Scholarly Publishing's Napster Moment: Are Paywalls or Poor Ux Driving Users to Pirated Content?

Even for journals to which the university has access, Sci-Hub is becoming the go-to resource, says Gil Forsyth, another GWU physics Ph.D. student. “If I do a search on Google Scholar and there’s no immediate PDF link, I have to click through to ‘Check Access through GWU’ and then it’s hit or miss,” he says. “If I put [the paper’s title or DOI] into Sci-Hub, it will just work.”[1]

Sci-Hub is a Napster-like site that aggregates pirated articles from scholarly journals and provides free access worldwide. With media attention from the NY Times and others, the site has garnered a lot of attention recently & has raised the profile of the Open Access movement.

As detailed in this overview of Open Access by Peter Suber, one of the leading advocates of Open Access (OA), two key defining characteristics of OA are:

1)      OA removes price barriers (subscriptions, licensing fees, pay-per-view fees) and 

2)      OA removes permission barriers (most copyright and licensing restrictions).

In essence, the OA movement adheres to the belief that scientific research findings, especially those funded with public funds, should be available to all without fees for the benefit of scientific advancement.

However, there’s an interesting article in Science Magazine this week that raises the point that ease of use may be an equally important driver of the use of Sci-Hub for accessing articles published in scholarly journals: http://www.sciencemag.org/news/2016/04/whos-downloading-pirated-papers-everyone

Millennials (and others who might describe themselves as digital natives[2]) are accustomed to quick and easy search functionality to find just about anything they are looking for.  Furthermore, once something is identified online, the digital natives expect to be able to gain quick access to the full object, whether it is a full-text article, physical book, or a consumer good. Think of it as the Google Apple Facebook Amazon mindset.

The fact that usage of Sci-Hub includes a base of users who likely have pre-paid access to a base of content far greater than what is included in Sci-Hub underscores how important it is to make content easily accessible with user interfaces that match – or nearly match – what is available via search engines and consumer sites.

Upfront barriers to access—multiple log-ins and passwords, restrictions on mobile usage, and even lack of awareness that access is available—are fatal errors. If your intended audience doesn’t know you exist or gives up on using your service because it is too difficult to figure out how to log in, then the delivery channel mechanism in your business model is broken.

In my view, the interest in using pirated sites is an indictment on the design and technical capabilities of the publishing platform companies that serve scholarly publishers. There are other aspects of the scholarly publishing business models that need updates (including pricing), but turning pre-paid users away at the front door needs to be fixed first.

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[1] http://www.sciencemag.org/news/2016/04/whos-downloading-pirated-papers-everyone

[2] Note, I want to start a new category for those of us who have been early adopters and digital enthusiasts our entire adult lives—no matter how old we are now. Our wisdom and perennial enthusiasm has value, too.

At HIMSS16, Massachusetts Leads Health IT into Next Stage of Data Analytics and Value-Based Care

Massachusetts is known for pioneering healthcare reform programs that led national efforts and we continue to demonstrate leadership in advancing quality improvements in healthcare delivery.  At the recent annual HIMSS16 conference in Las Vegas, where approximately 42,000 health IT vendors and customers convened to exchange the latest information on health IT and analytics innovations, it was clear that Massachusetts is in the pole position to retain the lead in developing the next generation of health IT and analytics solutions.

Healthcare analytics depend on a reliable foundation for data collection and data management. With database infrastructure that serves 2/3 of the US population via its healthcare provider clients, InterSystems has played a key role in establishing the health IT foundation. Although they have generally operated behind-the-scenes, InterSystems is moving into a more visible role as they offer solutions for care coordination and advanced data analytics. I expect more people in healthcare will know their name in the future.

InterSystems booth at HIMSS16

GE, IBM and Xerox are extremely well-known corporate names that are recognized in the healthcare sector. These storied corporate brands have demonstrated a history of innovation and reinvention that they are applying to an array of data management, analytics, and connected health initiatives. With decades of experience in enterprise computing and cultures that are skilled at integrating acquisitions to build best-of-breed solutions, these corporate giants will likely remain leading names in healthcare for the foreseeable future.

