#hpm - Healthcare Social Media Transcript

6/27/12 1:20 PM

#hpm transcript
Healthcare Social Media Transcript
From: To: Wed Jun 20 18:00:00 PDT 2012 Wed Jun 20 19:15:00 PDT 2012 change time period

New ! Explore analytics for this time period: #hpm analytics Explore the world of healthcare social media: Healthcare Conferences - Healthcare Tweet Chats - Disease Hashtags Learn more about #hpm at The Healthcare Hashtag Project

nursefriendly

Wednesday #Healthcare #Tweetchats (all EDT): http://t.co/omhhurig 9p #dsma 9p #hpm 9p #mHealth 9p #premeded 9p #SocMedChap #nurseup
Wed Jun 20 18:00:20 PDT 2012

_lizzy_

@aliciabloom Hi! Sorry to steal your tweet...it kept telling me it was too long #Hpm
Wed Jun 20 18:00:46 PDT 2012

aliciabloom

welcome to #hpm chat! let's get started with some introductions. . .

Wed Jun 20 18:01:06 PDT 2012

aliciabloom

@_lizzy_ haha! no worries. #hpm

Wed Jun 20 18:01:29 PDT 2012

MarksPhone

Mark here #Hpm

Wed Jun 20 18:01:56 PDT 2012

aliciabloom

hi @MarksPhone! glad you're joining us. #hpm

Wed Jun 20 18:02:41 PDT 2012

_lizzy_

Hi! Lizzy Miles from Columbus Ohio. Active hospice volunteer, msw/lsw, thanatologist and passionate about eol care and #Hpm
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#hpm - Healthcare Social Media Transcript

6/27/12 1:20 PM

Wed Jun 20 18:03:25 PDT 2012

aliciabloom

MSW, LSW practicing in #hpm. i'll be your host tonight! #hpm

Wed Jun 20 18:04:27 PDT 2012

TexasKidDoc

I'm here - Pediatric Resident in TX. Will be in and out. Trying to do my laundry too! #hpm
Wed Jun 20 18:04:46 PDT 2012

ctsinclair

Hi everyone. Christian Sinclair here. Palliative care doctor, blogger. In Kansas city #hpm
Wed Jun 20 18:05:03 PDT 2012

aliciabloom

welcome @TexasKidDoc! glad you're here, even if it's in between wash cycles :) #hpm
Wed Jun 20 18:05:36 PDT 2012

_lizzy_

@TexasKidDoc I am doing laundry as well! #Hpm

Wed Jun 20 18:05:37 PDT 2012

ctsinclair

Hey @texaskiddoc glad to see your name again. Hoping @haslingerppc or @kukidshp join us for #hpm chat, maybe a special peds edition? #hpm
Wed Jun 20 18:06:05 PDT 2012

aliciabloom

@ctsinclair is here! #hpm

Wed Jun 20 18:06:05 PDT 2012

ctsinclair

@_lizzy_ Hooray for advocacy and household chores! #hpm

Wed Jun 20 18:06:29 PDT 2012

nursefriendly

Hello Everyone, Andrew Lopez, RN from New Jersey :) #hpm

Wed Jun 20 18:06:35 PDT 2012

TexasKidDoc

Glad to join again. would love special peds edition! Kids are extra awesome. ;) #hpm
Wed Jun 20 18:07:16 PDT 2012

aliciabloom

pre-T1: read the overview & we'll discuss: new study to test the value of a checklist in advance care planning (http://t.co/PoJop6aM) #hpm
Wed Jun 20 18:07:55 PDT 2012

_lizzy_

@ctsinclair @texaskiddoc. I too was excited to see the peds focus. I am on other end so it would be nice to learn more about peds #Hpm
Wed Jun 20 18:08:03 PDT 2012

JenLBose

Hi all, Jen Bose- Marketing @aahpm in WI #hpm

Wed Jun 20 18:08:09 PDT 2012

http://hashtags.symplur.com/healthcare-hashtag-transcript.php?ha&smin=0&tdate=06-20-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1

