Purpose The purpose of this paper is to share the experience of a university library in response to the COVID-19 pandemic since early March 2020. The paper describes the library’s position during the crisis and illustrates the uncharted challenges that the pandemic has posed to its digital services. Furthermore, it details how the library has adapted some existing services into a digital format and explored new initiatives/practices to support the university’s full online teaching and learning since March 23, 2020. Design/methodology/approach This paper describes the library’s various digital services that are used to meet the needs of its end-users during the COVID-19 pandemic. The approaches used are the authors’ personal experiences working at an academic library, observations of the library’s responses with regards to its digital services, as well as their reflections on what can be considered for development now and in the future. It highlights the current initiatives and best practices for digital library services during a public health crisis. Findings This paper aims to make other university libraries aware of what the library has implemented with providing digital services to its teaching faculty and students during the pandemic. It also describes the challenges and implications for the library professionals working in-house and remotely. Originality/value This paper is of great value in providing insights and practical solutions responding to the global health crisis for other libraries that are coping with the similar challenges for digital library services.

Background: The COVID-19 pandemic amplified traditional access barriers for patients. However, responses to the pandemic have also seen attempts to avoid negative health consequences with improved access. Appropriate and well-understood access is a threshold condition for timely diagnosis and adherence but must be supported by both regulatory and reimbursement decisions. Americans often delay medical care due to inconvenience and out-of-pocket expense, particularly as many are responsible for growing out-of-pocket medical expenses under high-deductible employer plans. Non-adherence has been estimated to cost billions annually in the US alone. Patients who received health literacy interventions have shown a higher rate of treatment adherence than did those who did not, suggesting that millions of US adults with low health literacy could be assisted to better adherence with improved health literacy. Objective: We review the trends in access related to COVID-19 and contextualize, provisionally, how these changes may continue to improve access after the pandemic. Developments: Government and private insurers responded by expanding access with lower out-of-pocket costs and greater leveraging of technologies for more convenient care. These technologies, like telemedicine and remote monitoring in trials, can enhance the evidence available for regulatory and reimbursement policy decisions, including data on relevant subpopulations. Access to COVID-19 related care was enhanced with lower OOPs, and chronic conditions advantageously reclassified as preventative medicine. Coverage expanded for telemedicine and mail order and home delivery. Physicians conducting video chats increased by 159% and telemedicine by 106% in March compared to a year ago. Conclusion: Access has been improved and there has been greater utilization of digital technologies that can enhance both outcomes and evidence. However, the level of health literacy with respect to these changes remains an open question.

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