BMJ  2006;332 (21 January), doi:10.1136/bmj.332.7534.0-f

Editor's choice

Singing the body electronic

Five years ago we began a monthly journal aimed at primary care doctors in the United States. BMJ USA comprised articles selected from the weekly BMJ by a US based editor, along with commissioned commentaries and editorials. Despite the journal's popularity with readers, we couldn't attract sufficient support from the US pharmaceutical market, and last month's issue was the last.

This week we start "US highlights"—assembled on the same principle as the print journal BMJ USA—but available solely in electronic form from the BMJ's website (http://bmj.com/us_highlights). The fact that BMJ USA's editor, Douglas Kamerow, remains the BMJ's US editor provides further continuity. In addition to selecting articles of interest to US doctors, he will be working to increase the number of such articles published in the BMJ.

If this cheap online model succeeds where the expensive print model failed, we could roll out "highlights" targeted at users in other countries. After the US our biggest non-UK markets for bmj.com are Australia, Canada, Italy, and Germany.

Could such an exercise in internationalism lead to a catastrophic change in the make up of the print BMJ from the point of view of UK readers? Not necessarily—the print BMJ, which goes mainly to UK doctors, could comprise material selected from bmj.com for its particular interest to the UK, just as the online "US highlights" is a selection of articles of US interest. The one place to find everything we published would be, as it is now, bmj.com.

As well as thinking more about what goes into the print BMJ, we think it's time to change its "look and feel." We've shortlisted three designs and we want readers to tell us which one they prefer. There's nothing new about consulting readers over such a crucial issue; last time we published the shortlisted designs in both the print journal and on bmj.com and received over 350 responses (although in those days postcards and letters outnumbered emails) (BMJ 1996;312: 232[Free Full Text]). This time we're posting the designs on bmj.com and we'd welcome your feedback.

If electronic developments have changed the way that scientific journals are interacting with their readers then it is nothing compared with how they will revolutionise the delivery of health care—once such developments have got off the ground. Connecting for Health, the UK initiative responsible for the world's largest civil IT project (costing £6.2bn) had an unhappy Christmas with its all important "spine" crashing after a software upgrade (p 139).

It's now embarking on a charm offensive— although many of its intended users will take a lot of convincing (p 180). Nearly two years ago, we published Nancy Lorenzi's advice on surmounting non-technical barriers to the introduction of information systems (BMJ 2004;328: 1146[Free Full Text]). Too bad this advice from Nashville, Tennessee, wasn't heeded when it could have made a difference.

(tdelamothe{at}bmj.com)

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