When nurses need to find out the latest drug information—whether to verify a dose, check for possible interactions with other medications or side effects—many of them turn to the "Nursing Drug Handbook." Making sure this critical information is accurate and clearly presented is the task of nursing and medical publisher Lippincott Williams & Wilkins (LWW), a unit of Wolters Kluwer Health, which produces the annual "Nursing Drug Handbook" as well as 4,000 other titles.
To streamline the process of publishing the 1,400-page "Nursing2006 Drug Handbook," LWW decided to switch from producing PDF pages using QuarkXPress to an XML-based publishing program. By doing so, LWW is cutting costs and avoiding recreating previously published documents. Its content can now be in several places at one time.
LWW would sometimes have to make editorial changes in as many as five places because of the use of multiple applications when producing content for several channels, according to Larry Bryant, LWW's director of content management processes. Since LWW repurposes content from the "Nursing Drug Handbook" into a "Drug Guide" and an electronic version for PDAs, the company felt that "Handbook" would be a logical choice for its initial trial of XML-based publishing.
"We saw how the market was changing in preparing and delivering content … moving away from print revisions to delivering content to different publishing channels in multiple formats," says Bryant, who was consulting for the company in mid-2003 when LWW decided on its pilot project.
LWW stores its content in XML in EMC Documentum's data repository and uses Arbortext's Epic Editor for editing the XML. The company is primarily a Windows environment, with some Macs used in the creative services departments.
LWW reviewed the capabilities of three XML publishing systems for six months, and chose XyEnterprise's XML Professional Publisher (XPP) because of its WYSIWYG (what you see is what you get) interface and the ability to control XML data until the end of the publishing cycle. "We needed to be able to deliver content in smarter ways, and XML gives us the flexibility to deliver to our customers' needs," according to Bryant.
After five months of evaluating various software solutions, LWW sent Bryant, a design operator who would make the changes in XPP, and a composition manager for two weeks of training with XyEnterprise. The company also purchased professional services to assist in translating the text into the stylesheets via XSLT (eXstensible Stylesheet Language Translation). XyEnterprise provided an on-site person, who proved invaluable in answering questions and instructing how to optimize the presentation of XML content.
Bryant says one of the advantages of XPP is its ability to contain adjustments to individual pages or lines without having the changes flow over into other sections of the document. LWW has developed its own rigorous rules for hyphenation and line breaks as well as baseline alignment of multiple columns. XPP was configured to automatically create near-final pages, but when operator intervention was required, the WYSIWYG interface simplified the editing process.
Keeping data in XML format throughout the editing process enabled LWW staff to make changes in Epic Editor and have them carried through into XPP, rather than making changes in multiple locations. Custom development for the project included setting up a "watched folder" to automate some of the stylesheet formatting. Files could be moved to a folder, and then scripts written in the Perl programming language would perform XLST transformations.
Symbol keys are used in the "Handbook" monographs to show important drug characteristics, but XPP smoothly handled the XML data flow from Arbortext. "The data is very complex and requires a tremendous amount of markup," Bryant says, but XPP successfully presented the tables and unique icons.
XPP is helping LWW to meet manufacturing requirements by enabling staff to estimate page counts earlier in the process. "With XPP's high-speed batch-pagination capability, we can learn well in advance of the publication date how many pages are in a particular set of content, which allows us to add or remove content as needed," Bryant says.
While the project was completed on time early this year, Bryant was initially concerned about meeting the production schedule while testing a new technology. "We were working with a set of content that had a very high-quality standard and was at the same time an important product for our customers."
Dollars Made Sense
Bryant says he can't disclose the cost of changing the publishing process, but he anticipates that the company will recoup its investment in two to three years. LWW received an immediate return in the cost of producing the PDA version of the "Nursing Drug Handbook." Bryant says now that XML is used throughout the publishing process, LWW has eliminated most of the $20,000 it spent annually on converting Quark files to XML for the PDA product.
Creating the PDA version of the "Nursing Drug Handbook" usually took several months. Now the electronic content can be synchronized to be released along with the print version, providing an important time-to-market benefit and getting the most up-to-date information in the hands of medical professionals sooner, according to Bryant.
The XML Transition
The pilot program is paying dividends in creating new processes that will streamline editorial workflow. LWW has created scripts that automate creating PDFs, enabling editors to instantly preview how the XML content, such as a drug monograph or a chapter of a book, will be presented.
Having successfully leveraged XML throughout a major publishing effort, LWW is evaluating how best to expand the use of XML Professional Publisher to manage and publish additional content for other products. The XML content from the "Handbook" will be reused for a derivative product, the "Nurse's Essential Drug Guide," says Bryant.
Also on the agenda is to use it to format the medical terminology content for the Stedman's dictionaries and specialized word books where rapid turnaround is very important.
John Gartner is a Portland, Ore.-based freelance writer and consultant. He is a regular contributor to Wired News and Technology Review.
Tips for Implementing an XML Publishing Solution
1. Build in extra time. Negotiating software licenses can take several months, especially if multiple vendors are involved.
2. Get on-site support. Questions invariably come up about producing stylesheets and data conversion, so pay for the technical expertise at the outset of project rather than dragging out the process.
3. Start with a single publication. It's better to get your XML processes perfected through one project instead of trying to enact a platform change on many fronts at the same time.
4. Pick the right project. Make sure that if your publication slips there will not be a ripple effect on other publications dependent on the data.
Snapshot: Lippincott Williams & Wilkins
Lippincott Williams & Wilkins (LWW) is a leading international publisher of professional health information resources for physicians, nurses, specialized clinicians and students. Nearly 275 periodicals and 1,500 books in more than 100 disciplines are published under the LWW brand, as well as content-based sites and online corporate and customer services. LWW is part of Wolters Kluwer Health, a leading provider of information for professionals and students in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.
Wolters Kluwer Health is a division of Wolters Kluwer, a leading multinational publisher and information-services company with annual sales, as of 2004, of more than $4 billion and approximately 18,400 employees worldwide.
Larry Bryant, director of content management processes at Lippincott Williams & Wilkins. Converting to an XML-based publishing program cut several months off production time for creating a PDA version of the "Nursing Drug Handbook" and eliminated most of the $20,000 it spent annually on converting files to XML.
A screen snap of the XML Professional Publisher (XPP) WYSIWYG editor. A full page from the Nursing Handbook is shown. The user can enter, delete, or reformat text as well as control the extent of the changes from this interface.