I shared these thoughts with my professor at the conclusion of a recent course in Consumer Health Information.

The recent COVID-19 pandemic has emphasized not only the importance of Consumer Health Information (CHI) but the need for public health agencies and medical libraries to focus on both the delivery medium for health information and ways to promote health, information and digital literacy.  All signs indicate that the primary delivery vehicle for  Consumer Health Information will be mobile apps, social media, and to a lesser degree, CHI websites.  Of course, there will continue to be a need for the type of visual aids that are displayed on the walls and on desks in doctors’ consultation rooms because they are vital teaching tools during patient/doctor conversations.  However, the days of printed brochures displayed on tables in the waiting rooms of primary care physicians is ending and being replaced by social media posts. In fact, many people are substituting watching television doctors (i.e., Dr. Oz, Sanjay Gupta, The Doctors) for a call to a Telehealth line or their primary care physician. While there are upsides to the availability of this abundance of health information, not all of it is credible, and some of it is dangerous if misinterpreted, taken out of context, or assumed to be scientific fact.  Therefore, public health agencies like the Center for Disease Control (CDC), the National Institutes of Health (NIH), and National Networks of Libraries of Medicine should continue and even escalate their community outreach and public communication activities. 

As I shared in my term paper, I view the trend towards making CHI available through public libraries as a positive step toward reaching marginalized and vulnerable populations.  People need access to health information from sources that are not only credible but trusted.   I will risk revealing my age group with the following statement.  We are far removed from the days of “Marcus Welby, MD” and Billy Ray Cyrus’ “Doc” when individuals formed long-term relationships with their family doctor.  For example,  I went to the same pediatrician until I was in high school, and she was in the same practice as my mother’s primary care physician and OB/GYN.  As a result, a patient/doctor “relationship” was formed.  As an adult, I went to the same doctor for well over a decade and only changed doctors when my health insurance changed, and their practice was no longer “in-network.”  While I do not have statistics on this, I will venture to say that today, millions of Americans would not relate to that scenario for a variety of reasons.  Unless you live in a state with only one major health insurer, stay at the same job for 30 years, or never change residences, you may never stay with the same medical practice long enough to develop a trust relationship. Besides, doctors frequently change practices. 

What still exists is a high regard for the “trustworthiness” of libraries and the opportunity for individuals to build a trust relationship with a local public or school librarian; however, that is changing too.  In many public school systems, the position of “School Librarian” has been replaced by that of  “Media Specialist.”   Also, many public, as well as academic libraries, are reducing the size of their Reference Desks. So while in theory, public libraries are one of the best ways to reach individuals with limited internet access, or who are undocumented, homeless, or without access to a regular healthcare provider, they will need to escalate their efforts to promote information and digital literacy, and ensure that staff is comfortable with conducting reference interviews when asked for CHI.  The role of public librarians in the delivery of CHI will be curating materials and developing programming which invites the community in for discussions and educational events featuring trained medical and public health professionals.  Therefore, it will be critical that public libraries form strong partnerships with medical libraries, public health agencies, and the National Network of Medical Libraries to offer cross-training opportunities for staff and develop a pool of resources for programming. 

Another trend will be the embedding of trained social workers in public library facilities.  Several public library systems are already doing this because they realize that they are the front lines when it comes to dealing with communities in crisis.  Public libraries are already involved in the “Safe Place”  program, so it would be a natural evolution for trained social workers to have offices within a library building. 

Public libraries can provide the venues for health information programming, collections of CHI materials, internet access, Safe Places, and safe spaces for vulnerable populations who may feel unwelcome in traditional academic or medical library settings.  Public libraries can also offer access to digital resources to their cardholders, which may otherwise be behind paywalls or require an institutional subscription.  And of course, librarians can teach information seeking techniques, information literacy, and basic computing skills. However,  I do not foresee public libraries as being the primary creators of CHI resources.  I still see that as the domain of medical and academic libraries. Most public libraries do not maintain a full in-house information technology staff, so their ability to develop CHI websites or mobile applications would be limited.

Conversely, it would be risky to turn the responsibility of developing CHI over to purely “tech” firms because they tend not to consider issues of diversity. For example, a mobile application that is optimized to run on the current or last generation of Android or Apple software may be unusable for an individual with an older model phone with less storage space or RAM.  This could be a real issue for individuals with the government issued phone provided to SNAP and public assistance recipients.  Librarians, on the other hand, are trained to consider the problems of accessibility.  

As I have progressed through the LIS program, my interests have shifted as I’ve learned more about the various fields of librarianship.  As a former family caregiver for one parent who had cancer and another who had dementia, I recognize the necessity for credible CHI resources.  I spent a considerable amount of time researching my parents’ conditions so I could talk to them about their conditions, have conversations with their doctors and with pharmacists,  and, when necessary, make health decisions on their behalf.  I am not alone in this experience.  The current pandemic has shone a light on how much health care occurs in the home and why it so important to empower individuals with health information.  I was fortunate to have home internet access,  copies of books like Gray’s Anatomy and the Time-Life Medical Encyclopedia on my shelves,  adequate information literacy skills, and an excellent, long-term relationship with not only mine, my parents’ primary care physicians.  However, access to CHI should not be a matter of good fortune. 

Internet technology and the evolution of Web 2.0 has created the means to reach everyone with information.  Now, the healthcare community needs to take advantage of every available resource, including technology and librarians, to provide CHI to every member of the public.  Hopefully,  I will have the privilege of playing a part in that effort. 

Pamela L. Kemp
Updated: May 15, 2020