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6/27/12 1:20 PM

AfternoonNapper

Hi to all. #hpm
Wed Jun 20 18:08:16 PDT 2012

TexasKidDoc

@_lizzy_ lights or darks? I just put in a cycle of reds, which felt extra special. It's the simple things. #hpm
Wed Jun 20 18:08:26 PDT 2012

aliciabloom

@TexasKidDoc @ctsinclair @haslingperppc @kukidshp would love to see us do a special peds edition of chat! #hpm
Wed Jun 20 18:08:55 PDT 2012

aliciabloom

hi @JenLBose & @AfternoonNapper-- glad you're both here! #hpm

Wed Jun 20 18:09:15 PDT 2012

PracticalWisdom

MT @VillageMemorial: Giving life 2 #language of #death - choosing vocabulary 4 dying http://t.co/PisAZOYf #eol #hpm #DWDchat #choice
Wed Jun 20 18:10:36 PDT 2012

PracticalWisdom

MT @NHPCO_news: #NowHiring Nursing Career Fair | Hospice & Palliative Care Charlotte Region: US - NC Pl... http://t.co/F5yA40j5 #hpm #jobs
Wed Jun 20 18:11:17 PDT 2012

TexasKidDoc

T1 - I'm a big checklist fan (and Atul Gawande fan with his checklist manifesto!) Doctors think in checklists, at least I do most days #hpm
Wed Jun 20 18:11:20 PDT 2012

aliciabloom

here's our pre-T1: new study to test the value of checklist in advance care planning (http://t.co/PoJop6aM). quick read & we'll discuss #hpm
Wed Jun 20 18:11:22 PDT 2012

ctsinclair

Excited about the first topic tonight! #hpm

Wed Jun 20 18:11:32 PDT 2012

ctsinclair

@PracticalWisdom Miss you in chat, come join us! #hpm

Wed Jun 20 18:11:53 PDT 2012

_lizzy_

@TexasKidDoc lol just one load of darks in dryer. #Hpm

Wed Jun 20 18:11:54 PDT 2012

aliciabloom

yay! me too! RT @ctsinclair: Excited about the first topic tonight! #hpm
Wed Jun 20 18:12:21 PDT 2012

aliciabloom

agree! join us RT @ctsinclair: @PracticalWisdom Miss you in chat, come join us! #hpm
Wed Jun 20 18:12:30 PDT 2012

http://hashtags.symplur.com/healthcare-hashtag-transcript.php?ha&smin=0&tdate=06-20-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1

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MarksPhone

What is interesting in that to me is the assumption the patient & family agree or understand what their goals are. Not sure most do #hpm
Wed Jun 20 18:12:32 PDT 2012

_lizzy_

T1 i think it is a good start, but I think it would be difficult for the contemplative types. These are not simple decisions. #Hpm
Wed Jun 20 18:13:36 PDT 2012

ctsinclair

What intrigued me in reading this article is learning about the Intl Society for Adv Care Planning and EOL Care. Never heard of it #hpm
Wed Jun 20 18:13:56 PDT 2012

aliciabloom

T1: after reading about the proposed study to assess the value of EoL checklist, please share initial thoughts & then we'll drill down #hpm
Wed Jun 20 18:13:58 PDT 2012

AfternoonNapper

Checklists at least provide a list of things to be contemplated. @_lizzy_ #hpm

Wed Jun 20 18:14:28 PDT 2012

MarksPhone

I begin at the point patients and family are tone deaf to assimulating new knowledge facing terminal illness #hpm
Wed Jun 20 18:14:30 PDT 2012

aliciabloom

MT @TexasKidDoc: I'm a big checklist fan (and Atul Gawande fan with his checklist manifesto!) Doctors think in checklists #hpm
Wed Jun 20 18:14:43 PDT 2012

rlanzara

RT @PracticalWisdom: MT @VillageMemorial: Giving life 2 #language of #death - choosing vocabulary 4 dying http://t.co/PisAZOYf #eol #hpm ...
Wed Jun 20 18:15:31 PDT 2012

MarksPhone

Check lists work in medicine that is proven, surgery, procedures etc. Here we are integrating chklist w/human emotions #hpm
Wed Jun 20 18:15:47 PDT 2012

aliciabloom

wonder if EoL checklist will make addressing issues about goals of care more accessible for physicians, who often think in checklists #hpm
Wed Jun 20 18:16:06 PDT 2012

_lizzy_

@AfternoonNapper Agreed... As long as it is not expected to be completed in one setting. I come from comm background too. #Hpm
Wed Jun 20 18:16:16 PDT 2012

MarksPhone

@aliciabloom that's a great point it can be a two way learning tool as well. #hpm
Wed Jun 20 18:16:46 PDT 2012

nursefriendly

@MarksPhone #Checklists are often ignored by #doctors #nurses #healthcare professions.

