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National Network of Libraries of Medicine
Pacific Northwest Region

Annual Report

May 1, 2003- April 30, 2004


The mission of the National Network of Libraries of Medicine is to advance the progress of medicine and improve the public health by: 1) providing all U.S. health professionals with equal access to biomedical information; and, 2) improving the public's access to information to enable them to make informed decisions about their health. The Program is coordinated by the National Library of Medicine and carried out through a nationwide network of health science libraries and information centers.

Network goals are:

  1. To develop collaborations with NN/LM libraries to improve access to and sharing of biomedical information resources throughout the nation;
  2. To promote awareness of and access to biomedical information resources for health professionals and the public; and
  3. To develop, promote, and improve access to electronic health information resources by network member libraries, health professionals, and organizations providing health information to the public.

The Statement of Work focuses on:

Continuing to work with the libraries in the network in establishing connections with health professionals in rural and inner city locations who still do not have adequate access to information;
Working with the NN/LM and other organizations to increase public awareness of and access to health information via the Internet, with particular focus on senior citizens, minority populations and persons of low socioeconomic status; and

Strengthening network capabilities through collaborations and by implementing national support centers in key areas of need, such as outreach evaluation, training and distance education.

This annual report covers the period May 2003 through April 2004, Year 3 of the NN/LM PNR 2001 - 2006 contract.

Highlights this year include:

  • In response to network member librarians' request for support from the NN/LM in all regions, Maryanne Blake (with Betsy Kelly, NN/LM MCR) developed and taught a hospital library evaluation class, "Measuring Your Impact: Using Evaluation to Demonstrate Value"; to the Colorado Council of Medical Libraries.
  • Gail Kouame and Cathy Burroughs (along with Heidi Sandstrom) presented at the MLA joint chapters meeting in Sacramento in January 2004, focusing on the development of the "Public Libraries and Community Partners" web resource.
  • Collaboration with Nez Perce Tribe in Idaho culminated in production of four short videos (three on diabetes topics, one on dangers of smoking), starring tribal members. Tribal staff developed scripts and handled all aspects of production. The RML provided financial support and text for credits (including links to Medlineplus).
  • NLM conducted a site visit at the University of Washington in October, to review the Pacific Northwest RML programs, issues, and progress. In addition to PNR staff and several UW HSL librarians, other UW attendees at the site visit included: Louis Fox, Vice Provost for Educational Technologies and Community Partnerships; Mark Oberle, Associate Dean for Public Health Practice, School of Public Health and Community Medicine; and Lizabeth Wilson, Director of University Libraries. Also attending the site visit was Patrick O'Carroll, Regional Health Administrator, Region X, DHHS.
  • The Consumer Health Advisory Committee met at University of Washington in November.
  • PNRNews, the NN/LM PNR announcement list, was refurbished. We invited all network members who were not currently subscribed to join, and 83 network members were added.
  • OCLC serials holdings records for 22 libraries in the region were updated by regional office staff. We deleted records for titles deleted from SERHOLD, as preparation for the first SERHOLD-to-OCLC batch data transfer in July. The successful batch transfer was a cause for celebration in this region because a group of network members from the Pacific Northwest lobbied strenuously with OCLC to make this possible. OCLC has indicated that this group's efforts were important to the decision to move forward.
  • The Directory of Health Science Libraries and Network Members, 2003-2006 was mailed to all network members and affiliate members in June. We sent out approximately 405 copies: 380 to network members and Canadians, and 25 to libraries that requested extra copies.
  • The first draft of a new DOCLINE tutorial about updating routing tables was completed. It is the first component of the all-new DOCLINE tutorial for version 2.0, which updates the content and moves from a static PowerPoint presentation to one which includes videos produced with Camtasia.

A. Network Programs

1. Health Professional Access to Information Services
A significant increase in LinkOut libraries in Idaho followed a presentation about LinkOut and PubMed to the Idaho Health Information Association. Idaho now has a rate of LinkOut participation of 40% of its DOCLINE libraries. The regional rate of participation is 27.5%; the national rate is 21%. This high rate of LinkOut participation in Idaho, and the fact that most libraries signed up after the May presentation, is an indicator of the value of the tailored, in-person presentation to a medical library professional group.

