Internet access to the National Library of Medicine.

Internet Access to the National Library of Medicine T he U.S. National Library of Medicine (NLM), the source of Index Medicus and MEDLINE, is a pioneer in using computers to make medical information available to scientists and health professionals. Today, the Library is using modern communication technology to make its unparalleled collections and other authoritative health information available directly to the general public. The NLM, which is currently located on the campus of the National Institutes of Health (NIH) in Bethesda, Maryland, had its start more than 160 years ago in the office of the U.S. Army Surgeon General. Index Medicus, begun in 1879, is still published by the NLM and is found in many medical libraries around the world. MED-LINE, the on-line database of references and abstracts to journal articles (including Effective Clinical Practice), appeared almost 30 years ago. It has been called " the Model T of online databases " : Although it usually got you where you wanted to go, it required a pioneering spirit to master its intricacies and the patience of Job to deal with its idiosyncrasies. Even so, the NLM received more requests than it could handle from medical librarians who wanted to be trained so that they could provide literature search services for health professionals and scientists in hospitals, universities , and laboratories. The original system covered 239 journals, and the NLM boasted that it was " capable of supporting up to 25 simultaneous users. " 1 In the past few years, the Library has made tremendous efforts to make its contents more accessible to health professionals and the general public through the Internet. In this Policy Matters, I review the origins of this effort and describe four of our Web sites (Table 1). I conclude with the Library's recent efforts to provide Internet access to people in the United States who are not connected. MEDLINE today has 11 million records from more than 4000 journals and covers the medical literature published since 1965. Michael DeBakey, MD, chairman of the Library's Board of Regents in the mid-1990s, strongly urged the NLM to open up MEDLINE to all Internet users. Although the NLM had never restricted access to its collections and databases, such factors as search fees, limited access to computers and telecommunications, and the technical nature of much of the information in NLM databases discouraged their use by the general public and the …