Statement of National Need
Many educators and professionals in Library and Information Science (LIS) are unfamiliar with the technology and publication format for Mobilizing Computable Biomedical Knowledge (MCBK). MCBK publications include “dynamic knowledge” with encodable prediction models and computable code, in addition to text and graphics. Computable knowledge can provide readers (or users) with a diagnosis or tool to compute a risk score for coronavirus infection from data (Friedman & Flynn, 2019). Learning how to support publications and collections with computable knowledge is the training goal of this proposal.
MCBK has become an important aspect of establishing learning health systems (LHSs) in the United States. The vision of LHS grew out of the imperative to improve healthcare in the U.S. and internationally, where system-level challenges include the underutilization of appropriate care and the overutilization of inappropriate care, despite rising costs, patient safety issues and evidence of health disparities (Friedman, et al., 2017). With training in MCBK collections and technology, LIS professionals can be contributors to LHS and help design more effective data archives and repositories to improve information accessibility for healthcare professionals, patients and researchers. From a pilot class to a sustainable Open Educational Resource (OER) with a community of practice (CoP) that can use online materials, this proposal will improve the delivery of computable applications to LIS professionals and healthcare providers.
The need to speed up access to information and computable tools is prevalent in healthcare and other sciences. Whereas printed publications provide human-readable information, new technologies and platforms support the electronic publication of computable knowledge. The availability of computable information can reduce the gap between research and practice from years to a few months. Additionally, data and knowledge can be part of a continuous cycle in which a health problem of interest, such as COVID-19, provides data that can become knowledge (D2K); knowledge that can change medical performance (K2P); and new performance that can provide more data (P2D). In the world of libraries and information centers in health clinics, medical schools and healthcare businesses, data and knowledge could be shared on a mass action level through the application of computable knowledge objects, digital libraries and new interfaces for information that is interactive and dynamic (Friedman & Flynn, 2019).
As summarized after the 2019 and 2020 MCBK conferences,
most organizations do not yet have the infrastructure required to consume and apply computable knowledge, and national policies and standards adoption are not sufficient to ensure that it is discoverable and used safely and fairly, nor is there widespread experience in the process of knowledge implementation as clinical decision support (Richesson, 2020; Williams, et al., 2020).
LIS professionals can contribute to defining the tools, infrastructure and policies needed. At the 2020 conference, a four‐person panel provided descriptive examples of how libraries can lead the future mobilization of Computable Biomedical Knowledge as co‐moderated by Christopher Shaffer and Terrie Wheeler (Williams, et al., 2020). That is, although some MCBK information is already being published online and shared under creative commons licenses for repositories, new standards, policies and sustainable metadata tools need to be defined and developed. Professional organizations and consortiums, such as Healthcare Information and Management Systems (HIMSS), the American Medical Informatics Association (AMIA) and the Clinical Pharmacogenetics Implementation Consortium (CPIC), are moving from human-readable formats to including computable, machine-readable objects in their conference papers and publications. For example, articles applying MCBK principles may provide computable information for applying large-scale data analytics.
Specifically, the Observational Health Data Sciences and Informatics (OHDSI) program supports a multi-stakeholder and interdisciplinary collaborative approach to create open-source knowledge based on large-scale analytics. Applying data standards for systematic research, OHDSI is already connecting almost 3,000 users in 18 countries with a network of databases as presented to MCBK and LHS groups (Banda, et al, 2017). Other examples of MCBK-oriented research are Dr. Grace Peng’s knowledge treatment models and Dr. Herbert Sauro’s call for repositories to preserve and manage long-term digital, biomedical models. In addition, Bart Ragon has called on library science to move knowledge forward so that libraries of the future would be the gatekeeper, creator and consumer of Computable Biomedical Knowledge (Williams, et al., 2020). Recent research on rapidly translating clinical guidelines for COVID-19 describes the promising use of AI and knowledge engineering to create decision-making models (Fox, et al., 2020). Thus, MCBK publications are growing, and the need for trained LIS professionals is increasing.
This proposal supports the Institute of Museum and Library Services (IMLS) project category of the National Digital Platform by focusing on interactive, electronic publications. With MCBK experience, LIS professionals will be able to create new theories and practices for the digital infrastructures of the 21st century. The National Library of Medicine (NLM) is already working with MCBK experts from the Michigan School of Medicine and Duke University. However, few LIS professionals and graduate students are familiar with the protocols and models for storing biomedical research software and data. The training will include demonstrations, exercises and hands-on labs with protected electronic health records and medical data for LIS students to learn computer and database processes for storage and access using meta-data and reference models, phenotypes for machine learning and how to maintain healthcare data repositories.
Diversity and Inclusion: As a prominent HBCU, NCCU's School of Library and Information Sciences (SLIS) will be able to recruit librarians and information professionals among recent and interested Master of Library Services (MLS) and Master of Information Sciences (MIS) students who represent diverse ethnical backgrounds. Health disparities are prevalent in economically challenged communities of color. Ethnically diverse students in the pilot class and future CoP will be able to support research into the application of computer programs and biomedical informatics to reduce disparities. The proposed training and resources will support the inclusion of diverse patients, providers and researchers using decision support systems, machine learning and AI to improve diagnoses and chronic care management. Considering effective practices for recruiting underrepresented minorities into medicine, the MCBK pilot class attendees will be provided a stipend and a social media structure for communicating and sharing as a cohort and CoP, will complete community outreach projects and activities and will have mentors from the collaborative partners for the grant (Figueroa, 2014). The grant funding will have an impact on urban and rural communities with health disparities.