Susan Barnes , Resource Sharing Coordinator, facilitated arranging a group subscription by almost 50 institutions to the Lippincott Williams & Wilkins Total Access ejournal package from Ovid. This group subscription provides online access to 230 full-text ejournals for almost fifty thousand health professionals, hospital staff, and faculty and students in health education programs. Participants come from all five states in NN/LM PNR plus British Columbia.

2. Assess Needs of Health Science Librarians
Susan Barnes participated on the NN/LM Information Technology Task Force, charged with designing a methodology for collecting information from network members about successful strategies for working with information technology units.

Gail Kouame posted a survey on the HLIB-NW discussion list for the Washington Medical Librarians' Association regarding continuing education needs.

We developed a brochure aimed at recruiting affiliate Network members.

3. Network Membership Program


4. Document Delivery

SERHOLD Participants
DOCLINE Participants

Electronic Document Delivery Awards:

We solicited proposals for awards of up to $2,000 to support DOCLINE libraries' acquisition of software and equipment for electronic document delivery. Proposals were due November 3, 2003. Six libraries received awards: Kaiser Permanente Center for Health Research Library, Portland, OR; National College of Naturopathic Medicine Library, Portland, OR; Providence Everett Medical Center Library, Everett, WA ; St. Joseph Medical Center Library, Tacoma, WA; Tuality Healthcare Health Sciences Library, Hillsboro, OR and Willamette Falls Hospital, Oregon City, OR.

To help libraries prepare for providing EDD services, Susan Barnes developed and conducted a class on the Basics of Electronic Document Delivery for the PNC/MLA CE Day. The class was approved for 4 MLA CE units and was developed in collaboration with Mark Goldstein from NER, Joanne Jahr and Denise O'Shea from MAR, and Bob Pringle, director of the Intercollegiate College of Nursing library (a Resource Library).

DOCLINE informational sessions:

  • Held a DOCLINE Roundtable as part of the 2nd annual Northwest Interlibrary Loan and Resource Sharing Conference in Portland, OR, providing an update on EFTS, LinkOut, free full-text, and DOCLINE Version 2.0 for DOCLINE users.
  • At the same meeting, conducted an introductory orientation to DOCLINE for libraries that are not DOCLINE participants, to recruit libraries that would benefit from joining.
  • Provided an overview of DOCLINE Version 2.0 for the Idaho Health Information Association's fall meeting in Sun Valley, ID. The PowerPoint slides produced for this session were placed on the national NN/LM Web site at the request of DOCLINE coordinators from the other regions.

DOCLINE activities:

  • Encouraged NN/LM member participation in the beta test of DOCLINE 2.0 by working with several libraries in the region to conduct early testing and then by sending information out to the regional email list and by sending requests in the test system to all DOCLINE libraries in the region.
  • Collaborated with the NN/LM Pacific Southwest Region to present a DOCLINE 2.0 update at the Joint Meeting of the Medical Library Group of Southern California and Arizona, the Northern California and Nevada Medical Library Group, and the Pacific Northwest Chapter, Medical Library Association.

Electronic Fund Transfer System (EFTS):

There are now 29 EFTS participants in the NN/LM Pacific Northwest Region, 18% of the region's DOCLINE libraries. That is lagging behind the national participation rate of 26% (868 EFTS participants out of 3282 DOCLINE libraries). Our region is one of the five that are relatively new to EFTS; when just those 5 regions are considered, our rate of participation compares favorably. The rate of participation in EFTS in regions 2, 3, 4, 6, and 7 is 14% (276 out of 1988 DOCLINE libraries).

5. Resource Libraries
Representatives from the region's Resource Libraries and professional medical library organizations met here for a day and a half, June 2 and 3. The group was joined by a representative from BRIN (Biomedical Research Infrastructure Network) for the Pacific Northwest -- participating states include Alaska, Idaho, Montana, and Wyoming. It was a fruitful meeting characterized by information sharing, brainstorming about group purchasing for BRIN participants, and discussion of priorities, issues, and needs.

