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MLA Position Statements and FAQs
The National Information Infrastructure and
Health Sciences Librarians Position Statement
MLA's Position
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 [1] 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 [2].
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.
Basic Principles
- 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.
Background
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 [3]. 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.
Conclusion
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.
References
- 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.
- 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.
- 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.
Author
Prepared in May 1996 by
Sara Anne Hook, Indiana University School of Dentistry Library,
Indianapolis, and Ruth Riley, University of Arkansas for Medical
Sciences Library, Little Rock
MLA Governmental Relations Committee members
For more information, contact Mary
Langman, 312.419.9094 x27.
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