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The following statement was requested by the Board of Regents. It reflects the underlying assumptions about the future-so far as we can tell-of many of the persons contributing to our planning process, as well as that of NLM leadership. No one will be terribly surprised, however, if events take their own turn!

IN HEALTH CARE...

• A major reorganization of health care services will have evolved from current solo- and group practice models, with fee-for-service and insurer indemnification financing and paper-based information systems, to nationwide managed care plans employing enhanced computer-based information systems. All this is accompanied by substantial changes in traditional health care delivery schemes.
• The public will own their health records and subscribe to "health records escrow services" that provide secure, provider-and-plan-independent online access to their fully computerized health records.
• Health care providers will prescribe information for their patients that in many cases will be delivered by a direct Internet connection.

IN EDUCATION...

• Simulators, virtual patients, and interactive curriculum content via distance education methods over the Internet will be commonplace practices for the education and training of health professionals.
• Trained informatics professionals will be in great demand and fully integrated into all aspects of teaching, research, administrative and practice activities of health science centers.

IN RESEARCH...

• Molecular biology discoveries will in some cases be made in extremely short periods, where novel disease-related hypotheses, gene cloning, and gene expression analysis can be done in an afternoon.
• Molecular compatibility screening will be part of drug selection for most common diseases, so that physicians will no longer just guess about which of dozens of drugs to use for conditions such as hypertension and diabetes.

IN TECHNOLOGY...

• Electronic personal publication will be the norm and will supplement traditional commercial publishers but not replace them.
• In a world populated by trillions of network-connected microprocessors, a significant fraction of users of NLM applications will not be human beings sitting at keyboards.
• The integrity of our medical heritage will be preserved in digital form.

IN LIBRARIES...

• Public, hospital, university, medical, and national libraries will continue to exist as physical facilities and collections, as well as places of meeting, learning, instruction, and enjoyment. Users will evermore expect libraries to be portals to electronic as well as physical knowledge sources. Users will in effect expect librarians to be expert guides in the uses of information and communication technologies.

AT NLM...

• Learning to manage in the midst of constant change will be NLM’s major challenge. Changes in NLM services and procedures will be required by increasingly "savvy" users from all of the Library’s constituent communities - the public, biomedical researchers, and health care professionals.
• Carrying out the responsibility for permanent access to the digital biomedical literature will occupy an increasingly prominent role. This task will be carried out in partnership with non-medical public institutions, and will rest upon NLM’s overseas MEDLARS network as well as the National Network of Libraries of Medicine.
• There will be constant rearrangement and realignment between public and private providers of electronic information and access to this. NLM will continue to be the major public portal to careful presentation of “vetted” biomedical scientific information.
• NLM support of research, intramural and extramural, will continue to produce new forms of information and knowledge representation. Major medical discoveries will arise directly from studies of NLM files.

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Last reviewed: 25 October 2004
Last updated: 02 March 2002
First published: 18 March 2001
Metadata| Permanence level: Permanent: Stable Content