6. Communication
The Dragonfly newsletter had 36 articles this year. Featured were articles on:

  • reports on outreach projects in the continuing series Focus on Funding: " Empowering Parents of Children with Special Health Care Needs" (Children's Hospital and Regional Medical Center, Seattle) and " Computer Health Literacy for Seniors in Northern Idaho" (Kootenai Medical Center, Coeur d'Alene, Idaho)
  • a new series by Susan Barnes called "Free Full-Text Journal Articles on the Web."
  • an EFTS update
  • an article by one of our network members, Michele Spatz, about URAC (Michele serves as the only librarian on URAC's Health Web Site committee) outreach project reports in the series, Network Members Conclude Outreach Projects: one by Brendan Ashby, MPH, CHES, Program Director, Area Health Education Center (AHEC) of Southwest Oregon, "Cyber Health Camp" and one by Alyssa Sampson, Librarian, Cross Cultural Health Care Program, "Cross Cultural Health".

210 NN/LM and NLM related announcements were distributed via PNRNews this year, an increase from last year of 23%.

753 messages were sent to HLIB-NW, the regional e-mail list for health information community, about a 17% decrease from last year.

The NN/LM PNR Web Group worked with the UW Health Sciences Center for Educational Resources, to make minor design changes to the NN/LM PNR Web site.

The RML sponsored a broadcast of the MLA satellite teleconference "Reading Between the Lines: Focusing on Health Information Literacy" in September. Twenty-three network members and other interested individuals attended.

Maryanne Blake conducted the annual Joint RML and PNC/MLA Continuing Education survey in January. The responses assist the NN/LM PNR and state and regional library associations in setting the direction of continuing education for network members in our region for the coming year. Maryanne is the Chair of the PNC/MLA Professional Development Committee.

7. Regional Advisory Committee
Gail Kouame finalized membership of the Consumer Health Advisory Committee, and a meeting of the committee was held at the University of Washington on November 21, 2003.

We continued to host the email discussion list for our Consumer Health Advisory Committee, and will try to schedule another meeting in February 2005.

8. Monitor Region's Programs
Gail Kouame and Roy Sahali visited Northwest Indian College in Bellingham, WA to inquire about possible future programs/projects.

Gail Kouame also visited two network member libraries in Washington in October: the Washington State University Health Sciences Library in Pullman, and the Intercollegiate College of Nursing Library in Spokane.

In addition we made site visits to two local network libraries: the University of Washington Alcohol and Drug Abuse Institute Library in December and the Group Health Cooperative Medical Library in January.

We tested the OARF, NLM Outreach Projects, and Exhibit databases; and updated all regional information in those files.

Tina Bullock, IT Director for Nimiipuu Health (Nez Perce Tribe, a Tribal Connections 3 participant) visited the RML on March 18. The following day, Linda Milgrom accompanied her on visits to Community Health Information Centers at Harborview Medical Center (Seattle) and Highline Community Hospital (Burien, WA).

9. User Feedback
Appended to this report is the booklet prepared for the site visit. In it are comments from network members that provided feedback to the RML and the NNO and NLM.

10. Training Facility
NTCC trainers taught a TOXNET class on October 20 for 12 students, and a PubMed class on October 21 for 13 students.

11. NLM User/Non-User Needs Assessment
Nothing to report.

12. NLM Grants
Linda Milgrom participated in an IADL grant review session at NLM on June 9 as member of the special emphasis panel.

Linda also reviewed a draft IADL proposal and wrote a letter of support for the proposal which was prepared by Susie McIntyre, Voices of Hope, Great Falls, MT. She also met with representatives of the Port Gamble S'Klallam Tribe, on the tribal reservation near the Seattle area, regarding a possible IADL proposal and offered comments on a draft of the proposal.

In addition she wrote letter in support of application by Larry Keil, Public Health -- Seattle & King Co, in response to NLM's AIDS outreach RFQ.

13. Follow-up with NLM-funded Projects
Gail Kouame performed training needs assessment with member of African Americans Reach & Teach Health Ministry as part of their funded project on July 9, 2003.

Linda Milgrom discussed progress with Marcia Francis (Idaho State University) and Pam McBride (Clearwater Valley Community Hospital, Orofino, ID). Both IADL-supported projects are going well. Pam McBride plans to apply for RML outreach funding to extend her outreach to additional counties in Northcentral Idaho.

In conjunction with the Northwest Regional Rural Health meeting (Spokane, March 25-26), Linda Milgrom met with Pam McBride and Kathryn Allen, investigators of a current NLM IADL Project in Orofino, ID. The project is going well and planning is underway to extend training and collaboration to additional community agencies. Linda also reviewed a new application Pam is preparing, Transforming Healthcare Quality Through Information Technology (joint NLM-AHRQ funding program).