There are far too many product and corporate development announcements made at HIMSS to attempt a recap, even if it were limited to companies with strong ties to Massachusetts. However, the announcement of the $2.6 billion acquisition of Truven Health Analytics by IBM Watson is one that captured a lot of attention. Furthermore, I heard from more than a few experienced health IT professionals who would jump at the opportunity to join IBM’s expanding team at its new Watson Health headquarters near Kendall Square.

In healthcare, financial incentives and regulatory requirements factor into most major business and clinical decisions.  Telehealth is a great example. The technology has been available for some time, but regulations held back the supply of doctors available to practice across state lines. More important, the lack of a clear path for reimbursement constrained interest from clinicians. With the advent of recognition of the value of telehealth by payers, Boston-based American Well has been able to expand its portfolio of services to include multiway video, a mobile SDK, and the Telemed Tablet that facilitates specialist consultations via mobile teleconferencing.

Securing access to protected health information is another area where the right technology can overcome barriers to efficient workflow. Lexington-based Imprivata, a leading provider of health IT solutions for single sign-on and secure communications, is known for its clever and informative presentations at HIMSS which attract a large audience to its booth every year and didn’t disappoint this year.

Imprivata booth at HIMSS16

The overarching theme of my coverage of HIMSS16 has been how health IT has entered a more mature phase, where basic IT capabilities are a required part of doing business and more advanced solutions are in the spotlight. New value-based care and payment models depend on a higher degree of care coordination and need to involve patients in care decisions. Massachusetts has many early-stage and more “mature” health IT companies that offer solutions for secure communications, data exchange, population health analytics, and patient decision tools that all contribute to a more efficient connected care continuum. Other notable MassTLC member companies that are playing a role in transforming healthcare & were represented at HIMSS16 run the gamut from start-up PatientPing, not-for-profit government systems engineering and analysis company Mitre, and big data analytics company, Optum Labs and athenahealth, whose CEO, Jonathan Bush, always manages to capture the spotlight at HIMSS.

HIMSS is not just a conference; it is an event that combines education sessions, keynote addresses, exhibit hall demonstrations, and social events. Health IT companies from Massachusetts also stood as sponsors of some of the “must-attend” social events, too. Here’s a picture of the author at HIStalkapalooza, posing with Elvis and Pat Rioux, who works for Elsevier in the Boston area. Elsevier and athenahealth are both sponsors of HIStalkapalooza.

 

Janice McCallum, “Elvis”, and Pat Rioux at HIStalkapalooza, HIMSS16

This article first appeared in the MassTLC blog: http://blog.masstlc.org/2016/03/at-himss16-massachusetts-leads-health.html. This is an updated version and is republished here with permission. 

Parsing the Progress of Health IT at HIMSS16

Since my first HIMSS conference in 2010, my consistent theme has centered on how health IT will get more interesting as it matures. My rationale: the types of problems we can solve become more complex and impactful as more core data become accessible for analysis.

That’s the focus on one of my articles in the HIMSS16 newsfeed, Identifying Signs of Maturity in Health IT at HIMSS16. One sign of maturity includes an increasing volume of partnerships and merger & acquisition (M&A) activity, especially among established firms. I’d like to thank IBM for announcing its acquisition of Truven Health Analytics prior to HIMSS16; that relieves me of relaying that information during the conference! At $2.6 billion, I expect this acquisition to be one of the biggest announced for the health IT and analytics community for the whole quarter and I look forward to learning more about the combined entity next week.

Another sign of maturity can be found in terminology changes. I’ve already seen indications that some specific categories in health IT will be rolled up into larger categories. For instance, the distinction between the EMR and the EHR categories is blurring.[1] Over time, more amorphous categories such as clinical decision support will likely get subsumed into larger categories like clinical intelligence. And, before long, we won’t need a dedicated area to showcase interoperability at HIMSS; instead, we will be able to talk about all the things we can do because of the underlying interoperability between previously distinct systems.

Moving From Meaningful to Valuable Uses of Health Data

With the foundation for ‘meaningful use’ of basic EHR data nearly complete, we can move forward to developing analytic solutions that depend on a solid foundation of process and outcomes measures. We’re making progress understanding the relationships between outcomes and interventions, but in this segment, we’re at very early stages of maturity. However, the shift to a value-based payment system will accelerate developments in outcomes measurement and analysis.

Where to Find Me at HIMSS16

My schedule for HIMSS16 is a mish-mash of 1:1 meetings, press briefings, receptions, keynotes and education session with a few minutes here & there left open to wander the exhibit hall.

