The Business of Health Care

Healthcare: The Journal of Delivery Science and Innovation

Healthcare: The Journal of Delivery Science and Innovation, a new journal promoting cutting edge research on innovation in health care delivery, has launched. The questions is, do we really need yet another journal? The short answer is yes. The longer answer is, absolutely yes. Here’s why.

The Need for New Knowledge on Healthcare Delivery

There is an urgent need to improve our mess of a health care system. Healthcare will consume about $2.8 trillion in 2012 – that’s an astronomical amount of money.  To think of it in another way:  spending in Intensive Care Units will make up 1% of all economic activity in the U.S.  In a broader context, about 1 in 5 dollars in the economy will be spent on healthcare.

How will we actually spend the $2.8 trillion? Over a million doctors and nurses will see patients in hundreds of thousands of clinics, hospitals, nursing homes, and countless other settings.  They will see patients who are sick and suffering and will make decisions about how to help them get better.  These intensely personal decisions will be made in the context of a broader healthcare delivery system that is mindboggling diverse, complex, and fundamentally broken.  We are probably wasting more on healthcare than we are spending on education.  Yet, despite all this money and excess (or may be because of it), tens of thousands of Americans are dying each year because of poor quality, unsafe care.  We can do so much better.

Despite all of the attention on healthcare, we still don’t know how to make the system work better.  There are lots of good ideas and no shortage of smart people working on these issues.  We need a venue to see the smartest of these ideas get out.  We need a venue to see bright ideas about policy efforts that might make a difference, or delivery innovation that worked really well.

The Gap in the Existing Healthcare Journal Landscape

Of course, one might ask – aren’t there already venues for good ideas to be disseminated?  The answer of course is yes – but there are not nearly enough.  Not even close.

For a system as complex and messy as ours, the amount of learning we need to do to improve care is immense.  There are terrific journals like New England Journal of Medicine, JAMA, Annals of Internal Medicine, Archives of Internal Medicine and a few others.  They publish high impact research in this area, but they are general medical journals.  They can only dedicate a small amount of space to strategies that improve healthcare delivery.  They need to balance a study on how health IT can reduce medical errors with a randomized, controlled trial of the latest drugs that might change clinical practice.  The number of slots in these journals for high quality work on healthcare delivery is small.

On the other end, there is a journal like Health Affairs.  They are firmly in the health policy space, and have been tremendously impactful.  However, one journal, publishing monthly, can only cover so much ground and they have to leave so much good work behind.  Further, by focusing primarily on policy, they spend a lot less space on innovations in healthcare delivery.  There are others, such as the  BMJ Quality and Safety journal, which also publish important studies, but these typically have a more international focus.

Our goal is not to compete with these journals. We hope to become another important venue for high quality work, with a particular focus on delivery innovation.  Do you have a new way to improve population health?  Tell us about it.  Do you think a quality measure that we’re using is not improving healthcare delivery?  Show us the data.  Ultimately, we want to be a venue for authors as they consider innovative ways to tackle the incredibly complex healthcare delivery system.  We’re looking for data on solutions, but also opinions and synthesis of good ideas.

Our Promise

Why should you send your work to us?  We have three promises:

  • First, we will treat you with respect.  We will review your paper quickly and make a decision quickly.  If we make a commitment to taking a paper, we will work with you to make it as good as possible.  We will not ask you to make multiple sets of revisions and then reject it.
  • Second, we will publish your work quickly.  In its initial form we’ll be a quarterly journal and we’re still figuring out a web strategy.  However, our hope is that good work gets out there quickly in time for it to have an impact.  That’s what authors care about – and that’s what we care about.
  • Third, we will help you disseminate your work.  We not only have a great editorial advisory board, but we have relationships with key clinical leaders and policy makers.  If we think your paper is important enough to publish, then we think it’s important enough for us to email a copy to a key person who could benefit from your insights.  We are dedicated to ensuring that your work has impact.

One of my favorite quotations is one attributed to Vaclev Havel, the visionary and late President of the Czech Republic.  “Keep the company of those who seek the truth.  Run from those who have found it.”  We don’t know the truth about how we improve the healthcare delivery system.  We are seeking the path.  It’s a journey where will need everyone to play a role – clinicians, policymakers, clinical leaders, researchers, and yes, journals.  We hope to play an important role in that journey, facilitating the dissemination of good ideas, tested rigorously.  We hope you’ll give our journal a try and always let us know how we can do our work better.

Ashish Jha, MD, MPH is the C. Boyden Gray Associate Professor of Health Policy and Management at the Harvard School of Public Health. He blogs at An Ounce of Evidence. He will serve as a Senior Editor-in-Chief for Healthcare: The Journal of Delivery Science and Innovation. Submission is open now, and the first issue will be released in late spring 2013.

3 replies »

  1. Bill Hersh-You make a good point. Why not allow for open access? And how will this decision affect inclusion of NIH-funded studies (which this upcoming spring will be subject to scrutiny in terms of open access to be granted funding)?

  2. I agree that there is a great need for a new journal like this. But why publish it through Elsevier as opposed to some other more open publisher, or perhaps even an open access publisher?

  3. How timely though can a journal article be that will be published quarterly and will almost certainly use data that is either 2-3 years old? A quick review process would help maybe shave 1-2 months off the process.