B. Expanded Outreach Programs

1. Outreach to Health Professionals
Maryanne Blake taught a class at on May 22 for the UW School of Medicine Native American Center of Excellence. There were six participants, three of whom were Native American and one who was African American. It was a class on finding health information that highlighted TOXNET, PubMed and MEDLINEplus.

Linda Milgrom taught a PubMed and MedlinePlus class on May 22 for UW Information School students.

Linda Milgrom was contacted by Kathleen O'Leary, Oregon Department of Human Services, about a workshop for public health nurses. Dolores Judkins (OHSU) taught the workshop on June 17 and subsequently collaborated with Ms. O'Leary on an application for an outreach project award.

Maryanne Blake, Linda Milgrom, and Neil; Rambo attended a distance learning planning meeting at the Northwest Center for Public Health Practice (UW, Seattle), May 27. NWCPHP staff are coordinating an investigation of web conferencing system options to be used to deliver training to the public health workforce throughout the northwest.

Linda Milgrom traveled to McCleary, WA, on October 16, at the invitation of Jodi Palmer, Western Washington AHEC. She presented information about funding opportunities and options for library service to 12 members of the Western Washington Rural Health Care Collaborative, a group of administrators of very small rural hospitals, none of which has organized information services for staff.

Gail Kouame provided a training session for health care interpreters for Public Health -- Seattle & King County, on October 17.

Linda Milgrom and Neil Rambo attended the Regional Network Steering Committee meeting of the Northwest Center for Public Health Practice on October 27-28. Distance Learning Coordinators and public health trainers from all PNR states (and Wyoming) attended. Neil and Linda briefly described the NN/LM public health initiative and made valuable contacts for reaching the public health workforce in the region.

2. Consumer Health Information Services
Maryanne Blake met with Ginger Kwan from the ARC of King County. Ms. Kwan's office is providing " culturally relevant support and assistance to families as they navigate the developmental disabilities service system on behalf of their family member (children or adults) living with developmental disabilities." Maryanne explained the RML's services and the funding we have available.

Gail Kouame met with Sue Jackson in the Library Development department at the Montana State Library in June 2003 to discuss upcoming Public Libraries initiative; and with Cynthia Gustafson (faculty member, parish nurse) and Lois Fitzpatrick (Library Director) from Carroll College in Helena, MT to discuss possible projects in which they could participate. Gail also participated in a meeting sponsored by the Washington State Library regarding a grant focusing on schools and libraries and met Director of Library Development and discussed upcoming Public Libraries initiative. She also met with the Public Services Manager from Whitman County Library in Colfax, WA who inquired about regional training in her area regarding consumer health information. Gail will be working with other Consumer Health Coordinators to create a resource for public librarians focusing on partnering with area health agencies.

Linda Milgrom met with Gwen Shepherd and Ray Rogers of the Bremerton, WA, branch of the NAACP on June 27 to discuss possible collaboration. They followed up with an application for a planning award to support developing a partnership with the public library, health department, and faith-based organizations in Kitsap County.

Mary Devlin, outreach project manager, Oregon Health & Science University, Portland, OR, visited the RML to share her methodology for focus groups and findings about website use by seniors, on June 30.

Gail Kouame provided an informational session for the New Futures community group (a community-based organization working with low income families who may have children at risk) on August 18. New Futures provided a Spanish language interpreter for the session.

Gail Kouame has also been working actively on a web resource aimed at public librarians as part of the Public Libraries Outreach Initiative. The web resource is aimed at encouraging public librarians to partner with NN/LM members and other health-related agencies in their communities to provide health information. The draft of the web site is at - .

3. Training to Support Electronic Access to Health Information
As part of the Tribal Connections 3 project, the Resource Sharing Coordinator provided MEDLINEplus training for the Samish tribe. Members of the tribal health department and Head Start program attended, and were very enthusiastic about MEDLINEplus, especially the drug information and news feed.

Eight applications for the PNR Outreach Project Award were received by the August 1 deadline. This is a record number of applications, and we were impressed by the diversity of the agencies and quality of proposed activities.

