The Evolution of Fast Facts – Form Follows Function

Fast Facts is a series of handbooks that has been published for over 25 years covering various medical conditions. For over 10 years now, the series has included manuals not only for healthcare professionals, but also for patients and their supporters.

E-Books as a Complementary Medium

In the early years, the print version of the Fast Facts books was the authoritative format. The books were mainly distributed at medical congresses in the form of handouts and could also be purchased through bookstores. At congresses, they provided a convenient means of conveying congress-related topics while establishing themselves as a reliable source of information for HCPs.

Fast Facts were already available as PDF versions at that time, but only on request and not as E-Books that were freely available in stores. Thus, the distribution of Fast Facts was limited in terms of format and numbers.

E-Books as a Physical Format

Another variant that became popular over time in parallel with the distribution of printed Fast Facts was the PDF version on USB sticks in credit card format. These USB sticks were designed like the book covers of the Fast Facts themselves and could be equipped with additional information, for example from sponsors, in addition to the cover-to-cover PDF version of the books. The USB sticks provided a welcome alternative to the printed books, as they were easier for congress visitors to carry around and the PDF file itself could be shared.

This opening up of the publication format brought greater flexibility for the reader. For the publisher, giving away the electronic version also meant greater distribution, readership, and awareness.

Equivalence of Formats

Up until this time – we are in 2018 now – Fast Facts had been published as commissioned works, large print runs of which were ordered by clients and that were otherwise only requested in larger quantities through translation and rights agencies to be distributed for their clients. With the acquisition of Health Press by Karger Publishers, technical requirements and a distribution infrastructure were now available to make Fast Facts also available as full-fledged E-Books in HTML, PDF, and EPUB formats.

From 2019 on, readers could choose between the printed edition, online text, PDF for downloading and printing, or the format for E-Book readers, depending on their needs. For us and our customers, we had now achieved the maximum possible format diversity, which also went hand-in-hand with the greatest possible distribution of the content on various distribution channels.

Fragments and Derivatives

Especially in the area of patient information, there is a need for simplified presentation in a nutshell. Fast Facts for Patients and their Supporters often build on those for HCPs but are conceptualized in a condensed form. Another level of simplification, for example for use in medical practice, is offered by the Fast Facts Summary Sheets, two-page documents that live mainly from images with short explanations. This content was fragmented even further as “Patient Pictures,” a comprehensive series of explanatory illustrations that no longer exist as a stand-alone product, but which find further use in our patient blog The Waiting Room, for example outlining medical examinations in a very focused way.

A very different way of processing content has been emerging since 2020: beyond the basic flexibility of digital content, we are creating Fast Facts eLearning courses that allow us to not only make content available digitally, but to make it interactive, allowing users to move from reading to engaging with content.

Does a Book Remain a Book?

With all these changes – on the level of the medium while retaining the book format, and on the level of the format while retaining the content – the character of Fast Facts has not changed: in all formats and media forms, they offer reliable, concise information on diseases, diagnoses or therapies, always structured in largely the same way.

In the end, the book remains a book: we see the Fast Facts title in its usual form (whether printed or electronic) as the core of a Fast Facts project. It does not matter to us whether the project started in a different form of publication (e.g. eLearning) or whether the de facto book was never realized. What has changed is the question of which formats and media we actually publish in – you don’t publish a book for the sake of it, but to satisfy the demands of a readership.


This post is part of the mini-series “A Book is a Book”. Check out the introductory post.

A Book Is a Book Is a Book – or Is It?

Introduction to the Mini-Series

Karger Publishers’ first publication appeared in book form, the “Geburtshülfliche Vademecum” (a handbook for obstetricians) from the beginning of the 19th century. Since then, we have witnessed many developments in the book market, book production, and book distribution, and have been adjusting the screws on our operations ever since.

This mini-series will be showing how we as a publisher of scientific and specialist works have developed our book portfolio, what effects changes in the markets had, how we intend to deal with an ever-changing publishing environment in the future, and how these changes are also reflected on the part of authors and readers.

