According to Monique Fayad, senior vice president at Elsevier and publisher at OncologySTAT, Elsevier chose oncology for its first vertical portal for three reasons. First, "it was tied to our business model through the commercialization in the number of drugs in the pipeline and the significant research and commercial advertising interest. The second factor was the information intensiveness built into the disease. Third, there is a significant need for patient and physician collaboration which brings in the clinical trial component and the need for a platform to help facilitate it."

The more than 100 Elsevier medical journals in OncologySTAT include Lancet, Lancet Oncology, Breast, Lung Cancer, Cancer Letters, The American Journal of Medicine, Seminars in Oncology, Seminars in Radiation Oncology, Seminars in Hematology, Blood Reviews, etc. (A complete list of the Elsevier journals tapped for OncologySTAT appears at www.oncologystat.com/journals/index2.html.) For titles targeted at cancer, users could expect to retrieve all or most of the articles; for journals with a broader range, cancer-related articles will be selected for inclusion. Though many features on OncologySTAT are available to all, only registered users will be allowed to search, access, or download full-text articles. Since Elsevier does not publish all the leading cancer journals, OncologySTAT offers journal scans, consisting of substantive, lengthy (500–700 word) abstracts of important research articles published in 25 other leading journals, including the Journal of Clinical Oncology, Journal of the National Cancer Institute, CA: A Cancer Journal for Clinicians, Blood, JAMA, and the New England Journal of Medicine. (A complete list of these 25 journals, with links to each of their Web sites, appears at www.oncologystat.com/journals/Non_Elsevier_Journals.html.) A "What Patients Are Reading" section identifies stories on cancer and cancer treatment in the popular press, apparently to give medical professionals a chance to brace for calls. Clever.

The Cancer News Feeds section covers regulatory and drug approval updates from the Pink Sheet (the color of the FDC Reports dedicated to prescription pharmaceuticals and biotechnology), plus medical and conference news from the International Medical News Group, MDConsult, and Elsevier Global Medical News. A weekly InfoBLAST enewsletter covers key oncology news, research, and site content features. Conference coverage includes articles reporting—for registered users—on sessions at major medical conferences in the field, as well as calendars of upcoming events in both narrative and graphic formats.

The site also carries reference content, including "Spotlight" collections of information by 27 cancer types providing key information, such as news, journals, article scans, clinical texts summaries, patient handouts, and webinars. Text sections come from Abeloff’s Clinical Oncology (3rd edition, 2004). The site also carries chemotherapy regimens from the Elsevier Guide to Oncology Drugs and Regimens (2006), searchable by drug or cancer type, as well as the Professional Drug Monograph and Interactions database powered by Gold Standard. The site also carries downloadable patient handouts. A Practice Management section carries articles focused on tips and discussions of how to manage an oncological medical service.

The clinical trials content includes NIH government and public trials, more than 5,000 clinical trials from the National Cancer Institute, the World Health Organization’s International Clinical Trials Registry Platform, the European Organisation for Research and Treatment of Cancer Protocols database, the UK Clinical Research Network: National Cancer Research Network Portfolio database, the Cooperative Groups Coalition of Cancer Cooperative Groups, plus active trials from associations, leading cancer research centers, the pharmaceutical industry, etc. Clearly this section is designed to recruit candidates for clinical trials.

However, when it comes to broadening research outside the time limits of 1 year’s worth of Elsevier journal content or even outside of oncology into other medical subjects, OncologySTAT turns to every health researcher’s friend—the National Library of Medicine’s Medline. In this case, the version of Medline used consists of the one used by Scirus, Elsevier’s free Web sci-tech search engine. Click on a search result and you will find yourself inside PubMed.gov with all the possibilities which that site offers, including related article links and—in some cases—connection to the full text. You may even find links to Google Scholar offerings, if you dig deep enough. A general "All Sources" search in OncologySTAT produces a set of search results grouped in the following order: OncologySTAT journal citations, News Results, Patient Handout Results, then Medline Search Results. In the case of searches for pharmaceuticals, the Drug Reference may top the list.

Elsevier hopes that the site may grow more interactive and become a home for discussion of cancer research and therapy issues. Fayad said that Elsevier wanted a physician-only area to form a safe community. "There are lots of sensitivity and liability problems we have to work through. We need more information to help validate contributors, though we didn’t want to come out of the gate with that. But we will implement that within the next six months or so. We want to become a new way for discovery and communication among oncologists." Fayad indicated that Elsevier was even considering patient social networking.