http://hashtags.symplur.com/healthcare-hashtag-transcript.php?ha&smin=0&tdate=06-20-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1

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6/27/12 1:20 PM

Need better adoption rates. #hpm

Wed Jun 20 18:17:23 PDT 2012

AfternoonNapper

@_lizzy_ Agree. I'm the kind who spends a lot of time breaking down the meaning of questions/wording. #hpm
Wed Jun 20 18:17:35 PDT 2012

MarksPhone

Another point to consider is when to implement it? #hpm

Wed Jun 20 18:17:42 PDT 2012

ravipm2000

Hi.I'm Ravi Maharaj, pall care fellow in Madison,WI #hpm

Wed Jun 20 18:17:57 PDT 2012

JenLBose

T1 Checklists will at least bring up the topic, regardless if the patient can digest it at the time. It's something to think about #hpm
Wed Jun 20 18:18:01 PDT 2012

_lizzy_

T1 I have seen hospice w/ 29 documents in admission packet. I am always worried about info overload. But reminder for MD is good #Hpm
Wed Jun 20 18:18:03 PDT 2012

aliciabloom

i think checklists could serve as a good framework for goals of care discussions-- gives physician & patient/family a starting point #hpm
Wed Jun 20 18:18:06 PDT 2012

fischmd

Not surprised ppl fear running out of $, losing independence & disability more than death. http://t.co/WZqxUZgr RT @dianeemeier @50PLUS #hpm
Wed Jun 20 18:18:10 PDT 2012

nursefriendly

@aliciabloom At the very least, using #checklists give a starting point for the discussion on end of life options. #hpm
Wed Jun 20 18:18:44 PDT 2012

TexasKidDoc

Peds specific issue, maybe more common too- at my hosp we only ask about code status in the ICU. Not even a start of a convo for others #hpm
Wed Jun 20 18:18:49 PDT 2012

ravipm2000

Checklists are great in medicine. The physician needs to add some style to make any list more of a conversation. #hpm
Wed Jun 20 18:18:50 PDT 2012

ctsinclair

I knew dr.block & gawande had been collaborating since his article "letting go." I was wondering if a checklist about eol would come up #hpm
Wed Jun 20 18:19:32 PDT 2012

_lizzy_

T1 in studies like these, i wonder if they do a pretest with a few docs first to work out kinks? #Hpm

http://hashtags.symplur.com/healthcare-hashtag-transcript.php?ha&smin=0&tdate=06-20-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1

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Wed Jun 20 18:19:43 PDT 2012

fischmd

RT @dianeemeier: Hospitalization markedly increases risk of death/decline in #dementia. http://t.co/4DRHyRY6 #palliative #hpm
Wed Jun 20 18:19:45 PDT 2012

aliciabloom

study will train Oncologists to use the serious illness communication checklist with patients @ "earlier stage in the disease process" #hpm
Wed Jun 20 18:20:12 PDT 2012

MarksPhone

There is a reality CAPC study showed that about 70% patients didnt have a clue about palliation and nearly and equal number of hcp #hpm
Wed Jun 20 18:20:22 PDT 2012

ctsinclair

We obviously have to be careful of checklist-mania but for high impact procedures and treatments including goals of care)-great idea! #hpm
Wed Jun 20 18:20:32 PDT 2012

lsaldanamd

RT @fischmd: RT @dianeemeier: Hospitalization markedly increases risk of death/decline in #dementia. http://t.co/4DRHyRY6 #palliative #hpm
Wed Jun 20 18:20:58 PDT 2012

ravipm2000

T1. The docs should have training in communication or else this checklist will become impersonal and robotic. #hpm
Wed Jun 20 18:21:12 PDT 2012

aliciabloom

@ctsinclair seems to me like Dr. Block + Dr. Gawande = ideal collaboration for this kind of study #hpm
Wed Jun 20 18:21:16 PDT 2012

aliciabloom

RT @ravipm2000: Checklists are great in medicine. The physician needs to add some style to make any list more of a conversation. #hpm
Wed Jun 20 18:21:28 PDT 2012

ctsinclair

RT @_lizzy_: T1 in studies like these, i wonder if they do a pretest with a few docs first to work out kinks? "most likely" #hpm
Wed Jun 20 18:21:38 PDT 2012

