MLA Position Statements and FAQs
The National Information Infrastructure and Health Sciences Librarians
The Medical Library Association (MLA) maintains that
- the National Information Infrastructure (NII) must include all libraries, particularly health sciences libraries, to ensure basic access to information for all health professionals involved in patient care, health education, and research, as well as for patients and the public.
- the key principles of equitable access, security, privacy, intellectual property rights, and integrity of data should be incorporated into the formation of the NII.
- the National Library of Medicine's (NLM) leadership role in the development and implementation of the NII should be sustained through the High-Performance Computing and Communications (HPCC) program and other initiatives.
Why MLA Supports This Position
Health sciences librarians provide prompt and relevant information to support the delivery of effective patient care, the education of health professionals, research, and the distribution of consumer health information. The Rochester study  confirmed the value of the information and services provided by health sciences librarians to improve patient care and to help reduce health care costs. Increasing emphasis on electronic information sources has resulted in new roles for health sciences librarians as leaders in developing and managing large-scale electronic information systems; establishing health sciences libraries as key access points for biomedical information found on the Internet and local networks; developing World Wide Web sites with subject-oriented, user-friendly interfaces to medical information on the Internet; and providing Internet training.
Health sciences librarians play vital roles in many of the health care projects that are being implemented through access to the NII . Such projects include instituting telemedicine programs, providing information to health care professionals and students in remote and underserved areas, sharing medical records that link care providers across organizational boundaries, providing consumer health information to citizens, and designing and implementing the electronic universal patient record.
In response to recent health reform initiatives, a growing mission of health sciences librarians is to provide health information to consumers. Informed health care consumers will create a healthier citizenry, thus lowering aggregate costs. Health sciences librarians and libraries are receiving federal funding to develop and implement consumer health information resources and networks using the NII as a cost-effective delivery tool.
NLM has taken an active role in developing health-related applications of HPCC technology. NLM has provided health sciences institutions with Internet connection grants that have resulted in newly-created test-bed networks for sharing patient information and medical images. NLM's Visible Human Project is creating a digital image data set of complete male and female human cadavers in MRI, CT, and anatomical modes. NLM is making these images available on the Internet to assist the advancement of biomedical sciences and to aid the dissemination and exchange of information important to the progress of medicine and public health.
- The NII must include health sciences libraries and all libraries.
- Affordable access to the NII must be available to all health care providers and consumers.
- The privacy and confidentiality of users and the information they access on the NII must be ensured.
- The intellectual property system must ensure a fair and equitable balance between the rights of creators and other copyright owners and the needs of users.
- Measures must be taken to preserve the integrity of data on the NII.
At the Telecommunications and Information Infrastructure Policy Forum convened by the American Library Association in 1993, MLA joined fourteen other national library and information associations in endorsing several key principles that must be used to guide the development of the NII . Following is a modification of these principles for purposes of focusing on the role of health sciences libraries in the NII.
- Inclusion of Health Sciences Libraries in the NII. Health sciences libraries must be included in the NII to secure basic information access for all health care professionals and consumers. It is vital that health sciences libraries be part of the computerized health information network that will link academic health centers, hospitals, clinics, and private practices to the NII. Timely access to current biomedical information is essential for health care practitioners, educators, researchers, and consumers. Health sciences libraries create and provide access to electronic resources.
- Equitable Access. Equitable access requires universal service. A society that is committed to ensuring a basic level of health care for all citizens cannot allow any group to be deprived of vital information. Access must be available to all providers of health care, as well as to patients, since having informed health care consumers leads to better disease prevention and informed decision-making by patients. Access to health care information through the NII must be available to public and school libraries and other community locations because they may be the primary source of consumer health information, particularly in remote and underserved areas. Equitable access also requires affordability. While the NII will rely on commercial entities for its infrastructure, a basic level of service must be provided to institutions and citizens at minimal or no cost.
- Security and Privacy. To ensure the privacy and confidentiality of users and the information they access, sufficient checkpointswhether based on hardware, software, or the use of passwordsmust be in place to prevent unauthorized intrusion into the records and the transaction of anyone using the NII to locate or transmit information. Personal data on users that is collected or transmitted by groups external to the library should be limited to a necessary minimum, and a system of informed consent should be established
- Intellectual Property. The new electronic information environment has forced a variety of agencies and library organizations to take a fresh look at the issue of intellectual property. Clearly, if the NII is to survive as a viable vehicle for health sciences information, there must be a reconfigured approach to copyright, which protects the rights of information creators to just compensation for their efforts, yet at the same time makes this information accessible to the widest audience at the lowest cost.
- Integrity of Data. Database producers such as NLM adhere to stringent quality assurance guidelines in producing, updating, and maintaining their information products. Since it may be used in the treatment of patients or in competitive research, it is vital that the integrity of this information be protected. Database producers distributing their products via the NII must take precautions to ensure that data elements may not be altered or deleted.
The expertise of health sciences librarians in envisioning, planning, organizing, manipulating, and facilitating the use of electronic information systems makes them key members of the health care team. In order for the NII to serve as an effective tool for the management and delivery of health care information, health sciences librarians must be and are included in the planning and development of this important piece of the nation's information infrastructure.
1. Marshall, JG. The impact of the hospital library on clinical decision-making: the Rochester study. Bull Med Libr Assoc 1992 Apr;80(2):169-78.
2. Lindberg, DAB, Ed. Symposium: building the National Information Infrastraucture: role of high-performance computing and communications. Bull Med Lib Assoc 1995 Jan;83(1):28-57.
3. American Library Association. Principles for the development of the National Information Infrastructure. Presented at: Telecommunications and Information Infrastructure Policy Forum, Washington, DC, 1993; Chicago: American Library Association; 1993.
Prepared by Sara Anne Hook, Indiana University School of Dentistry Library, Indianapolis
Ruth Riley, University of Arkansas for Medical Sciences Library, Little Rock
MLA Governmental Relations Committee