Comments of the Medical Library Association and Association of Academic Health Sciences Libraries
to the Advisory Committee to the NIH Director Working Group
on the Future Biomedical Research Workforce
Submitted via http://grants.nih.gov/grants/guide/rfi_files/bmw/add.cfm
October 6, 2011
Name of Individual(s) Submitting Comments:
Patricia L. Thibodeau, President, Association of Academic Health Sciences Libraries and
Associate Dean, Duke University Medical Center Library, Durham, NC
Donna Timm, Chair, Governmental Relations Committee, Medical Library Association
and Head, User Education, Medical Library, Louisiana State University, Shreveport, LA
Affiliation:
Commenting on behalf of Association of Academic Health Sciences Libraries, Seattle,
WA and the Medical Library Association, Chicago, IL
Comment 1: For any of the areas described in the RFI and any other specific areas you believe are worthy of consideration by the working group, please identify the critical issue(s) and impact(s) on institutions, scientists, or both.
These comments made on behalf of the and Association of Academic Health Sciences Libraries (AAHSL) and Medical Library Association (MLA) address the issues of Balance/demand, Clinician-research training, Training grants, Characteristics of PhD Training, and NIH policies.
- Balance/demand
Increasing complexities in the recording, structure, analysis, and long-term use of biomedical and biosciences data is creating a new demand for people with these skills. At this time, the need for individuals who can apply skills and knowledge is greater than the need for those pursuing research in the field. This presents the imminent need for training programs that quickly equip health and biomedical professionals with the requisite knowledge and skills needed to carry out this demand.
- Clinician-research training
There is a high demand for more physicians who understand informatics concepts and the development of complex systems. This is especially critical as the health care enterprise continues to address and implement the goals of “meaningful use” and the procurement of data to determine “comparative effectiveness” and quality of health care delivery and patient care.
Health systems are currently implementing systems that demand the special perspective of the trained physician who understands the workflow and interfaces in patient care. For example in the arena of EHRs, the interface for ordering treatments and tests may seem reasonable to a programmer, but a physician understands how a physician thinks and behaves when reviewing a patient chart, ordering data, and responding to prompts to consider best evidence or standard order sets. A physician would also understand the value of structuring and retrieving specific sets and subsets of data from a common data repository that would monitor the quality of care, determine meaningful effectiveness, or contribute to translation research.
There is a need for more “capstone”-type programs for individuals who have already achieved PhD or MD degrees and wish to pursue this as an additional career track. It would be beneficial to create programs that are flexible to undertake on a part-time basis as well as offering short-term “capstone” programs for those who have already achieved higher level degrees.
Curricula must address specific problems/issues surrounding patient care data such as personal health identifiers, HIPAA, retrospective data, data mining repositories, and integration of knowledge resources, including text mining into the clinical research. Training on structuring and extracting data sets for population studies, so vital for public health information, should be included as well.
Training programs such as the one offered by the National Library of Medicine provide good models for clinician-research training. NLM supports research training in biomedical informatics at 18 educational institutions in the United States which offer graduate education and postdoctoral research experiences in a wide range of areas including health care informatics, bioinformatics and computational biology, clinical research translational informatics, and public health informatics, and library informatics. NLM’s training programs constitute one of the largest training programs for PhD level bioinformaticians and for postdoctoral training of MD’s who require further informatics training.
- Training grants
There is a need for more training than research grants at this point to meet the demand for the workforce.
- Characteristics of PhD Training
As data management and sharing increase, there will be a need for more training within the research community for these skills. Individuals with PhDs in informatics need to understand these skills and be able to train others in the most effective management of data and how to appropriately share it. While these skills and knowledge have been in the domain of library and information science for many years, more interdisciplinary training is needed among those in informatics, information, and library science. This would also support more collaborative efforts to train researchers/scientists in important data management skills that cut across the disciplines. Such training should also be part of the various health professional curricula as well.
- NIH policies
As data plans are increasing in importance, grant teams need more informatics and library-based skills to manage and complete their projects. These types of positions need to be directly funded through the grants instead of layering on additional requirements that place a financial burden on institutions and investigators. Funding through grant dollars should be included for data intensive projects, systematic review, and other projects with complex data collection and analysis.
Comment 2: Identify and explain which of the issues you identified are, in your opinion, the most important for the working group to address and why.
Balance and demand is a high priority because the demand for professionals and training programs far outweighs the demand for the entry of new researchers into the profession as outlined in comment 1.
Clinician-research training should be given equal priority to successfully achieve the current goals of our health care system to support the meaningful use of electronic health records and implement standards for an electronic health record incentive program. In addition, within translational science, information among physician scientists is growing in importance as well.