TexasKidDoc

adding checklists like smoking questions made it normative and nonjudgmental. Important step for EOL care too. Universal conversations #hpm
Wed Jun 20 18:22:01 PDT 2012

aliciabloom

@ctsinclair absolutely! goals of care discussions involve emotion & do not always occur in a methodical way #hpm
Wed Jun 20 18:22:03 PDT 2012

ctsinclair

@_lizzy_ most likely a small pilot study presented as posters, but then a larger grant funded study follows like this #hpm
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#hpm - Healthcare Social Media Transcript

6/27/12 1:20 PM

Wed Jun 20 18:22:30 PDT 2012

aliciabloom

@_lizzy_ the participating Oncologists will have a 2 1/2 hour training session about using the tool-- should work some kinks out. #hpm
Wed Jun 20 18:22:49 PDT 2012

_lizzy_

@ctsinclair Yes, just read that it was piloted and fine-tuned #Hpm
Wed Jun 20 18:23:19 PDT 2012

ctsinclair

@TexasKidDoc Great point about normative and nonjudging, similar to comprehensive sexual history in teens, adults #hpm
Wed Jun 20 18:23:46 PDT 2012

ctsinclair

RT @ravipm2000: T1. The docs should have training in communication or else this checklist will become impersonal and robotic. #hpm
Wed Jun 20 18:24:02 PDT 2012

aliciabloom

Dr. Block says We need to ask the right questions." What are your thoughts on the proposed questions highlighted in the study summary? #hpm
Wed Jun 20 18:25:18 PDT 2012

TexasKidDoc

important to note that this is happening at Harvard with MA's new EOL care discussion law #hpm
Wed Jun 20 18:25:22 PDT 2012

ctsinclair

@ravipm2000 I see the checklist as a process (was this done) and outcomes tool (what was the end result), not how to instruction guide #hpm
Wed Jun 20 18:25:23 PDT 2012

ctsinclair

@fischmd join us in hpm chat tonight! #hpm

Wed Jun 20 18:25:45 PDT 2012

_lizzy_

T1 the article did not mention if training would include whether/how MD would advise on intervention intensity...hot topic lately #Hpm
Wed Jun 20 18:26:04 PDT 2012

aliciabloom

great, interesting point! RT @TexasKidDoc: important to note that this is happening at Harvard with MAs new EOL care discussion law #hpm
Wed Jun 20 18:26:10 PDT 2012

MarksPhone

http://t.co/hbEI4rSW 2011 Public Opinion Research on Palliative Care If this helps to overcome barriers to care it is perfect #hpm
Wed Jun 20 18:26:27 PDT 2012

aliciabloom

good point @_lizzy_. what could the physician/clinician bring to the checklist discussion? #hpm
Wed Jun 20 18:27:16 PDT 2012

http://hashtags.symplur.com/healthcare-hashtag-transcript.php?ha&smin=0&tdate=06-20-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1

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ctsinclair

@TexasKidDoc in chronic serious illness in peds rarely seeing addressed adv care planning. Not today, always tomorrow. #hpm
Wed Jun 20 18:28:09 PDT 2012

ctsinclair

RT @AfternoonNapper: Checklists at least provide a list of things to be contemplated. @_lizzy_ #hpm

Wed Jun 20 18:28:39 PDT 2012

_lizzy_

T1 well, a lot of patients still look to their doctor for advice. If they turn ?'s back on MD, how should the MD respond? #Hpm
Wed Jun 20 18:29:36 PDT 2012

aliciabloom

Another question for this T1: What are your thoughts on the proposed questions highlighted in the study summary? #hpm
Wed Jun 20 18:30:19 PDT 2012

_lizzy_

t1 don't get me wrong, I am in support of the checklist...just thinking of the next steps after implementation #Hpm
Wed Jun 20 18:30:35 PDT 2012

aliciabloom

it seems like checklist aims to focus on goals, values & preferences as opposed to which procedures someone wants or doesn't want... #hpm
Wed Jun 20 18:31:27 PDT 2012

ravipm2000

@_lizzy_ the physician would have to look at the patient's goals and advise according to what the pt views as important. #hpm
Wed Jun 20 18:31:56 PDT 2012

MarksPhone

I keep thinking dont throw good to achieve perfect. Any where we can start this discussion w/pat w/family is a success #hpm
Wed Jun 20 18:32:17 PDT 2012

