Open medicine in today’s research landscape

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Tell us a little about your background and qualifications

I run the medical information and education business at Wolters Kluwer, which includes the Lippincott journals portfolio (with top journals in medicine, nursing and allied health) and Ovid, the leading global aggregator for medical research content. In that sense, I’m involved in thinking about the future of medical information dissemination every day. I’ve previously led businesses in the legal space, life sciences and in education.  

What is your primary objective this year in your role as Senior Vice President and General Manager for the Medicine Segment of the Health Learning, Research & Practice business at Wolters Kluwer?

The portfolio that I manage has highly valued global solutions in markets ranging from research to education. My primary focus is driving a strategy to ensure that the social impact this group of businesses has can grow sustainably for the foreseeable future. 

Among our priorities this year are Ovid Synthesis and open access. Ovid Synthesis is a powerful new workflow solution aimed at hospitals, which we launched in January 2022 after several years of customer research. Ovid Synthesis enables hospital systems to take a structured, collaborative approach to drawing insights from published medical literature and translating them into improved clinical pathways that have a measurably positive impact on patient outcomes. Open access, of course, is the fastest growing segment of the peer reviewed literature market, and we are investing heavily to make open access more widely available to authors and clinicians in the medical space.  

What does open medicine mean today, and how have the FAIR guiding principles influenced it? 

Today, I would say that most people would equate open medicine with open access, which refers to making research papers free to read. I think that open access is a critical part of open medicine; while most clinicians in the United States, Europe and China have access to up-to-date medical literature through their university or hospital library, there are many clinicians in low- and middle-income countries (LMICs) who don’t, and who benefit when content is made openly accessible to them. But I think that open medicine goes far beyond open access and encompasses a range of other significant issues that need to be made a more central part of the conversation. 

For instance, I think that medicine cannot be viewed as truly open until high quality medical research can be conducted in all parts of the world, including LMICs. This will not only improve health outcomes in those countries, but also globally, because it is a core tenet of science that the greater the volume and the wider the origin of freely exchanged ideas, the more rapid the collective advance of knowledge. So, in my view, the open medicine conversation needs to include strategies on how to more widely disseminate funding and infrastructure for medical research. Another area of focus in open medicine that goes beyond open access is acceleration of techniques for translating research into practice. Medicine thrives when clinicians everywhere in the world incorporate innovations into their practice, which often lags 10 or even 15 years behind the publication of those innovations in peer reviewed literature. Shortening that lag time would have a profound impact on patient outcomes. This is where the FAIR principles become critical, because creating a broad culture of data-sharing is essential to shortening the timeframe for the medical community to test, validate and assimilate new ideas. Government policy and the role of NGOs and academic institutions must also be an area of deep focus for the open medicine community; translation of research into practice is much less a matter of information dissemination than a question of access to training, of incentives and of collaboration between institutions across the ecosystem. 

In your opinion, how can all stakeholders, including funders, institutions, publishers and researchers, collaborate to deliver on the collective benefit of research?

To begin with, all of the stakeholders can acknowledge that the task at hand is one that can only be tackled collectively and through collaboration, and can agree that the collective goal must be to improve global health outcomes. When the combined efforts of all stakeholders in the space can be united in pursuit of global health equity, tremendous progress can be made by ensuring that each stakeholder’s steps forward are purposefully complementary to the others’. For example, most of the global funding for medical research comes from a handful of governments and prominent non-profit institutions, almost all centred in the United States and Europe, and as a result most funding today is granted to researchers in those countries. Funders could make a concerted effort to distribute ever greater percentages of its grant-making to LMICs. But this would not have its full impact unless publishers make a meaningful commitment to establishing editors in those regions and developing business models that allow researchers there to publish their findings globally. But this will not succeed unless academic institutions in developed economies make long-term investments in collaborating with hospitals in LMICs to develop sophisticated research and translational capacity. Of course, none of this is relevant unless government policy in LMICs supports and properly rewards local clinicians who dedicate part of their time to conducting and disseminating research, on top of patient care duties. All of this illustrates why improving global health equity is challenging but also why it’s critical for the community to accept a common vision.  

What are your predictions for the advancement of global health equity?

Medical research is always advancing, and as key findings are disseminated around the world, they have a continually positive impact on people’s life outcomes. And yet the sobering reality is that there are backwards steps in global health as well, mostly due to geopolitics and climate change. For global health equity to become a reality, we must as a community accept that the challenge has to be approached in an interdisciplinary and collaborative way. There can be no long-term progress on global health simply through medical techniques or pharmaceuticals, for instance, if climate change continues to erode nutrition and access to water and healthcare for hundreds of millions of people. I believe the COVID-19 pandemic was a moment when the global community truly recognised that we share common threats that we can only address in concert. I’m optimistic and hopeful that all of the stakeholders in the space will engage in meaningful dialogue and agree on collaborative actions to advance global health equity steadily throughout the 21st century.

Vikram Savkar is Senior Vice President & General Manager, Medicine Segment, Health Learning, Research & Practice at Wolters Kluwer Health