CHRTlines

September 7, 2010

Peer Reviewed or Not: A Reflection on How We Communicate About What Works (Blogging and All of That)

Marianne Udow-Phillips

Director
Center for Healthcare Research & Transformation

Labor Day ought to be a time to think and reflect on one’s work. This Labor Day I found myself thinking about this blog and the form of communication it represents. At the end of August, the New York Times ran an article about a change in the approach to publishing scholarly work in the humanities. The opening line of the article says:

“For professors, publishing in elite journals is an unavoidable part of university life. The grueling process of subjecting work to the up-or-down judgment of credentialed scholarly peers has been a cornerstone of academic culture since at least the mid-20th century.”

The article goes on to talk about some new approaches being tried in the humanities to publish in a more open environment: using the Internet to quickly get information out and get much broader feedback. Myriad new approaches are being tried for scholars to share their work on the web, get feedback, and broaden the dialog about whatever they are writing about. While the article is focused on the humanities, it raised a question in my mind about why such an approach couldn’t be used in other disciplines, such as health policy.

There is no question that peer review serves a valuable function of helping readers have confidence that an article has been assessed and found worthy by those knowledgeable in the field. It’s a kind of vetting process that can be very useful, and as noted in the New York Times, came about as a way of increasing the professionalism of academic disciplines.

At the same time, however, it is an extremely limiting process: many more articles are submitted for publication than ever see the light of day. And, while in some cases that may be because the articles were flawed in some fundamental way, it may also be simply because the article wasn’t on a topic relevant to or in a style appropriate for the journal to which it was submitted.

The traditional approach to vetting scholarly work is also a very lengthy: findings/insights are often delayed in reaching the public for six months to a year while articles are in review.

At CHRT, we have thought about whether we want to try and publish our work in traditional journals or distribute them through other means. For the most part, we have come down on the side of publishing the works ourselves and distributing the information widely. And, to date, our experience is that many more people are seeing and using our work (and, more quickly) than if we had waited to try and get it accepted in peer reviewed journals.

There is certainly a place for traditional journals and many of them are experimenting with getting things to the public more quickly. But, to do so, they have a tendency to rely on those individuals/scholars that they already know and whose work has already been established. While that can have great benefits in terms of quality control, it can also be enormously limiting in terms of bringing new voices and approaches to the table.

The challenges we face in health care are immediate and the answers aren’t clear: particularly when it comes to ideas to increase the quality of care, improve population health, and moderate cost trends. Being able to learn from others about what works and what has been tried is essential if we are going to make progress on these issues. And, in that context, those in health policy can learn from our colleagues in the humanities: new approaches to communication that distribute information quickly and widely and allow the reader to judge whether the information is of value may be just what we need to truly make progress.