_lizzy_

@aliciabloom i like the ?s. intervention v time is going to come back to MD...with age-old question "how much time do i have?" #Hpm
Wed Jun 20 18:32:47 PDT 2012

aliciabloom

yes! RT @ravipm2000: physician would have to look at the patients goals and advise according to what the patient views as important. #hpm
Wed Jun 20 18:32:52 PDT 2012

rhgerard

JAMA:| Challenges of Do-Not-Attempt-Resuscitation OrdersReply: http://t.co/bxmZ6Vaa #hpm #hospice #geriatrics

Wed Jun 20 18:33:16 PDT 2012

ctsinclair

@aliciabloom Could you rt link to the study? #hpm

Wed Jun 20 18:33:35 PDT 2012

http://hashtags.symplur.com/healthcare-hashtag-transcript.php?ha&smin=0&tdate=06-20-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1

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6/27/12 1:20 PM

ctsinclair

@_lizzy_ prognosis is always the tricky bit! Need more research here! #hpm
Wed Jun 20 18:34:05 PDT 2012

ravipm2000

MT @aliciabloom: it seems checklist aims to focus on goals/ prefs opposed to which procedures someone wants or doesnt want... #hpm
Wed Jun 20 18:34:13 PDT 2012

aliciabloom

here's the link- http://t.co/RfDtnNDf #hpm

Wed Jun 20 18:34:53 PDT 2012

_lizzy_

@ctsinclair agreed... This will spark more prognosis questions, I think...but maybe more realistic conversations too #Hpm
Wed Jun 20 18:35:30 PDT 2012

aliciabloom

this is a tricky ?- "How much medical intervention they are willing to undergo to gain more time"- will really need to unpack it #hpm
Wed Jun 20 18:35:40 PDT 2012

ctsinclair

Ack, gotta go gang. Sick kid upstairs. #hpm

Wed Jun 20 18:36:38 PDT 2012

MarksPhone

If at the time of dx the oncologist begins shared decision making a scaffold is begun to build on all of this is SDM I think #hpm
Wed Jun 20 18:36:58 PDT 2012

TexasKidDoc

Think questions are very open ended, less important what content comes out than questions are asked. Opening dialogue is important #hpm
Wed Jun 20 18:37:16 PDT 2012

aliciabloom

@ctsinclair bummer! sending get well wishes. #hpm

Wed Jun 20 18:37:47 PDT 2012

rhgerard

JAMA Network | Dignity Therapy: Final Words for Final Days: http://t.co/Mf5P6Vsr #hpm #hospice #eol #hpmglobal
Wed Jun 20 18:38:37 PDT 2012

aliciabloom

really like this question- "their biggest fears and what functional abilities they could not imagine living without." #hpm
Wed Jun 20 18:39:37 PDT 2012

_lizzy_

T1 i guess my concern is that the checklist isn't going to solve the oncologists' comfort level issues...but maybe training will help #Hpm
Wed Jun 20 18:40:07 PDT 2012

aliciabloom

@MarksPhone great point. starting off from diagnosis on the right foot with shared decision making is critically important. #hpm
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#hpm - Healthcare Social Media Transcript

6/27/12 1:20 PM

Wed Jun 20 18:40:42 PDT 2012

TexasKidDoc

@_lizzy_ routine makes it far more comfortable #hpm

Wed Jun 20 18:41:05 PDT 2012

aliciabloom

@_lizzy_ i wonder if the checklist will help them feel more comfortable. guide the conversation, key points to touch on = less scary ? #hpm
Wed Jun 20 18:41:22 PDT 2012

MarksPhone

@_lizzy_ We are not going to solve onc's issues until we do a serious needs assessment etc. I'm people are doing that but that is key #hpm
Wed Jun 20 18:41:46 PDT 2012

TexasKidDoc

@_lizzy_ ask any med student about taking a sexual history and they squirm, most doctors ask "men, women or both" without discomfort #hpm
Wed Jun 20 18:42:10 PDT 2012

ravipm2000

T1: my fear is that an emotionally unintelligent doc will ask the questions like a shopping list. #hpm
Wed Jun 20 18:42:29 PDT 2012

TexasKidDoc

@_lizzy_ Same issue with EOL. The more you ask, the easier it gets #hpm
Wed Jun 20 18:43:01 PDT 2012

aliciabloom

check labs, review meds, discuss next chemo, go through serious illness communication checklist. i like it! it could work. #hpm
Wed Jun 20 18:43:15 PDT 2012

