Top Five Reasons to Publish with Health Reform Observer – Observatoire des Réformes de Santé

  1. HRO-ORS addresses the big Canadian health reforms of our time -- what happened, how and why, and with what impact;
  2. HRO-ORS is edited by many leading health-system researchers from across Canada;
  3. HRO-ORS is designed for and successful in reaching top-level health-system policymakers and stakeholders across Canada;
  4. HRO-ORS is indexed in Health Systems Evidence, so more than 4,000 health-system leaders signed up for an evidence alert are notified when new HRO articles are published in their area of interest and more than 12,000 registered users (and many more unregistered users) will find HRO articles when searching for evidence about a particular topic;
  5. HRO-ORS charges no author fees or reader fees.

Focus and Scope

Health Reform Observer – Observatoire des Réformes de Santé is an open access, peer-reviewed, online journal presenting descriptive and comparative analyses of important reforms related to the governance, financing and delivery of health care (including public health care) in the Canadian provinces and territories. The journal aims to be a bridge between scholars and decision-makers and facilitate the flow of rigorous, evidence-based information and is successful in reaching top-level health system policymakers and stakeholders across Canada.

This initiative was born out of a recognition of the decentralized nature of the Canadian health systems and the need to support inter-jurisdictional learning. The journal publishes four types of content:

  • Provincial/territorial Health Reform Analyses (HRAs): These are short (max. 2,000 words), primarily descriptive articles pertaining to one salient health reform in a specific jurisdiction. Candidate reforms for HRAs may include: (i) proposed reforms that resulted in a “no-go” decision; (ii) reforms originating at the federal level such as those pertaining to First Nations and Inuit health care; and (iii) reforms originating at the regional level, if particularly far-reaching and significant in scale and/or emerge from a unitary health authority. HRAs will follow a standardized format to facilitate cross-issue and cross-jurisdiction analyses of Canadian health reforms and are peer-reviewed. See HRA GUIDELINES.
  • Comparative Health Reform Analyses (CHRAs): These longer (max. 4,000 words) analytic articles may include cross-issue and cross-jurisdiction comparisons of Canadian health reforms. The latter may include comparisons across provinces and territories or comparisons with reforms in other countries. CHRAs will follow a standardized format and are peer-reviewed. See CHRA GUIDELINES.
  • Letters to the Editor / Commentaries: In this category, HRO-ORS invites two types of contributions: Letters to the Editor are short, specific comments aimed at disputing, nuancing, or supporting and illustrating a statement made in an HRA, CHRA or a Network Editorial published by the journal. Commentaries are longer pieces prompted by a HRA or CHRA, and either provide background information or respond in some way to conclusions reached in a HRA or CHRA. Both letters and commentaries are peer reviewed and can be rejected or revised for resubmission, but are not subject to the guidelines for HRAs or CHRAs. 
  • Network Editorials are invited. They are reviewed by the Editorial Team and, in some instances, by the Editorial Board.

Should you have any questions about the suitability of your manuscript for submission to Health Reform Observer – Observatoire des Réformes de Santé, please feel free to email us at this address: health.reform.observer@gmail.com.

Peer Review Process

Health Reform Observer – Observatoire des Réformes de Santé operates a rigorous and open review process, meaning that the identities of both the author(s) and reviewers are disclosed to one another.  Our reviewers are encouraged to provide all prospective authors with constructive and timely advice regarding how to improve their manuscript regardless of their recommendation to accept or decline the manuscript for publication.

All submissions are screened by the editors to determine whether or not they should be sent for external review. If your paper is deemed unsuitable for the journal, it will be returned to you without being sent to review. A paper may be found unsuitable if it does not fit within the journal's focus and scope or it does not sufficiently follow the appropriate article format. (Please refer to "Section Policies" as well as HRA GUIDELINES and CHRA GUIDELINES.)

Once it has been determined that a submission is to be sent to review it will be assigned to two independent reviewers. Reviewers are chosen on the basis of their familiarity with the subject health care reform(s) as well as their availability for completing the review within the allotted time. The journal endeavours to complete the review process for Health Reform Analyses (HRAs) within 6-8 weeks and that for Comparative Health Reform Analyses within 10-12 weeks. Occasionally, either review process can take longer. We regret any delays that authors may experience during the course of the review process, as these are often out of our control.

Health Reform Observer – Observatoire des Réformes de Santé asks its referees to evaluate all manuscripts based on the following general criteria:

  1. Whether it represents a valuable new contribution to: the available evidence on a particular health care reform in a Canadian province or territory (HRAs), or the scholarly literature on comparative health care reform analysis (CHRAs).
  2. Whether it is accessible to both a scholarly and decision-maker audience.

