIER AMERICA OR. >> IMPROVED HEALTH FOR ALL. >> MEAT MATE >> AND WE MAY WANT TO SOMEHOW ALIGN OURSELVES WITH THAT BUT I THINK THE END POINT IS THE HEALTH OF THE PUBLIC. >> SO YOU'RE SAYING TO ADD THE WORD PUBLIC HEALTH? >> NO, NOT PUBLIC HEALTH. NLM -- >> I DON'T THINK AS A GROUP WE'RE GOING TO BE AN EFFECTIVE EDITING BODY. >> GO BACK TO BARBARA AND THE TEAM AND LET THEM COME BACK WITH SOME WORDS. >> OKAY. IS THE GROUP WILLING TO DO A PHONE CALL IN LATE OCTOBER AFTER WE HAVE THE NEXT DRAFT? I THINK THAT WOULD BE GOOD. >> I AGREE WITH JANE WE CAN SPEND THE NEXT 40 MINUTES WORDSMITHING BUT WE NEED TO MAKE SURE THE HIGH POINTS ARE WELL EM EMBRACED BY THE MEMBERS OF OUR BOARD AND WOULD REACH OUT TO OUR ONCOMING MEMBERS, DR. TAYLOR FROM CONNECTICUT AND DR. MANN FROM HOUSTON TO BRING THEM UP TO SPEED SO WE DON'T SURPRISE THEM AND HAND THEM SOMETHING. >> COULD I ASK BEFORE WE GO, BOB POSED -- LET'S GET AN IDEA AS TO HOW MANY AGREE OR DISAGREE WITH BOB IN TALKING ABOUT ORGANIZING THIS ALONG THE PIPELINE IDEA OR CIRCLE OF DATA TO HELP TO DATA CIRCLE. DOES ANYBODY FEEL YEA OR NAY ABOUT THAT. >> OR TO A DIFFERENT ORGANIZATION. >> I THINK IN THE LATE HOUR I DON'T SEE A QUANTUM LEAP ACHIEVED BY RETRAINING THE WHOLE THING BY REORGANIZING THE PRINCIPLE. THERE'S ALWAYS A DEEPER CHECK OF EVERY PARAGRAPH HAVING TO BE WRITTEN. IT LOOKS APPROXIMATELY RIGHT. I THINK WE'RE AT THE TUNE-UP STAGE AND BUFFING IT AND SPRINKLING PIXIE DUST ON IT RATHER THAN REBUILD THE FOUNDATION BECAUSE THE HURRICANE JUST BLEW THE ROOF OFF. >> ANY OTHER COMMENTS? >> SO IT'S A BEEN FASCINATING WATCHING THE PROCESS. I'VE BEEN INVOLVED IN A COUPLE STRATEGIC PLAN INITIATIVES AT A HOSPITAL AND ENTERPRISE LEVEL AND WHEN WE ASK OURSELVES WHEN THINGS ARE DONE AND WE GET TO THE END OF THE TIME FRAME, HOW DO WE IDENTIFY WHETHER WE'RE SUCCESSFUL IN SETTING THE STRATEGY AND WILL WE BE ABLE TO MEASURE THE SUCCESS IN THE IMPLEMENTATION OF THE PLAN. >> IF I CAN COMMENT. THE PLAN IS TO USE THIS AS OUR STRATEGIC PLAN AND VISION AND OVERARCHING GOALS. NEXT ON MY TO-DO LIST WHEN THIS IS ABOUT DONE IS TO HELP DEVELOP AN IMPLEMENTATION PLAN. WE'VE TALKED ABOUT THIS WITH SPECIFIC RESPONSIBILITIES AND TIME LINES AND WANTED TO BRING THAT BACK TO THE BOARD ON OCCASION. >> GO TO SPECIFIC OBJECTIVES OUTLINED IN THE PLAN, HOW WE'RE SPENDING FUNDS IN ACCORDANCE WITH THE OBJECTIVES. >> AND MY EXPERIENCE AT NLM I'VE ONLY BEEN HERE SIX YEARS, NLM SEEMS TO TAKE STRATEGIC PLAN AND WHAT WAS SET OUT PRETTY SERIOUSLY. MORE SERIOUSLY THAN I'VE SEEN AT OTHER PLACES. >> DO YOU THINK THAT SHOULD BE ADDED AT A COUPLE SENTENCES AT THE END. THIS SHOULD BE USE TO ESTABLISH OR -- >> TO ME, I'D LIKE TO SEE US AT SOME POINT AND MAYBE IT'S IN THE APPENDIX ERIC WAS TALKING ABOUT, I'D LIKE TO THINK ABOUT MILESTONES AND CHECK POINTS. IT'S NOT UNREASONABLE TO SAY AT THREE YEARS WE'RE GOING TO TAKE AT LOOK AT THREE THREES ASPECTS OF THIS PLAN OR PROPOSING TO DO WORKFORCE DEVELOPMENT AROUND THE AREA OF SCIENCE AND THERE'S TYPES OF POINTS. >> WE NEED THE FLEXIBILITY TO SAY IT'S NOT WHERE WE WANT TO GO. >> I WAS REFLECTING ON THE PLAN FROM 2005 AND THEY HAD PROCESS-ORIENTED VERBS, IMPROVE THIS WITHOUT STATING EXPLICIT END STATES OF ACHIEVEMENT. IT'S SORT OF WORKED WELL BECAUSE PROCESS ORIENTED WORDS COUNT AND YOU CAN COUNT THE BEANS IN THE JAR WITH PROCESS IMPROVEMENT. AND WITHOUT HARD INFLUENCE SPECIFY SUCH AS NASA WOULD HAVE TO SPECIFY TO GO FOR LUNCH, THEY GET REAL PROGRESS DONE. I DON'T KNOW WHERE THE MIDDLE GROUND IS. IT'S AN A COGENT AND LUCID POINT. >> CAN I ASK THIS TO PATTY OR WHOEVER IN THE STAFF IS THERE SOMETHING IN NIH OR NLM'S GUIDES TO PROTECT THE GUYS OUT ON THE FIELD OR IS THIS MORE OF A REQUIREMENT TO BE LESS DIRECTIVE. >> THERE'S NO REQUIREMENT. DAN AND I TALKED ABOUT THIS IN OUR LAST PHONE CALL. WE NEED TO BE CLEAR WHETHER WE'RE LAYING OUT A STRATEGIC PLAN. I THINK WE'RE LAYING OUT A STRATEGIC PLAN. I THINK WE'RE SAYING THERE'S A LOT OF THINGS WE WOULD DO AND THAT'S WHERE THE PRODUCT IS AND MAYBE WE SHOULD THINK ABOUT THAT ON AN ANNUAL BASIS ON HOW TO BENCHMARK THOSE AND WHAT WE THINK OF AS BEING GAME CHANGERS OR A REAL NEW INVESTMENT FOR US WE SHOULD BE ATTEMPTING AND THAT'S THE CRUX OF THE PROJECT. THIS DOCUMENT. I'VE STARTED WORK WITH OUR LEADERSHIP TO LOOK AT WHAT ARE YOU TRYING TO ACCOMPLISH IN A YEAR AND HOW DO WE HAVE THE RESOURCES IN PLACE TO DO THAT. AND THIS FEELS TO ALL OF US LIKE A DIFFERENT WAY OF OPERATING WITHIN NLM SO WE'RE USED TYING PROJECTS PROJECTS TO DOLLARS BUT WE'RE NOT THERE YET. >> ONE THING THAT'S MISSING FROM THE INTRODUCTION OF THIS DOCUMENT THAT COULD BE PART OF THE METATO META TO THIS IS MAYBE THIS COULD HAVE BEEN SAID IN '95 AND 2000 BUT I DON'T THINK SO. IT SEEMS WE'RE AT A REAL INFLECTION POINT IN THE ROLE OF COMPUTATION AND HEALTH CARE AND OTHER FIELDS. MORE SIGNIFICANT THAN THE HOCKEY STICK CURVE RIGHT NOW. THE IDEA OF WHAT IS WRITTEN OUT THREATENS, CHALLENGES, PROVIDES OPPORTUNITIES FOR WHAT THE NLM SHOULD BE PERHAPS WITH A LENS THAT'S DIFFERENT THAN PRIOR STRATEGIC PLANS. WE DEFINE THE WHOLE -- WHAT THE NLM IS AND WE'RE DOING THESE THINGS BUT AT THE SAME TIME I THINK WE WANT TO CALL ATTENTION TO THE BEING CRITICALLY IMPORTANT OF BEING FOLLOWED AND IMPLEMENTED WITH CARE AND MONITORED EVEN THE CHANGES GOING ON AND THERE'S A COUPLE SENTENCES THAT DON'T -- >> THE HOMAGE -- >> WE'RE UP AGAINST A CHANGING BOAT. >> IT'S LIKE A SEIZE THE MOMENT OR SEIZE THE OPPORTUNITY. >> IT'S A SEIZE THE MOMENT FOR NIH. >> THE ONLY THING I WOULD SAY IS WE THINK WE'RE AT THAT POINT AND WE MAY WELL BE. HAVING LIVED THROUGH THE PROCLAMATION OF THE PAPERLESS OFFICE AND STILL HAVING MULTIPLE FILING CABINETS TO WRESTLE WITH I THINK WE HAVE TO BE CAREFUL WITH ABSOLUTE. I AGREE IT'S A CRITICAL POINT. AND A DIFFERENT TYPE OF CHALLENGE BUT I'D BE CAUTIOUS IN SAYING THIS IS ABSOLUTE WHERE THINGS ARE GOING TO GO. >> SO EACH HAVE VIEWED THEMSELVES WITH EXCITEMENT THAT THE WORLD WAS CHANGING IN A DIFFERENT WAY. IT TURNS OUT THE INFLECTION POINT ARE NOT DISTRIBUTED ACROSS THE LANDSCAPE. AND THE EXPECTS OF ALL THE WONDERFUL THINGS -- EXPECTATIONS OF ALL THE WONDERFUL THINGS THAT COULD HAPPEN AND IT WAS LESS CLEAR IN 2005 AS WE OBSERVED IN OUR DISCUSSION, THE PLAN CAME OUT FOUR MONTHS BEFORE THE iPHONE WAS RELEASED. WHAT WE SEE CLEARLY AS THE CHANGE IN THE ENVIRONMENT IS GLOBAL ACTIVITY AND NETWORK DEVICES FOR THE MAJORITY OF INDIVIDUALS. THAT THE INFLECTION POINT OF NEW OPPORTUNITY BUT AT THE HIGH END OF COMPUTING THINGS AND WHAT I THINK WE LACK IN THIS ROOM AND THE OPPORTUNITY IS PROVIDED BY HIGH COMPUTATION. >> ON THE OTHER HAND I LOVE WHAT YOU SAID GLOBAL CONNECTIVITY FOR POCKETS OF EVERYONE ON THE PLANET. THE MAJORITY OF PEOPLE. THANK YOU. >> AND THERE'S THE VISION THEY'RE ALL PART OF THE CHANGE. ARE YOU SAYING WE SHOULDN'T INCLUDE THAT. >> AND IT'S RELEVANT WITHIN ITS REACH. >> SO THESE ARE GREAT POINTS AND EXCITING WORDS. GARY. THE POINT IS THAT YOU WILL BECOME OBSOLETE IF YOU DON'T DO SOMETHING. SO YOU HAVE THAT I AM PER IT TIF. IMPERATIVE. IT'S NOT OPTIONAL HERE. YOU HAVE TO MOVE FORWARD IN SOME DIRECTION. >> I WANT TO MAKE SURE WE'RE AT A POINT WHERE I UNDERSTAND THERE ARE CONSIDERATIONS BOB WANTS TO BE SURE APPEAR IN OUR HIGH-LEVEL OUTLINE. AND I'M HEARING DAN SAY THE HIGH-LEVEL OUTLINE IS ROBUST, PUTTING WORDS IN YOUR MOUTH. ARE THERE WAYS -- AND BOB I HEARD YOU MENTION OUTREACH SPECIFICALLY WHICH IS NOT SOMETHING WE ADDRESS SPECIFICALLY IN THE THREE BIG POINTS THAT WE HAVE. IS THERE A WAY YOU WOULD SEE US MAKING SURE WE HIGHLIGHT THAT MAYBE UNDER GOAL TWO? EXPRESSED OR MAYBE NOT AS OBVIOUS WITHOUT CHANGING THE OUTLINE THEY COULD BE BEEFED UP INTERSECTION HEADS OR SOMETHING. I'D LIKE TO SEE THAT. >> ONE IS KNOWLEDGE BEING SERVIENT AND IF WE CAN BEEF THAT UP TO RECOGNIZE DATA IS A LINE. AND I SAID APPLICATION AS YOU GO THROUGH THE PIPELINE. IT INVOLVES ALL THE CONSTITUENCIES THIS NEEDS TO REACH. IT'S THE PUBLIC, PUBLIC HEALTH, IT'S THE CLINICIAN, THE DISCOVERER, RESEARCHER, IT'S THE LIBRARIAN. WHERE WE DELIVER AND ADAPT THE KNOWLEDGE