TexasKidDoc

@ravipm2000 Shopping list may be better than never taking about it #hpm
Wed Jun 20 18:44:10 PDT 2012

ravipm2000

T1: I've seen scenarios where the checklist is covered in 2 or more visits but time is used to respond to emotion or probs arise #hpm
Wed Jun 20 18:44:10 PDT 2012

aliciabloom

RT @TexasKidDoc: @ravipm2000 Shopping list may be better than never taking about it #hpm
Wed Jun 20 18:44:57 PDT 2012

ravipm2000

@TexasKidDoc I agree that it should be discussed but one has to be trained to communicate well or else it is perceived as insincere. #hpm
Wed Jun 20 18:45:24 PDT 2012

_lizzy_

The checklist implies knowledge deficit which isn't necessarily issue. Pro #hpm onc already having convos. Will this convert onc? #Hpm
Wed Jun 20 18:45:40 PDT 2012

http://hashtags.symplur.com/healthcare-hashtag-transcript.php?h&smin=0&tdate=06-20-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1

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MarksPhone

@ravipm2000 another point to consider beginning early so when the poop hits the fan receptors for tough decisions are open #hpm
Wed Jun 20 18:46:21 PDT 2012

TexasKidDoc

good point MT @_lizzy_: The checklist implies knowledge deficit which isnt necessarily issue. Pro #hpm onc already having convos. #hpm
Wed Jun 20 18:46:42 PDT 2012

_lizzy_

@ravipm2000 i guess that is what i am trying to say...that if they aren't onboard will #hpm then will checklist change things? #Hpm
Wed Jun 20 18:46:47 PDT 2012

ravipm2000

@MarksPhone Agreed! I've seen many transplant pts thrown off that cliff! #hpm
Wed Jun 20 18:47:15 PDT 2012

MarksPhone

@_lizzy_ not supported look at this study http://t.co/hbEI4rSW. both pcp and oncs are reluctant #hpm
Wed Jun 20 18:47:31 PDT 2012

TexasKidDoc

@_lizzy_ I think it can-Checklists changed much in other parts of med, Normalizing hard convos make them happen more across the board #hpm
Wed Jun 20 18:48:21 PDT 2012

aliciabloom

@MarksPhone @ravpim2000 great point. many patients/families experience decision fatigue when in crisis situations. #hpm
Wed Jun 20 18:48:28 PDT 2012

ravipm2000

@_lizzy_ At least they will help the patients plan more thoroughly provided that they can respond to the emotive data from the pt. #hpm
Wed Jun 20 18:48:32 PDT 2012

_lizzy_

@MarksPhone yeah i did a paper in school...so many barriers, sadly. Age, ego, training. Hopefully checklist will start pt thinking. #Hpm
Wed Jun 20 18:49:13 PDT 2012

aliciabloom

@TexasKidDoc i agree! more we can normalize these conversations, more likely they'll happen. better that they occur than not at all. #hpm
Wed Jun 20 18:49:41 PDT 2012

ravipm2000

T1: the onc docs @UWMadison are pro pall care and mention that path early on so as time goes by,they refer to the earlier convos #hpm
Wed Jun 20 18:50:01 PDT 2012

aliciabloom

@_lizzy_ SO. MANY. BARRIERS. ugh! #hpm

Wed Jun 20 18:50:13 PDT 2012

TexasKidDoc

@ravipm2000 this won't make bad docs good, but may at least give a framework instead of

http://hashtags.symplur.com/healthcare-hashtag-transcript.php?h&smin=0&tdate=06-20-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1

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6/27/12 1:20 PM

EXTRA awkward/avoided/bad convos #hpm

Wed Jun 20 18:50:25 PDT 2012

MarksPhone

@_lizzy_ I was referring to physicians who dont get palliative care or hospice and wait too long. This is binominal equation #hpm
Wed Jun 20 18:50:38 PDT 2012

MarksPhone

For Donna and me the key for hboth of us was our onc managed us well as equals w/respect. We both understood medicine he understood us #hpm
Wed Jun 20 18:52:05 PDT 2012

_lizzy_

@MarksPhone Or the onc wait for family doc and family doc wait for onc...and pt waits for either. This will at least start convo #Hpm
Wed Jun 20 18:52:16 PDT 2012

ravipm2000

@TexasKidDoc I am happy with the qu's on the list it's just that I've seen the questions in the list asked really badly #hpm
Wed Jun 20 18:52:49 PDT 2012

aliciabloom

we've had a lively discussion about this EoL checklist, the hour will soon be coming to a close- thank you! please share final thoughts #hpm
Wed Jun 20 18:52:50 PDT 2012

