Impact of Open access: healthcare, public health, and own practice

Image of open hands

This post is by Pia Sebastian who recently completed my module in February 2023 and is a nurse educator. Her essay is licensed under CC-BY NC and she writes….

Today, the marvel of technology and digital advancement has led us to believe that all information can be accessed through the snap of our fingers, or in this case just a few clicks (Arakelyan, 2021). The accessing of information in digital landscape has evolved tremendously throughout years and is still evolving at this present age, it has made easier and more open, however in previous years this was not the situation. This essay will seek to explore the implication of Open Access in healthcare, public health industry and my own practice.

 Growing up, I tend not to notice how I access information, although what I knew back then was that it was more tedious, and it required more effort. Most of the time, information I would gather were insufficient and inadequate especially in terms of research for schoolwork, there were not enough printed journals, articles, or books to dig myself into for knowledge and information. I never realized that most of those that I required was because most journals and articles would need to be retrieved through subscriptions. Access to research data has always been limited to journal subscribers and this implies that those people and organisations engaged in research who cannot afford the cost of a subscription do not have access to these journal articles. According to traditional subscription-based publishing models, authors must either transfer their rights to publishers or allow them the sole right to publish their works. Publishers may govern the reuse of a work once it has been published, but writers may still have some restrictions on how, where, when, and with whom their work may be shared (Research Publications and Open Access Policy – Staff Home, University of York, n.d.). However, there is a progressive shift towards accessing journal through electronically, consequently there is also an increase in number of journals existing globally (Strydom et al., 2022).

Impacts in Public Health and Healthcare

Publishing literacy and research works, journals and articles may it be printed or in digital form can be a profitable industry due to subscriptions. Lawton and Flynn (2015) stated that most of the peer-reviewed scholarly research are published journals which can only be accessed by institutions willing to pay for subscription fees or those individuals that can afford to do so. Further, these subscriptions can be exorbitantly expensive only a well-funded universities libraries can pay for it and primarily this are in developed countries (Open Society Foundations, 2018). Tennant et al. (2016) indicated that access to 75% of articles is not directly possible unless one has the privilege to work in an institution that has subscription access to these articles or has enough money to pay on a per-article basis subscriptions to all peer reviewed journals.

I believed that this generated a huge predicament for researchers and academics who are in need most of these important and vital sources of information essential to their work, innovation, and research. Ellison et al. (2019) recognized that each year huge amount of money by hundreds of billions of dollars are being utilized to finance medical research by government and different commercial and charitable organizations and institutions with the primarily objective is to improve and prolong lives. Publication plays a vital role in dissemination of scientific invention, yet translation of medical research into clinical practice is slow. In connection with this, application of research published via the conventional subscription publication model is hampered by copyright limitations that prevents reusing the published content and paywalls that forbid public use.

For instance, according to Open Society Foundation (2018), this meant that those doctors who treats HIV and AIDS in Africa will not be able to have access to the medical results on treatments even when the research upon which these articles were created were embarked on locally. Thus, impacting adversely to patient’s care. Moreover, emailing request for articles across the time zones does not offer fast solutions when these are necessary the most. This also impedes researchers not to study their found pursuits and interests due to no free access to information and or limited literature.

Apart from this, the Ebola’s 2014 outbreak was terrible for countries like Guinea, Sierra Leone, and Liberia. Although there was an article in Annals of Virology published in 1982 indicating that Liberia had a high potential for endemic Ebola and warned health authorities of the risk of probable outbreaks however it was only accessible by subscription. Since these results were published in a subscription journal and were therefore buried behind a paywall, local public health officials were probably unaware of them. Limiting access to such information may have prevented information from reaching public health professionals who were caught off guard and unprepared by the 2014 endemic (Smith et al., 2017).

Open Access Movement proposes to remove price and permission barriers for accessing peer-reviewed research work and making research work freely available to anyone who wishes to see it (Elle & Gray, 2020). Open Access refers to the practice of producing scholarly research freely and permanently accessible instantly for anyone to gain access to globally. Research results can be downloaded, reviewed, shared copied and printed within legal requirements, as long as the authors and original sources are properly cited under the Creative Commons licenses, for which articles and journals can be legally used, built upon, and adapted without permission (What Is Open Access; Its Benefits & Other FAQs | BMJ, n.d.). Greenberg (2019) pointed out that authors can retain copyright licensed under Creative Commons. Further, under open access there is high standards of production and rigorous per review with promotion and publishing quality research.

Consequently, because there is an immediate and unlimited access to content research findings, producing breakthroughs and innovation especially in health sciences, paved way to better the lives of people and for humanity. Barbour (2006) acknowledged that open access makes medical knowledge widely disseminated and freely accessible to all, including academic researchers, medical professionals, policymakers, and laypeople. This data can influence the laws and practises that affect population health. In addition, increasing the reach and use dynamically influences how medical research is conducted and disseminated in a wider global audience by supporting innovations and advancing discoveries. Ross-Hellauer et al. (2020) stressed that the distribution of other open science outputs that would typically be kept secret not only contributes to increased reproducibility and transparency of research, but it also results in the release of more research components that may have an effect on others by generating network effects through reuse.