Outreach Subcontracts (Outreach Project Awards) were funded for:

  1. Technology Training for Trusted Sources in Diverse Communities (Associates in Cultural Exchange, Seattle, WA)
  2. Public Health Nurses and the Internet (Oregon Health & Science University, Portland, OR)
  3. Health Information On-Line Project (St. Mary's Hospital, Cottonwood, ID)
  4. AHEC/Lincoln Country Health Coalition Internet Access Project (AHEC at WSU, Spokane, WA)

4. Exhibits and Presentations at Meetings
Gail Kouame presented "Health Information Free and Easy!" at the Tribal College Librarians Institute in Bozeman, MT in June 2003.

Maryanne Blake staffed the NLM exhibit and gave mini-presentations at the Public Library Association annual meeting in Seattle, WA in February.

Regional exhibits:

  • Building Healthy Families Together, May 3, 2003, Lincoln City, OR (exhibit done by Oregon Pacific AHEC)
  • HIV/AIDS in the African American Community Leadership Summit, May 30-31, 2003, Seattle, WA (exhibit done by AARTH)
  • Tabernacle Missionary Baptist Church Health Fair, July 12, 2003, Seattle, WA (exhibit done by AARTH)
  • International District Street Fair, July 12-13, 2003, Seattle, WA (exhibit done by Harborview Medical Center, X-plain Vietnamese Language Breast Cancer outreach project)
  • Annual Vietnamese Health Fair, July 19, 2003, Seattle WA (exhibit done by Harborview Medical Center, X-plain Vietnamese Language Breast Cancer outreach project)
  • La Fiesta Celebration, Corvallis, OR, Sept 6 (done by Oregon Pacific AHEC)
  • Healthy Communities Planning Day, Yachats, OR, September 17 (done by Oregon Pacific AHEC)
  • Idaho Library Association annual meeting in Post Falls, ID, October 1-3.
  • Oregon Rural Health Conference, Newport, OR, October 4 (done by Oregon Pacific AHEC)
  • Washington Joint Conference on Health, Yakima, WA, October 12-15
  • Oregon Public Health Association, Beaverton, OR, November 3-4 (Dolores Judkins)
  • Medical Home Leadership Conference Seattle November 7 ( Maryanne Blake)
  • Women's Health Forum, Juneau, AK, November 15 (Patty Owen)
  • Alaska Health Summit, Anchorage, AK, December 2-3 (Patty Owen)
  • Joint conference PNC/MLA and California Chapters, Sacramento, CA, January 29-30
  • Northwest Regional Rural Health Conference, Spokane, WA, Mar 25-26, 2004
  • Montana Faith Health Summit, Billings, MT, Mar 25-26 (Bill Kehler)
  • Oregon Library Association, Eugene, OR, April 13-16
  • Montana Library Association, Bozeman, MT April 24-27

National exhibits:

  • Tribal College Librarians Professional Development Institute, June 24-28, Bozeman, MT
  • American Association of Laboratory Animal Science (AALAS) in Seattle, WA.
  • National Association of Biology Teachers, Portland OR, October 9-11
  • American Assn. for Laboratory Animal Science, Seattle, WA, October 12-15
  • National Community Pharmacists Assn, Seattle, WA, October 19-21
  • American Dental Education Association, Seattle, WA, March 7-9

5. Technology Awareness and Integration
Maryanne Blake, Michael Boer, Cathy Burroughs, and Gail Kouame attended GIS training for NN/LM staff at the Polis Center/IUPUI in Indianapolis on September 4-5.

Gail Kouame attended the PNC/MLA continuing education session on using Camtasia software to produce online tutorials in October.

6. Library Improvement
Neil Rambo wrote a letter to administrators at Kennewick General Hospital, commenting on their decision to close the hospital library and dispose of library collection.

Gail Kouame and Linda Milgrom met with the Washington State Library Training Coordinator, Elizabeth Iaukea, to discuss possibility of planning training events and to discuss the NN/LM Public Libraries Outreach initiative.

Gail Kouame, Cathy Burroughs and Maryanne Blake attended a satellite teleconference entitled "The Visible Librarian" about marketing in libraries. Promotion of this teleconference prompted regional discussion about the need for a hospital library forum to assist hospital libraries in staying viable in the institutions. Maryanne is taking the lead on developing this forum.

Maryanne Blake made a site visit to McKenzie-Willamette Hospital in Springfield, Oregon where Susan Murray RN, the education coordinator, is trying to revive the medical library at the hospital that closed in the past year.