At present, OncologySTAT offers forums, commentary, blogs, podcasts, surveys, and a video network of interviews with top researchers. At launch, OncologySTAT’s bloggers were Edwina Baskin-Bey, surgical resident at the Mayo Clinic, and Nicholas Genes, emergency medicine resident at Mount Sinai Hospital. But the site urged users to contribute input by entering a forum on an array of topics or starting their own blog provided Elsevier approved their credentials.

The service can provide channels for accredited and nonacredited eCME/CME programs with the potential for delivering live interactive educational programs or other educational content. Support for the OncologySTAT comes from some educational grants as well as sponsors and advertisers. In the future, the service hopes to build strategic alliance with recognized publishers, societies, and research organizations that can supply high-quality research articles, news, conference coverage, original content, and educational programs.

Business Strategy Implications

So, what do we have here? OncologySTAT seems a very handsome, efficient, useful tool for medical professionals who deal with cancer and, possibly, for the cancer patients and families of cancer patients who deal with the medical professionals. But a lot of the discussion about the new service seems to focus more on what it means for the future of the giant STM publisher Elsevier and its customers.

Some contend that OncologySTAT may lead to a drop in subscriptions to print publications or their subscription-based online equivalents. Such a migration might play into the hands of the dreaded open access advocates that seem to threaten all STM publishers. Clearly the Elsevier people intend OncologySTAT and any subsequent end-user vertical portals now in development or under consideration to add to their revenue flow, not cannibalize their current revenues.

The chance of OncologySTAT substituting for library or institutional subscriptions to print or Elsevier digital packages, such as Science Direct, range from minimal to nonexistent. For one thing, Fayad made it very clear that the journal offerings would never go back further than a year. The Medline searches may find earlier references, but OncologySTAT enables no links to library collections. Fayad said, "We have no plans for it, no live URLs, no detection of users at institutions. OncologySTAT is designed as a one-stop shop to stay current, but not as a hard core research tool."

The company’s announcement of the new service pointed out that there are more than 1 million oncologists, hematologists, oncology nurses, and other healthcare professionals involved in treating, caring for, or diagnosing cancer patients. And that’s in the U.S. alone. Those health professionals already rely heavily on the Web. According to Axel Grothey, M.D. and associate editor at OncologySTAT, "Oncologists who are classified as heavy online users may visit cancer-related Web sites four to five times per day to access the latest scientific information. Oncologists research the Web more often than any clinical specialty. …"

Fayad pointed out that the prices for Elsevier publications are much lower on the medical and health sciences side than those on the sci-tech side. When combined with discounted prices for individuals, as compared to institutional charges, and other significant discounts through scholarly society membership deals, prices for subscriptions were not that great. She also stated that more than 80 percent of oncology practitioners were in noninstitutional settings that probably did not have access to medical library or institutional collections. At this point, Elsevier hopes to add some 150,000 users to OncologySTAT within the first year of launch.

When it comes to estimating the probabilities of Elsevier’s success in applying an advertising supported model, the odds look pretty good. In 2006, according to a study by TNS Media Intelligence, pharmaceutical advertising posted a 13.8 percent increase in advertising expenditures over 2005. Although pharmaceuticals still rely most on television ads and other traditional outlets, expenditures for Internet advertisements topped expenditures for newspaper ads for the first time. As more and more individuals—including health professionals—turn to the Web for medical and health information, pharmaceuticals are expected to increase their Internet ad expenditures correspondingly.

OncologySTAT offers a number of marketing and promotional opportunities, including targeted advertising and sponsorship of specific site sections and content types. To help in the targeting, Elsevier aggregates information from registrants for general, anonymous, statistical manipulation. It also may share information with third parties, but only when registrants "opt-in" and agree to the sharing.

Fayad points out that "Elsevier already has significant relationships with pharmaceutical firms and their ad agencies through our journals, though mainly in print. One of our main reasons for the new program was inquiries from companies about our online offerings. We needed to be flexible. We need products and services to satisfy the needs. OncologySTAT is pulled by market forces; it fills an unfilled demand. Already we have proactive sales for the top ten pharmaceutical oncology companies that we’re going after directly."

As for future development of the site, Fayad indicated that Elsevier might examine Scirus’ open Web content in the future. The company is hoping to add more journals within the next few months and has begun approaching the sci-tech side of Elsevier to add more titles. She also indicated that Elsevier was evaluating several other areas for potential vertical portals. "We are waiting to see how OncologySTAT works out over the next six to 12 months. So far the receptivity on the commercial side has been good. We expect to do quite well. We will decide in a few months whether to plan another one. It takes a lot of time and energy. Some shortlist specialties under consideration fall in areas where Elsevier has a strong corpus of journal literature, areas like cardiovascular, psychiatry, neurology, and diabetes."