The closing day of the 2014 CSE annual meeting began with a plenary presentation by Howard Bauchner, MD, editor-in-chief of JAMA and the JAMA Network. Bauchner addressed a full room to discuss key points regarding changes in JAMA, the digital world, open access (OA), data transparency and sharing, and reflections on journals in general. He began by stating that his favorite day of the week when he was on the faculty of Boston University was the day that he spent in his office reading his print journals.

On the topic of JAMA, the following timeline highlights the rapid yet highly successful evolution to a digital world for the publication and its associated journals:

• September 2011: Launch of “Online First” (online publication ahead of print) for all journals, with time from acceptance to publication at 4 months.
• February 2012: Creation of the JAMA Network.
• May 2012: New Web site launched with SilverChair, capitalizing on semantic tagging; according to Bauchner, “search is still quite limited—the Holy Grail will be free-text search . . . but we are not quite there yet”.
• December 2012: Single submission portal for all journals, allowing authors to submit to JAMA and one other specialty journal simultaneously.
• March 2013: Debut of JAMA Network Reader, an HTML 5 app.
• July 2013: Redesign of all 10 journals, taking on a more traditional journal look, moving from artwork on the covers to a traditional journal style in which the table of contents is on the cover.
• December 2013: Statewide continuing medical education (CME) for all MDs.
• January 2014: Electronic–digital conversion complete.
• July 2014: Began online-only research publications.

Regarding the tradition of displaying artwork on the cover, JAMA received pushback from older physicians.

The JAMA Network removes the silo structure of the journals’ online presence, bringing all of them into a single network and renaming them with the JAMA brand. For instance, Archives of Dermatology became JAMA Dermatology. The JAMA Network also includes an eReader edition that is available free for all devices (smartphone, tablet, and desktop) and offers many dynamic electronic delivery features, including downloadability for offline reading.

With JAMA’s transition into a digital publishing world, more than 350,000 digital subscribers view over 25 million page views every year. When combined with social networkers, podcast listeners, video viewers, and CME participants, JAMA touches 500,000– 750,000 physicians worldwide each week.

On the topics of data sharing and transparency, which certainly have many complicated issues to resolve, Bauchner noted that data sharing has replaced trial registration and appropriate data analysis of randomized clinical trials as a major issue. Data sharing among organizations is an ethical imperative, but there is a sense of uncertainty in academe and industry regarding it. Bauchner affirmed that “we will get there”.

Bauchner asserted that OA is an important intellectual initiative. The OA distribution model has proved lucrative; Bauchner cited 2012 profits of $7 million for PLOS on revenues of $34.5 million.¹ Ethical aspects include the fact that OA publishing is not free and the question of whether a predetermined acceptance rate is necessary.

With regard to the overall climate of journals in 2013, there have been more changes in the last 10 years than in the first 100 years of scholarly publishing. Now journals are printed but also available as electronic products. And we will continue to move toward more creative uses of technology, data sharing, and new business models. Regardless of the complex relationships among industry, academe, and government as health care evolves, journals have a crucial role in the future of medicine.

After his talk, Bauchner responded to questions about the impact factor (the biggest concern is knowing what’s being counted, it needs to be more transparent, and it’s a metric that is more important outside the United States), about predetermined acceptance rates for OA journals when some OA fees are waived (publishers cannot survive without a minimum number of paid submissions), about JAMA’s vision of OA journals (“We debate that every year; the ultimate decision is mine, but at this time all our content is free on the JAMA Network Reader, and after 6 months, all our original research is free on our Web site”), and about the prospect of foreign-language editions of JAMA (they have been tried but ha ve been unsuccessful; “the international language of science is English,” and the JAMA Network Reader is important to low-and middleincome countries).

1. Van Noorden, R. PLOS profits prompt revamp. Nature. 19 November 2013.