Medical &
Biomedical
Library Planning
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TL;DR
Key Takeaways
Medical and biomedical libraries serve four simultaneous institutional missions: clinical care, education, research, and community service, and the building must support all four without spatial conflict.
Digital integration with electronic health records and clinical decision support systems is now a facility-level planning requirement, not merely a software selection to be made after the building opens.
Experienced library facility planning consultants navigate Joint Commission compliance, HIPAA spatial requirements, and the embedded informationist model to create health sciences environments that serve institutions for decades.
When the Building Is the Problem
A Familiar Pattern of Failure
The director of a health sciences library at a regional academic medical center had spent three years trying to solve the same complaint: the building was failing two communities at once. Medical students, trained in team-based curricula that expect collaboration and discussion, arrived each morning to find that every group room was booked before 7 a.m. Clinical faculty preparing for rounds needed a quiet, private consultation room where they could review a patient record alongside a licensed evidence database without violating HIPAA requirements for visual and auditory privacy. There were no such rooms. The building had been designed in a different era, built for rows of Index Medicus volumes, individual carrels, and a single reference desk staffed by a librarian who performed every MEDLINE search herself.
The library had adapted, as libraries always do. Stacks had been pushed aside to make room for computer clusters. Carrels had been rearranged into something approximating group zones. But the adjacencies made no institutional sense: the noisiest student collaboration space sat directly against the quietest individual study area, and the sole videoconference room was wedged behind a print journal run that no longer justified its footprint. When the dean of the medical school proposed that the library simply go digital and return the square footage to clinical education, the director knew it was time to bring in library facility planning consultants. Not to defend the library's existence, but to restate it in language the institution already understood: mission, evidence, and return on investment.
This is the nature of health sciences library facility planning. The problems are specific, the regulatory stakes are real, and the user communities are unlike those of any other library type. Getting the facility right requires a discipline that sits at the intersection of architectural programming, clinical workflow analysis, library science, and institutional strategy. Our firm has worked across pharmaceutical research libraries, hospital library installations, and academic health center facilities for decades, and the pattern of failure is nearly always the same: a building conceived for one era of information practice pressed into service for another without a structured rethinking of its spatial logic.
The Four-Pillar Mission and Its Architectural Consequences
Mission Clarity Drives Every Square Foot
The Association of Academic Health Sciences Libraries articulates the contemporary health sciences library by four simultaneous institutional missions: clinical practice, education, research, and community service. This is the correct framework for understanding why health sciences library facility planning is a distinct discipline, not a variation on academic or public library design. Each mission places demands on the building that the others do not share, and often cannot share within the same space.
Clinical practice demands HIPAA-aware consultation areas where licensed point-of-care resources can be accessed and patient information can be reviewed without visual or auditory breach of privacy. The Medical Library Association's Standards of Practice for Hospital Libraries and Librarians, substantially revised in 2022, are explicit: all knowledge-based information functions must be performed in compliance with applicable federal, state, and local laws, including HIPAA. That compliance requirement has a floor plan. Education, driven by team-based and interprofessional learning models that now define health professions curricula, demands group study rooms, electronic classrooms, and spaces that mirror the clinical environment. Research demands systematic review suites, bioinformatics workstations, and data management consultation areas.
When an institution holds a Clinical and Translational Science Award, the research mission may also require dedicated collaboration space for CTSA personnel embedded within or adjacent to the library. The Spencer S. Eccles Health Sciences Library at the University of Utah, for example, allocated 2,025 square feet to its Center for Clinical and Translational Science unit, a project funded at $160,392 for design and remodeling and an additional $32,450 for furnishings. That investment created a space for statisticians, grant writers, and librarians to collaborate under one roof, with consulting cubicles, a private conference room, and a shared reception area that made the research support function visible and accessible across the campus.