Reviewers are asked to consider the usual questions of peer review, with an idea to improving the article through concrete suggestions for revision. These questions include:

  1. Does the article describe (and in the case of CHRAs, compare) in an accurate and fair way the following: history and context of the reform(s), goals of the reform(s), factors that brought the issue(s) to the agenda and influenced the policy choice(s), how the reform(s) was/were achieved, and evaluation plans/efforts?
  2. Does the article provide a concise and balanced analysis of the strengths, weaknesses, opportunities and threats of/to the health care reform (HRAs) or what can be learned about the linkage between processes, contexts, and outcomes (expected or demonstrated) from the compared reforms (CHRAs)?
  3. Does the article touch on the most important or salient points to be made about the health care reform (HRAs) or about the comparison of reforms (CHRAs)?
  4. Is the writing style clear and effective? Is information presented in a way that helps to clearly communicate the key points to the intended audience (i.e., scholars and decision-makers)?

Publication Frequency

Journal items are published as soon as they are ready by adding them to the current issue. An issue is "closed" at the Editors' discretion. Health Reform Observer – Observatoire des Réformes de Santé aims to publish 2-4 issues per year.

Open Access Policy

This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.

Publication Ethics and Publication Malpractice

Health Reform Observer - Observatoire des Réformes de Santé  strives to deliver high-quality, trusted content and to uphold the integrity of academic scholarship and publication. It operates a rigorous and open review process, meaning that the identities of both the author(s) and reviewers are disclosed to one another. The journal follows the Committee on Publication Ethics (COPE) Core Practices (formerly, Code of Conduct and Best Practice Guidelines for Journal Editors), the International Committee of Medical Journal Editors' (ICMJE's) Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals, and the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS 2). Editors, reviewers, authors and others involved in the publication process are expected to follow the best practice guidelines on ethical behaviour contained in these documents.

HRO-ORS recognizes that for research involving Indigenous Peoples authors are expected to uphold agreements that are in place as per TCPS 2 Chapter 9 and will reflect the direction of the agreements in authorship and/or the acknowledgements. Given the nature of research published in HRO-ORS, sub-chapters 9.15 and 9.2 of TCPS 2 are particularly relevant for authorship and acknowledgements.

Key responsibilities of authors, reviewers and editors include, but are not limited to, those highlighted below. All parties should consult the COPE, ICMJE and TCPS 2 guidelines for full details. COPE Flowcharts provide guidance to HRO-ORS's editors on addressing ethical problems.

 Responsibilities of Authors

  • Authors should ensure that they have written works that are independently created and make a novel contribution to the literature. If they have used the work, words, images (e.g., photos, charts and diagrams) and/or data of others, these have been appropriately cited and/or appropriate permissions have been obtained. Reusing one’s own previous writing without being transparent about this or appropriately referencing/quoting from the original (a practice known as self-plagiarism or "text-recycling") is unethical and unacceptable.
  • A paper should contain sufficient detail and references to permit others to replicate the work. Fraudulent or knowingly inaccurate statements constitute unethical behaviour and are unacceptable.
  • Papers describing essentially the same research or scholarship should not be published in more than one journal or primary publication. Corresponding authors should confirm in the Submission Preparation Checklist that manuscripts submitted to HRO-ORS have not been published elsewhere in identical or substantially similar form, nor that manuscripts submitted to HRO-ORS are in any portion under consideration elsewhere. Please note that HRO-ORS does not consider "publication" in a working-paper series or as an abstract only "prior publication." Authors should, upon submission, make this known to the editors, disclose the identity of previous peer reviewers, and provide a copy of the working paper or abstract.
  • Only persons who meet the following authorship criteria should be listed as authors in the manuscript: (i) made significant contributions to the work reported whether it is in the conception or design of the work, or the acquisition, analysis or interpretation of the data for the work; and (ii) drafted the manuscript or revised it critically for important intellectual content; and (iii) have seen and approved the final version of the paper and agreed to its submission for publication; and (iv) agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All persons who made substantial contributions to the work reported in the manuscript but who do not meet the criteria for authorship must not be listed as an author, but should be acknowledged in the "Acknowledgements" section after their written permission to be named has been obtained. Given the nature of articles published in HRO-ORS, this would particularly apply to policymakers or civil servants who provided information or advice on the specific aspects of the manuscript, but who do not take responsibility for authorship and conception of the manuscript. Corresponding authors should confirm in the Submission Preparation Checklist that all appropriate co-authors (according to the above definition) and no inappropriate co-authors are included in the author list. Corresponding authors should also confirm that all co-authors have seen and approved the final version of the manuscript and agreed to its submission for publication.
  • A member of the journal's editorial board or editorial team may submit articles for consideration, as sole author, lead author or co-author. To ensure that submissions authored or co-authored by a member of the journal's editorial board or editorial team receive an objective and unbiased evaluation, the member of the editorial board or editorial team who submits the article removes themselves from the editorial process. When a submission's author is a member of the editorial team, a member of the editorial board is assigned as the lead editor on the submission and one other member of the editorial board will be assigned to review the peer review process and editorial decision before it is communicated to the author(s).
  • Authors should disclose any financial, personal or professional relationships that could inappropriately influence (bias) their work.  Examples of such financial relationships include employment (working for the organization implementing the policy reform or for an organization with a vested interest in the policy reform) and consultancies/honoraria/paid expert testimony/grants or other payments. Examples of personal or professional relationships include a spouse/partner working for an organization implementing or with a vested interest in a reform, a role as a board member for an association representing affected organizations or a researcher whose work provided the intellectual justification for the policy reform or who has advocated personally for or against the reform (or related reforms). In addition, all sources of financial support for the work should be disclosed (including granting agency name, grant number or other reference number if any) even when there is no potential for bias.
  • Authors are obliged to participate in the peer review process by responding promptly to editors' queries and to the reviewers’ comments systematically, point by point, and in a timely manner, revising and re-submitting their manuscript to the journal by the deadline given.
  • When authors discover significant errors or inaccuracies in their own published work, it is their obligation to promptly notify the journal’s editors and cooperate with them to either correct the paper in the form of an erratum or to retract the paper. If the editors learn from a third party that a published work contains a significant error or inaccuracy, then it is the authors’ obligation to promptly correct or retract the paper or provide evidence to the journal editors of the correctness of the paper.

