Prepared by Morag Clarkson, Library and Knowledge Manager, Croydon Health Services Library morag.clarkson1@nhs.net

The paper for discussion: Murphy, J. (2021), Digital Health Interventions: New opportunities for health science librarians. Health Info Libr J.2021 Sep;38(3):231-236. https://doi: 10.1111/hir.12374. Epub 2021 Jul 3. (Free to read for 90 days courtesy Wiley)

This article opens with a concise overview of the use of computers in health which sets the scene for the reader of how embedded IT and digital skills have now become in the health field, for patients and clinicians as well as LIS workers. As Murphy states,   “the growth of new applications, many aimed at patients, has given rise to what is called Digital Health” This in turn is changing how patients interact with health services.

Murphy gives useful definitions of the broad spectrum of digital health interventions (DHIs) which include, but are not exclusively, health apps, and provides an overview of the benefits citing WHO reports, the UK Topol Review and several systematic reviews.

Given, “there is still little reliable evidence from  randomised  controlled  trials  of  improved  health outcomes”, Murphy cites one view that “the main  demonstrable  benefits  of  DHIs  are  that they bring doctors and patients closer together digitally, while removing the need to meet face to face, and can place valuable data in the pocket of caregivers”

The risks of DHIs are clearly outlined by Murphy; namely sacrificing an examination of the evidence base on benefits and harms in the rush to get apps rolled out. The author highlights that “DHIs are also likely to increase inequalities  in  accessing  health  care  with  a  marked  digital  divide  between  those  with  up-to-date  technology  and high-speed broad band and those who lack both digital skills and ready access to technology” (Rich et al., 2019; Veinot et al., 2018)

For those end users who can access DHIs, how sure can consumers be that the information contained within a health app is accurate? Murphy highlights a fascinating study by Akbar et al. 2020, which identified several safety concerns relating to digital interventions. Murphy asks the important question ‘who is responsible if a patient is harmed’ when most DHIs are not subject to government regulation?

It was helpful to read that The National Institute for Health and Care Excellence (NICE) and NHS England recently reviewed the level of evidence for clinical effectiveness required for apps commissioned in the  UK  health and care system. (NICE, 2019)

What is the role of Health Science Librarians in relation to DHIs? Murphy cites Lake  (2018),  “health  science  librarians  can  play  a  valuable  role  in  providing  digital  health  technology  services to both consumers and health care professionals.” Murphy suggests a signposting role, giving training and supporting the research into DHIs. Murphy further highlights how through partnership working “NHS  librarians can support health literacy alongside digital skills development in other sectors”  (NHS  Health  Education  England,  2021).

Murphy highlights work in the US around a digital health technology hub and suggests Health Science Librarians can input into leaflets, curated collections such as the NHS App Library, and developer workshops.

Murphy states that digital health will only increase and Health Science Librarians have many skills to enrich it’s development.

Murphy closes with a useful action plan for drawing up a road map to assist health science librarians in becoming involved in digital health.

I agree that there are many ways that the health science library community can input into DHIs and also support the digital skills agenda, despite many organisations’ libraries being understaffed and struggling to keep up with demand for their services.

NHS Librarians support Health Literacy with a community of practice, signposting, and accredited training.

In July we celebrated Health Information Week. Many NHS Library and Knowledge Services are heavily involved in health and wellbeing in their organisations as well as promoting the uplifting resources from the NHS, which includes a selection of apps.

As a profession, we work well collaboratively and make good strategic partners. I will certainly keep DHIs and library involvement on my radar after reading this article.

I am drafting my Action Plan as we speak.