Community service, the fourth mission, demands consumer health resources with thoughtful separation from the clinical and academic zones. Members of the public seeking health information about a diagnosis or a family member's condition should encounter a welcoming, approachable environment rather than an intimidating research infrastructure. Planning the transition between public-facing and clinician-facing space is a genuine adjacency problem with both behavioral and regulatory dimensions. Sector-specific library design always begins with mission clarity, and nowhere is that principle more consequential than in the health sciences context, where a poorly planned adjacency can create both a user experience failure and a regulatory liability on the same afternoon.
Mission Planning Checklist
Before a Single Square Foot Is Assigned
Five Foundational Actions
Every health sciences library programming engagement at Aaron Cohen Associates begins with the same five foundational actions. These are not preliminary steps to be completed quickly before the real work begins; they are the real work, and the quality of every subsequent decision depends on how rigorously they are executed.
Map each of the four AAHSL institutional missions before a single square foot is assigned to a zone.
Confirm which regulatory standards govern each mission area, including Joint Commission information management standards, HIPAA physical safeguards, and applicable health professions accreditation requirements.
Identify whether a Clinical and Translational Science Award or equivalent research initiative will require dedicated embedded space within the library.
Understand the clinical education model in use, whether team-based, interprofessional, or simulation-anchored, before sizing and configuring group study zones. Determine community health outreach obligations and plan their spatial separation from clinical and academic zones with explicit adjacency logic.
Specialized Workflow Zones
What Health Sciences Libraries Require That Others Do Not
Health sciences libraries do not merely serve a wider range of patrons than other library types; they serve patrons who operate under conditions of professional urgency. A resident searching a clinical database at 2 a.m. before a morning case conference is not browsing. A clinical pharmacist reconciling drug interactions against a patient record is not studying. A nursing faculty member preparing simulation scenarios for the following day's lab is not simply doing research. The building must be calibrated to this urgency, and that calibration begins with zone differentiation more fine-grained than any other library type requires.
Research published in the Journal of the Medical Library Association drawing on visits to three recently renovated and newly constructed academic health sciences libraries identified noise control as among the highest-priority planning challenges in this building type. Informal observations gathered across those sites found that group interaction and computer station activity had elevated ambient noise levels across virtually all facilities studied. Noise masking systems, glazed partition walls with acoustic barrier properties, and deliberate zone sequencing from noisiest to quietest across the floor plan are not optional refinements here. They are core program elements. Study rooms with glass partitions were specifically noted as a solution that provides a sound barrier while maintaining visual supervision, an important operational consideration in a facility that serves students and clinicians simultaneously.
Beyond the standard quiet-to-collaborative gradient found in any academic library, health sciences libraries require several zones that appear nowhere else in library planning. The evidence-based medicine consultation suite is a semi-private area, typically adjacent to the reference desk, where a librarian and a clinician can conduct a structured literature search or systematic review planning session in a setting that protects any incidental disclosure of patient context. The clinical informatics cluster is an infrastructure-intensive workspace housing terminals integrated with the institution's electronic health record system, enabling the library to fulfill the Medical Library Association's requirement that knowledge-based resources be available at the point of clinical need, including within the EHR. The 24/7 access zone, mandated by MLA Standard 9, which states that knowledge-based resources must be available to staff around the clock, must be designed from the start as a separately controlled area with its own secure entry, so the entire building need not remain open and staffed at all hours.
The spatial strategy documented by Shipman, Stoddart, and Peay in their 2013 review for the Journal of the Medical Library Association offers the clearest articulation of what adjacency planning can accomplish in the health sciences context. The University of Arizona's approach of positioning its Phoenix health sciences library within a building that also houses clinical education suites and a simulation center is exactly the kind of intentional co-location that multiplies the library's value across a building's lifespan. When simulation debriefings run and students move from a mannequin lab to a review session, the evidence infrastructure is a corridor away and naturally embedded in the educational loop. Conducting a visual scan assessment of the campus before the architect draws a single line can identify whether such adjacencies are achievable and what the cost of missing them will be over twenty years of operation.
Zone Planning Priorities
Five Zone Planning Actions
The following five actions translate the workflow zone requirements of health sciences libraries into concrete programming decisions. Each must be addressed before design development begins, not during it.