Responsibilities of Reviewers

  • Invited referees should agree to review only if they have the required expertise to give proper assessment of the submitted paper.
  • Invited referees who know they will be unable to complete the review promptly should notify the editors and decline the invitation to review so that alternative reviewers can be contacted.
  • Invited referees who have conflicts of interest resulting from competitive, collaborative, or other relationships or connections with any of the authors, institutions or organizations connected to the manuscript and the work described therein should immediately notify the editors to declare their conflicts of interest and decline the invitation to review so that alternative reviewers can be contacted.
  • Reviews should be conducted objectively and observations articulated clearly with supporting arguments so that authors can use them for improving the manuscript. Personal criticism of the authors is inappropriate.
  • Reviewers should identify relevant published work which is not cited by the authors. Any statement that is an observation, derivation or argument that has been reported in previous publications should be accompanied by the relevant citation.
  • Reviewers should notify the editors of any substantial similarity or overlap between the manuscript under consideration and any other manuscript (published or unpublished) of which they have personal knowledge.
  • Privileged information or ideas obtained through peer review must be kept confidential and not used for the reviewer’s personal advantage. This applies also to invited referees who decline the review invitation.

Responsibilities of Editors

  • Editors are accountable for everything published in their journal.
  • The Editor-in-Chief has full authority over the entire editorial content of the journal and the timing of publication of that content.  The Editor-in-Chief is responsible for deciding which of the manuscripts submitted to the journal will be published, based on academic merit, importance to researchers and readers, reviewers’ comments, and such legal requirements as are currently in force regarding libel, copyright infringement and plagiarism. The Editor-in-Chief may confer with other editors or reviewers in making such decisions.
  • Decisions to edit and publish are not determined by the policies of governments, the journal's sponsors, nor any other agencies outside of the journal itself.
  • Editors ensure that all submitted manuscripts being considered for publication undergo peer-review by at least two reviewers who are expert in the field.
  • Editors evaluate submitted manuscripts exclusively on the basis of their academic merit and relevance to the journal’s aims and scope, without regard to the authors’ race, gender, sexual orientation, ethnic origin, citizenship, religious belief, political philosophy, institutional affiliation, or relationship to the journal.
  • Editors, in conjunction with the Editorial Board and society, will take responsive measures when ethical concerns are raised with regard to a submitted manuscript or published paper. Every reported act of unethical publishing behaviour will be looked into, even if it is discovered years after publication. Editors follow the COPE Flowcharts when dealing with cases of suspected misconduct or disputed authorship. If, on investigation, the ethical concern is well-founded, a correction, retraction, expression of concern or other note, as may be relevant, will be published in the journal.
  • Editorial board members will actively contribute to the development and good management of the journal. 

 International Committee of Medical Journal Editors' (ICMJE's) Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals. Defining the Role of Authors and Contributors.

Sources of Support

Health Reform Observer – Observatoire des Réformes de Santé gratefully acknowledges the financial assistance provided by the Canadian Institutes of Health Research (CIHR) Institute of Health Services and Policy Research (IHSPR) in the form of the Spring 2012 Planning Grant Priority Announcement (Health Services and Policy Research) (Principal Applicant: Michel Grignon) as well as sponsorship of the keynote plenary panel "The Pan-Canadian Health Reform Analysis Network (PHRAN)" at the 2013 Conference of the Canadian Association for Health Services and Policy Research (CAHSPR). The journal was also supported by a grant from Health Canada / Santé Canada (October 2013 to March 2014).

It presently receives support from McMaster University Library Press, the North American Observatory on Health Systems and Policies, the Centre for Health Economics and Policy Analysis (CHEPA) at McMaster University, and the Institute of Health Policy, Management and Evaluation (IHPME) at the University of Toronto.

Journal History

Health Reform Observer - Observatoire des Réformes de Santé published its first article in July 2013. For the initial 15 months of its publishing history, the journal was available to readers via DigitalCommons at McMaster University Library. On 1 October 2014, the journal became part of Public Knowledge Project's Open Journal Systems and Escarpment Press (a new imprint supported and published by McMaster University Library). All issues previously available at DigitalCommons at McMaster University are available under the new imprint.