D E PA RT M E N T

OF

H E A LT H

&

HUMAN

SERVICES

Public Health Service

National Institutes of Health

National Library of Medicine

Bethesda, Maryland 20894

April 9, 2015
Peter M. Heimlich
3630 River Hollow Run

Peachtree Corners, GA 30096

Dear Mr. Heimlich,

The National Library of Medicine (NLM) has reviewed your request to Dr. Collins and Dr. Lindberg for
information regarding licensed content from ADAM on our Web site, especially the image "Heimlich
Maneuver for Unconscious Adult":

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NLM licenses the ADAM encyclopedia as well as other content to provide authoritative health
information from reliable sources. We look for content created and maintained by health care
professionals following established editorial and review policies. NLM does not verify or edit content
unless we see typographical or other errors; if we notice or users report medical errors, we report the
issues directly to ADAM or other content providers for them to investigate and correct if necessary.
In response to your questions:
1. Information regarding ADAM's URAC accreditation, its Editorial Policy, Review Process, etc. are
inked on MedlinePlus in the footer on each ADAM page:
ADAM. Inc. IS accredited by URAC. also known as tt>e Amencan Accreditation HeaithCare Commission (www urac org) URACs accreditation

*AI1A.VI tyoaram is an independent audit to ventv that ADAM touows ngorousstandards of quality and accountability ADAM is among the first to achieve
qy*tv iTiis important distincton for online health information and services Learn more about A D A M "s editonal oolicv editonai orocess and onvacv oolicv
A D A M IS also a founding member of Hi-Ethics and subscnbes to the pnncipies of the Health cm the rjet Foundation (www hon ch)

2. ADAM is fully accredited by URAC through 6/1/2016 according to the URAC Web site at
h t t p s : / / w w w. u r a c . o r g / d i r e c t o r v / D i r e c t o r y S e a r c h . a s p x

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Some of the URAC considerations for accreditation of health content providers are at
https://www.urac.org/wp-content/uploads/STDGIance HealthContProv.pdf

3. Regarding our agency standards and how the ADAM information came to be published on the NLM
website, the technical evaluation criteria we used when last reviewing the ADAM Encyclopedia
content quality before renewing our current license were:
Criterion A: Quality of Content

The proposal must provide evidence that the Offeror understands the statement of work and is
able to meet all of the content requirements set forth in the statement of work. This includes, but
is not limited to, providing authoritative content, governed by well-established editorial policies
and practices, written at a consumer reading level. The proposal should include a copy of the
editorial policies and procedures, and the names and affiliations of the members of the editorial
and/or medical board.

Criterion B: Technical Capabilities

The proposal must provide evidence of the Offeror's understanding of the technical approach to
the statement of work, including the technical requirements and methods that would be employed
to ensure a seamless experience for the user. The Offeror should demonstrate technical expertise
about these processes. Offerors should include an XML Sample, that includes 5 English articles,
5 English illustrations, and their Spanish equivalents in both XML format and an example of the
final presentation format. They should also include a schema. They should demonstrate adherence
to applicable 508 clauses.
Criterion C: Organizational Experience

Offerors should describe their management methods and processes for the support of this activity.
They should describe the expertise of the staff who monitor, review and provide the content, and
also facilitate the technical support and troubleshooting. They should describe their customer
service policy and other evidence to their commitment to customer service. They should describe
their resource planning processes and procedures to support the changing needs of the
environment. Describe responsiveness and ability to respond to user needs.

Criterion D: Past Performance

Offerors shall identify three contracts with customers that demonstrate recent and relevant past
performance. Evidence should be provided to support experience providing the encyclopedia to a
high-volume, non-commercial consumer Web Site.

4. According to Isla Ogilvie from ADAM, their current medical reviewer, Joseph L. Heller, MD, MHA
(Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington) confirmed in February
of this year that the information in question is not a medical error. Dr. Heller reviewed the text pages
in the encyclopedia related to choking in July 2013, and these pages reference chapters in Marx JA,
Hockberger RS, Walls RM, et al, editors. Rosen's emergency medicine: concepts and clinical practice

7"'' ed. Philadelphia: Mosby/Elsevier; c2010. 2 vol.

5. Isla Ogilvie indicates that ADAM responded to you on February 26"^ of this year that they'll redraw
the image in question (http://www.nlm.nih.g0v/medlineplus/encv/imagepages/l 7172.htm) to be in
line with the article in reference (http://www.nlm.nih.gov/medlineplus/encv/article/000051 .htm)
based on the American Red Cross guidelines.
6. As of April 9,2015, both of the above mentioned pages have been updated on MedlinePlus with the
new image and description that ADAM provided.
MedlinePlus
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Thank you for your interest in NLM's information services.

Sincerely yours,

Betsy L. Humphreys, MLS

Acting Director