In his study Tennant et al. (2016) stressed out that open access does not only beneficial to academics but also impacts the other domains in society. It makes research available to everyone with an internet connection, therefore it exceeds academic affiliation and strengthens lifelong learning. For instance, anyone who uses information from open access can lead to possibilities for knowledge to be   used in unexpected creative and innovative ways beyond the mainstream professional research. It surpasses all other potential alternative modes of access to scholarly literature because it allows for unfettered re-use and long-term stability independent of the financial restrictions of traditional publishers that limit knowledge exchange.

West (2015) stressed out that in Médecins Sans Frontières (MSF), a medical and humanitarian organization, access to research evidence is vital for MSF health staff to be able to make the best informed decisions in field programmes. Not only that, it is not only the MSF, but there are also several organizations that conducts research, and the vast majority are in low- and middle-income countries or developing countries stricken by conflicts, natural disasters, and poor access to healthcare. By open access sharing of experiences can be accomplished with other authors and experts worldwide, building collaborative findings thus, making a great impact to society.

In addition, World Health Organization (WHO) observed a policy wherein all WHO authored and WHO funded articles that are presented for publication in peer-reviewed journals must be distributed in an open access journal or an open access platform ensuring that it is freely accessible and reusable to the public. Further, WHO believes that having a universal access to publicly funded research as well as research data is indeed essential to addressing public health challenges of the 21st century (WHO | WHO Policy on Open Access, n.d.).

Moreover, Day et al. (2020) by enhancing patient empowerment and their capacity to avoid receiving false information that could harm their health and wellbeing are two benefits that could result from increasing access to primary sources of medical literature through open access publishing. Thus, has a result for the population’s overall goal of promoting public health.  For instance, those patients looking for information about complex or unusual medical illnesses such as rare diseases or genetic disorders for which there is little information available outside of academic journals may find open access to be especially valuable with to the most recent medical research without being restricted by a paywall.

Another impact of open access was described in the article written by Strydom et al. (2022), this recent pandemic brought about by SARS- COV 2 and COVID- 19 have emphasized the benefits of open access in dissemination of the research results as swiftly as possible, researchers embraced open access platforms rather than utilizing traditional methods of publishing thereby accelerated research and scientific collaboration and partnership by data sharing and by hastening the replication of investigations and expanding data reuse. Essentially with this, there has been more information readily available about COVID-19 and thereby saving lives of millions of people throughout the globe and mitigate further health threats brought about by the pandemic.

Impact on Personal Practice

The nursing profession faces a variety of challenges in the twenty-first century, including an ageing nursing workforce, an increase in the proportion of elderly and seriously sick patients, rising healthcare costs, and a shortage of nursing personnel (Fawaz et al., 2018) and as a profession that rely on evidenced-based practice through research, open access plays a crucial part on this. Nick (2011a) had emphasized that accessing recent literature is necessary in the evidence-based practise environment of today. However, it can be difficult to maintain and acquire enough current reference materials. The culture of evidence-based practise is challenging to establish under these circumstances and reference collections are frequently decades out of date.

Attributing to the open access that it is freely available online and provide professionals, like me all across the world a greater level of information proficiency especially in light of the emphasis on achieving evidence-based practise. Networking, collaborations in nursing research, and the use of new and improved therapies could all benefit from universal access and to create urgently required nursing systematic reviews, clinical practise guidelines, critically acclaimed topics, or best evidence topics, completed research from several nations can be integrated as these can affect and improve my practice and benefit patient’s care. Thus, would help clinical practise match more closely with the objectives for evidence-based practice (Nick, 2011a).

Nick (2011b) had also stressed out that by providing access to Open Access resources, there is a reduced in financial burden and improved online information access, which would ultimately aid in adopting evidence-based practise. Increasing access to academic resources can have a positive impact on my clinical practise, useful for student learning and teaching content, and to patient care results. These encounters brought home to the value that Open Access may provide to healthcare professionals who struggle to get access to up-to-date knowledge and research on practical challenges. In essence, Open Access gives the chance to align information gathering on a global scale.

The Future of Open Access

It is imperative that results of publicly funded research should be accessible to stimulate discovery and innovation. In UK, it has been mandated in National Institute for Health and Care (2021) requiring all peer-reviewed research activities arises from NIHR-funded research studies made open access under open license. This meant that the research output funded by UK government are freely available to taxpayers who funds research, regardless of institutional affiliations by health and social practitioners. Further, this new policy ensured it works for the diverse stakeholder community as it impacts on patient and the public by empowering for further drive to innovation and discovery globally.



CC-by-nc 4.0 Foto: Pay Numrich / KohleerSetzen!
by Kohle erSetzen!

This license allows reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercially purposes only, and only so long as attribution is given to the creator. It includes the following elements: BY – Credit must be given to the creator; NC – Only non-commercial uses of the work are permitted (Creative Commons, 2019).


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