WHERE WE CREATE IT FROM THE DATA. THAT'S THE END POINT. THAT PROVIDES MORE DATA THAT FEEDS BACK INTO IT. SOMEHOW I GUESS I WANT TO SEE US CONVEY THAT DYNAMIC AND WHETHER IT'S SEPARATE MAYBE A PARAGRAPH THAT DESCRIBES THAT -- >> SO I HAVE BROUGHT THIS UP BEFORE, WHY NOT HAVE A FIGURE. ARE YOU ALLOWED TO HAVE FIGURES IN THESE THINGS? >> WE KEEP TALKING ABOUT IT BUT IT'S EASIER TO VISUALIZE. IT DOESN'T TAKE MUCH OF THE SIX PAGES AND THAT HIGHLIGHTS IT. A PICTURE'S WORTH A THOUSAND WORDS. >> LET ME GET THE REACTION OF THE GROUP, IF I CAN. BOB WANTS US TO EMPHASIZE KNOWLEDGE MORE AND MAYBE IT'S THE TRANSLATION OF DATA AND DATA TO KNOWLEDGE AND WHICH IS FAMILIAR TO THE INFORMATICS PEOPLE. I WANT TO MAKE SURE WE'RE HEARING THIS CORRECTLY AND THAT IS I'M HEARING AT LEAST IN BOB'S WORDS A SUGGESTION HOW THE NLM CAN PROCESS UP WHAT WE'RE CURRENTLY PROVIDING WHICH IS THE LITERATURE OR GENOMIC DATA TO PACKAGING WHAT WE'RE PROVIDING INTO MAYBE SOME LEVEL OF DARE I SAY PRECISION KNOWLEDGE OR -- >> THERE'S A LOT OF EFFORT IN THE CLINICAL SPACE AND MAYBE ON PRECISION MEDICINE IN ARTIFACTS THAT CAN BE USABLE IN THE DATA. THAT'S LARGELY DONE BY OTHER ENTITIES LIKE HL7 AND ONC AND OTHER ENTITIES BUT WHERE SHOULD THE REPOSITORIES LIVE AND COORDINATED FOR THE COMMUNITY. >> THAT'S HELPFUL BECAUSE IT MAKES ME THINK OF OUR VALUE CENTER. FOR THE SECOND APPLICATION OF STAKEHOLDERS I HEAR TWO NEW STAKEHOLDERS ARE COMING IN SO IT WILL EXCEED SIX PAGES. WHAT I HEAR IS PARTNERSHIPS TO THE EXTENT WE CAN'T WITH ASSOCIATIONS AND PUBLIC GROUPS WHETHER IT'S HL7 OR CMS OR THE ARL. AND I THINK THESE PARTNERSHIPS WILL BE EXTREMELY IMPORTANT AS WE GO INTO A FUTURE FOR DATA SCIENCE BECAUSE WE WILL NOT HAVE ALL THE DATA REPOSITORIES INSIDE THE NLM FIREWALL. WE HAVE NOT BOARD THE I-BOARD TO THE COVERING BACK IN AND I WILL THAT'S INDUSTRY. WE NEED TO THINK OF THE PHARMA INDUSTRY AND IF WE THINK OF THE CHAIN OF OPENNESS WE NEED TO LOOK AT NEW WAYS OF INVESTING. I'M NOT GOING TO ALL OVER THE INDUSTRY BUT WE'RE TALK THE SAME INDUSTRY HERE. >> YOU WANTED TO SAY SOMETHING, JIM? >> SHE >> THE SUPER HIGHWAY IS RESONATING WITH ME BECAUSE WHEN YOU JUST TALK DATA YOU LOSE KNOWLEDGE AND HOW DO YOU GET MORE OF THE TOOLS TO THE KNOWLEDGE AND THERE'S LIKE A PROCESS I FEEL -- >> MAYBE SUPER HIGHWAY IS NEW. WE HAVEN'T USED THAT. >> UH-OH. >> THE HELL SUPER HIGHWAY. >> AS A COMMENT, I DON'T WANT TO WORD SMITH NOW BUT -- GOING FROM DATA TO KNOWLEDGE AND INSIGHT, COMMA, AND INCLUDING NEW MEDICAL FACTS, PATIENT-SPECIFIC COMMISSION SUPPORT AND TOOLS USED IN THESE WAYS. THE IDEA IS KNOWLEDGE IS BEING CAPTURED AS THE IDEA OF CAUSAL RELATIONSHIPS, NEW MEDICAL RESULTS AND FINDINGS AND INSIGHTS REFER TO HOW YOU TREAT A PARTICULAR PATIENT OR POPULATION COMING FROM THE DATA. AND THEN COMMA, YOU HAVE TO HAVE TOOLS AND VISUALIZATION. >> CAN YOU SEND THAT PHRASE TO MIKE. >> I WAS THE ONE IN THE FIRST TWO SENTENCES PUT DATA, INFORMATION, KNOWLEDGE. HAVING SAID THAT, KNOWLEDGE HAS GOTTEN BEAT UP RECENTLY. IT'S A SYNTHESIS AND INFERENCE BASED ON DATA. AND THINGS WE USE TO -- USED TO KNOW AND THINGS HAVE SINCE BEEN PROVEN TO BE WRONG. IN MEDICAL SCHOOLS WE TELL YOU HALF OF WHAT WE TELL YOU IS WRONG WE JUST DON'T KNOW HOW. IT IS THE CASE THOUGH. YOU THINK OF ALL THE THINGS WE THOUGHT WE KNEW AND HORMONE REPLACEMENT THERAPY WAS A GOOD THING. ESPECIALLY WHEN IT COMES HEALTH CARE. KNOWLEDGE SEEMS TO EPHEMERAL BECAUSE IT ERODES QUICKLY OR GETS DESTROYED OR REVISED SO DRAMATICALLY IT GETS TO BE A STAIN -- WE WERE SO CERTAIN WE WERE RIGHT AND NOW WE'RE WRONG. SO IN A SENSE THE ASSUREDNESS AND BY THE WAY, IF I'M AN EXPERT MOLECULAR BIOLOGISTS I LOOK AT A GENE SEQUENCE AND I SAY TO ME THAT'S KNOWLEDGE BECAUSE I RECOGNIZE AND RECOGNIZE THE CAUSALITY. THERE'S NO LINES BETWEEN THE DATA. >> I LEARNED THIS WORKING WITH THE FORMER DIRECTOR OF THE HISTORY OF MEDICINE DIVISION, LOOKING AT IT FROM A HISTORIANS POINT OF VIEW IT'S NOT THIS SHINING HIGHWAY THAT LEADS US TO THE CASTLE ON THE HILL WHICH SCIENTISTS THINK IS THE KNOWLEDGE OF THE END. AND THIS SPEAKS TO JEFF RESNIK'S CIRCLE IS MAYBE WE NEED IT NOT BE AAL TO THE END BUT A CIRCLE COMING BACK AND THAT WAY IT'S NOT KNOWLEDGE FINAL. IT KEEPS GOING. THE IMAGE GOES FROM STRAIGHT LINE TO CIRCLE. WOULD THAT SATISFY YOU AND YOU? >> SO KNOWLEDGE IS NOT CAST IN STONE BUT PREDICTIVE MODELS, EVIDENCE-BASED AND CONTINUALLY BEING REVISED. WE DON'T DO THAT RIGHT NOW BUT WE HOPEFULLY WILL BE IN A MORE DYNAMIC AREA -- >> MAYBE THAT'S THE WORD, DYNAMIC. >> MORE WIDE LY ACCEPTED VIEW OF KNOWLEDGE. GENERALIZABLE TRUTH THAT IS THE STATE OF THE WORLD. IT HAS AN ELEMENT OF IT OUGHT TO HAVE A DURABILITY THAT TRANS TRANSCENDS. >> I HAVE SEEN AN E-MAIL ABOUT IT. SO IT'S INTERESTING TO SEE WHAT'S BEEN GOING ON AND THINGS HAVE BEEN POPPING IN AND OUT AND FLASHING IN AND OUT. AND HERE'S A PERFECT EXAMPLE. WE WERE TRYING TO PUBLIC IN THE MAINSTREAM MEDICAL LITERATURE WE WERE TRYING TO GET AN ARTICLE TO CIRCULATION, THE JOURNAL ON FINDINGS OF MANY LEARNING OF LARGE DATA SETS TO COME UP WITH GUIDANCE IN A HOSPITAL ABOUT HOW TO BEST PREDICT ADMISSIONS FOR CONGESTIVE HEART FAILURE AND KEPT GETTING REJECTED. IT WAS A GREAT PIECE OF WORK BY MAINSTREAM LITERATURE. AND WE THOUGHT WHAT ARE THE FACTS? WE'D GET WEIGHTS FOR THE HOSPITAL. WHERE ARE THE FACTS, LOOKING FOR MEDICAL FACTS YOU'VE GOT RESULTS. THE POINT HERE IS WE HAVE A SYSTEM IN PLACE FOR TAKING INFORMATION, LARGE INFORMATION FOR A HOSPITAL SETTING AND CAN TRANSFORM THAT FOR MAKING PREDICTIONS. THAT KEPT FALLING THROUGH THE GAPS AND SO WHAT DAN'S SAYING IS YOU LET INFORMATION OUT THERE AND WE MIGHT HAVE TOOLS TO GIVE US PROBABILITY AND THERE'S KINDS FROM THE CURRENT DATA AND WE STILL ARE PURSUING KNOWLEDGE, PRACTICES, INSIGHTS, WHETHER IT'S SPECIFIC OR GENERAL. AND WE SHOULDN'T THROW OUT THE KNOWLEDGE BABY WITH THE BATH WATER AND WORRY ABOUT BEING OVERCONFIDENT FROM THE PAST. IT'S STILL THE GOAL. BEING HOSPITAL SPECIFIC WIN DNA AND RNA WHICH WE CAN'T ARGUE ABOUT ANY MORE OR OTHER THINGS. >> IT'S THE POSTER CHILD OF THE TOTAL REVISION OF TRUTH. >> WHAT ARE YOU TALKING ABOUT? >> YOU SKIPPED WISDOM. >> HIV CAME ALONG AND GUESS WHAT, MOTHER NATURE RUNS THE MACHINERY BACKWARDS. THE PROBLEM WITH KNOWLEDGE IS THAT IT EMBEDS A CONCEPT THAT I KNOW THINGS. WHEN I SAY I KNOW SOMETHING, I HOLD IT TO BE A TRUTH ABOUT THE WORLD. >> POINT OF CLARIFICATION. WE NEED TO INTRODUCE IN THE BEGINNING THE NATURE OF THIS DIALOGUE. HEALTH CARE MEDICINE HAS UNCERTAINTIES AND A PASSION FOR PERSISTENT TRUTH AND RECOGNITION THAT TRUTH IS DEFINEABLE. THE LIBRARY IS NOT HERE TO DECLARE TRUTH BUT CREATE AN ENGINE FOR REASONING. >> THAT'S GREAT. >> WE NEED TO GET TO ACTIONABLE. >> THIS IS WHERE THE HOCKEY PUCK STICK IS TAKING OFF AND CHANGING. BY HAVING THESE TOOLS WE ARE GOING TO BE ABLE TO CHANGE THE WAY WE GET -- >> I'VE SAID RESOURCES AND DIFFERENT WAYS TO GET -- I DON'T WANT TO GET TOO METAPHYSICAL BETWEEN THE KNOWLEDGE AND THE TRUTH. I THINK WE COULD HAVE A WHOLE SET OF NEW RESOURCES WE CAN PROVIDE TO DEVELOP TOOLS TO GET BETTER INSIGHT AND IMPROVE TREATMENT OF PATIENTS AND IMPROVE PUBLIC HEALTH AND UNDERSTANDING OF PROCESSES. >> WE'RE DISRUPTING SOME THINGS BECAUSE WE SOLD EVIDENCE-BASED PRACTICE TO PHYSICIANS AND NOW WE'RE ASKING THEM TO TRUST USIN A WAY AND SAME WITH RESEARCHERS. WE FINALLY GOT YOU TO REALIZE YOU HAVE ENOUGH POWER TO DO A "T" TEST BUT MAYBE THAT'S NOT THE BEST WAY. >> THAT'S DISRUPTION. THAT'S A GOOD WORD. >> I HAVE AN ABSTRACT IN WHAT WE'RE DOING WITH DATA SETS. IT WAS TOWARDS GENUINE EVIDENCED-BASED MEDICINE. >> A PHILOSOPHER SAID WE DON'T HAVE THE KNOWLEDGE TO ESTABLISH TRUTH WE CAN ONLY FALSIFY. >> I LOVE IT. >> THAT GETS TOO CLOSE TO FAKE KNOWLEDGE. >> IT WAS AN INTENT TO FIND TRUTH IN MATHEMATICS AND TO LEAD TO ANOTHER POINT, ONE OF THE THINGS THAT EXCITED ME ABOUT THE STRATEGIC PLAN WAS AROUND REACHING OUT TO DIVERSE AUDIENCES AND THE PUBLIC COMPONENT OF THE STRATEGIC PLAN. I THINK THAT'S INCREDIBLY IMPORTANT. I WANT TO MAKE SURE IT GETS CAPTURED IN THE SIX PAGES. THE