Designate a HIPAA-compliant evidence consultation zone adjacent to the reference desk, with both acoustic and visual separation confirmed against applicable standards.
Plan a clinical informatics cluster integrated with the institution's EHR and clinical decision support infrastructure as a distinct program element.
Identify the 24/7 access zone in the earliest programming phase and design controlled egress, redundant network connectivity, and appropriate lighting accordingly.
Reserve defined workstation space for embedded informationists and clinical librarians who operate partly in clinical units but return to the library building. Locate the library on campus relative to simulation centers, clinical skills labs, and interprofessional education suites wherever the site plan allows, and document the rationale where adjacency is not achievable.
Digital Integration, Regulatory Compliance, and What They Demand of the Physical Building
Infrastructure Flexibility as a Programming Priority
The phrase digital integration is used broadly enough in library planning that it can mean nearly anything. In the health sciences context, it means something specific: the library's information systems must connect to the institution's clinical enterprise. MLA Standard 4, drawn from the 2022 Standards of Practice, requires the health sciences librarian to collaborate with the information technology team to ensure that online resources and services are functional and available at the point of clinical need, including within the electronic health record. That collaboration has a physical dimension. Servers, network infrastructure, and workstation environments that touch a hospital's EHR system are subject to the same HIPAA security requirements as the clinical systems themselves. The library's IT closets, network drops, and workstation layouts become regulated spaces, and that regulation must be reflected in the architectural program before construction documents are issued.
The Ithaka S+R analysis of academic health sciences libraries published in 2020, based on interviews with leaders from 28 of 129 AHSLs across the United States, found that AHSL roles are expanding specifically in research data management, bioinformatics, systematic reviews, and assessment of research impact. Each of these service areas carries a distinct physical infrastructure requirement. A systematic review service requires workstations with licensed access to multiple databases and citation management platforms operating at research-grade reliability. A bioinformatics support function may require high-performance computing connections or proximity to the institution's computational research infrastructure. Research data management demands storage and consultation environments coordinated with institutional data governance policies and, in many cases, federal funding agency requirements for data management plans.
The Joint Commission requirement IM.03.01.01 states that knowledge-based information resources must be available, current, and authoritative. This accreditation standard creates an institutional obligation that runs directly through the library and into its facility planning. Libraries that cannot demonstrate continuous, reliable access to clinical knowledge bases risk contributing to an accreditation deficiency for the health system they serve. Redundant network connectivity, uninterruptible power for critical workstations, and secure remote access provisioning belong in the architectural program from the earliest planning phase, not as construction-phase additions.
The technology observations documented in health sciences library literature from as early as 2003 remain instructive: projecting how new technologies will affect the library over the next twenty years was already described as daunting at the start of this century. The correct response then, as now, is not to predict the specific technology but to build maximum infrastructure flexibility into the structure from the beginning. Conduit capacity well beyond current demand, raised flooring or structured cabling systems that accommodate reconfiguration without structural work, and modular workstation environments that can be reoriented as service models evolve are the physical expressions of digital flexibility. They cost a modest premium during construction and return that premium many times over during the decades of operation that follow. Our work alongside pharmaceutical research libraries, including engagements with Lederle Laboratories, Schering Plough, and Upjohn Laboratories, and across academic medical center installations confirms that the institutions most satisfied with their facilities at the twenty-year mark are those that treated infrastructure flexibility as a programming priority, not an architectural afterthought.
Digital Infrastructure Planning
Five Infrastructure Imperatives
Digital infrastructure decisions in a health sciences library are programming documents, not design details. The following five imperatives must be resolved before design development proceeds, with sign-off from both library and clinical IT leadership.
Specify network infrastructure that meets both library and hospital IT security standards before design development begins, not as a review of a completed design.
Include HIPAA-compliant private consultation areas wherever patient-related information may be discussed alongside licensed clinical databases.
Plan for 24-hour system availability with redundant network connectivity and uninterruptible power for clinical reference workstations.
Incorporate EHR-integrated workstation capacity as a day-one program element, not a future retrofit. Design bioinformatics and research data management support areas as discrete program components with their own infrastructure allocations and adjacencies to computational research environments.
