Donald Lindberg: visionary leader in medical informatics and director of the US National Library of MedicineBMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l5480 (Published 10 September 2019) Cite this as: BMJ 2019;366:l5480
In a 2014 lecture, Donald Lindberg gave an example of the value of medical informatics. He described how Nobel prize winner Allan Cormack in 1963 had to calculate a mathematical formula in computed tomography scanning from first principles, even though it had been worked out in 1917. Lindberg said, “Today we have somewhere to look. This guy didn’t.”
Lindberg was the director of the US National Library of Medicine (NLM) for more than three decades and devoted his life to making programs that changed the way biomedical information could be accessed, shared, and analysed by scientists, health professionals, and the general public. He was the founding director of both the White House High Performance Computing and Communications Program and the American Medical Informatics Association, and was regarded as the pre-eminent leader in medical informatics.
Training in pathology and information technology
Lindberg was born in Brooklyn, New York, to parents of Swedish descent. He attended the Poly Prep Country Day School and Amherst College in Massachusetts, before studying medicine at Columbia University. In 1957 Lindberg married Mary Musick, and the couple went on to have three sons. Theirs was a very close relationship, and Lindberg said: “It was a marriage made in heaven. That’s the whole story.”
Lindberg joined the pathology faculty at the University of Missouri-Columbia in 1960. He became involved in computerising the clinical pathology laboratory services and developed innovative applications to assist in pathology diagnosis. He became professor of pathology and director of the information science group at Missouri-Columbia, overseeing the first computer based clinical laboratory in the world. Speaking of this transition, Lindberg’s colleague, George Lundberg (who later spent 17 years as the editor of the Journal of the American Medical Association), said: “Pathologists are problem solvers. It’s logical that a pathologist would gravitate to information gathering. They are in the business of getting the right information and putting it in the right place so it can be used.”
Director of the National Library of Medicine
Lindberg was rapidly gaining an international reputation in the world of medical information systems and in 1984 was chosen to become the director of the NLM. A strategic thinker, he produced a 20 year plan, which he described as “the best thing I did for the institution.”
The plan aimed to help to widen access to Medline, NLM’s bibliographical database. Early software included “Grateful Med,” an application developed in 1986 to improve access and “Loansome Doc,” which allowed users to order Medline documents from participating libraries. PubMed followed in 1997. It was an application to make it easier to access Medline and was described by Lindberg’s colleague as a “a marriage between librarianship and informatics.”
PubMed and Medline, however, contained only article abstracts, so Lindberg worked with publishers to overcome paywalls and set up PubMed Central in 2000, which gave users unprecedented access to a free full text archive of biomedical and life science journal literature.
Lindberg predicted that soon the majority of the general public would have access to the internet and could use it to become more informed about their health. So in 2000 he brought out MedlinePlus, a website for the general public. He was keen to help minority populations and, among other things, personally interviewed Native American healers for Native Voices, an NLM oral history project.
Resources for biomedical research
Part of Lindberg’s long term plan was to aid biomedical research, starting with language. In 1986, work began on the Unified Medical Language System. Its goal was to bring together and standardise health and medical vocabularies for use in computing. Lindberg said: “It was the achievement that I am most proud of. I knew we had to do it and I knew it would take 20 years.”
Realising that clinicians did not have a way to find out about trials to benefit their patients, in 1997 Lindberg set up Clinicaltrials.gov, a free international database of research studies. He also made available another free resource: two digital anatomical atlases, Visible Human Male (1994) and Visible Human Female (1995).
Lindberg’s contribution went beyond setting up software programs. He was involved with biomedical planning at the highest level. As planning for the Human Genome Project got under way, for example, in 1988 he secured Congress backing for the National Center for Biotechnology and Information, which controls the GenBank DNA sequence database. In 1997 he was awarded the Morris F Collen Award of Excellence for lifetime achievement in biomedical informatics.
In 2015 Lindberg retired from the NLM after 31 years, to focus on his family and hobbies—reading and photography. He died in Bethesda Hospital in Maryland and leaves his wife, Mary; two sons; and two grandchildren. A third son, Christopher, died in 1996.
Donald Allen Bror Lindberg (b 1933; q Columbia University, New York, US, 1958; MD, FACMI), died after a cerebral haemorrhage after a fall on 17 August 2019