Opinion on NHS's changes causing us to embrace the digital library

Written by Alyssa Clark

Wayne Sime, director of library services at the Royal Society of Medicine explains why the NHS changes mean that medical librarians should no longer fear digitisation and why the time has come for them to truly embrace the digital library.

When I joined the Royal Society of Medicine (RSM) in 2006, a year before the Kindle was invented and four years before the iPad dominated the tablet market, the RSM’s library was a very different place.

Footfall was low, books and journals could take an age to locate as library staff and members needed to use card catalogues to retrieve items. Librarians could often take days to deal with more complex requests and often when they were able to provide the information, books from the historical collection were found in varying states of deterioration.

Fast forward just a couple of years and despite gradually replacing hardcopy books and journals with electronic versions, the wide reaching impact of commercial eBooks and tablets meant that our members, mostly made up of busy junior doctors and senior clinicians, were becoming frustrated that clinical reference material was not more readily available in a digital format to help them in their daily role. In addition, the RSM was reputed as the largest provider of Continuing Professional Development (CPD) training in the UK and it was our duty to ensure that members could find the training materials they needed in order to continue practicing.

As with virtually every other aspect of their lives, members wanted content to just ‘be there’, with no blockages or difficulties. Whether that was in the hospital setting on the ward or even at home while doing research, medical professionals needed information as quickly and as easily as possible.

So what next?

However, we faced the same challenges and questions as the many NHS organisations looking at the implications of digitisation. Would the building still be needed if almost everything was online? How would the role of the librarian change? Was going electronic really affordable?

With the library one of the major reasons our 21,000 members joined the RSM, irrespective of our concerns, the demand could not be ignored. We knew that it was imperative that we did not just become a medical archive and a new strategy was developed, which made digitisation a key strategic priority.

The outcome has been astonishing. The implementation of electronic resources, including recent products such as Clinical Key, which has seen more than 3,000 journals including the Lancet titles and around 1,500 books accessed directly online, has increased the footfall through the library dramatically. In fact in 2006, 16,000 people came through our doors, and this year we are expecting over 30,000 visitors. Not only is this a record number of visitors for the library but also satisfaction rates for the library service are at an all-time high.

Keeping pace with change and demand

But why has providing information electronically had such a positive effect on the organisation? The amount of information that clinicians need access to is constantly changing and increasing. The vast amount of clinical trials, patient data and new drugs available combined with patients who are much more informed about their conditions, means that clinical reference material is becoming much more complex and readily available in greater quantities.

Clinicians struggle to keep on top of this using books and journals alone and often if they are not provided with an easy option, they will turn to the likes of Dr Google as a last resort. This can be problematic for clinicians in identifying whether the information they come across is really trusted and whether they feel confident that they are using the right information to make decisions, which may ultimately affect a patient’s life.

It is because of this that medical librarians are becoming even more relevant and important to clinicians. Many clinicians struggle to find the answers that they need and require training and assistance in searching databases to find research evidence to answer clinical questions. In many ways, the librarians’ role is increasingly moving towards becoming a trusted advisor, providing the collective ability to integrate services and practices into teaching and learning processes.

One day a medical librarian might help a doctor to find guidance for treating a rare condition, the next a manager might ask for evidence to support a staffing decision. Either way the role of the medical librarian is vital in helping to obtain and translate research into meaningful knowledge to ensure decisions are made based on the best and most up to date evidence possible.

Medical librarians on the NHS frontline

Digitisation is also changing the role of the medical librarian and extending their remit beyond the walls of the physical space, moving the information to the clinician’s workplace as opposed to waiting for them to come to the library - something that many healthcare professionals may increasingly struggle to find time to do. Librarians have the opportunity to become part of the frontline, which can be incredibly rewarding in seeing how patient care has been improved as a result of their role.

We see that digitisation is simply a way of enabling medical librarians to cope with the increasing demand on them to provide more information to the people who need it most, often using less resource. This challenge is likely to become even more prevalent as the financial strain on our NHS continues.

As for the expense, we are reaping the benefits of using electronic resources. Our librarians are able to use their time more effectively as there is far less laborious searching for information. Although we continue to grow our content, we no longer have to worry about where new books and journals will be housed and are able to provide our Members with enhanced working spaces. There will be less need to replace older books that are in poor condition and we are providing far greater access to our members at the same cost to them, as multiple people can view clinical reference material simultaneously.

By the beginning of 2014, we expect all of our journals to be electronic. We anticipate footfall continuing to increase and have no doubt that the library will continue to evolve as the NHS faces more challenges and technology advances. For now, we are confident that the changes we are making are supporting the medical professionals of today in the best way possible.

About the Author

Wayne Sime, director of library services at the Royal Society of Medicine (RSM). In his opinion Wayne explains why the NHS changes mean that medical librarians should no longer fear digitisation and why the time has come for them to truly embrace the digital library