Client Stories

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Customer case study: American Academy of Orthopaedic Surgeons (AAOS)

Medical education provider AAOS adopted Typefi Cloud to produce complex textbooks faster and more accurately while maintaining consistent and well-formed BITS XML.

The American Academy of Orthopaedic Surgeons (AAOS) is the preeminent provider of musculoskeletal education to orthopaedic surgeons worldwide, offering continuing medical education to over 36,000 members through events and courses, electronic and multimedia resources, journals, and a suite of scientific and medical textbooks.

AAOS publishes between six and ten textbooks each year, ranging in size from 300 to 1300 pages and containing highly detailed, technical and illustrative material.

Sample pages from an AAOS publication about sports-related injuries of the foot and ankle.

Some AAOS textbooks are published as series, with one main title supported by a range of smaller publications dealing with orthopaedic specialty areas. With new editions of each textbook or series released every one to five years, the publishing workload is high.

The challenge: Producing more content with less effort

Prior to 2014, AAOS authored and edited its textbook content in Microsoft Word, using Inera eXtyles to produce XML in BITS (Book Interchange Tag Suite)—an XML model for scientific, technical and medical books which enables publishers and archives to efficiently exchange book content.

At design stage, the completed XML file was imported into an XML-based layout program, where the production team created page layouts and printed them for review. Corrections were manually entered into the page layout until the content was finalised.

While the result was a well-produced textbook, the entire process was resource-intensive and prone to error.

The design software did not allow for the creation of reusable templates, and was not used widely enough in publishing to be accepted as industry-standard. Training for designers and production editors took place on the job, and the program was neither user-friendly nor intuitive.

Despite being XML-based, the design software did not keep the source XML parsed, which meant that the team had to run post-production scripts in order to revalidate the XML. This introduced potential for errors in the print-ready file.

There was also no easy way to bring the finalised content back into Microsoft Word from the corrected design files, making it difficult to maintain the master source content.

AAOS needed a new, user-friendly, single-source publishing system that retained valid XML throughout the production process—the more automated, the better.

The solution: Typefi Cloud

AAOS chose Typefi Cloud—the hosted version of Typefi’s enterprise publishing platform for medium to large organisations—to automate its book publishing process.

Typefi Cloud’s seamless integration with industry-standard software allowed AAOS’s editorial team to continue to author and edit content in Microsoft Word and eXtyles, while the design and production team switched from their cumbersome layout software to Adobe InDesign.

“Using InDesign was a welcomed change for the production team because we’re comfortable and confident with the product,” said Abram Fassler, AAOS Publishing Systems Manager. “Typefi Cloud is great; it’s all done over the web, and it connects to our Adobe Creative Cloud.”

An automated, streamlined publishing workflow

Typefi’s Professional Services team worked closely with AAOS to integrate modules which automatically handle sophisticated layout requirements such as colour changes, positioning of thumb tabs, tables spanning a two-page spread, and tables that extend beyond two pages.

A two-page spread from an AAOS publication showing a multi-page table.

The addition of the Typefi BITS Import module into AAOS’s publishing workflow ensured that valid BITS XML is maintained throughout the entire production process.

“The quality and consistency of the XML is extremely important,” Abram said. “Knowing that the XML is consistent and well-formed is a major bonus for Typefi.”

With the click of a button, AAOS’s editorial team sent a completed Word manuscript to Typefi Cloud, which automatically created InDesign page layouts in templates pre-prepared by the AAOS design and production team. Typefi Cloud then returned a PDF proof for review.

Corrections to content were made to the master source document in Word, and the automated process was repeated as needed until a final proof was ready.

The same content in more formats, faster

Within six months of implementation, the AAOS team had successfully produced three large textbooks of up to 600 pages. The design template for each textbook could be reused for smaller books in the same series, and for future editions of the same book.

“The time spent setting up one template is very cost-effective, because that will essentially be all our templates for that series,” Abram Fassler said.

“We’ve had really good success with Typefi Cloud. We’ve been able to publish three textbooks in a new system in six months. That’s no small feat.”

With its final content automatically produced in valid XML, AAOS could easily repurpose that content for different outputs including HTML and EPUB. According to Abram, having the option of producing e-books in-house alongside the printed textbooks is an unexpected bonus.

“We need EPUBs for our content; that’s going to be huge for us,” he explained. “The ultimate goal here is to produce more content with less effort.”


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