Data from the Updated Cochrane review on Antibiotics for Acute Otitis Media.

Chris Cates has updated his excellent "NNT" digrams for the management of acute otitis media.  He's got these cool charts that help explain the concept of an NNT.  I use these in the office .. pulling up his site on the internet and walking parents through these concepts.  WHile 1st year medical students seem to have a problem with "NNT" — mom and dad seem to "get it" without too much trouble.

MGMA Center for Research – EMR study

Intereresting and useful reports on the barriers to Electronic Medical Records implenetation.

Top Barriers:

  • Lack of Resources to invest in IT
  • Time and effort to prepare the organization for EMR
  • Difficulty integrating systems
  • Difficulty establishing a good ROI
  • Lack of provider support
  • Skills and preferances of existing support staff

Coordinating Government Roles in Improving Healthcare Quality

Today, the IOM released another report on the state of medical care and medical errors.

"We strived to view the health system from the perspective of patients, especially those with chronic conditions, where a premium is placed on care that is coordinated over time, across settings, and across multiple payers. Such a coordinated focus requires government programs and health care providers to unify and standardize their quality-improvement efforts. Our report encourages the federal government to take full advantage of its influential position to set the quality standard for the entire health care sector"

It's compelling stuff, and deserves a careful read at the very least.  Their take-home message is a valuable one:  if we are going to have significant, coordinated progress in reducing medical errors, and improving efficiency, there needs to be clear, agressive federal leadership.

I think that this is another suggestion that the "free market" doesn't apply to healthcare.  While it may very well work for widgets and alkaline batteries and perhaps even corn meal .. healthcare .. and the enormous economies that are woven together around healthcare … is different.  I agree that we need to develop strong leadership to coordinate such an effort .. but .. as my former boss used to say .. "it's like herding cats."

AMEDEO: The Medical Literature Guide

"All AMEDEO services are free of charge. " Amedeo provides literature searches and updates via e-mail.   Pretty easy to use:  select your topic(s) of interest, and you will get a weekly e-mail update with a listing of newly published journal articles.