PURSUIT OF KNOWLEDGE IS A WONDERFUL THING BUT IF WE DON'T EDUCATE THE PUBLIC, WHAT'S THE POINT. AND THE LIBRARY DOES HAVE THAT MISSION. I THINK IT'S A GREAT OPPORTUNITY TO GET INFORMATION INTO THE HANDS OF AMERICANS ACROSS THE COUNTRY. I DON'T KNOW THE NUMBERS NOW. I WAS LOOKING AT THE HIGH SCHOOL GRADUATION LEVEL AND OVER 70% OF AMERICANS GRADUATE FROM HIGH SCHOOL. I DIDN'T REALIZE THE NUMBER. IN D.C. IT'S 35%. THESE ARE COMMUNITY WE HAVE TO GET INFORMATION I WAS LOOKING AT LINKING GOAL TO GOAL ONE. THERE WAS A CONNECTION IN PARTNERS AND LINKING PARTNERS AND I THINK YOU HAVE TO REACH OUT TO THOSE COMMUNITY. YOU CAN'T ASSUME THEY'LL COME TO YOU AND IN GOAL ONE I GOT THE FEELING YOU WERE EXPECTING THE PARTNERS TO COME KNOCK ON YOUR DOOR. I DON'T THINK THAT'S GOING TO HAPPEN THAT WAY. YOU'LL HAVE TO FIND MEANS TO NOT ONLY GET TO THAT PUBLIC BUT IF YOU THINK OF IT IN THE CLINICAL SETTING THE PROVIDERS WHO WERE SERVING THEM ARE UNDER STRESS. IF YOU LOOK AT THEIR PATIENT PANELS, THEY'RE MUCH HIGHER, THE QUALITY OF CARE. IT'S WELL DOCUMENTED THE QUALITY OF CARE THE POPULATIONS ARE GETTING ARE OPTIMAL SO THE PROVIDERS NEED INFORMATION. THEY'RE UNDER STRESS. SO THEY'RE NOT READING JOURNALS. THEY'RE NOT GOING TO PUBMED AND HEMP THEM MAKE DECISIONS QUICKLY IS IMPORTANT. IT'S NOT JUST THAT POPULATION BUT THE DISH HOSPITALS ARE UNDER TARGET WHERE THEY'RE UNDER STRESS. I THINK THERE'S A LOT YOU CAN DO HERE. >> I AGREE I THINK THE LIBRARY IS NOT RECOGNIZED BY THE PUBLIC FOR ALL IT DOES. I WANT TO QUOTE -- I THINK SHE WAS THE FIRST ONE TO SAY THIS ANTONIO NOVELLA SAID PUBLIC KNOWLEDGE IS PUBLIC HEALTH. I THINK THAT IS REALLY, AND YOU CAN CHECK WHETHER SHE WAS THE FIRST ONE OR QUOTING SOMEBODY BUT IT ENCAPSULATES THAT POINT. >> I'VE ASKED BARBARA TO GIVE US SENTENCES AS AN NIH INSTITUTE WE NEED TO ADDRESS THE STRATEGIC PLAN OF THE NATIONAL INSTITUTE OF MINORITY HEALTH AND DISPARITIES. WOULD YOU TALK ABOUT HOW WE'RE THINKING ABOUT THAT? . >> EACH INSTITUTE IS REQUIRED TO HAVE A STRATEGIC PLAN AND HOW TO INCORPORATE THAT AND WE'RE ASKED TO PROVIDE TO THE STRATEGIC PLAN AND GATHERING INFORMATION TO EXPLAIN TO THEM HOW WE ADDRESS HEALTH DISPARITIES. AND WE NEED TO REFLECT THAT IN OUR OWN STRATEGIC PLAN. TOUGH WE MENTION IT IT'S NOT CALLED OUT SPECIFICALLY ENOUGH IN THE CURRENT PLAN. WE'LL ADDRESS THAT SPECIFICALLY AND WE ARE INTERACTING WITH YOU ARE PARTNERS IN APPROACHING HEALTH DISPARITIES. >> I WANT TO MAKE SURE WE ADDRESS THAT IN TERMS OF OUR EXTRAMURAL PROGRAMS BECAUSE THE OTHER INSTITUTES THE CONCERN ON MINORITY HEALTH AND HEALTH DISPARITIES IS NOT REPRESENTED IN CLINICAL TRIALS. WE DON'T DO ANY ANY MORE BECAUSE OF THE NEW STRUCTURE. BUT WE MUST MAKE SURE OUR TRAINING PROGRAMS ADDRESS ISSUES RELATE TO HEALTH DISPARITY AND APPROVE SAMPLES AND ARE BEGINNING TO LOOK AT THE PORTFOLIO OF PEOPLE WE FUNDED TO MAKE SURE WE'RE LOOKING AT A BALANCED PORTFOLIO. >> I WANT TO SAY I HAD A CONVERSATION ON FRIDAY WITH SOMEONE FROM THE INSTITUTE TO TALK ABOUT WAYS WE MIGHT GIVE THEM THE FOCUS OF OUR EXTRAMURAL PROGRAMS AND THE THAT COULD HELP THEM. I THINK THE COMBINATION OF THE FORM AND THE DELIVERY AND USEFULNESS OF INFORMATION THAT SOMETIMES NEEDS TO BE MORE CULTURALLY FINE TUNED OR ACCESSIBLE IN DIFFERENT WAYS AND DIFFERENT FORMATS. THOSE ARE THINGS ON OUR MINDS WHEN WE THINK OF WAYS WE MAY GET TO THE MINORITY HEALTH AND HEALTH DISPARITIES. THOSE ARE TWO SEPARATE TOPICS. >> WHEN WE THINK ABOUT TRANSLATION OF OUR RESEARCH KNOWLEDGE INTO ACTION IT'S NOT ONE TRANSLATION. IT'S MULTIPLE. >> AND I'M IMAGINE THE APPENDICES BEING PART OF THE STRATEGIC PLAN SEEN THROUGH THE LENS OF THE NIH INSTITUTE AND ALL THAT STUFF. ONE OF THOSE WOULD BE A TOPIC. THAT'S REDUCING HEALTH DISPARITIES. IT'S SCATTERED THROUGH EVERY SECTION. WHERE IT'S IMPORTANT TO IMPORTANT TO SOMEBODY TO SEE THE AGGREGATED PICTURE OF THAT FOR A PARTICULAR USER GROUP OR PURPOSE OF HEALTH DISPARITIES THAT COULD BE A SUPPLEMENTARY APPENDIX. THAT GATHERS POINTS THROUGH THE TEXT AND PUTS IT IN A LINEAR STORAGE. >> IF WE LOOK AT THE HELP OF RURAL POPULATIONS, I THINK WE HAVE TO THINK DISPARITIES IN THE BROADEST CONTEXT OF THE WORD. I ALSO WANT TO PICK UP SOMETHING THAT ERIC SAID YESTERDAY. WHERE YOU HAVE TREMENDOUS LEVERAGE. AS YOU LOOK AND MAKE SURE THAT THEY'RE IN LINE WITH YOUR GOALS AROUND REACHING THESE DIVERSE AUDIENCES. ONE OF THE THINGS WHEN I LOOKED AT THE AMAZON MAP THERE WAS NO CENTER IN AFRICA. I'M SORRY. >> MICROSOFT IS SITTING HERE. >> I'M JUST SAYING -- >> IT'S A GOOD POINT. >> IT'S TRUE IN THIS COUNTRY AS WELL. WHERE THE CENTERS GO BRINGS EMPLOYMENT AND YOU HAVE LEVERAGE. IT'S A CONVERSATION ON WHO YOU WORK WITH AND WHAT YOU EXPECT TO DELIVER. WHAT I'M SAYING IS WE SHOULD LOOK AT THIS IN THE BROADEST CONTEXT OF WHAT WE'RE DOING INTERNALLY AND WHAT YOU'RE ASKING OF YOUR PARTNERS. >> AND WE HAVE OUR OUTREACH PROGRAMS. HISTORICALLY THEY HAVE CONCENTRATED IN MANY MANY WAYS ON MINORITIES AND DISPARITY. >> I DON'T KNOW WHERE THIS WILL COME FROM BUT WHAT DO WE DO WITH THE NETWORK BECAUSE IT'S ONE OF OUR VISIBLE CONNECTIONS TO AREAS WHERE -- I OFTEN SAY TO MY COLLEAGUE FROM MINORITY HEALTH AND HEALTH DISPARITIES. WE'RE ALREADY THERE. WE'RE NOT BUILDING A BRIDGE TO THE COMMUNITIES WE HAVE TO MAKE SURE IT'S USE AND OPEN AND HAS THE RIGHT PEOPLE. WE'RE ALREADY IN THE COMMUNITIES SO WE NEED TO LOOK AT HOW WE REFLECT THAT. I THINK WE HAVE A BIGGER FOOTPRINT THAN WE REALIZE AND WE HAVE TO FIGURE HOW TO DO THAT. >> IT SPEAKS TO YOUR POINT, GARY, ABOUT PULLING PEOPLE IN NOT JUST HAVING THE BRIDGE THERE. >> WE ARE ALREADY THERE WITH THE BIG FOOTPRINT. A LOT OF WHAT WE THINK OF IN OUR WORK OF DISPATRIOT DISPARITIES IN THE PLAN. OUR IS STILL DATED 2013 AND EXTENDED UNTIL THERE'S A NEW PLAN. WE DO REFLECT THERE QUITE BROADLY WHAT WE HAD THOUGHT OF IN TERMS OF WHAT WE DO WITH THE HEALTH DISPARITIES. IT'S REFLECTED IN OUTREACH OF SERVICES, THE WORKFORCE AND OUR WORK WITH DATA STANDARDS AND THE RULE THAT ALL THAT AND THE ROLE THAT CAN HAVE IN ALLOWING RESEARCH TO BE DONE AND RESEARCH TO BE ANALYZED THROUGH VARIOUS COHORTS. THAT PIECE IS IN THERE AS WELL. IT SHOULD BE HEIGHTENED. >> WE HAVE A PROGRAM FOR DISPARITIES AND I'M GOING TO CRITIQUE IT BECAUSE THAT PROGRAM IS A RESOURCE. LIKE MANY RESEARCH TRENDS AND OTHERS, THE SUSTAINABILITY IS IN QUESTION. MAYBE THERE'S A WAY FOR THE NETWO NETWORK CAN RESHAPE THE PROGRAM TO TEST THE WAY WHETHER THE PRODUCTS ARE MEETING THEIR GOALS AND WHETHER THEY'LL CONTINUE. >> A QUICK FOLLOW-UP, THE WORK THEY DID ON HIV AND PULLED THE KNOWLEDGE AND SUPPORTED THE RESEARCH EFFORTS AROUND HIV. IN THE DISPARATE COMMUNITIES IS THERE A WAY TO PULL A BODY OF KNOWLEDGE TO MAKE SURE THEY HAVE KNOWLEDGE AND HAVE APPROPRIATE KNOWLEDGE AND IT SEEMED TO WORK WELL WITH ANOTHER PROGRAM AS WELL. IS THERE A WAY TO BEGIN TO DO SOME THINGS LIKE THAT? >> ANOTHER GROUP THAT HASN'T BEEN MENTIONED BUT DESERVES OR ARE THE PEOPLE WITH DISABILITIES. >> THAT'S VERY GOOD. >> THEY FEEL THEY'RE LEFT OUT OF MAINSTREAM HEALTH CARE OR THEIR CONCERNS ARE NOT ADEQUATELY UNDERSTOOD AND ADDRESSED. >> IN TERMS OF THE RESEARCH YOU'RE LOOKING AT, ALSO THE PROCESS OF HOW WE CAN GET INFORMATION TO THE VARIOUS GROUPS IS IMPORTANT. I THINK -- ERIC TOLD A STORY AND I THINK ABOUT MY CO-WORKER WHO THE PEOPLE IN HER COMMUNITY UNDERSTAND SHE WORKS IN THE LIBRARY. SO WHENEVER THEY NEED HELP FILLING OUT A FORM WHETHER IT'S MEDICARE, THE WHOLE BIT, THEY COME TO THAT PARTICULAR PERSON TO HELP THEM. THAT'S A WAY OF GETTING THE INFORMATION OUT TO THE GROUP. I REMEMBER SOMEWHERE ALONG THE LINE THERE WAS A PROGRAM WHERE THEY SENT INFORMATION TO THE HAIR DRESSES, THE BARBERS HOPING TO GET THEM TO MENTION IT. SO WHAT CREATIVE WAYS ARE THERE TO GET THE INFORMATION OUT. FACEBOOK. PEOPLE USE FACEBOOK FOR COMMUNICATION. THOSE METHODS. >> A QUICK COMMENT ON THAT. THEY NEED TO BE FORMALIZE AND IN UCLA THEY'RE WORKING WITH THE HOMELESS IN LOS ANGELES TRYING TO GET OUT HIV INFORMATION AND PROCESSING THE SOCIAL GRAPH COMING OFF THE OBAMA PHONES THEY ALL USED. IT TURNS OUT THE