#Hpm Tweet Chat 4:11:12

7/31/2019 #Hpm Tweet Chat 4:11:12

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6/27/12 1:hpm - Healthcare Social Media Transcript

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#hpm transcript

Healthcare Social Media TranscriptFrom: Wed Apr 11 18:00:00 PDT 2012

To: Wed Apr 11 19:15:00 PDT 2012

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jfclearywisc Jim Cleary, UW Palliative Care & PPSG (@painpolicy ) joining #hospice & palliativeMedicine tweetchat for next hour #hpm

Wed Apr 11 18:00:06 PDT 2012

AnkurB_MD Hi& Welcome to #hpm chat about #hospice& #palliative medicine, please take a momentto introduce yourself & say hello #hpm

Wed Apr 11 18:00:58 PDT 2012

AnkurB_MD @ctsinclair@jfclearywisc Great to c u.. #hpmWed Apr 11 18:02:15 PDT 2012

ctsinclair Intro: Christian Sinclair, palliative care doc at Gentiva, editor of @Pallimed, connoisseur ofAmerican airports #HPM

Wed Apr 11 18:02:26 PDT 2012

ctsinclair @AnkurB_MD Looking forward to you hosting tonight #HPMWed Apr 11 18:02:59 PDT 2012

rjcrossno RT @rfberry: Tell #TEDMED that End of Life Care is a priority & vote http://t.co/XqbJGd4Rvia @Paul_Malley#hpm#NHDD Please RT

Wed Apr 11 18:03:16 PDT 2012
http://www.twitter.com/AnkurB_MDhttp://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/hospice/http://www.symplur.com/healthcare-hashtags/http://www.symplur.com/healthcare-social-media/http://www.symplur.com/healthcare-hashtags/conferences/http://www.symplur.com/healthcare-hashtags/conferences/http://www.symplur.com/healthcare-hashtags/tweet-chats/http://www.symplur.com/healthcare-hashtags/tweet-chats/http://www.symplur.com/healthcare-hashtags/tweet-chats/http://www.symplur.com/healthcare-hashtags/diseases/http://www.symplur.com/healthcare-hashtags/diseases/http://www.symplur.com/healthcare-hashtags/hpm/analytics/?hashtag=hpm&fdate=04-11-2012&shour=18&smin=0&tdate=04-11-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1http://twitter.com/21002369/status/190243653925613569http://www.symplur.com/healthcare-hashtags/NHDD/http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/Paul_Malleyhttp://t.co/XqbJGd4Rhttp://www.symplur.com/healthcare-hashtags/TEDMED/http://www.twitter.com/rfberryhttp://www.twitter.com/rjcrossnohttp://twitter.com/17206739/status/190243585214513152http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/ctsinclairhttp://twitter.com/17206739/status/190243445439344640http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/Pallimedhttp://www.twitter.com/ctsinclairhttp://twitter.com/55394837/status/190243400317022208http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/jfclearywischttp://www.twitter.com/ctsinclairhttp://www.twitter.com/AnkurB_MDhttp://twitter.com/55394837/status/190243075916967936http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/palliative/http://www.symplur.com/healthcare-hashtags/hospice/http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://twitter.com/27231379/status/190242858249367554http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/hospice/http://www.twitter.com/painpolicyhttp://www.twitter.com/jfclearywischttp://www.symplur.com/healthcare-hashtags/http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/diseases/http://www.symplur.com/healthcare-hashtags/tweet-chats/http://www.symplur.com/healthcare-hashtags/conferences/http://www.symplur.com/healthcare-social-media/http://www.symplur.com/healthcare-hashtags/hpm/analytics/?hashtag=hpm&fdate=04-11-2012&shour=18&smin=0&tdate=04-11-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1http://www.symplur.com/healthcare-hashtags/hpm/?hashtag=hpm&fdate=04-11-2012&shour=18&smin=0&tdate=04-11-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1http://www.symplur.com/healthcare-social-media/

7/31/2019 #Hpm Tweet Chat 4:11:12

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crgonzalez Carmen Gonzalez, clinical research enrollment strategist, and prodigal participant in HPMchats #HPM

Wed Apr 11 18:03:18 PDT 2012

aliciabloom MSW, LSW practicing in #hpm. passionate about improving patient access & clinicaleducation. just stocked up on Peeps & Cadbury Mini Eggs.