A Long History with some Harsh Changes

According to experts, the oldest printed book in the world is the “Diamond Sutra”, which dates from 868, making it a good 600 years older than the Gutenberg Bible. Yet long before the Diamond Sutra, handwritten texts were already being bound into books. Between the revolutionary introduction of the printing press in Europe and today, not much has happened that has not somehow been connected with the technical progress of printing.

It wasn’t until the late 1990s that eBooks began to gain momentum. Since then, many have pronounced the printed book dead. However, it quickly became apparent that eBooks in PDF-form were more of a supplement than a replacement for printed books. The next big change came with the introduction of books in HTML, EPUB and other formats, and the advent of eBook readers that could replace an entire print library. Yet meanwhile, the printed book still exists.

So where is the book going, what is a book anyway, and what does this mean for our scientific and specialist publications?

When Is a Book a Book?

There are, in fact, definitions of what a book is. For example, according to the UNESCO definition, a book is a non-periodical publication of at least 49 pages. More general definitions describe the book as a larger and bound printed work, or as literary or non-literary texts published in book form.

Form(at) Follows Function

So, if books have been around for so long and their purpose (multiplying and transporting information) and form are quite clear, why did the development of eBooks cause such a stir? How could it be that the very existence of the book was seen to be threatened by what were then new digital formats? Surely it takes a bit of fatalistic thinking to conclude that a format change could wipe out an entire cultural form.

Fiction still sells very well in print. The situation is different for technical and non-fiction books. The reasons are understandable: It makes a big difference whether I’m reading a book for relaxation or using it because I need further information quickly at work, or because I’m learning something new from scratch.

After the decades in which printed and electronic books have now lived side by side, it should be clear that the use – and thus the existence – of one format or the other is directly related to both the type of content and the form of use. Finally, personal preferences also play an important role when it comes to choosing between print, PDF, EPUB, databases, audio books, and many other formats.

Leveling Out Information Asymmetries Between Research, Practice and Patients

Research findings in the health sciences are at the core of improving health globally. Preparing these scientific findings for use in daily practice and making them available to a much broader audience of patients and the public is an important task that we’ve anchored in our strategy. 

The Cycle of Knowledge

The “Cycle of Knowledge” is the visualization of the field we work in. It outlines the research area where we’re active in publishing scientific outcomes and services around this vast area of work, but also encompasses the “translational” field where we transfer research knowledge to healthcare professionals, patients and the general public.  

karger cycle of knowledge

Knowledge traveling the Cycle

The Cycle of Knowledge also shows us that knowledge in health sciences can and should pass through different levels of the Cycle: the research level, the clinical level, and the patient level. This could start with research knowledge from a scientific article in a journal being transferred to the practitioner level, e.g. in one of our Kompass titles.  

From there, the same knowledge could further be transferred to the patient level, for instance in a blog post of The Waiting Room 

There are, of course, possible variations of the journey of knowledge through the Cycle: it could start as well on the practitioner level or only be transferred between two instead of all three levels. 

Transferring Knowledge Across Different Levels of Expertise

One goalof our portfolio strategy is to close the Cycle of Knowledge, meaning not only transferring knowledge through all or some levels of the Cycle but bringing the “far ends” of the Cycle together and starting the Cycle over by transferring knowledge “up” from the patient level to the research level.

Personalized Nutrition and Mascne – Two Examples of Closing the Cycle

Two recent cases serve as nice examples for this closing of the Cycle of Knowledge when research knowledge was transferred to the patient level and made it back to the research or clinical level:

From Research to Patient to Research

In The Waiting Room, we showcased an article from our journal Lifestyle Genomics: What Is Personalized Nutrition. We checked in with the journal’s editor and shared the post with him. He was impressed and thought this was an excellent idea, finding it to be a “fantastic learning resource”, which he promptly posted on his social media channels. To close the circle, the editor found other content in The Waiting Room that he immediately incorporated into his next lecture. 