EXPERIMENTS AND OPTIMIZATION TO WHO YOU HAVE TO REACH OUT TO IDEALLY DISSEMINATE THE INFORMATION TO EVERYBODY. >> THEY CALL IT THE INFORMATION RICH PERSON. >> TURNS OUT THE CONNECTION AND LINKS THEY HAVE AND THE PERSONALITY TYPE. >> I WANT TO ADD ANOTHER ASPECT IS LANGUAGE AND CULTURE. IT WAS TOUCH ON BUT ANOTHER POINT MADE DURING 9/11 FROM THE DIRECTOR OF PUBLIC HEALTH FOR NEW YORK CITY AND THEY WERE SAYING HEART AND THEY WERE DIRECTED TO CARDIOLOGISTS BUT THEY WERE STRESSED AND IT'S NOT JUST DIRECT LANGUAGE STRATRANSLATION BUT HOW DO YOU CAPTURE THE CULTURAL ASPECTS OF OTHER LANGUAGES. SO ADD TO YOUR LIST -- >> I GOT IT. I'LL SEND THIS OVER TO MIKE. >> I'M REMINDED IN THE HEALTH PANEL THERE WAS A STRONG STATEMENT OF A THEME OF SPECIALIZED LITERACY SENSITIVE HEALTH INFORMATION THAT WAS ADDITIONALLY FILTERED BY ACTIONABLE. IF YOU'RE GOING TO DO -- ACTABILITY. IF YOU'RE GOING TO DO SOMETHING WHAT CAN I MAKE A DECISION AND DO BETTER RIGHT NOW ON. AND I THOUGHT THAT WAS A VERY USE. THOUGHT FOR AN ATTRACTIVELY LARGE BODY OF INFORMATION. >> ONE TRADITIONAL MEANS IS FAITH-BASED COMMUNITIES. I KNOW THEY'VE BEEN A FOCUS OF OUTREACH IN THE PAST. I WANT TO GO BACK TO WHAT GARY WAS TALKING ABOUT WITH AIDS. IT WAS ALMOST LIKE AN S.W.A.T. TEAM RESPONSE TO THE AIDS CRISIS FROM NLM POURING IN RESOURCES AND OUTREACH AND CONTRACTS AND GRANTS AND THAT SORT OF THING. IS IT TIME FOR US TO PUT THAT SORT OF EFFORT TOWARDS HEALTH DISPARITIES. THAT WOULD BE A HUGE CHALLENGE. >> I WOULD LIKE TO POINT OUT WE GET $8 MILLION A YEAR TO DO THE AIDS WORK AND WE HAVE A COMMITMENT. IF YOU'RE DIRECTING US TO THINK ABOUT THE MOUNTING OF A PROGRAM AS A SCOPE WITH THE FEATURES OF THE HIV PROGRAM WHICH IS SPECIALIZED SET ASIDE FUNDS FOR ACROSS-NLM COMPETITION FOR FUNDS, I THINK WE CAN DO THIS BUT I THINK THAT'S A VERY NICE WAY OF DIRECTING IT AND IT'S FINDING A MORE SYSTEMATIC APPROACH. >> YOU'RE SAYING TO DIRECT THE AIDS -- >> DIRECT THE FUNDS AS A MODEL. WE HAVE S.I.S. GET INVOLVED AND WE CAN FORMALIZE IT BUT I THINK IT COULD BE CALLED OUT. THAT WOULD HELP US IN SAYING WHAT WE WANT TO DO WITH THIS. WHAT WE WANT TO DO FOR MINORITIES HEALTH AND DISPARITIES WHAT WE'VE DONE WITH HIV. >> THAT'S GREAT AND DOESN'T TAKE UP MUCH ROOM. OTHER COMMENTS? >> I HAVE MANY. NOW YOU READY TO WORK? FIRST AND FOREMOST WHICH VALUES MUST WE REFLECT IN THE OPENING STATEMENT OF THE DOCUMENT? LIBRARIES HAVE A LONG-EMBRACING OF A VALUE THAT RESEARCHES THE PROCESS. DO WE NEED TO EXPRESS AND EXPLICITLY STATE THAT? WE HAVE A COMMITMENT IN PERPETUITY TO PERSISTENT STORAGE OF RESOURCES. DO WE NEED TO SAY THOSE? YOU MAY THINK OF THIS ON THE TRIP ON THE WAY HOME BUT WE'RE SET ASIDE FROM THE OTHER NIH S PERHAPS WITH THE EXCEPTION OF THE MINORITY HEALTH AND DISPARITIES WHERE WE HAVE PUBLIC ACCOUNTABILITY FOR THE PRACTICES IN PLACE THAT ARE OFTEN INVISIBLE TO COLLEAGUES. THE FACT WE WERE CHARGED IN ONE OF THE BLOGS OF GIVING INFORMATION TO GOOGLE. NO, WE DON'T GIVE INFORMATION TO GOOGLE. COULD WE SEARCH OUR SEARCH LOGS? NO, WE DON'T SHARE OUR SEARCH LOGS WITH OTHER PEOPLE. ARE THERE OTHER PARTICULAR VALUES WE THINK SO IMPORTANT TO SAY WE'RE HOLDING ON TO THESE VALUES AND THEY'RE GUIDING US. >> THAT SOUNDS LIKE A REALLY IMPORTANT ONE. >> IN THE CURRENT ENVIRONMENT WE SAW A LITTLE BIT IN THE EDITING IS THE COMMITMENT TO THIS BEING A LIBRARY FOR THE ENTIRE PLANET IN THE ARE ERA OF RISING NATIONALISM AND THE ANCHOR IS FOR EVERY HUMAN BEING. >> WE DONT BRING IN ARTICLES FROM ALL OVER THE WORLD OR INDEX JOURNALS -- >> AND THEY GET VIEWED BY COMMUNITIES WE ARE NOT AWARE OF AND THEY DO MORE GOOD THAN WE IMAGINE IN THE INTERNATIONAL SETTING WITHOUT THERE BE A SPECIFIC INTERNATIONAL PROGRAM BY VIRTUE OF OPEN, FREE ACCESS. >> HEALTH AND HEALTH KNOWLEDGE HAS NO BORDERS. >> EXACTLY. >> WE'RE MAKING AMERICA GREAT. [LAUGHTER] >> WHEN YOU TALK ABOUT EBOLA THAT'S AFFECTING U.S. HEALTH AND ZIKA IS AFFECTING U.S. HEALTH. >> I THINK THE ENDURING VALUE OF THIS INSTITUTION FOR ALL OF ITS 175 YEARS HAS NOT BEEN GEOPOLITICAL BOUNDARIES. >> BUT IF YOU WANT TO FRAME IT, WHY THE UNITED STATES BE THE CENTER? WHY THE NATIONAL LIBRARY OF MEDICINE. BECAUSE THE BUGS, ZIKA AND EBOLA CROSS BORDERS AND IT IMPACTS OUR HEALTH. WE NEED TO KNOW ABOUT THAT IN ADDITION TO DOING GOOD FOR THE REST OF THE WORLD. I AGREE IT NEEDS TO BE EXPLICIT UP FRONT GIVEN WHAT'S BEEN DONE WITH OTHER SEARCH ENGINES AND OTHER COMPANIES THAT USE PEOPLE'S SEARCHS. IT'S IMPORTANT TO SAY THAT UP FRONT THAT YOU COULD NOT. -- WOULD NOT. >> FREE AND OPEN ACCESS ABOUT THE COLLECTIONS AND RESOURCES. SO -- I MEAN, I DON'T WANT US TO EVER SAY NO. THAT'S WHAT LIBRARIES ARE. INDIVIDUALS.T TRACKING - >> >> DOES ANYONE HAVE A GENERAL CONSENSUS? >> WE'D LIKE YOUR GUIDANCE AS YOU THINK OF IT. >> WE DON'T USE THEM EVEN ACROSS THE LIBRARIES. WE DON'T EXPOSE ALL OF OUR GRANT APPLICATIONS. SO NOW I HAVE A MORE COMPLICATED QUESTION. WE HEARD FROM IT'S JUPITER NOTEBOOKS IN GATHERING INFORMATION AND SHARING AS WORK TEAMS WORK TOGETHER INSTEAD OF WRITING DRAFT PAPERS THEY PUT EXECUTICAL CODE IN SOMETHING CALLED A JUPITER NOTEBOOK. INCREASINGLY THIS COULD BE A DIFFERENT KIND OF PUBLICATION AND SOMETHING THAT GETS SHARED MORE BROADLY. WITH INNOVATION SUCH AS JUPITER NOTEBOOKS GET USED HOW DO WE INDEX TO WHAT WE CALL THE PROCESS OF RESEARCH? >> IT THINK IT GOES BACK TO THE FUNDAMENTAL QUESTION OF RELIABILITY. LIBRARIES ACROSS THE COUNTRY WERE BEING ASKED ABOUT THE SCIENCE AND THE THEY CAME BACK WITH IT'S NOT FINISHED WORK OR RELIABLE, IT HASN'T BEEN PEER REVIEWED AND AT THE END OF THE DAY IT'S NOT YET A RECORD OF KNOWLEDGE. MANUSCRIPTS YOU CAN GO TO AN INSTITUTE AND READ THEM BUT I THINK THERE'S A HUGE CHALLENGE WITH THE JUPITER NOTEBOOK AS IT EXISTS NOW IF YOU'RE ALSO GOING TO BE A PLACE OF RELIABLE INFORMATION. A JUPITER NOTEBOOK CAN HAVE UNRELIABLE INFORMATION THAT HAS NOT BEEN REVIEWED. >> AND THERE'S LEGAL RAMIFICATIONS. WE WERE HEARING ABOUT OUR NOTEBOOKS AND THE JUSTICE DEPARTMENT SAID IT'S NOT INFORMATION YET. IT'S WORK PRODUCT. IT'S VARIABLE. IT CAN BE CHANGED. >> THE KIDS ARE CHANGING THE GAME. THIS IS THEIR FORM OF COMMUNICATION. THEY'RE NOT WAITING FOR THE ARTICLES TO COME OUT AND THEY'RE WILLING TO TOLERATE THIS IS UNFINISHED PRODUCT. >> THEY ALL HAD ERRORS AND STILL DO HAVE ERRORS. THIS IS A FUZZY THINGS -- IT CALLS BACK TO THE NOTION OF KNOWLEDGE AND TRUTH OPPOSED TO WORK PRODUCT WHICH ARE USEFUL TO OTHER PEOPLE. THIS IS PRETTY MESSY BUSINESS FOR THE NLM AND OTHER LIBRARIES THAT DON'T HAVE TO -- >> I CAN'T WRITE THIS IS MESSY BUSINESS. >> I WAS LOOKING AT THE QUOTE, ALL MODELS ARE WRONG BUT SOME ARE USEFUL AND IT'S THE STATE OF MANY NLM RESOURCES THAT BIOINFORMATICS THAT NONE ARE TRUE AND CORRECT BUT THE MAJORITY ARE FOUND TO BE QUITE USEFUL. >> IT'S THE WAY RESEARCH IS DONE. IT'S LIKE SAILING A BOAT ACROSS A CURRENT AND YOU CAN CORRECT AND CHANGE BUT YOU'RE GOING IN A DIFFERENT CORRECTION. THE PEER REVIEW SEQUENCE IS USE. . >> IT'S INFORMATION NOT IN THE MAINSTREAM PUBLISHED LITERATURE BUT STILL HAS VALUE. TO A POINT THAT CAME UP EARLIER, THE MORE WE HAVE THE DISPARATE OBJECT ARE NOT PART OF THE LITERATURE THE MORE WE'LL NEED LIBRARIES AND LIBRARIANS TO HELP PEOPLE FIND WHAT THEY NEED TO DO THEIR WORK. >> WE DON'T PEER REVIEW EVERYTHING AND SAR THEY'RE SAL ID. IT EXTENDS TO KNOWLEDGE OBJECTS AND DATA. WE SAY HERE IT IS. CAVEAT EMPOR, USE AT YOUR OWN RISK AND WITH KNOWLEDGE. >> IT'S HELPFUL. IF I'M THE PUBLIC AND I DON'T KNOW ANYTHING YOU HAVE CATEGORIES. THIS IS FUZZY KNOWLEDGE AND THIS COULD BE CHANGED WITH FUTURE DISCOVERIES. THAT ENGENDERS DISTRUST WHEN ONE DAY CHOLESTEROL IS GOOD AND THE NEXT DAY IT'S BAD AND THEN IT'S GOOD AGAIN. IT'S THE NATURE OF DISCOVERY THAT NOT UNDERSTOOD AND WE NEED TO HAVE KIDS UNDERSTAND THIS. >> I UNDERSTAND WITH JOURNAL ARTICLE AND PEER REVIEWS BUT I'D WANT TO WALK SOFTLY ON WHAT'S APPROPRIATE. IF THE PUBLIC AND YOU'RE NOT PASSING JUDGMENT. >> DOES THE NATIONAL SCIENCE FOUNDATION -- I KNOW PHYSICISTS IN THEIR WORLD SEND TO SHARE STUFF EARLY AND ASTROPHYSICISTS. HOW