Technology is transforming medical publishing

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Medical information is increasingly becoming dependent on digital technology, and business media companies are becoming more like software companies to take advantage of this long-term shift. A few cases in point:

• Hearst Business Media's Zynx Health serves more than 1,700 hospitals with medical-order sets, in which doctors and nurses share instruction on how to treat patients, in both print and digital formats.

• Wolters Kluwer's UpToDate, an evidence-based, peer-reviewed information resource distributed via the Web, has more than 7,700 topics in 14 medical specialties, with 80,000-plus pages of text, graphics and a drug database.

• Thomson Reuters' Clinical Xpert Suite can be used to monitor clinical work flows by aggregating clinical data from across an entire hospital information system.

These examples were cited in a recent report on the rapidly changing landscape for medical publishing. Amid the larger transformation of b-to-b media—and the decline of traditional products—medical publishers are moving aggressively to develop (or acquire) information-based products that are often accessed via mobile devices and can be integrated into the workflow within the health care system.

The report, “Growth Trends in the Market for Clinical Decision Support Tools,” was conducted by media research company Outsell Inc. and released in June. It identified several media companies in the health care marketplace and described how their role in the clinical decision support market is likely to change in the next few years.

Outsell interviewed publishers and C-level executives from Hearst Business Media, Reed Elsevier, Thomson Reuters and Wolters Kluwer; key executives from the Healthcare Information and Management System Society (HIMSS) and KLAS, which provides measurement tools for health care IT; and vendors in the health care content and technology arenas.

David Bousfield, VP-lead analyst at Outsell, who conducted the study and covers the science, technical and medical sectors, said Outsell initially focused on the health care market because of the surge in demand for clinical decision-support tools spurred by the American Recovery and Reinvestment Act, which provides $19 billion in incentives to encourage the digitization of medical records.

The integration of content-based products into the supporting Health Information Technology (HIT) infrastructure relies on a hierarchy of standards, ranging from HL7 (Health Level 7), which provides a common language and process definition for sending and receiving messages reliably to and from systems designed by other manufacturers, to ICD-9, ICD-10 and SNOMED, which are essentially taxonomies, or controlled vocabularies that enable disease characteristics and lab test requirements to be identified and billed, according to the report.

The increasing demand for more information-based products, combined with associated educational resources, could create opportunities for significant growth for science, technical and medical publishers in at least three areas: clinical decision support, continuing professional education and management analytics, the report said.

“The companies that are doing well in terms of market penetration have adapted best to the fact that they're now providing not a journal or a book in a digital format, but a form of software with embedded rules linked to small pieces of information,” Bousfield said. “It's a more granular world.”

Indeed, the groundswell among medical publishers toward work flow and outcome-based products could be an indicator for many other b-to-b media verticals that are grappling with creating new revenue steams amid the erosion in their print portfolios.

“Publishers are realizing that to continue to grow and retain market share they have to get much closer to the user and provide the information in a way that's much more friendly to the time constraints people have when they're doing their work,” Bousfield said.

Thomson Reuters' strategy is to develop health care products that combine evidence-based recommendations with patient data from disparate information systems, said Jill Sutton, VP-product manager.

For example, next month Thomson Reuters will roll out Pharmacy Xpert, a clinical dashboard designed to help pharmacists identify and prioritize patient care in real time. In early 2011, it plans to introduce Nurse Xpert, which is tailored to nurses' work flows.

“For health care—and I think this is applicable for other verticals—the focus is on process: If you put information tools in the hands of smart professionals and that can improve their process, it will lead to better outcomes,” said Jerry Oschcroff, chief clinical informatics officer at Thomson Reuters. “To improve outcomes, you have to have spectacular content, deep expertise and capabilities to support work flow, and a robust analytics capability to know what's going on.”

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