7. Connections
Linda Milgrom discussed options for connectivity and training with Mary Sue Rose, librarian at Sheldon Jackson College, Sitka, AK.

Tina Bullock from Nez Perce tribe traveled to Seattle to meet with RML staff and discuss future planning for Nez Perce Tribal Clinic. They are building new facility which will have computer stations for patients to access health information.

C. Enhancements

Tribal Connections Phase 3:

Susan Barnes provided MEDLINEplus training for the Samish tribe in Anacortes, Washington. Members of the tribal health department and Head Start program attended, and were enthusiastic about MEDLINEplus, especially the drug information and news feed.

Tribal Connections Phase 4 (cross-regional):

Catherine Burroughs, R. Sahali, and N. Rambo participated in the Tribal Connections cross-regional planning meeting in Tucson, Arizona, June 26-27. The meeting was hosted by the University of Arizona Health Sciences Library, and included representatives from NLM, four RMLs (MCR, PSR, SCR, and PNR), and Resource Libraries in Colorado, Arizona, and New Mexico.

Maryanne Blake continued to work on content management for the Tribal Connections website with Pat Chinn-Sloan, Roy Sahali and the web content management advisory group: Pat Bradley (NM), Siobhan Cahamp-Blackwell (NE), and Stephanie Weldon (CO).

D. NN/LM Web Service

"Reports" are how many searches are conducted on DOCUSER data for libraries that offer Loansome Doc and/or reference services. The reports generated indicate that this is a popular service and that it decreases the number of telephone calls for Loansome Doc referrals.

Month Visits Reports
May 2003 120,018 2,952
Jun. 2003 129,144 2,870
Jul. 2003 113,496 3,364
Aug. 2003 105,733 2,936
Sep. 2003 120,650 4,287
Oct. 2003 131,414 3,400
Nov. 2003 122,141 2,968
Dec. 2003 116,020 2,048
Jan. 2004 127,248 1,921
Feb. 2004 130,983 1,342
Mar. 2004 154,616 1,450
Apr. 2004 138,927 1,367

TOTAL VISITS: 1,510,390 (125,866 average/month)
TOTAL REPORTS: 30,905 (2,575 average/month)

In cooperation with MLA, we implemented an archive of MP3 files from this year's MLA annual meeting. In August, 177 MP3s were distributed to about 38 different visitors. In September, 9 MP3s were distributed to about 6 visitors. There were no files distributed after September 22.

The initial meeting of the Web-STOC Advisory Committee was held on September 15.

E. Administration, Staff, and Other

All RML professional staff members attended the RML Directors meeting on May 2 in San Diego.The PNR staff participated in many other NN/LM- and RML-related meetings at the MLA annual meeting in San Diego:

Gail Kouame assumed role of Washington state representative for membership committee for PNC/MLA.

Gail Kouame participated in Chapter Roundtable discussion at MLA focusing on Consumer Health. She also participated in "California Chat" at MLA regarding multicultural/multilingual health information.

Maryanne Blake attended an all-day advanced Dreamweaver class in anticipation of teaching a Dreamweaver MX in-service to the RML staff.

June 30 Mary Devlin (OHSU outreach project manager) visited the RML to share her methodology for focus groups and findings about website use by seniors.

Linda Milgrom hosted a visit by Marti Szczur, Deputy Associate Director, of Specialized Information Services, NLM, on July 28.

Maryanne Blake and Cathy Burroughs taught the outreach evaluation class in Richmond, VA, at Virginia Commonwealth University (VCU) at the invitation of Jean Shipman, Director of the Thompkins-McCaw Library at VCU, on September 25, and in Shreveport, LA, at the South Central Chapter of MLA annual meeting, on October 7.

Gail Kouame was appointed to the Staff Development Advisory Committee for the University of Washington Libraries. She also assumed the role of Continuing Education Chair for WMLA.

Gail Kouame attended the annual new NN/LM staff orientation at NLM on September 11-12.

Neil Rambo participated in the MLA Board of Directors meeting in Chicago on September 4-6. He also appeared in the MLA video teleconference on health information literacy on September 10, representing the work of the MLA task force on health information literacy, which he chairs.

Neil Rambo participated in the Partners for Information Access for the Public Health Workforce steering committee meeting at NIH on October 29. The meeting was a day-long strategic planning session.