DO YOU DEAL WITH THAT? >> CAREFULLY. WHERE BIOLOGISTS WANT TO USE ARCHIVES IT'S TRICKY STUFF. THE POINT IS DOES NLM WANT TO BE THE VEHICLE THROUGH WHICH YOU SHARE THESE THINGS OR NOT AND HAVE YOU A FINITE BUDGET. UNLESS YOU CAN DO IT EFFICIENTLY LEVERAGE IS ALL YOU HAVE TO DO IT. IT SOUNDS LIKE IT MAY BE TOO BIG TO TACKLE. HERE'S THE OTHER ISSUE. THE PEOPLE THAT WANT THOSE, THE USERS WILL FIGURE OUT HOW TO FIND THEM. YOU KNOW. >> WE DON'T WANT TO CREATE A SECONDARY SCIENCE COMMUNICATION CHANNEL WHERE WE BECOME IRRELEVANT. I THINK WE NEED TO STAY ENGAGED WITH NEW MODES OF DISSEMINATION AND COMMUNICATION AND NOT BECOMING A REPOSITORY AND COLLECTOR. >> YOUR ROLE PROBABLY SHOULD NOT BE GETTING INTO METHODOLOGY OR REPRODUCIBILITY WHICH IS HUGE. BUT MORE ACCESS AND CURATION. >> WE HAVE A WHOLE INFORMATICS ACTIVITY THAT IS INVOLVED IN METHODOLOGY. >> THERE'S NOT SET TRIAL DESIGN AND EVIDENCE THAT I THINK IS GETTING PROBLEMATIC >> SO WE DO BELIEVE IT'S AN ASSET BECAUSE WE'RE EXEM FATING AND WE NOW COLLECT AND HAVE DEPOSITED BASICALLY THE PROCEDURES RELATED TO THE CLINICAL TRIALS. I THE QUESTION IS TO WHAT EXTENT SHOULD WE BE PROVIDING OTHER, IF YOU WILL, TOOLS TO HELP PEOPLE DOCUMENT A PROCESS. AND THERE WOULD BE INTEROPERABLE TOOLS AND TOOLS TO ORGANIZATION IT AND ARE YOU SUGGESTING THAT REALM -- >> THAT'S PERFECT FINE. THE PROBLEM IS LIMITING WHAT YOU USE SO YOU'RE NOT TAKING ON THE ENTIRE BIOMEDICAL KNOWLEDGE. >> WE'RE NOT GOING TO DO THAT. I HAVE UP WITH MORE QUESTION AND THIS IS A QUESTION WE POSED AT LEAST IN ONE OF THE PANELS AND I WANT TO POSE IT TO THIS GROUP, IS THERE ANYTHING YOU CAN IMAGINE HAPPENING IN THE NEXT FIVE YEARS THAT WOULD TORPEDO OUR PLANS? >> I THINK SOME OF THE WORK THAT GOOGLE'S DOING WORKING ON AND A HUGE PERSONAL HEALTH CLOUD SYSTEM THEY'RE PUTTING UP IF IT WORKS EVERYONE'S HEALTH INFORMATION WILL TRY TO GET ALL THE HEALTH RECORDS BECAUSE OF THE PROBLEMS THAT HAVE COME UP WITH THE ELECTRONIC HEALTH RECORDS. THAT'S A POTENTIAL GAME CHANGER THERE AND THERE'S MANY INDUSTRIES INVOLVED IN THAT. THERE MAY BE SOME STANDARDS THAT WILL OCCUR OR NOT OCCUR BECAUSE OF THE INDUSTRY. I KNOW MICROSOFT ARE DOING SOME PRETTY SPECTACULAR THINGS. >> NEW TECHNOLOGY AND CLASSES OF DATA THAT BECOME AVAILABLE WILL SIGNAL A NOISE TO THE LANDSCAPE. I THINK YOUR THREATS COME NOT FROM THINGS THAT EXPAND BUT THINGS THAT CAUSE CONTRACTION. THE NUMBER ONE THING THAT WOULD KILL YOU IS PRIVATIZATION OF THE INTERNET. BASICALLY CONVERTING IT INTO A SET OF PRIVATELY OWNED PAYWALLS THAT ARE EVERYWHERE BECAUSE PEOPLE CAN MAKE MONEY. IT'S THE ARGUMENT OF PRIVATIZING ANYTHING THAT'S CURRENTLY A PUBLIC GOOD. THE CURRENT ADMINISTRATION WANTS TO PRIVATIZE AIR TRAFFIC CONTROL. AND NLMs CLEARLY IN THE CATEGORY OF THE CATEGORY OF PUBLIC GOOD TO A TRANSITION OF SERVICE-FOR-FEE TRAFFIC MODEL AND WE'RE SUNK. >> I'M THINKING OF COMPANIES LIKE 23 AND ME AND ALL THE WELLNESS GROUPS THAT ARE OFFERING TO DO HUMAN GENOMES SO THAT'S A DIFFERENT KNOWLEDGE BASE THAN WHAT IS IN SAY ALL OF US. IT'S A GROWING MARKET. >> THAT'S A SCARY ONE. >> OPENNESS IS NOT QUITE THE SAME BUT YOU THINK OF ALGORITHMS THAT END UP CREATING INHERENTLY DISCRIMINATORY DECISIONS BUT YOU DON'T KNOW WHAT'S IN THE BLACK BOX. OR USED FOR ADVERSE SELECTION. >> SO THEY'RE SO OPEN WITH OUR RESOURCES THEY GET PICKED UP BY NEFARIOUS USERS. >> I DON'T WANT TO BE SO DRAMATIC BUT THE SEARCHABILITY, TESTABLE OF THINGS IN BLACK BOX I THINK IT WILL BEAL GA BE LIKE ALGORITHMS AND USING FACIAL RECOGNITION PATTERNS TO PREDICT A SEXUAL ORIENTATION AND INFORMATION FROM DATABASES LIKE DATING SITES. >> IT WAS 90% PLUS ACCURATE. IT'S INTERESTING TO SEE WHERE INDUSTRY IS HEADING. YOU DON'T EVEN KNOW WHAT'S THERE. >> THERE'S A POTENTIAL CONFLICT WITH OUR VALUE OF TRANSPARENCY AND OUR LOSS OF CONTROL OVER THE APPLICATION. >> WE CAN ALSO WORRY ABOUT IT TOO MUCH. AND THERE'S A DYNAMIC IN LIBRARIES AND INFORMING EXCHANGE. I THINK GREAT SOMETHINGS AND THIS LIBRARY IS A SPECIAL LIBRARY IT'S NATIONAL AND MEDICAL. IT HAS A PLACE WITH A CON -- CONSERVATION EFFORTS AND THINGS WILL CHANGE BUT I DON'T THINK ANYTHING WILL FUNDAMENTALLY UNDERCUT THE LIBRARY. THE PLAN IS NO MORE GUARANTEED THAN ANYBODY HE WILL ELSE'S DREAMS. IF WE HAVE TO RETRENCH IT IN THREE YEARS BECAUSE THERE'S A NEW VERSION OF AN APPLE iPHONE WE FALL BACK AND FUN. -- PUNT. I DON'T THINK THERE'S ANYTHING TO WORRY ABOUT WITH THESE KINDS OF DISRUPTIONS BECAUSE THEY'VE OCCURRED BEFORE. >> ACTUALLY IN OUR DISCUSSION IN THE BOARD'S ROLE WE TALKED ABOUT REVISITING THE STRATEGIC PLAN MORE FREQUENTLY. >> THAT'S GREAT. >> NOBODY'S WORRIED ABOUT WATER, FIRE, PESTILENCE? THANK YOU VERY MUCH. I APPRECIATE THIS. I'LL BE ASKING YOU A QUESTION IN AN FEW MINUTES IN AN ANOTHER HOUR ABOUT NEW NOMINATIONS FOR BOARD AND THOSE WHO ARE SUCH STRONG ADVOCATES FOR REACHING THE PUBLIC I'LL BE ASKING IF WE SHOULD ADD A PUBLIC MEMBER TO THE BOARD. >> WELL, WE'RE DONE WITH TWO MINUTES TO SPARE IF ANYBODY HAS URGENT POINTS PLEASE SPEAK NOW IF NOT WE'LL HAVE OUR BREAK. AND WE'LL BE BACK AT 10:45. IT IS MY PLEASURE TO INTRODUCE DR. SMALHEISER A PROFESSOR OF PSYCHIATRY AT THE UNIVERSITY OF ILLINOIS AND OBTAINED HIS MEDICAL DEGREE AND Ph.D. IN NEUROSCIENCE FROM THE EINSTEIN COLLEGE AND STUDIES AND HAS A MULTI-INSTITUTE CONSORTIA TO TEXT MINING CREATING NEW MODELS AND WEB-BASED SERVICES AND HERE TO DISCUSS HIS NLM RESEARCH GOING BACK 20 YEARS INCLUDING HIS CURRENT GRANT TEXT MINING LINE TO ACCELERATED SYSTEMIC REVIEWS IN EVIDENCE-BASED MEDICINE. WELCOME DR. SMALHEISER. >> THANKS. SOMEONE EARLIER SAID YOU KNOW SCIENTISTS THEY'LL BE WILLING TO TALK ABOUT THEIR AT THE DROP OF A HAT AND I'M HERE TO PROVE YOU RIGHT. MY STORY BEGINS IN 1990 WHEN I GOT A PHONE CALL FROM DON SWANSON. HE AND I WERE BOTH AT THAT TIME AT THE UNIVERSITY OF CHICAGO. HE WAS THE DEAN OF THE GRADUATE LIBRARY SCHOOL. I WAS A WET LAB NEUROSCIENTIST. I WAS FAMILIAR WITH HIS WORK BECAUSE HE PUBLISHED IN THE UFC JOURNAL CALLED PERSPECTIVES AND ONE OF THE GIANTS OF THE FIELD AND PROBABLY BEST KNOWN FOR HIS CONCEPT OF UNDISCOVERED PUBLIC KNOWLEDGE. THE IDEA, RADICAL AT THE TIME, WAS YOU CAN DO MINING AND GET NEW IDEAS AND ASSERTIONS AND POTENTIALLY NEW KNOWLEDGE. AKA, LITERATURE-BASED STUDIES AND YOU CAN FIND PIECES OF ASSERTIONS IN THE LITERATURE. IN ONE ARTICLE THEY SAY A AFFECTS B AND IN OTHER DISCIPLINES AND YEAR IT MAY SAY B AFFECT C. IF YOU CAN FIND THESE AND PUT THEM TOGETHER LIKE ASSEMBLING A JIGSAW PUZZLE MAYBE YOU WOULD FIND THIS ASSERTION A AFFECTS C AND ADD IS IT INTERESTING AND PLAUSIBLE AND WORTH STUDYING. IT'S NOT AUTOMATIC KNOWLEDGE BUT POTENTIAL KNOWLEDGE. NEW HYPOTHESES. HIS APPROACH WAS TO LOOK AT COMPLIMENTARY LITERATURE AND IT'S A SET OF ARTICLES THAT REPRESENT AS A PROBLEM AREA OR RESEARCH FIELD. DISCONNECTED MEANS YOU HAVE TWO LITERATURES, THEY DON'T HAVE ARTICLES IN COMMON OR AUTHORS IN COMMON, THEY DON'T CITE EACH OTHER. THEY'RE SEPARATED. COMPLIMENTARY MEANS THERE'S INFORMATION IN ONE FIELD THAT'S KNOWN THAT CAN POTENTIALLY CONTRIBUTE TO SOLVING THE PROBLEM IN THE OTHER LITERATURE. AND HE DID TWO ICONIC EXAMPLES. ONE WHERE HE PROPOSED FISH OIL AS A POTENTIAL TREATMENT FOR RANODE SYNDROME AND ANOTHER TREATMENT FOR HEADACHES AND THEY WERE OF THE A, B, C NATURE THAT PRODUCE PHYSIOLOGICAL AFFECTS IN THE BODY THAT IS B THAT ARE IN THE OPPOSITE DIRECTION FROM PATHIOLOGIC DIRECTIONS SEEN FROM THE DISEASE. WE BEGAN TO WORK TOGETHER COLLEGIALLY AND HE HAD PREVIOUSLY DONE THIS HAPHAZARDLY. WE CREATED A SYSTEMATIC COMPUTER-SYSTEM APPROACH TO FIND LITERARY S LITERARY APPROACH. WE START WITH THE C, ONE IS MIGRAINE. THE APPROACH WAS IS TO TAKE ALL THE WORDS AND PHRASES IN THE TITLES AND YOU LOOK AT HISTAMINE AND CALCIUM CHANNELS AND WE CREATE A LITERATURE APPROACH FOR THE B TERMS AND TAKE THE TITLES FROM EACH OF THESE AND GET THE WORDS AND PHRASES AND LIST THEM SHOWN ON THE LEFT, IT SAYS A-WORD CANDIDATES. THEN WE RANK THEM AND THE WINDSOR MAGNESIUM CONNECT TO B TERMS. IT'S A CRUDE APPROACH AND MANY GROUPS ARE PROPOSED REFINEMENTS TO THIS PROCESS. THE