From research to patient and back to (future) researchers — what a nice way to maximize value from our content!

Patient to Clinic

For The Waiting Room, we interviewed Sarah T. Arron on the topic of  “Digital Aging and Mascne in the Time of COVID-19”. The post raised interest on the Clinical Resources side at Karger Publishers, which lead to a German translation of the interview that found its way to a large audience of German dermatologists in our journal Kompass Dermatologie 4/2021. 

These are just two examples of what else we can do with the research we publish in our journals, and of the interest that a resource for a broad audience could have for clinicians. It is great to see peer-reviewed research content receiving an extra layer of added value by making it accessible to a broader audience, but also opening the door to content for the public as a way to spark discussions among a professional audience. 

Knowledge Defeats Fear! How We Contribute to Patient-Centricity

Being informed about one’s health helps against anxieties, enables better communication between healthcare professionals and patients, and creates possibilities for patients to better live with their disease. Our new children’s book is a good example of how a complex topic like leukemia can be explained to the youngest patients.

Patient empowerment is a central keyword in healthcare systems that are changing globally towards a patient-centric model. Putting the patient at the center of everything health-related seems logical but has not been a reality for many years. It’s been less than a decade since healthcare experts and different stakeholders of the healthcare ecosystem began remodeling their view on how healthcare should work – putting the main characters at the center of the stage instead of financial transactions.

Building Knowledge

Empowered patients – better yet, an empowered public – are able to play an active role in healthcare. The positive effects of better-informed patients are easy to understand: avoiding disease where possible, giving patients the possibility to better live with their disease, and enabling better communication between patients and healthcare professionals all have a positive impact on the healthcare system. Building knowledge is at the core of patient empowerment. However, educating patients and the public is not as simple as it might sound. Who’s responsible for this task? Who is to trust with the information shared? Where can such information be found and accessed?

Reliable and Up-to-Date Information

We saw good reasons to take on this role ourselves as a publisher and decided to dedicate a whole department to patient information and to de-mystify diseases, work against fake news, and spare people the anxieties of diagnosis by “Dr. Google”. As a publisher in the health area, we have access to the latest research in health sciences and abundant contacts to experts, medical associations and societies, and industry. This positioning in the healthcare ecosystem enables us not only to publish reliable, well-curated content for patients, caregivers, and the interested public, but also to collaborate with strong partners to distribute our patient information.

Knowing Your Audience

Each topic calls for a different way and format of communication to be helpful for our audience. We always need to consider age, level of education, regional factors, and others to make sure we “hit the right tone”. This was especially important for the children’s book “Frisst ein Krebs die Haare auf?” (engl.: Does the cancer eat my hair?). The book tells the story of the little leukemia patient Ela from the girl’s point of view. Written and illustrated by herself as project for her highschool diploma the young author Grit Brunner delivered a remarkable wealth of information for children with leukemia with her manuscript.

Book cover of "Frisst ein Krebs die Haare auf?", a picture book about leukemia

A picture book about leukemia. Text and illustrations by Grit Brunner.

Realizing this project not only gave us the opportunity to expand our patient portfolio in oncology, but also offered an excellent collaboration with a young talent. This is a project of the heart that we took on because we believe in the power and benefits of knowledge and good information. In this case, we hope to help little patients, their siblings and friends to better understand what leukemia is and what the treatment encompasses.

Publishing information for children is maybe the “supreme discipline” in a field as complex as patient information, where highly technical, scientific facts need to be transferred to a level of common understanding without compromising accuracy and correctness. After all, if young or old: it is always better to deal with something when one is well informed.

Joachim Flickinger

As the former Head of Clinical and Patient Markets, Joachim was responsible for the development of our portfolio of products and services for healthcare professionals and patients. His enthusiasm to make a difference in healthcare information is what drives him to finding the right content and formats for these audiences and bring them to life with his team.