The Health Sciences Library Programming Protocol
Experienced library facility planning consultants apply a structured, five-phase method when approaching medical and biomedical library projects. The clinical and regulatory environment is too specific to accommodate the generalized approaches that serve other library types well. The following protocol reflects the sequencing we have found most effective across health sciences, hospital, and academic medical center engagements.
Phase 1: Mission Profiling
Before any square footage is discussed, document the institution's relative weighting of the four AAHSL pillars: clinical practice, education, research, and community service. Interview the library director, the dean of the relevant health sciences school, the chief medical information officer, and at least one clinical department head. The distribution of institutional emphasis across these four pillars will determine every major zone allocation decision that follows. A library serving a primarily clinical enterprise will look meaningfully different from one anchored in graduate biomedical research, and both will differ from a library serving a comprehensive health sciences complex that houses medicine, nursing, pharmacy, and dentistry simultaneously.
Phase 2: Constituency Mapping
Identify every user community the facility must serve: medical students, nursing students, allied health students, residents and fellows, attending physicians, clinical nurses, research faculty, community health consumers, and any CTSA or research center staff whose work will be embedded in or adjacent to the library. For each constituency, document their typical use pattern, their peak hours, their noise tolerance, and their privacy requirements. This map will drive zone differentiation and determine the size and acoustic treatment of the separations between incompatible user behaviors. The fact that declining gate counts have been documented in health sciences libraries since the late 1990s does not reduce the importance of this mapping; it shifts its focus toward understanding which constituencies remain the primary physical users and what their specific facility needs are.
Phase 3: Regulatory Compliance Baseline
Establish the full regulatory environment before programming begins. This includes Joint Commission information management standards, including IM.03.01.01 requiring that knowledge-based resources be available, current, and authoritative; HIPAA requirements for physical and technical safeguards affecting any space where patient-related information may be present; health professions accreditation standards from LCME, ACGME, or other bodies as applicable; and any institutional data governance policies governing access to clinical or research data. Translate each regulatory requirement into a spatial or infrastructure specification. HIPAA consultation rooms, secure IT infrastructure zones, and after-hours access controls all emerge from this step as program elements with defined square footage and technical requirements, not as design additions to an otherwise complete plan.
Phase 4: Workflow Zone Architecture
Using the mission profile, constituency map, and regulatory baseline, develop a zone matrix that assigns every functional area to a defined category: clinical consultation with HIPAA-compliant acoustic separation; evidence-based medicine instruction in a semi-public variable-noise setting; group collaborative study with acoustic buffer; individual quiet study with maximum acoustic protection; digital media and clinical informatics with EHR integration; data management and bioinformatics with research-grade computing adjacency; consumer health as welcoming and public-accessible but separated from clinical zones; the 24/7 access zone with secure separately controlled entry and egress; and administrative and librarian workspace including home positions for embedded informationists when they are not deployed in clinical settings. Each zone receives a square footage target, an acoustic specification, an infrastructure requirement, and an adjacency preference that will guide architectural planning.
Phase 5: Digital Infrastructure Specification
Develop a comprehensive technology specification in collaboration with the institution's IT department and, where applicable, the hospital's clinical informatics group. The specification must address network security zoning that bridges library and clinical systems without creating a vulnerability in either; EHR workstation integration requirements including authentication, session management, and audit logging; redundant connectivity for 24/7 zones; conduit and cabling infrastructure sized for ten-year projected demand; bioinformatics computing adjacency and bandwidth requirements; and mobile device support for clinical staff accessing resources on handheld devices during rounds. This specification becomes a binding component of the architectural program and must receive sign-off from both library and clinical IT leadership before design development proceeds.
Putting It into Practice
What to Do
The following actions represent the highest-leverage decisions available to institutions undertaking a health sciences library facility project. Each reflects a pattern we have observed across successful engagements and, equally, a pattern whose absence we have observed in facilities that required costly remediation within a decade of opening.
