Hello HIFA Forum!
I am a trauma surgeon, dissemination and implementation scientist, and public benefit corporation co-founder. My research focus for the last decade has primarily been rooted in understanding what clinicians do when they experience clinical uncertainty, and what they want from the resources they go to. I've had the privilege of partnering widely in these efforts.
In reflecting on the Impact of OA on health care, and my experience of OA as a healthcare professional/reader and researcher/author -
After years of querying different populations and defining the problem in different scenarios, I've come to believe the following things:
- The needs of the patient/provider (i.e. access to information) and the publishers (i.e. financial gain) are not aligned, and this systematically and structurally inhibits the flow of evidence into practice. There are 'outcome positive partners' in the space, including, for example, pharmaceutical companies that make products which are generic, time-sensitive, affordable, and according to the highest level of evidence life-saving (e.g. TXA, alteplase). The current system is organized around enormous financial gain for publishers (some of which have a higher profit margin than any industry besides the entertainment industry), and 'every system is perfectly designed to get the results it gets'.
- Just like the development of the internet, the introduction of genAI holds huge promise, and huge risk, and its use will likely bend towards profit-generation for industries except where persons whose incentives are aligned with the patient choose to take an active role in defining how/where/when genAI is used in the evidence to practice continuum. In other words, it will be new tech, in an old way (the old way being inequity).
- Given the current less than ideal options, and following the lead of a global Open Access champion (Gates' Ashley Farley), I favor publishing pre-prints and then in an APC-free journal, so as not to financially bolster a broken system.
Satire is often the most effective means of communication: https://www.youtube.com/watch?v=8F9gzQz1Pms
Its an honor to be part of the community and to learn from each of you! - Lacey
HIFA profile: Lacey N LaGrone is Associate Director of Trauma Medical Research, UCHealth, United States. Professional interests: Evidence to practice gap / dissemination and implementation science. Global health. Injury. Lacey is a member of the HIFA working group on open access. https://www.hifa.org/support/members/lacey lacey.lagrone AT gmail.com