William F. Garrity

Medpedia launches at the end of 2008.  It is (http://www.medpedia.com/index.php/Special:Medpedia/About)

... is an extraordinary global effort to collect, organize and make understandable, the world’s best information about health, medicine and the body and make it freely available on the website Medpedia.com. Physicians, health organizations, medical schools, hospitals, health professionals, and dedicated individuals are coming together to build the most comprehensive medical resource in the world that will benefit millions of people every year.

In association with Harvard Medical School, Stanford School of Medicine, Berkeley School of Public Health, University of Michigan Medical School and other leading global health organizations, the Medpedia community seeks to create the most comprehensive and collaborative medical resource in the world. Medpedia will serve as a catalog, database, and learning tool about health, medicine and the body for doctors, scientists, policymakers, students and citizens that will improve medical literacy worldwide.

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See this article from The Wall Street Journal's MarketWatch and this detailed post to TechCrunch. 

Medpedia offers to send you an email notification when the service is live. 

Here's a new paper from the National Bureau of Economic Research: 

http://www.nber.org/papers/w14159 

Influence, Information Overload, and Information Technology in Health Care 

James B. Rebitzer, Mari Rege, and Christopher Shepard 
NBER Working Paper No. 14159 

July 2008 

We investigate whether information technology can help physicians more efficiently acquire new knowledge in a clinical environment characterized by information overload. Our analysis makes use of data from a randomized trial as well as a theoretical model of the influence that information technology has on the acquisition of new medical knowledge. Although the theoretical framework we develop is conventionally microeconomic, the model highlights the non-market and non-pecuniary influence activities that have been emphasized in the sociological literature on technology diffusion. We report three findings. First, empirical evidence and theoretical reasoning suggests that computer based decision support will speed the diffusion of new medical knowledge when physicians are coping with information overload. Secondly, spillover effects will likely lead to "underinvestment" in this decision support technology. Third, alternative financing strategies common to new information technology, such as the use of marketing dollars to pay for the decision support systems, may lead to undesirable outcomes if physician information overload is sufficiently severe and if there is significant ambiguity in how best to respond to the clinical issues identified by the computer. 

© 2008 by James B. Rebitzer, Mari Rege, and Christopher Shepard. All rights reserved. Short sections of text, not to exceed two paragraphs, may be quoted without explicit permission provided that full credit, including © notice, is given to the source. 

From http://www.healthmap.org/about.php: 

HealthMap brings together disparate data sources to achieve a unified and comprehensive view of the current global state of infectious diseases and their effect on human and animal health. This freely available Web site integrates outbreak data of varying reliability, ranging from news sources (such as Google News) to curated personal accounts (such as ProMED) to validated official alerts (such as World Health Organization). Through an automated text processing system, the data is aggregated by disease and displayed by location for user-friendly access to the original alert. HealthMap provides a jumping-off point for real-time information on emerging infectious diseases and has particular interest for public health officials and international travelers.

The Dartmouth Biomedical Libraries are very active in supporting evidence-based medicine and healthcare.  (For instance, see http://www.dartmouth.edu/~biomed/institute2008/.) 

In the June 16, 2008, Scientific American (online) Community, is a post by Merrill Goozner, "Evidence-based medicine in Russia: the challenge and the hope."

MOSCOW – On my last morning in Russia, I dined with Vasiliy Vlassov, professor of research methodology at the Moscow Medical Academy and head of a small but feisty group of Russian physicians called the Society of Specialists in Evidence-Based Medicine. “We’re trying to get the government to cancel ineffective care,” he said.

Give me an example, I said as I bit into an inch-thick lox sandwich. “The salt rooms,” he replied without hesitation. A quick check online later found that halotherapy, or speleotherapy as it is sometimes called because aerosolized salt dust is administered in cave-like rooms, has been widely practiced in Eastern Europe for over 200 years. There are dozens of spas, including some in government-run hospitals and health clinics, offering the salt cure for almost every lung disorder, ranging from chronic pulmonary obstructive disease to seasonal asthma.

However, the practice, which has almost no following in the U.S., has never been systematically studied. The National Library of Medicine’s PubMed database contains just 14 citations for halotherapy – all written by Russian physicians and none involving a test on more than 138 patients. Most were on just a few dozen. “It is from the middle ages. It is nonsense,” Vlassov said.

It’s been nearly four decades since the Scottish epidemiologist Archie Cochrane introduced the concept of evidence-based medicine in the west. It spawned a worldwide movement among physicians called the Cochrane Collaboration. Committees were established to evaluate all the clinical trials in a given area of medicine and issue objective clinical practice guidelines. Many reformers in the U.S. believe getting physicians to use evidence-based “best practices” generated by independent groups like the Cochrane Collaboration as key to holding down health care costs, since it could eliminate many useless medical practices.

But whereas American physicians often must be persuaded to ignore powerful financial incentives and pay close attention to the evidence, their Russian counterparts face an entirely different problem. They don’t have the intellectual tools necessary to evaluate the evidence. The Cochrane Collaboration’s local chapter, which Vlassov headed, fell apart a few years ago. 

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From the June 5, 2008, The Economist (subscription may be required): 

Telemedicine comes home

Jun 5th 2008

Medicine: Telemedicine permits remote consultations by video link and even remote surgery, but its future may lie closer to home

FEW places on earth are as isolated as Tristan da Cunha. This small huddle of volcanic islands, with a population of just 269, sits in the middle of the South Atlantic, 1,750 miles from South Africa and 2,088 miles from South America, making it the most remote settlement in the world. So it is a bad place to fall ill with an unusual disease, or suffer a serious injury. Because the islands do not have an airstrip, there is no way to evacuate a patient for emergency medical treatment, says Carel Van der Merwe, the settlement’s only doctor. “The only physical contact with the outside world is a six to seven day ocean voyage,” he says. “So whatever needs to be done, needs to be done here.”

Nevertheless, the islanders have access to some of the most advanced medical facilities in the world, thanks to Project Tristan, an elaborate experiment in telemedicine. This field, which combines telecommunications and medicine, is changing as technology improves. To start with, it sought to help doctors and medical staff exchange information, for example by sending X-rays in electronic form to a specialist. That sort of thing is becoming increasingly common. “What we are starting to see now is a patient-doctor model,” says Richard Bakalar, chief medical officer at IBM, a computer giant that is one of the companies in Project Tristan.

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