MarksPhone

@_lizzy_ bingo #hpm

Wed Jun 20 18:52:54 PDT 2012

aliciabloom

@MarksPhone it should be about mutual respect & open dialogue- that is truly personcentered care. #hpm
Wed Jun 20 18:53:39 PDT 2012

MarksPhone

Time to take Nina out thank you all glad to be able to join and share with such a distinguished group #hpm http://t.co/hom3oDPZ
Wed Jun 20 18:54:22 PDT 2012

aliciabloom

@_lizzy_ huge challenge. diversion of responsibility to the "other doctor." #hpm

Wed Jun 20 18:54:23 PDT 2012

TexasKidDoc

@ravipm2000 Me too. But many pts don't know how to change docs or cannot. If you are suck together, better to encourage conversations. #hpm
Wed Jun 20 18:54:48 PDT 2012

_lizzy_

@aliciabloom wow! Time flies when we are tweeting. Thanks for a great topic! #Hpm
Wed Jun 20 18:54:51 PDT 2012

ravipm2000

Having an EOL checklist: Good. Responding to pt and skillfully guiding pt through it: Better! #hpm
Wed Jun 20 18:54:53 PDT 2012

http://hashtags.symplur.com/healthcare-hashtag-transcript.php?h&smin=0&tdate=06-20-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1

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6/27/12 1:20 PM

aliciabloom

RT @_lizzy_: @aliciabloom wow! Time flies when we are tweeting. Thanks for a great topic! #Hpm
Wed Jun 20 18:55:11 PDT 2012

aliciabloom

RT @ravipm2000: Having an EOL checklist: Good. Responding to pt and skillfully guiding pt through it: Better! #hpm
Wed Jun 20 18:55:27 PDT 2012

ravipm2000

@TexasKidDoc:Agreed! #hpm
Wed Jun 20 18:55:34 PDT 2012

_lizzy_

@aliciabloom Heard a person hpm story from friend last week 3 docs, 3 opinions on care #Hpm
Wed Jun 20 18:55:50 PDT 2012

aliciabloom

@_lizzy_ yes it does :) #hpm

Wed Jun 20 18:55:52 PDT 2012

TexasKidDoc

RT @ravipm2000: Having an EOL checklist: Good. Responding to pt and skillfully guiding pt through it: Better! #hpm
Wed Jun 20 18:55:57 PDT 2012

_lizzy_

RT @TexasKidDoc: RT @ravipm2000: Having an EOL checklist: Good. Responding to pt and skillfully guiding pt through it: Better! #Hpm
Wed Jun 20 18:56:30 PDT 2012

aliciabloom

@_lizzy_ that's so hard. huge role for palliative care clinicians to be helpful and piece it all together. #hpm
Wed Jun 20 18:57:16 PDT 2012

_lizzy_

Remember #hpmglobal on Monday morning 8 est #Hpm

Wed Jun 20 18:57:30 PDT 2012

aliciabloom

thank you all for a really lively chat! hope to see you next week-- same time, same place #hpm
Wed Jun 20 18:57:45 PDT 2012

ravipm2000

RT @aliciabloom: @_lizzy_ thats so hard. huge role for palliative care clinicians to be helpful and piece it all together. #hpm
Wed Jun 20 18:57:45 PDT 2012

_lizzy_

@aliciabloom I respect the work that all the great docs do...not easy stuff! #Hpm
Wed Jun 20 18:58:11 PDT 2012

ravipm2000

Great chat! Talk to you all again soon! #hpm

Wed Jun 20 18:59:42 PDT 2012

http://hashtags.symplur.com/healthcare-hashtag-transcript.php?h&smin=0&tdate=06-20-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1

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#hpm - Healthcare Social Media Transcript

6/27/12 1:20 PM

TexasKidDoc

THanks for a great chat! #hpm

Wed Jun 20 19:01:10 PDT 2012

Kind4Kids

Multi-tasking! RT @nursefriendly Wed #Healthcare #Tweetchats (EDT): 8p #IVchat 8p #s4pm 9p #dsma 9p #hpm 9p #mHealth 9p #premeded #nurseup
Wed Jun 20 19:10:16 PDT 2012

http://hashtags.symplur.com/healthcare-hashtag-transcript.php?h&smin=0&tdate=06-20-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1

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