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Research Highlights
HSR&D is Partner in New Online, Open-Access Journal
March 14, 2006
This is the full-text of an interview excerpt that appeared in the March, 2006 issue of Research Currents.
Implementation Science is a new online, open-access journal supported in part by VA's Health Services Research and Development Service. The journal is published by BioMed Central, which publishes more than 140 open-access journals on the Web. More than half these journals, including Implementation Science, are "independent," in that the researchers who launch them have editorial control.
Research Currents interviewed Brian Mittman, PhD, of the VA Greater Los Angeles Healthcare System, who is co-editor-in-chief of the new journal along with Martin Eccles, PhD, a British health-services investigator.
RC: How long has this project been in the works?
BM: It's something many of the researchers in the field internationally had been discussing for a good two or three years. It seems the most intensive HSR&D discussions began in August and September 2004 at the HSR&D State of the Art Conference on Implementation Science. At that conference a group of investigators discussed the need for a journal and the possibility of a role for HSR&D in launching one. Our first international planning committee call in January 2005 was the beginning of the planning effort that led to the journal.
RC: Why is there a need for a new health-services research journal?
BM: Many of our discussions surrounded the fact that there are existing journals that publish this kind of work, but for those journals it is a secondary field. The traditional, or conventional, health-services journals cover a very broad range of topics, and Implementation Science, or quality-improvement research, is only one of them. There's also a set of journals that we label the "quality and safety" journals, but these have a more applied orientation and target a different audience. The highly technical., theoretical, methodological papers that any field needs did not have a home.
RC: What is VA's role in the project?
BM: HSR&D is providing in-kind support, and many of the planning- committee and editorial-board members are HSR&D investigators. VA's Center for Information Dissemination and Education Resources (CIDER) in Boston serves as the editorial office for the journal. This in an international journal without any formal sponsor, but VA is recognized as the primary supporting organization.
RC: Who else provides financial support?
BM: Authors whose articles are accepted pay an article-processing charge that supports the production by BioMed Central. We as editors have the option of adding a surcharge to help support our time, but we've opted not to do that for now. It's an atypical model, although it's becoming more common. The costs are modest, compared to those of print journals, and they're supported by authors' article-processing fees.
RC: Why an online, open-access journal?
BM: We've seen evidence of a vicious cycle in journal publishing—as print subscription fees for institutions go up, libraries will review their subscriptions and identify a few where the readership and use of the print version are too small to justify the subscription. As they begin to pull out, publishers find it more difficult to support the print version and they move to online-only. BioMed Central has been attracting a number of professional associations that have moved away from a print publisher to online-only because of the economics.
It makes economic sense for our readers, too. This field, perhaps more than others, is international in scope, and we expect a significant number of readers from developing countries where the library budgets just don't allow for a costly print journal. That was one of our considerations.
Another advantage to an online journal is that the amount of space needed to fully document our interventions is typically greater than that required to document a new drug or surgical procedure. Some of the management and quality-improvement programs we design are multifaceted and require a lot of space to describe. Traditional print journals do not allow for that level of documentation.
RC: Who can publish in Implementation Science?
BM: We're open to anyone who's interested, who's active in the field and willing to pay the article-processing fee, once that's applied. (For the first six months, authors do not incur a fee—that's a feature of BioMed Central to help journals like this become established.) The assumption is that perhaps about a quarter of the submissions will come from VA, but that's just a very rough estimate, and it's not any kind of target.
RC: What do you hope will be the impact for VA health-services researchers?
BM: It's an outlet for us to publish our work and share our findings and insights among ourselves and other colleagues. There are many methodological tools and details of projects that are never documented and thus do not become available for other researchers. One of the main motivations for the journal was the feeling that the field has not progressed as rapidly as it should have, not because of any lack of creativity or shortage of research, but because of lack of dissemination and open exchange of ideas and insights. We end up reinventing the wheel, making the same mistakes over again.
RC: Your co-editor-in-chief is from the UK, and this is an international journal. How much of this research in VA and elsewhere in the US is relevant abroad?
BM: There have been a number of collaborations among health-services researchers in VA and the UK's National Health Service. Dr. [Jonathan] Perlin has been involved in some of those, and QUERI [VA's Quality Enhancement Research Initiative] has been involved in and initiated some.
If you look at many of the issues having to do with finance and insurance, there are too few parallels between the UK and the US for these kinds of comparative studies to make sense. There are many more parallels in terms of thinking about how to reorganize healthcare delivery—how to take a mix of physicians, nurses, and other healthcare professionals, along with computing systems and other forms of technology, and combine them into an effective, efficient healthcare delivery system—or how to develop evidence-based clinical-practice guidelines and convince physicians to support them and use them.
We've always recognized the similarities between VA and certain other national health systems, all of which are large, integrated healthcare delivery systems. The journal will have somewhat of an emphasis on that kind of setting, although certainly the private sector in the US—which has some parallels in Canada, and even in the UK—will be of interest as well.
The idea is that human nature, the medical profession and many of the issues are applicable universally. We are taking care to make sure that authors who publish articles on a specific country's healthcare system spend time thinking and writing about the implications for other healthcare delivery systems. That's one of the challenges, but also one of the benefits, of having an international journal.
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