WORK WAS WELL RECEIVED. DON BECAME AN AN EMERITUS AND WE GOT A 501 SUPPORTED BY NLM AND THE CO-INVESTIGATORS WERE A STELLAR CREW OF PEOPLE BESIDES DON, RAMINE HOLIOME AND MARK FAVRE AND OTHERS WERE INVOLVED AND INSTEAD OF FOCUSSING ON THE ONE-NODE SEARCH WE BEGAN WITH A FINDING OR HYPOTHESIS THAT CONNECTS TO THINGS IN A NEW WAY AND WANTS TO LOOK AT THE LITERATURE LINKS BETWEEN THEM AND SEE AND IS THERE LITERATURE SUPPORT AND IS THERE A MECHANISM TO THE LINKS. WE GAVE IT TO TESTERS WHO USE IT DAILY IN THEIR SCIENTIFIC LIFE AND GAVE US FEEDBACK AND GAVE US A SET OF PLEATED SEARCH RESULT WE USE FOR QUANTITATIVE MODELLING. THE GOAL WAS FOR ANY SEARCH, A TWO-NOTE SEARCH WE RANK THE B TERMS ACCORDING TO THE PREDICTED LIKELIHOOD THEY'D BE RELEVANT pTHE TOOL IDENTIFIES THE B TERMS AND RANK THEM ACCORDING TO THE PREDICTED RELEVANCE. IT IS DISPLAY THE LITERATURE BACK TO THE LITERATURE IN THE C TERM AND IT'S A SMALL SLICE AND YOU CAN LOOK DIRECTLY FROM ONE TO THE OTHER TO SEE IF THERE'S A MEANINGFUL LINKAGE THERE AND IT'S ON OUR PUBLIC WEBSITE AND HAS BEEN CITED BY A VARIETY OF INVESTIGATORS ANYONE IN THE WORLD CAN USE IT IT HAS HELPED PEOPLE SAYS THEIR HYPOTHESES. [QUESTION OFFMIC] >> WE HAD EIGHT DOMAIN FEATURES HAVING TO DO WITH WHETHER THE SUBLITERATURE SHARED MESH TERMS. IT'S ALL PUBLISHED. I CAN SEND YOU THE LINK. THEY WERE DOMAIN INDEPENDENT. WE DIDN'T USE ANY KNOWLEDGE SOURCES. THEN WE MADE A LOGISTIC REGRESSION. SO WE USED THE FIELD TESTER SEARCH RESULTS THAT HAD BEEN MARKED AS RELEVANT OR NOT RELEVANT TO MAKE A MODEL. IT'S A NICE MODEL. ALL RIGHT SO BESIDES AEROSMITH GENERATING THE TOOL IT WAS FERTILE IN GENERATING FOUR SPINOFFS. AM IS A DATABASE OF BIOMEDICAL ABBREVIATIONS WIN ACRONYM AND NON-ACRONYM ABBREVIATIONS USED AS A BENCHMARK IN THE COMMUNITY AND I'LL SHOW YOU IN SUBSEQUENT SIDES IT'S A PUBMED INTERBASE WE WRAP AROUND FUNCTIONS PUBMED DOESN'T HAVE AT LEAST NOT YET. . AUTHORITY IS A LARGE PROJECT IDENTIFYING WHICH INDIVIDUALS WROTE WHICH ARTICLES IN PUBMED. IT'S LITERATURE-BASED DISCOVERY. I'LL GO THROUGH THESE INTERN. ALL THE TOOLS ARE ON THE PROJECT WEBSITE. SO ANN O'TATE. THIS IS REALLY A PUBMED SEARCH BOX WE CREATED INTERFACE AROUND. JUST TO GIVE YOU AN EXAMPLE OF HOW IT CAN BE USED ANNETTE VALENT DEVELOP HEALTH INFORMATICS AND SAID HER STUDENTS HAVE DIFFICULTY SEARCHING THE LITERATURE THOUGH YOU'D THINK THEY'D BE KNOWLEDGEABLE. IF THEY'RE SEARCHING FOR PATIENT SAFETY THERE'S A MESH TERM FOR PATIENT SAFETY BUT IT WAS ESTABLISHED IN 2012 SO HOW DO YOU SEARCH THE OLDER LITERATURE TO CAPTURE PATIENT SAFETY. I SAID, WELL, THEY CAN USE ANN O'TATE, YOU PUT IN PATIENT SAFETY, IT RETRIEVES 12,000 ARTICLES. THIS IS JUST THE RESULTS FROM PUBMED DISPLAYED HERE. IF YOU LOOK ON THE LEFT THEY'RE ALL FUNCTIONS WE'VE ADDED. WE TAKE THE RETRIEVAL SET OF 12,000 ARTICLES AND THEN DO PROCESSING OF THAT IN WAYS, FOR EXAMPLE, IMPORTANT WORDS. IF I CLICK ON IMPORTANT WORDS IT LOOKS AT ALL THE WORDS IN THE TITLES AND AC -- ABSTRACTS AND WHICH WORDS ARE VERY WELL RANT TO MED LINE AS A WHOLE. AND THERE'S HAND-OFF, HAND-OVER, THINGS THAT MAY NOT NECESSARILY POP IN YOUR HEAD IN ADVANCE. IT'S NOT AN ORDER OF FREQUENCY BUT HOW SPECIFIC AND OVERREPRESENTED IT IS IN THIS SET. WELL, THAT'S WORDS. PHRASES IS A DIFFERENT ALGORITHM. IF WE DO IMPORTANT PHRASES WE GET AGAIN BESIDES PATIENT SAFETY WE GET ADVERSE EVENT, MEDICATION ERROR, OPERATING ROOM. AND TO SHOW YOU THE DRILL-DOWN ARCHITECTURE OF THE SITE, SUPPOSE WE WANT TO SEE THE AUTHORS WHO PUBLISHED ON PATIENT SAFETY. SO WE CLICK ON AUTHORS. WE CAN CLICK ON THE MOST PROLIFIC AUTHOR AND WE WANT TO KNOW WHICH JOURNALS THEY'RE IN AND IT TAKES THE 54 AND PROCESSES THOSE. YOU CAN SEE THESE ARE THE JOURNA JOURNALS THE PERSON HAS PUBLISHED. THEY DRILL DOWN AT WILL. AMERICAN JOURNAL OF QUALITY HAS NINE ARTICLES. BESIDES DRILLING DOWN WE CAN ALSO COME BACK UP. ANYTIME THE RETRIEVAL HAS MORE THAN 50 ARTICLES THE EXPAND BUTTON COMES UP AND THE PUBMED RELATED ARTICLES ARE IN A BATCH MODE SO WHICH ARE MOST RELATED TO THE NINE CONSIDERED AS A WHOLE. WE GET NEW ARTICLES NOT BY THE SAME AUTHOR OR INDEXED UNDER PATIENT SAFETY BUT CLOSEST TO THE SET BEING DISPLAYED. WE DEVELOPED IT BECAUSE I DO MED SEARCHS EVERY DAY AND THIS IS WHAT I LIKE TO DO AND AN EXAMPLE OF HOW YOU CAN TAKE THE PUBLIC RESOURCE AND ADD VALUE. SO TO SHIFT GEARS, WE HAVE THE AUTHORITY PROJECT. THIS SOLVES THE FOLLOWING PROBLEM, THERE'S 26 MILLION ARTICLES IN PUBMED. 2,000 A DAY KEEP COMING IN. EACH ARTICLE MAY HAVE MULTIPLE AUTHOR NAMES. EACH NAME ON A PAPER MAY RESPOND TO INDIVIDUALS. HOW MANY JOHN SMITHS ARE PUBLISHING IN PUBMED. WHAT MAKES IT DIFFICULT IS THERE'S NO GOLD STANDARD. THERE IS NO REFERENCE LIST THAT SAYS WHICH INDIVIDUALS ARE PUBLIC. IT'S A BIG PROBLEM. IT'S IMPORTANT FOR MANY PURPOSE. FOR THE NAME JOHN SMITH WE'D SAY WROTE THESE ARTICLES AND A DIFFERENT JOHN SMITH WROTE THESE ARTICLES AND A THIRD JOHN SMITH WRTE THOSE ARTICLES. WE'RE ABLE FOR EACH NAME TO IDENTIFY ALL THE ARTICLES IN PUBMED WE PREDICTED THEY WROTE. A TEAM FROM YALE DOUBLE CHECKED OUR ACCURACY AND IT'S HIGHLY ACCURATE AS A WHOLE. NLM USED OUR MODEL WITH A MINOR TWEAK AND THERE'S NOW AN AUTHOR FILTER AND THERE WAS A GRANT TO LINK THE AUTHOR PUBLICATION CLUSTERS TO U.S. PATENTS. WE'VE LINKED IT ALSO TO NIN AND IT'S CURRENTLY SUPPORTED FROM A PROJECT FROM NIA TO IMPROVE AND UPDATE THE MODEL THROUGH 2016, THE PRESENT. ESPECIALLY TO BE PREPARED FOR SOCIAL SCIENTISTS, ECONOMISTS AND POLICY RESEARCHERS STUDYING SCIENTIFIC INNOVATION. SO THESE CLUSTERS ARE PREDICTED PEOPLE. HOW DO YOU KNOW WHO IN THE REAL WORLD IT IS. SO BESIDES LINKING THEM TO AND USING OTHER PREDICTIVE TOOLS FOR THE GEOLOCATION. WHAT CITY THEY LIVE IN. GENDER, ETHNICITY, AUTHOR ATTRIBUTE AND INTERDISCIPLINARY AND ARE THEY A MENTOR. THINGS LIKE THAT. A SPINOFF OF LITERATURE-BASED DISCOVERY, WE HAVE TWO DISPRAARATE FIELDS. SAY I'M STUDYING ALZHEIMER'S AND YOU CAN ASK ARE THERE DISPARATE LITERATURES WITHIN A FIELD. IF YOU TAKE MESH TERMS TO BE TOPICS, THE ALZHEIMER'S LITERATURE HAS MANY DIFFERENT MESH TERMS. WE HAVE CAN LOOK AT MESH TERMS. SO THERE'S SITUATIONS WHERE TWO MESH TERMS JUST BY CHANCE BECAUSE OF THEIR FREQUENCY YOU'D EXPECT FOR THEM TO CO-OCCUR JUST FROM THEIR FREQUENCY IN THE LITERATURE. WE CALL THAT A GAP. WE CAN LOOK FIVE YEARS LATER AND SEE IF ARTICLES APPEAR FROM THE MESH TERMS. WE CALL THAT FILLING THE GAP. ARTICLES THAT FILL GAPS ARE MORE CITED HEAVILY THAN NON-GAP ARTICLES SO THEY'RE IMPORTANT TO STUDY. WE HAVE A PROJECT THAT'S SUPPORTED BY A SUPPLEMENT FROM NIA TO STUDY THE KINDS OF GAPS, WHAT THEY MEAN, HOW TO IDENTIFY THEM. SOME ARE LOW-HANGING FRUIT. THINGS THAT ARE VERY LIKELY TO BE STUDIES IN THE NEAR FUTURE AND SOME OF THEM DO REPRESENT SUBLIST DISCIPLINES THAT DON'T TALK TO EACH OTHER EVEN WITHIN A SINGLE FIELD. SO NOT EVERYTHING I DO IS A SPIN OFF OF AEROSMITH AND THE WAY IS TO THOSE WHO WRITE REVIEWS AND UPDATE EXISTING REVIEWS. THIS SAY CURRENT R01 AND I'M A PART OF A STELLAR TEAM AND JOHN DAVIS AT UIC. HE JUST WON THE LIEBER PRIZE FOR PSYCH -- PSYCHIATRY. AND WE HAVE A NEW ASSOCIATE PROFESSOR IN CHAMPAGNE, ILLINOIS WHO JUST JOINED THE TEAM. WE HAVE HAD A SNAFU WITH ONE OF OUR TEAM MEMBERS KEEP WITH CANCER AND HE'S BACK FROM MEDICAL LEAVE. WE'RE WORKING TOGETHER ACTIVELY NOW. HOPEFULLY IT'S IN THE PAST. WE'RE FOCUSSING ON THE INITIAL STAGES OF SYSTEMATIC REVIEW AND GIVEN SUBJECT LIKE IS ASPIRIN EFFECTIVE AGAINST MIGRAINE HEADACHES? YOU TAKE ALL THE CLINICAL TRIALS AND THERE'S A PROCESS HOW TO EVALUATE HE'S AND COME TO A CONSENSUS ABOUT EFFICACY AND SAFETY. IT'S DONE LARGELY MANUALLY. IT COULD TAKE SIX MONTHS TO TWO YEARS TO WRITE THIS. WE'RE DEVELOPING A SERIES OF TOOLS TO HELP IN THE PROCESS. THE FIRST IS A METTA SEARCH ENGINE AND SENT A QUERY TO THE DATABASES REVIEWERS USE AND REDUPLICATES THE SETS SO THE SAME ARTICLE DOESN'T COME BACK FIVE TIMES. THEN THEY WOULD MANUALLY TRIAGE THESE ARTICLES. THAT'S WHAT WE DO NOW. WHAT WE BELIEVE IS POSSIBLE IS TO USE AUTOMATED TOOLS TO GET THE SEARCH DOWN SEVERELY