A few notable sessions & events where I hope to run into friends and colleagues follow:

• Opening keynotes on Monday, March 1 at 5 pm.
• HIStalkapalooza Monday evening
• #HealthITChicks meetup, Tuesday, March 1 at 10 am, HIMSS Spot
• #TheWalkingGallery meetup, Tuesday, March 1 at 1:30 pm, Xerox booth #8005
• New England HIMSS reception, Tuesday, March 1 at 4:30 pm, Elsevier booth #3039
• Social Media Ambassador meetup, Wednesday, March 2, HIMSS Spot

I look forward to a super-charged week at HIMSS16. I’ll try to live up to the new “Health IT Maturity Champion” moniker that HIMSS Media has coined for me (or maybe not!).

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[1] The HIMSS Analytics team tipped me off to some terminology changes that are likely to occur soon. See my article on HIMSS Analytics LOGIC here: http://www.himssconference.org/updates/himss-analytics-logic-health-it-market-intelligence-value-based-world

Update on Saturday, February 27, 2016 at 11:20AM by Janice McCallum

Note, the time for the SMA meetup is 3:00 - 3:45 pm on Wednesday at the HIMSS Spot: http://www.himssconference.org/session/himss16-trendspotting-social-media-ambassadors

New Report on Digital Health Technology for the Underserved

A new report from Jane Sarasohn-Kahn for the California Health Care Foundation (CHCF.org), Digitizing the Safety Net: Health Tech Opportunities for the Underserved, canvasses the digital health technology landscape through the lens of connecting healthcare to social determinants of health (SDOH). In Jane’s inimitable style, she combines reviews of some notable digital health solutions with analysis of the key drivers of this emerging area. (Note, in my last blog I named Brian Ahier and Lisa Suennen as two of the best analysts & writers in healthcare; Jane is the beacon who sets the standard so that others of us aim high!)

Three key trends shine through for me:

• Encouraging signs of consumer marketing best practices are beginning to appear in healthcare marketing (e.g., understand your audience; segment the market & match the message to the segment; use technology that is appropriate for the segment)

• Recognition by the medical community that social determinants of health (SDOH) play a significant role in health and health maintenance.

• Change in payment models from fee-for-service to models that reward patient-centric care coordination is the ultimate driver of change in healthcare.

I highly recommend reading and bookmarking this report, which is available for download here:

http://www.chcf.org/publications/2016/02/digitizing-safety-net

Follow Jane on her blog, http://healthpopuli.com/, on Twitter @healthythinker and as part of the Social Media Ambassador list for the upcoming HIMSS conference, #HIMSS16 https://twitter.com/HIMSS/lists/himss16-sm-ambassadors. 

HIMSS16 Planning

 I am extremely pleased to announce that I will once again be a Social Media Ambassador at the HIMSS Annual Conference, which takes place February 29 - March 4 in Las Vegas.

This year, the theme of my posts before, during and after HIMSS16 will be the effects of the maturing of the health IT segment on the start-ups, EHR/EMR vendors, other established IT vendors, and analytics companies of all types that populate the HIMSS exhibit hall. 

As you might expect, there will be both good and bad news for health IT companies, depending on one’s perspective. My first post will build on recent trends that were highlighted at the JP Morgan Healthcare Conference in San Francisco. Fortunately, other industry experts have already covered the details of trends and announcements made at the JPM conference & associated events. You can check out Lisa Suennen’s blog post that manages to weave a David Bowie theme into her account of the event:http://venturevalkyrie.com/bowie-and-the-jpm-experience/ and Brian Ahier’s post:  http://www.ahier.net/2016/01/the-end-of-meaningful-use-as-we-know-it.html to get a well-rounded view of major developments at JPM from two of the industry’s most knowledgable insiders and best writers!

Speaking of the industry’s best, here is the official announcement of the HIMSS16 Social Media Ambassadors, a group that I’m very proud to call colleagues and friends:

http://www.himssconference.org/updates/introducing-himss16-social-media-ambassadors-and-three-reasons-follow-them

I’ll be posting more information about the HIMSS16 conference in the run-up to the event, so please check back here or contact me at: janice@healthcontentadvisors.com if you want to schedule a meeting at HIMSS16.