Involve clinical faculty, nursing education directors, and research administrators in the programming process alongside the library director. Their institutional knowledge of clinical workflow will surface zone requirements that librarians alone cannot fully anticipate.
Plan the 24/7 access zone in the earliest stages of programming. Retrofitting a separate-entry after-hours zone into a completed design is expensive and often architecturally impractical; it must be designed from the beginning.
Design HIPAA-compliant private consultation rooms near the reference and evidence service desk. These rooms serve multiple functions across all four institutional missions and repay their square footage many times over.
Size the digital infrastructure for clinical system integration from day one. A network designed only for library databases is already insufficient in a health sciences environment and will require costly remediation. Engage the institution's clinical informatics and IT security teams as co-stakeholders in the programming process, not as reviewers of a plan that has already been developed without them. Preserve maximum flexibility in stack areas by avoiding permanent structural attachments where possible, so that print footprint can be reduced and the space repurposed as collections continue their transition to digital formats over the building's lifespan.
What to Avoid
Common Planning Failures in Health Sciences Facilities
Treating the health sciences library as a scaled-down academic library is the most consequential planning error we encounter. The regulatory context, the urgency of clinical users, and the clinical integration requirements make it a fundamentally different building type that demands its own programming logic.
Designing group and quiet zones without acoustic separation is a close second. The documented evidence from multiple health sciences library site visits confirms that group learning and computer activity elevate ambient noise to levels that will disrupt quiet clinical study if the adjacencies are not carefully controlled from the start.
Placing consumer health resources in the same undifferentiated zone as clinical and research resources creates a compounded failure: the two user communities have different information literacy levels, different privacy expectations, and in some cases different regulatory environments.
Overlooking the facility needs of embedded clinical librarians and informationists is a recurring gap. These professionals leave the building to work in clinical units, but they return, and their workstations, consultation materials, and scheduling infrastructure need a defined and adequately equipped home in the facility.
Deferring digital infrastructure decisions to the construction documents phase is perhaps the most expensive mistake available to a health sciences institution. The IT specification for a health sciences library that integrates with clinical systems is a programming document, not a design detail, and must be developed with the same rigor as any other program element.
Underestimating the institutional and community value of history of medicine collections is a subtler but real planning failure. Research in health sciences library planning consistently finds that these collections receive new prominence and dedicated space during renovation projects, serving as a differentiating institutional asset and a community engagement tool.
Questions to Ask
Six Diagnostic Questions for Health Sciences Library Planning
These questions are not rhetorical. Each one surfaces a planning decision that, if left unresolved, will produce a facility deficiency that is expensive to correct after construction. We recommend that every institution undertaking a health sciences library project be able to answer all six before design development begins.
Does the facility plan accommodate 24/7 access to a clearly defined zone without requiring full building access after hours, and has that zone been assessed for security, redundant network connectivity, and adequate lighting?
Which of the four AAHSL institutional missions — clinical practice, education, research, and community service — drives the greatest facility demand at your institution today, and which will drive the greatest demand in ten years?
Do your planned private consultation rooms meet HIPAA requirements for both visual and auditory privacy when patient-related information may be discussed alongside licensed clinical databases?
Has the institution's clinical informatics or IT security team reviewed the library's proposed network infrastructure to confirm it can support EHR integration without creating a security gap in either system? Is the library's planned location adjacent to simulation centers, clinical skills labs, or interprofessional education suites, and if not, what physical or digital connections will substitute for that adjacency over the next twenty-five years of operation? What is your current print-to-digital transition trajectory for the collection, and does your architectural plan for stack areas reflect a realistic projection of where that balance will be at the building's twenty-year mark?
Sources
Current Issues in the Design of Academic Health Sciences Libraries: Findings from Three Recent Facility Projects
Spaces that Support Redefined Roles of Academic Health Sciences Librarians
Academic Health Sciences Libraries: Structural Models and Perspectives
Standards of Practice for Hospital Libraries and Librarians, 2022 — MLA Hospital Library Caucus
2025 AAHSL Recruitment Guide: Academic Health Sciences Environment
Top Design Trends for Health Sciences Education Facilities — Clark Nexsen