TO THROW OUT THE UNINTERESTING ONE WITHOUT LOSING THE RELEVANT ONES. THAT'S WHAT WE'RE TESTING NOW. THE MOST IMPORTANT ARE RANDOMIZED STUDIES. INSTEAD OF SAYING IT'S AN RCT OR NOT WE GIVE A PROBABILITY BETWEEN ZERO AND ONE. THE USERS CAN SET THEIR OWN PROBABILITY. THEY CAN SET 0.01 ANYTHING BELOW THAT THEY DON'T LOOK AT. THEY'LL LOSE VERY FEW RELEVANT ARTICLES BUT THROW OUT 85% OF THE RETRIEVAL. THE TRADE-OFF, HOW MUCH YOU SAVE AND LOSE IS WHAT WE'RE STUDYING. THERE'S ADDITIONAL COHORT AND CASE-CONTROL STUDIES AND OTHERS. WE'RE WORKING WITH SYSTEMATIC REVIEW GROUPS. FIRST WORKING IN PARALLEL. PARALLEL PLAY WHERE THEY DO THEIR OWN WORK, THEIR WAY, WE DO IT OUR WAY AND WE COMPARE THE SAVINGS AND TIME AND WHAT WE LOSE. WHEN SOMEONE PROPOSES THEY'LL NOT HAVE ENOUGH LITERATURE FOR THE CONCLUSION. A SCOPING TOOL WOULD BE VERY VALUABLE WHERE YOU SAY, WHAT'S THE SIZE AND TYPE OF THE EVIDENCE BASE ON THE QUESTION THIS WOULD ALLOW THEM TO HAVE AN ANSWER WHERE A SYSTEMATIC REVIEW AND THAT GOES STALE BECAUSE NEW ARTICLES ARE PUSH -- PUBLISHED AND A TOOL THAT HELPS IDENTIFY NEW ARTICLES THAT APPEAR ESPECIALLY THE ONES IMPORTANT FOR UPDATING. IT WILL SAY, YES, THIS IS TIME FOR YOU TO DO AN UPDATE. ALSO REGISTERED TRIALS IN CLINICALTRIALS.gov ARE NOT ALWAYS WELL CONNECTED THE PUBLICATIONS FOR THE TRIALS. YOU WOULD THINK THEY WOULD BE. THEY'RE NOT. WE'RE DEVELOPING TOOLS TO CONNECT THE TRIALS TO THE PUBLICATION ARISE FROM THEM. AND WHEN PUBLICATION COMES FROM THE SAME TRIAL. WITH DRUG COMPANIES THEY MAY PUBLISH MANY ARTICLES FROM ONE TRIAL WITH NO AUTHOR'S IN COMMON. SO IT'S ONE PIECE OF EVIDENCE INSTEAD OF 12 PIECE OF EVIDENCE. IT'S IMPORTANT TO AGGREGATE THE STUDIES FROM THE SAME TRIAL. THAT'S SOME OF THE THINGS WE'RE DOING NOW. IN CONCLUSION THE WORK IN MY LABORATORY HAS A FLAVOR. ONE IS EACH PROJECT THAT HAS SP SPIN-OFFS THAT HAVE TAKEN A LIFE OF THEIR OWN AND I DON'T HAVE GRANDCHILDREN BUT IT'S LIKE HAVING GRANDCHILDREN AND YOUR PROUD OF THEM. THEY HAVE RESOURCES IN NLM DEEPLY, ESPECIALLY PUBMED. WE'VE HAD MANY CONVERSATIONS WITH PEOPLE AT LISTER HILL AND NCBI FOR MANY YEARS. WE HAVE TEXT MINING AND QUANTITATIVE MODELLING WITH FIELD TESTERS. WE DON'T JUST GIVE THEM A TOOL AND LET THEM EVALUATE WE DEVELOP IT WITH THE FIELD TESTERS. WE DON'T POST THINGS ON GET HUB AND THEN YOU HAVE TO LEARN HOW TO DO COMPUTER PROGRAMMING. THE TOOLS DO NOT REQUIRE THAT KIND OF EXPERTISE. THE RESEARCH COMMUNITY THAT WE'VE SERVED ARE VERY DIVERSE. THEY RANGE FROM SCIENTISTS WHO TEST HYPOTHESES IN THE LAB AND CLINIC, SYSTEMATIC REVIEWERS, PROGRAM OFFICERS, ECONOMISTS AND WE PROVIDE A LOT OF INFRASTRUCTURE METRICS AND SO ON GOING FORWARD I HOPE WE WILL CONTINUE TO BE PRODUCTIVE. WE'RE THINKING OF NEW PROJECTS WE'RE HOPING TO START IN THE NEXT YEAR OR TWO AND IN A FUTURE DATE WHEN YOU DO A NEXT STRATEGIC PLAN I CAN COME BACK AND GIVE YOU ANOTHER UPDATE. THANKS. [APPLAUSE] . >> WE HAVE TWO COMMON -- COMMENTATORS. >> I'M NOT SURE I GOT NOMINATED FOR THIS BUT I LOOKED AT THE MESHER AND THE KEY WORDS AND HOW THEY EVOLVE AND HOW SOME DON'T USE THE SAME ONES AND IT LED ME TO THINKING HOW DYNAMIC ARE THE TOOLS IN THEIR CURRENT UTILIZATION. ARE YOU ABLE TO GO BACK AND UPDATE CHANGING DEFINITIONS OR CHANGE THE DEFINITION OF CLINICAL TRIALS AT NIH? IT LOOKS LIKE THE LIBRARY IS BEING REVISED TO LOOK AT THE TAXONOMY OF LYME DISEASE. WORDS STAY THE SAME BUT CHANGE MEANING AND HERE'S THE AEROSMITH WORK OF COMMON THEMES. SOME LOOKS LIKE IT WILL REQUIRE ONGOING MANAGEMENT WHERE A COMMERCIAL PRODUCT WOULD GIVE SOMEBODY INCENTIVE TO DID THAT. AS AN ACADEMIC EVERY TIME YOU DEVELOP ONE THE EFFORT TO KEEP THE OTHERS CURRENT IS REDUCED THE CLOCK. >> THAT'S RIGHT. THE PROBLEM OF UPDATING IS MOST SEVERE FOR THE AUTHORITY TOOL BECAUSE EVERYBODY NEW ARTICLE IS NOT IN THE DATA SET. THE WAY WE DO THE MODELLING IS ACROSS THE EXISTING CORPUS AND THOSE ARE ASSIGNED AND THEN A NEW ONE DOES NOT AUTOMATICALLY GET ASSIGNED. THAT WOULD REQUIR AN INCREMENTAL APPROACH WE HAVEN'T IMPLEMENTED YET. THE ABBREVIATION DATABASE WE FOCUS ON THE MORE IMPORTANT ABBREVIATIONS. THE TERMINOLOGY DOESN'T CHANGE A FELT THE NEED TO CHANGE THAT pSOME OF OUR BACK END RESOURCES ARE COMPUTED SO FOR EXAMPLE, SO WORD FREQUENCIES CAN CHANGE AND CAN BE RECOMPUTED BUT MOST REQUIRE LITTLE MANAGEMENT LIKE THAT. IN AUTHORITY WE'LL HAVE TO WRITE ANOTHER GRANT PROPOSAL TO DO INCREMENTAL MODELLING AS A PROJECT ITSELF. THE TWO-NODE SEARCH TOOL HAS NOT REQUIRED MAJOR UPDATING. WE HAVE TO DO UPDATES BUT THE TOOL ITSELF DOESN'T CHANGE MUCH. >> AND THE ARTICLE YOU DID WITH SWANSON, YOU HAVE REDEEMED MUCH OF THE PROMISE YOU MADE. >> ONE OF THE THINGS I LOVE ABOUT BEING ON THE BOARD IS REDISCOVERING THINGS I DIDN'T KNOW AND I'M A VIROLOGIST. I HAVE A PRACTICAL QUESTION ON THE AEROSMITH WEBSITE. >> THE ONLY TOOL NOT PUBLIC IS METTA BECAUSE WE'RE SEARCHING PROPRIETARY DATABASES THROUGH THE UIC LICENSE WHICH IS ONLY FOR OUR OWN RESEARCHERS. SO OUR TEAM CAN USE IT BUT IT CAN'T BE -- YOU CAN'T SEARCH DATABASES FOR FREE. OTHER THAN THAT, EVERYTHING ELSE FREE AND THERE'S NO SUBSCRIPTION OR LOG IN OR PASS WORDS OR REGISTRATION EVEN. YOU JUST GO AND USE IT. >> TERRIFIC. BECAUSE I THINK COMING FROM A SCIENTIFIC INSTITUTION THE AVERAGE SCIENTIST DOESN'T HAVE TRAINING IN HOW TO USE THESE SORT OF TOOLS. THIS IS A WHOLE STEP UP. I THINK THAT'S SOMETHING I'VE LEARNED. THE OTHER THING IS A PHILOSOPHICAL THING. YOU'VE BEEN SITTING THROUGH OUR DISCUSSION OF THE STRATEGIC PLAN IN THE LAST DAY AND A HALF AND YOU HAVEN'T READ THE DOCUMENT BUT YOU'RE GENERATING NEW KNOWLEDGE THAT IS DYNAMIC AND IS CLEARLY GOING TO EVOLVE. NOW, HOW DO WE USE THIS TOOL? IS IT JUST A TOOL TO CONNECT IDEAS OR DOES IT HAVE LARGER IMPLICATIONS. IS THAT AN UNFAIR QUESTIONS? CAN WE GENERATE NEW KNOWLEDGE WITH THE TOOL? >> YEAH. >> PEOPLE HAVE. THE TOOL ITSELF ASSISTS PEOPLE IN WHAT THEY'RE LOOKING FOR. THE NUMBER OF POTENTIAL CONNECTIONS BETWEEN THINGS IS VERY LARGE AND KIRCDIFFERENT PEOPLE WOULD HAVE DIFFERENT TAKES ON WHAT'S PLAUSIBLE. THE EARLY WORK FOCUSSED ON THINGS THAT WERE LIKELY TO BE TRUE AND THINGS THAT ARE LIKELY TO BE TRUE ARE NOT PARTICULARLY INTERESTING. WHAT'S SURPRISING AND PLAUSIBLE ARE DIFFERENT THINGS. IT'S FOR THE SCIENTIST TO USE THEIR JUDGMENT IN WHAT SEEMS RIGHT. >> AND IT COMES TO HAVING TO BE AT THE RIGHT PLACE AT THE RIGHT TIME WITH THE RIGHT IDEA. >> ALONG THOSE LINES, THE VERY FACT THAT YOU KEEP USING THE WORD TOOL I THINK IS VERY RELEVANT. YOU HAVE CREATED A TOOL. A HAMMER, WE CAN BUILD A BUILDING OR TABLE. YOU CAN BUILD WHATEVER BUT YOU HAVE GIVEN US THE TOOLS TO DO IT. DOES THAT ANSWER YOUR QUESTION, JILL? >> YEAH. [QUESTION OFF-MIC] >> WHAT IS THE COMBINED PROJECT? >> ARROWSMITH. >> IMAGINE TAKING THE GAP TOOL AND TURNING THAT AROUND. >> SO WE HAVE THIS ONE-YEAR SUPPLEMENT TO DO THAT. >> THE SECOND QUESTION IS [QUESTION OFF-MIC] >> DO YOU SEE A WAY TO USE THAT AS A RANKING FUNCTION FOR WHAT MIGHT GO TOGETHER? >> IT'S COMPLIMENTARY. THERE'S WAYS TO PUT TOGETHER THE DISCOVERY. THE MEDLINE IS MORE FOCUSSED BUT IT'S PART OF IT. >> THERE'S A GUY WHO WORKS WITH THE NLM A LOT DOING THAT. HE'S BUILDING IT ON SEMANTIC MEDLINE. THAT'S A DIFFERENT APPROACH FOR THE SAME GOAL. >> YOU MENTIONED THERE WAS A PIECE THAT WAS NOT READILY AVAILABLE ON ARROWSMITH AND MY QUESTION IS IS IT AVAILABLE TO ANOTHER INSTITUTION WITH LICENSING? >> SURE. SO ANY INSTITUTION. I TRIED TO GET EVENTUALLY THE PERSON IN CHARGE GOT A DIFFERENT JOB AND THE NEW PERSON HAD NO IDEA WHAT TO DO WITH IT. AND THERE'S EVENTUAL SUPPORT. >> THERE'S SHARED FUTURES. THAT'S A GENERAL PRINCIPLE. THAT'S WHAT PEOPLE DO TO SEW THESE TOGETHER OR THEY CONNECT OR CREATE INTERMEDIATE STRUCTURES. SO IT IS POSSIBLE I DON'T KNOW THE TEXT TOOLS I'M USING NECESSARILY TO TRY TO SCALE TO -- BUT THE PRINCIPLES ARE THERE. >> SO THE CONVERSATION THAT WE WERE HAVING ABOUT I STRATEGIC PLAN AND THE WORK YOU'RE DOING IS EXEMPLARY WHAT WE SHOULD BE DOING BECAUSE IT'S AGNOSTIC TO THE DATA. THE INDUSTRY WILL MAKE USE OF THE TOOL IN MULTIPLE WAYS AND RESEARCHERS