Something New and Different: The Unified Medical Language System

Abstract

Donald A.B. Lindberg M.D. arrived at the U.S. National Library of Medicine in 1984 and quickly launched the Unified Medical Language System (UMLS) research and development project to help computer understand biomedical meaning and to enable retrieval and integration of information from disparate electronic sources, e.g., patient records, biomedical literature, knowledge bases. This chapter focuses on how Lindberg’s thinking, preferred ways of working, and decision-making guided UMLS goals and development and on what made the UMLS markedly “new and different” and ahead of its time.

The U.S. National Library of Medicine and standards for electronic health records: One thing led to another

“…Following a 1986-1988 exploratory period, NLM and Lexical Technology, Inc. (LTI), a UMLS research contractor, built the first version of the UMLS Metathesaurus, a novel knowledge source intended for use by system developers, in 1989-1990 [13]. Building the Metathesaurus involved: analyzing then underspecified semantics of multiple biomedical vocabulary sources; converting relatively primitive machine-readable versions to a common fully specified relational format; using advanced lexical matching methods and human experts to group synonymous terms and codes into concepts; and assigning each concept at least one Semantic Type, e.g., Disease or Syndrome.…”

“…Many factors contributed to this outcome including: the Unified Medical Language System (UMLS); Lindberg's pre-NLM informatics and health services research contacts; helpful actions by the Institute of Medicine (IOM) (now National Academy of Medicine); the U.S. Congress, HHS, and other federal agencies. Other contributions included: Lindberg's appointment as the first Director of the National Coordinating Office for High Performance Computing and Communications (HPCC); and his decisions to use NLM's authorization to "engage in such other activities as the Secretary [of HHS] determines appropriate and as the Library's resources permit [13][14][15][16]".…”

Donald A.B. Lindberg and the U.S. National Library of Medicine transformed biomedical and health informatics

“…Several trailblazing NLM projects made key contributions that changed this situation. Their nationwide (and often global) impacts facilitated establishment of biomedical informatics as a modern, professional discipline [3][4][5][6][7][8][9][10][11][12]14]. Lorenzi and Stead describe the development and evolution of the Integrated Academic Information Management Systems project in NLM and the IAIMS Initiative: cross-institutional academic/advanced systems contributing to the evolution of networked information and resources [3].…”

“…Four key NLM projects provided the foundation for the above-mentioned advances in clinical care and research. Humphreys and Tuttle describe the first of these in Something new and different: the Unified Medical Language System [9]. Masys and Benson in Don Lindberg and the creation of the National Center for Biotechnology Information document the second critical development (NCBI), which has had world-wide impact in promoting "omics" research [10].…”

“…as its Director from 1984 to 2015, the U.S. National Library of Medicine (NLM) introduced complementary transformations that radically altered and advanced the landscape of biomedical and health informatics in the United States. The chapters of the Informatics Section of the book, Transforming biomedical informatics and health information access: Don Lindberg and the U.S. National Library of Medicine document these transformations [1][2][3][4][5][6][7][8][9][10][11][12].…”