Tuesday, June 29, 2010

Open access publishing & open peer review

Regular readers of this blog will know I am a supporter of the principles behind open access publishing, as a way of enabling the sharing of knowledge as widely as possible. One of my favourite open access journals is the Journal of Medical Internet Research (JMIR). During the last couple of weeks my dealings with the journal have increased and the journal has introduced a fairly innovative new peer review process.

I have never previously submitted a paper to JMIR or other open access journals, because the university I work for has no way of paying the submission and publication charges (although they spend a fortune on subscriptions to journals - some of which I and my colleagues have published in). This changed a few weeks ago when I persuaded my doctoral supervisors that the high impact factor and relatively fast review process of JMIR meant this was the right journal to submit my latest paper to. I had to make a special case (largely based on completing my doctorate before the next assesment under the Research Excellence Framework) and it was agreed that the university would pay the fees - but that this wouldn't set a precedent for the future.

Therefore I submitted the paper (thanks to help from a member of staff who is allowed to use the universities credit card), let out a sigh of relief and started to wait for the reviewers feedback.

A few days later I noticed on someone's facebook status that JMIR had set up a new open peer review process, in which registered users can sign themselves up as peer reviewers for specific articles currently under consideration by the Journal. Reviewers will be acknowledged by name if the article is published, but remain anonymous if the article is declined.

I noticed that my paper is included in the list (I'm not going to tell you which one as this could introduce bias/conflict of interest), but also noticed another on a topic which interests me, and in which I have some expertise. I clicked on "peer review me" and a few days later had access to the paper for review and the guidelines for reviewers. The process from that point on was the same as it has been when I have been asked by the editor of the journal to review other papers through normal invitations.

I have now reviewed the paper with suggestions for the authors, and wish them luck while they await the editors decision.

This experience has got me thinking further about the nature of the scientific peer review process. Perhaps open peer review, as instigated by JMIR, will move us some way from the shadowy and largely hidden traditional process, some way down the road to the almost completely open editing and reviewing process exemplified by Wikipedia. It will be interesting to see how far "the establishment" will be prepared to go down this road - perhaps spurred on by the speed of publication and citation which is a product of open access journals. The measures of impact such as journal citation factors also seem to be moving towards citation indicators for particular papers. It may be that one day we will also consider social impact as well as traditional scientific impact.

Labels: , , , ,

RCN eHealth Advisor post advertised

The Royal College of Nursing is once again advertising for an eHealth Nurse Adviser (Ref: NU0210-0610) - further details are available at Alternatively, email: or telephone 020 7647 3552 to request an application pack, quoting the appropriate reference.
For an informal discussion, please contact Jackie Cheeseborough on 020 7647 3616.

Application deadline: 19 July 2010
Location: Negotiable
Department: Information & Knowledge Management
Interviews will be held on: 30 July 2010

Salary - £47,283 pa (plus £3132 London weighting if applicable)

Job description

Up to 35 hours per week, secondments will be welcomed

This is an opportunity to influence UK policy and practice now and in the future in the area of eHealth, and to support and engage nursing staff in this agenda. You will advise and represent the RCN on eHealth issues, form collaborative eHealth partnerships, embed eHealth across the RCN, engage and support members with regards to eHealth including working with the Information in Nursing Forum and manage RCN eHealth web content. You will need a background in and enthusiasm for eHealth to ensure that it plays a significant part in nursing care in the future.

Closing date: 19 July 2010
Interview date: 30 July 2010

Labels: , ,

Thursday, June 17, 2010

SCR & Healthspace evaluation published

Today a major evaluation report of England's Summary Care Record (SCR) and HealthSpace programmes has been published at

I haven't yet digested the full 234 pages, but I have scanned the executive summary (p9-21( and it appears to be an extensive multi-level mixed-method study which has examined the initiatives from a variety of perspectives and disparate data sources. It follows a previous report which was instrumental in changing the consent model used in the SCR.

A couple of intriguing paragraphs which have leapt out at me & I will investigate further:

* In a pilot study supported by an independent IT supplier in which district nurses were lent portable digital assistant (PDA) devices to access the SCRs of patients they visited on their rounds, initial technical and operational challenges were overcome for the duration of the pilot. Overall, the nurses found PDAs useful and many accessed SCRs regularly, though they would have liked more clinical information on the records. The PDAs were recalled by the supplier and subsequent negotiations centred on the cost of supplying the devices and who would meet these costs.

* A number of ‘wicked’ (pervasive, seemingly insoluble) problems became recurring agenda items in national and/or local meetings. Wicked problems had a number of common characteristics:
a. They spanned the different ‘worlds’ of different stakeholder groups, which brought different assumptions and values;
b. They involved a tension between different philosophical models of reality (‘hard’, rationalistic, factual versus ‘soft’, contextualised, interpretive);
c. They tended to include a claim on contested resources (i.e. not everyone agreed that money or time should be spent on them);
d. They were vulnerable to multiple external influences, some of which were not under the control of those charged with ‘fixing’ them;
e. They had complex interdependencies with other problems and issues in the programme; and
f. They produced unanticipated ramifications elsewhere in the system.

* The most striking overall characteristic of the SCR and HealthSpace programmes was their scale and complexity. They can be thought of as emerging from a heterogeneous socio-technical network with multiple interlocking sub-networks:

* The SCR and HealthSpace programmes spanned a number of different ‘worlds’ – political, clinical, technical, commercial, academic – with different institutional logics, as well as the personal world of the patient.

* The huge scale of the programmes inevitably brought increased complexity as well as a tension between ‘national coordination’ and ‘local ownership’. The tension between standardisation (which helps stabilise the socio-technical network) and contingency (which reflects and responds to local needs and priorities) can never be resolved;

* The NHS and professional bodies should consider the implications of this study for training and support of front-line staff. Our empirical data highlight the lack of predictability or universal solutions at the level of the fine-grained detail of the patient encounter.

Other comments about this report are beginning to emerge eg:
* SCR and HealthSpace too complex, say academics - Smart
* Millions have online medical records 'without knowing it' - Telegraph
* Long-awaited report reveals 'insoluble' flaws in Summary Care Record rollout - PULSE
* Health e-records 'struggling to fulfil potential' -BBC
* Will Summary Care Records do more harm than good? - Computer Weekly
* SCR evaluation finds few benefits - EHealthInsider

I'm sure there will be lots more comment to come.

Labels: , ,