GO IN AND DO A LOT OF CLEVER WORK AND YOU TAKE ADVANTAGE OF THE TOOLS AND THAT'S WHAT WE'RE TALKING ABOUT IN TERMS OF HOW THE LIBRARY CAN POSITION ITSELF. >> WHEN WE MAKE NEW PUBLICATIONS OR TAGS ANYBODY CAN USE THOSE TAGS. AND NLM THEMSELVES HAVE A SECONDARY FIELD -- >> YOU'RE ALLOWING FOR CROWD SOURCING IN ITS OWN WAY. ANYBODY THE RESEARCHER CAN GO IN AND -- >> I'M CURIOUS. YOU SAID YOU TESTED YOUR RESULTS AGAINST THE RESULTS OF THE SYSTEMATIC REVIEW TEAMS. THAT'S WHAT WE ARGUED. DO THOSE TEAMS CONTAIN LIBRARIANS? >> OH, SURE. SOME THIS IS THE SECOND ITERATION. IF THE FIRST ITERATION IN FACT DID NOT USE THE INTERNET OR PUBMED SEARCHING BECAUSE THEY HAD LIBRARIANS FULL-TIME SEARCHI SEARCHING COMPREHENSIVELY INSTEAD OF DATABASES THEY DREW FROM. SO WE COULDN'T CONTINUE WORKING WITH THEM. THEY'RE THE PINNACLE BUT THEY'RE MOT THE AVERAGE. MOST SYSTEMATIC REVIEWS ARE WRITTEN BY THOSE KINDS OF PEOPLE. MOST ARE WRITTEN BY PEOPLE THAT GO, IF YOU'RE LUCKY TO AN ACADEMIC LIBRARIAN OR INSTITUTION. THE PEOPLE WORE WORKING WITH NOW HAVE LIBRARIANS ON THE STAFF. AND OF COURSE, JODY SCHNEIDER IS A LIBRARIAN. WE HAVE LIBRARIANS AS WELL. >> SYSTEMATIC REVIEWS ARE SO INTENSE AND TIME INTENSIVE, I HOPE THIS PROVES WONDERFULLY SUCCESSFUL AND WILL CUT DOWN ON OUR BURDEN OF DOING SYSTEMATIC REVIEWS. SO WE'RE WORKING ON THE FIRST HALF AT FINDING ARTICLES AND THEN COLLATING AND ANALYZING THE PROJECTS -- NOT ME BEING BUT OTHER PEOPLE WORKING ON THE SECOND HALF AND THERE'S SUPPOSEDLY A WORLDWIDE CONSORTIUM WHERE THEY SHOULD BE WORKING TOGETHER AND MAKING THEM INTEROPERABLE SO BOTH HALVES OF THE PROBLEM WILL BE HELPED. >> THANK YOU FOR A GREAT TALK AND WE'RE EXACTLY ON TIME. [APPLAUSE] THE NEXT AGENDA ITEM IS FUTURE BOARD OF REGENT TOPICS. >> THEY ASKED US TO TALK MORE ABOUT THE BOARD ABOUT WHAT OUR AGENDA ITEMS ARE FOR THE BOARD AND WHILE WE HAVE A STANDING SCHEDULE OF THREE MEETINGS A YEAR AND WE'RE FAR AHEAD OF OUR FEBRUARY MEETING I WANTED YOUR IDEAS ON TOPICS YOU'D LIKE US TO GO INTO SOME DEPTH WITH OR BRIEFNESS WITH OVER THE NEXT YEAR. >> I HAVE ONE IDEA THAT JUST CAME UP THIS MORNING AND I NOTED IT DOWN. YOUR INTERACTION WITH THE CENTER ON MINORITY AND DISPARITIES AND THE HIV SO THAT WOULD BE A TOPIC THAT MIGHT BE GOOD. >> WOULD YOU LIKE TO HEAR FROM THEIR DIRECTOR SAME WAY WE BROUGHT OTHER DIRECTORS IN? >> MINE WOULD BE A FUNCTIONAL SPECIFICATION WHICH IS A TOPIC -- AND THIS CAME UP YESTERDAY AT LUNCH, RATHER THAN WORK ALREADY COMPLETE FOR WHICH IT'S AN FYI AND PROFESSIONAL EDUCATION FOR THE BOARD, SOMETHING THAT'S IN THE THROES OF WHERE IT NEEDS A NEXT STEP KIND OF ADVICE THAT WOULD BE MEANINGFUL FROM THE BOARD. >> I'M TRYING TO THINK ABOUT -- IT COULD BE AN INDIVIDUAL PROJECT SUCH AS THOSE EARLIER PRESENTED BUT AT A DIFFERENT STAGE OF THE PROJECT. AND THEN THE OTHER ONE AND MAYBE THIS IS THE IMMEDIATE CONTEXT FOR THAT WOULD BE -- WELL, PRESUMING WE HAVE A STRATEGIC PLAN IN OUR POCKET BY THEN, I THINK A DISCUSSION OF THE PRINCIPLED APPROACH TO THE BOARD'S INVOLVEMENT WITH THE IMPLEMENTATION PLANS AND HOW WE CAN MONITOR THAT AND THE PROGRESS. SO SHIFTING -- >> AND THERE BE A TARGET AND SPECIFIC QUESTIONS. FOR EACH QUESTION THE PROS AND CONS AND THEN A DISCUSSION OF THE QUESTION BY THE BOARD. >> SO WE TALKED ABOUT THIS AT LUNCH AND ALSO FOR THE PRESENTER, SO FOR EXAMPLE THE CLOUD PRESENTATION WAS AN EXAMPLE. WHAT ARE ISSUES YOU'RE STRUGGLING WITH AND PROS AND CONS AND WHAT IS OUR THOUGHT ON WHICH DIRECTION TO GO BASED ON THESE PROS AND CONS. >> SO DO YOU HAVE IDEAS ABOUT HOW WE COULD FRAME THOSE IN A WAY THAT MAKES A PROPER USE OF THE BOARD BECAUSE WE DON'T WANT TO BRING YOU INTO OTHER LEVELS USING AMAZON AND GOOGLE. IF WE TAKE THIS AND THE ISSUE OF FUTURE DIRECTIONS OF OUR COMPUTATIONAL INFRASTRUCTURE, ARE THERE LEVELS WE COULD ORGANIZE THE CONTENT FOR YOU AND THE QUESTIONS SO THAT WE MAKE GOOD USE OF BOARD INPUT? THE SESSION WE HAD AT LUNCH WAS NOT ABOUT THAT TOPIC IN PARTICULAR. >> NO, AN EXAMPLE. >> THE IDEA WOULD BE PUSHING AN EXAMPLE BUT THERE'S MORE OF THE LINES OF IT SEEMS THE DISCUSSIONS AND QUESTIONS OF Q&A PERIODS ARE SHORT COMPARED TO THE PRESENTATION PERIODS. THERE'S AN INTEREST IN BROADENING AND FOCUSSING MORE ON ADVISEMENT VERSUS BRIEFING. BRIEFING IS CRITICAL BUT LESS OF A FOCUS ON DISCUSSION AND DELIBERATION. >> AND ONGOING PROJECTS AND START-UP PROJECTS WHERE IT'S ALWAYS THE PROJECT LEADER WHO'S THE FIRST SOURCE OF QUESTION AND TEND TO BE DOWN IN THE WEEDS OF TECHNICAL IMPORTANT QUESTION. IF YOU ASK THE PROJECT LEADERS TO GIVE YOU TEN QUESTIONS AND YOU FIND THREE LEADERSHIP THINK ARE AT THE APPROPRIATE LEVEL FOR THE BOARD THEN MAYBE WE'LL ALL FEEL LIKE WE MADE A CONTRIBUTION AND LEARNED SOMETHING. >> SO ONE OF THE THINGS I'M THINKING IS AS WE'RE THINKING ABOUT THIS IS THE QUESTION WE'LL DEAL WITH IS THE NEXT COUPLE YEAR IS WHAT WE'LL DO WITH INDIVIDUAL DATA TO THE EXTENT WE'LL BE ADDRESSING IT AND FRAMING THE ISSUES SOME AROUND A CLINICAL TRIAL BUT NOT EXCLUSIVELY RELATED TO CLINICAL TRIALS AND POLICY-LEVEL OF INVESTMENT AND ACCOUNTABILITY. THAT'S HELPFUL. >> AND OCCASIONALLY TO HAVE THE LEADER OF A LIBRARY PRESENT WHAT THEIR MAJOR PROBLEMS ARE AND CHALLENGES LIKE JOYCE IN LIBRARY OPERATIONS. THAT'S FOR DISCUSSION NOT MANAGEMENT. >> AT AN OPERATIONAL LEVEL NOT TACTICAL LEVEL. WHETHER YOU PAINT THE WALL RED OR GREEN I DON'T CARE. >> PAINT THAT WALL. THERE'S A LOT OF INTEREST IN THE REPORTS YOU WORK HARD TO PRODUCE. IT'S MORE BINDING FROM THE BOARD. ANY OTHER IDEAS. >> I WANT TO UNDER SCORE THE IDEA OF HAVING THE STRATEGIC PLAN AS AN ITEM, AGENDA ITEM EVERY TIME SO WE CONTINUE TO LOOK AT IT AND LOOK AT THE IMPLEMENTATION AND SO I THINK THAT WAS -- >> AND FALLS INTO WHAT THE ISSUES HAVE BEEN AT ONE MEETING COMPARED TO THE NEXT MEETING. >> ANY OTHERS? PATTY? >> THAT'S QUITE HELPFUL. MY PLAN WOULD BE I MEET WITH CHRISTINE AND WITH ESTER PROBABLY AROUND LATE DECEMBER WITH THE HOLIDAYS TO HAVE ENOUGH OF A PLAN IN TIME TO GET MATERIALS TO YOU BY MID JANUARY SO YOU'RE READY TO BE PREPARED. CHRISTINE HAS THE EXACT SCHEDULE FOR THAT. THE OTHER QUESTION I HAD FOR YOU IS WE ARE AT A WHERE WE WILL BE REPLACING TWO MEMBERS IN SEPTEMBER OF NEXT YEAR AND SO I WOULD ASK YOU TO THINK ABOUT WHAT KIND OF SUPPORT THE BOARD NEEDS EITHER SPECIFIC INDIVIDUAL OR NAMES OF PEOPLE WE SHOULD IN CONSIDERING. WE COME UP WITH A SLATE OF NOMINATIONS AND THEY HAVE TO BE VETTED THROUGH THE HHS SO IT TAKES SIX MONTHS TO GET THEM THROUGH. I'LL WORK WITH CHRISTINE ON PUTTING THE PACKAGE TOGETHER. CHRISTINE, IS IT BEFORE THE BOARD MEETING? >> SO IT'S HELPFUL IN THE NEXT MONTH IF YOU HAVE AN IDEA OF TALENT YOU THINK WE NEED SEND THEM TO ME INCLUDING THE EXTENT TO WHICH YOU THINK WE NEED TO BRING A CONSUMER VOICE INTO THE BOARD IN A MORE FORMAL WAY. >> IN POPULATING THE PANELS WHAT WE FOUND USEFUL IS THE LINEAR LIST OF PEOPLE WHO ARE ALREADY ON AN ADVISORY BECAUSE THEY TEND TO GET RENOMINATED WITH HIGH PROBABILITY. GOOD TO KNOW IF THEY'RE ALREADY COMMITTED. >> WE SHOULD PUT OUR LIST TOGETHER TO SHARE WITH THE BOARD FOR THE NEXT MEETING. >> THANK YOU VERY MUCH. >> THANK YOU. >> WE HAVE ONE MORE VERY PLEASANT ITEM. SO IT IS MY GREAT PLEASURE TO PRESENT THE REGENTS AWARD. THE REGENTS AWARD FOR SCHOLARSHIP OF TECHNICAL ACHIEVEMENT ESTABLISHED IN 1970 BY THE BOARD OF REGENTS TO STIM LIES INDEPENDENT CREATIVITY LEADING TO SCHOLARSHIP OR TECHNICAL ACHIEVEMENTS THAT ENRICH BIOMEDICINE. THE BOARD CONSIDERS IT THE HIGHEST MEMBER TO GIVE TO THE STAFF. THIS YEAR IT'S PRESENTED TO DR. THOMAS REINDFLEISCH IN THE COGNITIVE BRANCH OF THE LIST TER HILL CENTER FOR BIOMEDICAL COMMUNICATIONS AND YOU HEARD FROM HIM EARLIER. HE GAVE US AN INTERESTING SUM SUMMARY OF HIS WORK. HE RECEIVES THIS YEAR'S AWARD IN RECOGNITION OF HIS EXCEPTIONAL LEADERSHIP IN THE DEVELOPMENT OF METHODS AND TOOLS FOR EXTRACTING TEXT. THANK YOU AND PLEASE COME UP. [APPLAUSE] >> YOU CAN HOLD IT. [APPLAUSE] >> SO, WITH THAT IF THERE IS NO OTHER BURNING ISSUES, THE MEETING IS ADJOURNED AND WE'LL SEE YOU IN FEBRUARY. THANK YOU VERY MUCH. [APPLAUSE]