The Long Range Plan lays the foundation for the establishment of DIMRC and other disaster information-related efforts at NLM.

Recommendation 1.5. Ensure continuous access to health information and effective use of libraries and librarians when disasters occur.

It is a distressing aspect of our era that society faces a variety of potential large-scale threats, both acts of nature and acts of humans. NLM has a significant track record in building information resources and networks that are resilient and valuable in the face of disasters from Bhopal, India, to the U.S. Gulf Coast.

The Library's first responsibility is to ensure that NLM critical information services remain available during emergencies and disasters - and it takes this responsibility seriously. NLM devotes a staff of six experts to computer security measures that prevent, detect, and minimize the effects of hostile attacks on the Library’s computer systems. An offsite computer facility on a different power grid with multiple Internet access providers supports uninterrupted service from NLM’s key systems. Some services are actively served by both sites, each acting as a hot standby for the other. For the warm and cold standby services, NLM cooperates with the National Network of Libraries of Medicine (NN/LM) to regularly test rerouting requests for service and assistance from one facility to another. In addition, some NLM datasets are mirrored at other sites around the world.

NLM should continue to strengthen and test its already excellent emergency response capabilities. NLM should work with the Regional Medical Libraries to establish more extensive NN/LM disaster response plans, possibly including library pairing to provide personnel and other services during emergencies. NN/LM planning should take advantage of relevant expertise and mission within HHS and military agencies, including the Uniformed Services University. In the aftermath of Hurricanes Katrina and Rita, the NN/LM was highly effective in obtaining useful information from affected communities, rerouting requests for services, and getting equipment and personnel to locations serving evacuees and temporary health care facilities. Many public libraries served as communication and social service centers for evacuees.

Building on this experience, NLM should work with appropriate federal, state, and local agencies to ensure that libraries and librarians are included in disaster response information plans and to identify more specifically the kinds of information they should be prepared to supply. Local 211 agencies that provide directories of essential community services, health organizations and other agencies are identifying resources in their own areas.

NLM should work with relevant stakeholders to determine how this information can be organized and integrated into a national structure, analogous to the expanding MedlinePlus Go Local service that links information about locally available health services to authoritative disease, treatment, and prevention information. NLM should investigate the potential for expanding its services to encompass additional information relevant to disaster management.

Recommendation 1.6. Establish a Disaster Information Management Research Center at NLM to make a strong commitment to disaster remediation and to provide a platform for demonstrating how libraries and librarians can be part of the solution to this national problem.

NLM does not actually treat patients, investigate disease outbreaks, clean up toxic spills, or conduct clinical trials. Nonetheless, the Library’s intramural and extramural research programs have produced innovative and robust information systems and services that assist all of these activities. In recent years, NLM has conducted and supported selected research and development projects related to disaster information management, which have been similarly useful to those involved in disaster planning and management.

Work undertaken or sponsored by NLM has produced portable devices with toxic chemical information used by emergency responders after Hurricane Katrina, software tools for robust DNA identification of victims of 9/11[27] and Katrina, prototype self-healing wireless networks to restore connectivity and smart tags to track patients during triage, transportation, and treatment, and new insights into the evolution of flu viruses derived from the analysis of genomic data which suggest more effective strategies for vaccine development.

There is ample evidence of the enormous communication and information dissemination problems that arise in large scale disasters. The area is ripe for additional research that builds on NLM’s existing strengths and research portfolio. To complement and support the activities of the federal, state, and local agencies responsible for disaster planning and response, NLM should formally expand its research and development agenda in this arena and establish a Disaster Information Management Research Center within the Library. This new Center should:

• Maintain close collaboration with appropriate federal agencies and initiatives that aim at disaster prevention and remediation.
• Alert staff at NLM, NIH, and HHS to progress, experiments, and failures in this field, with special focus on information and communication systems.
• Operate across NLM Divisions so that all potential contributions to disaster remediation, including outreach and training, are coordinated and enhanced.
• Identify critical research and development opportunities, and initiate and/or collaborate in these.

[p. 99] Disaster Information Management- The Committee applauds NLM’s support of the Disaster Information Management Research Center [DIMRC], which has made important contributions to the Nation’s disaster preparedness and response efforts through the rapid creation of information resources for specific events; development of innovative information tools to aid in disaster preparedness, response, and recovery; the establishment of a disaster information specialty among librarians; and its participation in the Bethesda Hospital Emergency Preparedness Partnership. The Committee encourages NLM to continue to work through DIMRC with Federal and non-Federal partners, including the library community, to identify and implement best practices for maintaining access to health information before, during, and after disasters; develop innovative resources and tools to aid emergency responders and managers; collect, organize, and disseminate disaster health information; promote the development of disaster information specialists; engage the library community in disaster information management; conduct research into disaster health informatics; and develop and export community-based models of health resiliency during disasters.

[p. 118] Disaster Information Management- The Committee encourages NLM's continued efforts to identify and implement best practices for providing information during disasters, develop innovative products and services to serve emergency responders and preparedness activities, and conduct research to support disaster health information management and recovery efforts. The Committee also encourages the NLM to make accessible the broad range of literature on disaster health, including an information portal for traumatic brain injury and post traumatic stress disorders.

[p. 119] Disaster Information Management- The Committee supports the plan to establish a Disaster Information Management Resources Research Center, which will lead Federal efforts to identify and implement best practices for maintaining access to health information during disasters, develop innovative products and services to serve emergency responders and preparedness activities, and conduct research to support disaster health information management. The Center should also collaborate with other Federal agencies, local communities and public health officials in efforts to prevent, respond to, and reduce the adverse health effects of disasters.