M ost biomedical libraries separate searching for resources held locally from external database searching, requiring clinicians and researchers to know which interface to use to find a specific type of information. Google, Amazon, and other Web search engines have shaped user behavior and expectations. 1 Users expect a simple query box with results returned from a broad array of content ranked or categorized appropriately with direct links to content, whether it is an HTML page, a PDF document, a streaming video, or an image. Biomedical libraries have transitioned to digital journals and reference sources, adopted OpenURL link resolvers, and created institutional repositories. However, students, clinicians, and researchers are hindered from maximizing this content because of proprietary and heterogeneous systems. A strategic challenge for biomedical libraries is to create a unified search for a broad spectrum of licensed, open-access, and institutional content.n Background Studies show that students and researchers will use the search path of least cognitive resistance. 2 Ease and speed are the most important factors for using a particular search engine. A University of California report found that academic users want one search tool to cover a wide information universe, multiple formats, full-text availability to move seamlessly to the item itself, intelligent assistance and spelling correction, results sorted in order of relevance, help navigating large retrievals by logical subsetting and customization, and seamless access anytime, anywhere. 3 Studies of clinicians in the patient-care environment have documented that effort is the most important factor in whether a patient-care question is pursued. 4 For researchers, finding and using the best bioinformatics tool is an elusive problem. 5 In 2005, the Lane Medical Library and Knowledge Management Center (Lane) at the Stanford University Medical Center provided access to an expansive array of licensed, institutional, and open-access digital content in support of research, patient care, and education. Like most of its peers, Lane users were required to use scores of different interfaces to search external databases and find digital resources. We created a local metasearch application for clinical reference content, but it did not integrate result sets from disparate resources. A review of federated-search software in the marketplace found that products were either slow or they limited retrieval when faced with a broad spectrum of biomedical content. We decided to build on our existing application architecture to create a fast and unified interface.A detailed analysis of Lane website-usage logs was conducted before embarking on the creation of the new search application. Key points of user failure in the existing search options were spelling errors that could easily be corrected to avoid zero results; lack of sufficient intuitive options to move forward from a zero-results search or change topics without backtracking; lack of use of existing genre or role searche...