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Cochrane:Global perspectives & challenges

A new strategy to 2020

MARK WILSON, CEOMonterrey, May 20th 2013

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Dramatic growth: contributors to Cochrane

• Today there are more than 28,000 contributors in over 100 countries worldwide.

• Of these, more than 23,000 are registered authors of Cochrane Reviews.

• In 2008 there were fewer than 10,000 registered authors; in 2001 fewer than 1,000.

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Dramatic growth: organisational infrastructure

• 14 regional Centres & 18 Branches

• 53 subject-based Review Groups

• 16 Methods Groups

• 12 thematic Fields & Networks

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Dramatic growth: Cochrane Review production

More than 5,300 Cochrane Reviews, 2,300 protocols and 690,000 CENTRAL records published on The Cochrane Library

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Dramatic growth: use of Cochrane evidence

Usage of The Cochrane Library grew globally by 25%

on 2011 in 2012

5,434,662 full text downloads of Cochrane Reviews in 2012

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But are we as global aswe think we are?

Africa2%

Oceania9%

Asia19%

Europe35%

North America32%

South America4%

Two-thirds of Cochrane Review downloads come from users in Europe and North America

Most authors come fromEurope and AmericaMost funding comes fromthe UK and USA

Content is primarily in English

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ChallengesContent

production and delivery

o Complex Cochrane Review production process that: • Makes it unattractive for authors to keep reviews up-

to-date or return to do another review;• Can be slow and burdensome for groups;• Is difficult to provide adequate training for, especially if

most authors are first-time and one-time;• Leaves us exposed to competitors who can produce

reviews faster, more simply and efficiently, and with a better author experience;

• Still leaves gaps in Cochrane Review topic coverage

o Improved ‘user experience’ needed: content presentation, delivery and usabilityo Incomplete global access to content

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o Inadequate provision, presentation and discoverability of content in different languages

o Knowledge translation gap: A need to improve the applicability and links of Cochrane evidence to health policy and practice

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ChallengesOrganisationCompleting the plane that has already taken offo Unrealised potential of contributors from non-English

speaking countries and LMICs

o Over reliance on income from sales of The Cochrane Library as publishing moves towards Open Access

o Squeezed research budgets worldwide affecting infrastructural funding to Cochrane groups

o Complex structure that is:• Overly reliant on individuals in positions of authority within

their own organisations: creating challenges of accountability and generational change

• Blurring responsibilities, slowing responsive and nimble approaches to a changing world

• ‘Inward- facing’: creating problems for advocacy, marketing & communications, fundraising, partnership development and increasing membership

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Responding to the challenges

Stick to the organisational principles that have served us so well for 20 years:

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Responding to the challenges

o The Collaboration has a reasonable strategic framework in place, but it needs to be updated and refreshed, with two critically important areas of change to take place:

o Focusing externally; and o Becoming more supportive, effective and efficient internallyo The vision and mission also need to be refreshed to reflect

more accurately our view of the world and how we intend to accomplish our goals

… but bring new focus and dynamism in a new:

Cochrane Strategy to 2020

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Cochrane strategy to 2020

OUR STRATEGIC GOALS (as they are currently expressed – before any changes are made)

1To ensure high quality Cochrane systematic reviews are available across a broad

range of healthcare topics2

To promote access to Cochrane Reviews and the other products of The Cochrane Collaboration

3New Goal on Cochrane’s External Focus

4To ensure an efficient, transparent organisational structure and management

system for The Cochrane Collaboration5

To achieve sustainability of The Cochrane Collaboration

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STRATEGIC GOAL 1To ensure high quality Cochrane Systematic Reviews are available across a

broad range of healthcare topics

BETTER REVIEWS: RELEVANT, TIMELY & OF HIGH QUALITY – REVIEWS THAT ‘CHANGE PRACTICE & CHANGE LIVES’: • Focus on quality throughout the production process: CRG reform and utilise

technology to achieve this• Much greater orientation on ‘end-user’ needs and questions: ‘Perfection is

the enemy of good enough’• Concentrate much more on ‘improving the Cochrane author experience’• Embrace the challenge of Cochrane becoming the ‘go to’ place for

synthesized evidence on health

Cochrane strategy to 2020

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STRATEGIC GOAL 2To promote access to Cochrane Reviews and the other products of

The Cochrane Collaboration

COCHRANE IS COMMITTED TO ‘OPEN ACCESS’ BUT ALSO ON ‘END USAGE’: • New publishing agreement a great step forward on OA – but move to

‘author pays’ won’t work for Cochrane - coming years working with research funders to find new, sustainable models

• Turning Cochrane into a truly global organisation – maintaining strength in its existing areas but investing more on translation of content

• Much greater focus on ‘usability’ of content – on products and delivery mechanisms which meet diverse needs

• TECHNOLOGY at the centre of this approach – Cochrane at the leading edge of using ‘Linked Data’ to produce innovative products and reach many more audiences

Cochrane strategy to 2020

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STRATEGIC GOAL 3A new Strategic Goal on external focus

PROMOTE THE UNDERSTANDING OF EVIDENCE-BASED MEDICINE IN GENERAL – AND COCHRANE IN PARTICULAR: • Cochrane needs a transformation in the way it engages with the outside

world – it has rested on belief that the quality of its content will be enough

• We need to listen and engage more – in a more structured and coherent way

• Advocacy: punching well below our weight - Cochrane must be a worldwide champion of EBM

• Partnerships central to this – can’t do it alone• Diverse Network means this is a challenge – but the right framework and

tools will get the right balance of coherent messages, with vitality & room for individual initiative (remaining iconoclastic!)

Cochrane strategy to 2020

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STRATEGIC GOAL 4To ensure an efficient, transparent organisational structure and management

system for The Cochrane Collaboration

EFFECTIVENESS & EFFICIENCY! • Recognising that the Collaboration needs to establish clear

accountabilities and responsibilities - governance/executive structure that supports the volunteer base better

• Investment in a central executive structure will provide better governance & membership support; product development and fundraising, communications, advocacy and external engagement; informatics and KM expertise

• A clear strategy; governance reform; an executive focus on ‘Output & Impact’ whilst nurturing and supporting the ethos and volunteer basis which is the basis of Cochrane’s unique place in the world

Cochrane strategy to 2020

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STRATEGIC GOAL 5To achieve sustainability of The Cochrane Collaboration

FUNDERS RESPECT & VALUE OUR WORK AND OUR OUTPUTS – BUT WE CAN’T RELY ON FUNDING CONTINUING: • Development of diversified new products and services essential – use of part of

strategic reserves for ‘game-changing’ investments to build reach & sustainability

• User-centric, external focus critical – partnerships vital• Existing model of revenues from the Cochrane Library must change with OA -

expansion and diversification of major fundersORGANISATIONAL LEADERSHIP TRANSFORMATION: • Collaboration network built on a generation of dynamic, resourceful leaders in

their field – challenge of leadership handover • Need to create a more diverse base of ‘members’ – becoming a true

membership organisation

Cochrane strategy to 2020

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GraciasSend us your comments & questions:

Mark Wilson: mwilson@cochrane.orgLucie Binder: lbinder@cochrane.org