Thursday 27 September 2012

Breda Corish: From 20 Million Pieces of Content to a New Clinical Insight Engine: ClinicalKey

The first session at To Measure or Not to Measure: Driving Usage to Content - Marketing, Measurement and Metrics seminar was presented by Breda Corish, Head of Clinical Reference for UK and Northern Europe at Elsevier.

The focus was on publisher products that drive users to content. ClinicalKey is Elsevier's 'clinical insight engine', designed to think like a physician and provide information for diagnosis at point of care, the ability to share relevant answers and a resource to maintain knowledge with.

It took three years development work to develop a product platform to answer questions posed within a clinical care context. The scale of information overload is immense: back in the early 90s, the challenge for doctors was that medical knowledge doubled every 19 years. In 2008 this was down to 18 months. Now the forecast is that by 2020, it will double every 73 days.

This creates the doctor's dilemma: how to access trusted information quickly with a seamless experience. The challenge for Elsevier was how to unite 20 million pieces of content into one seamless experience including existing products such as MD ConsultJournals ConsultProcedures Consult, etc.

They started by understanding users. The 'mechanics' are driven by visual procedural content. Doctors are extremely time-pressed, require pre- and post-procedural care resource, with well-defined, fairly narrow, but deep information requirements.

They focused on understanding the patient care management workflow: from diagnosis to creating a care plan, from medical treatment to after-treatment care plans and patient education and compliance. They also identified collateral workflows for doctors on keeping current, sharing information and not working in isolation, but as part of a multi-disciplinary team.

Using this knowledge they moved from unstructured content to structured content and turned it into smart content and made it work in the clinical setting. They created the Elsevier Merged Medical Taxonomy (EMMeT) using 250,000 core clinical concepts, 1 million+ synonyms, 1 million+ hierarchical relationships and 1million+ ontological relationships.

Through concept mapping they focused on making vast amounts of content easily discoverable using speciality-specific navigation, dynamic clinical summary creation and meaningful related content recommendations. The semantic taxonomy was adapted for the clinical setting and semantic relationships are used to suggest other content (e.g. clinical condition, procedures, etc). Weighted tags are their 'secret sauce for better search'.

The smart content infrastructure is based on four areas:

Product development and enhancement

  • more accurage search results
  • faceted navigation
  • improved content discoverability

Content analytics

  • greater insights into what we publish
  • identification of co-occurring terms
  • link to related external content and data


  • individual content recommendations
  • targeted individual marketing
  • contextual advertising

Editorial productivity

  • flexible product types - new collections, image banks, etc.
  • increased speed to market

Usage tracking is based on usage events rather than page views. They have COUNTER-compliant content reports and monthly institution reports based on COUNTER filtering rules. They produce usage reports for different content types e.g. books, full-text articles, FirstConsult, Medline, Guidelines, etc. Every piece of content is tagged so they can produce usage reports. Usage event reports by month include analysis of: discovery (search, browse); content usage; and Advanced Tools usage.

With performance metrics they want to keep the number small for searches per content view as this is key to delivering relevant content quickly. They take insight from the usage reports on what search terms people are searching with and add them back into the product.

A recent Outsell report identified that the 'development of such taxonomies and their use to power the semantic enrichment of collecitons and aggregations of content will increasingly need to become core competencies for publishers further along the digital transition to higher value-added services.' This is something that Elsevier have engaged with directly.

Their plans for the future involve adapting for international markets using same content and powerful functionality, but adding in geographic-specific publications content. They are also looking at developing different interfaces for local languages. Even in cash-strapped health care systems around the world, there is still investment in IT. There is potential for mobile devices and tablets being used in hospitals. Doctors need information when they are on the move and not desk-bound.

They want to do more with content, more with features and functionality for doctors and end users, and develop product further for use any time, any place, any where. They are looking at how they can integrate their clinical or patient records portal or system so it's not disruptive to the experience e.g. developing query buttons to ping off to the other database. Something like 80% of hospitals in the UK are still in early stages of developing these services so there's great potential.

They are currently selling to institutions, but have recently launched a service for individuals - which focuses on their particular clinical specialism, with the option to add on. Overall, their aim is to hit the 'sweet spot' of being at the heart of comprehensive, trusted and speed to answer.

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