Wed Apr 11 18:03:22 PDT 2012

ctsinclair Followers, expect lots of tweets in the next hour as I chat about #Hospice and #palliativemedicine, join in by following -> #HPM

Wed Apr 11 18:03:36 PDT 2012

ctsinclair @aliciabloom did you get a discount? #HPMWed Apr 11 18:04:03 PDT 2012

AnkurB_MD .@ctsinclair It is my first time hosting the HPM chat, so pardon any jitters in thetwittersphere! #hpm

Wed Apr 11 18:04:04 PDT 2012

AnkurB_MD Thanks for joining! I'm hosting tonight, Palliative & Geriatric Medicine at Univ. of Cincinnati~ passionate about Our work! #hpm

Wed Apr 11 18:04:33 PDT 2012

ctsinclair @crgonzalez Hey Carmen, do you work on any clinical research around symptoms orinvolving community hospices? #HPM

Wed Apr 11 18:04:34 PDT 2012

aliciabloom it's that time again! expect a flurry of #hospice & #palliative care related tweets for the nexhour...join us! #hpm

Wed Apr 11 18:04:34 PDT 2012

rfberry Rene Berry here from CA, passionate about early #palliative care, started as a #hospicevolunteer, now working @goBeMoRe#hpm

Wed Apr 11 18:04:40 PDT 2012

ctsinclair @AnkurB_MD You sound perfectly calm and poised to me! #HPMWed Apr 11 18:05:03 PDT 2012

produceconsume RT @NHDD: Discussion on @NPR about Advance Healthcare Directives

http://t.co/Mz1Oq5uG via @HealthLitMO#NHDD#hpm#healthlit#s4pmWed Apr 11 18:05:07 PDT 2012

crgonzalez @aliciabloom Did you try the chocolate mousse-flavored, chocolate dipped peeps?fabulous! #HPM

Wed Apr 11 18:05:10 PDT 2012

aliciabloom @ctsinclair all 50% off! Easter is my favorite candy season. #hpm
http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/ctsinclairhttp://www.twitter.com/aliciabloomhttp://twitter.com/11763132/status/190244131052847105http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/aliciabloomhttp://www.twitter.com/crgonzalezhttp://twitter.com/173520079/status/190244120684531712http://www.symplur.com/healthcare-hashtags/s4pm/http://www.symplur.com/healthcare-hashtags/healthlit/http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/NHDD/http://www.twitter.com/HealthLitMOhttp://t.co/Mz1Oq5uGhttp://www.twitter.com/NPRhttp://www.twitter.com/NHDDhttp://www.twitter.com/produceconsumehttp://twitter.com/17206739/status/190244101470429184http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/ctsinclairhttp://twitter.com/121558178/status/190244009132834816http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/goBeMoRehttp://www.symplur.com/healthcare-hashtags/hospice/http://www.symplur.com/healthcare-hashtags/palliative/http://www.twitter.com/rfberryhttp://twitter.com/24399366/status/190243983371411456http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/palliative/http://www.symplur.com/healthcare-hashtags/hospice/http://www.twitter.com/aliciabloomhttp://twitter.com/17206739/status/190243979881742338http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/crgonzalezhttp://www.twitter.com/ctsinclairhttp://twitter.com/55394837/status/190243979026120704http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://twitter.com/55394837/status/190243854421721088http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/ctsinclairhttp://www.twitter.com/AnkurB_MDhttp://twitter.com/17206739/status/190243853134086144http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/aliciabloomhttp://www.twitter.com/ctsinclairhttp://twitter.com/17206739/status/190243736641474560http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/palliative/http://www.symplur.com/healthcare-hashtags/Hospice/http://www.twitter.com/ctsinclairhttp://twitter.com/24399366/status/190243678248386560http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/11763132/status/190243665178931201http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/crgonzalez

7/31/2019 #Hpm Tweet Chat 4:11:12

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Wed Apr 11 18:05:14 PDT 2012

crgonzalez @ctsinclair Not yet...would be fascinating #HPMWed Apr 11 18:05:28 PDT 2012

schwartzbrown Hello, Mindy here, social worker from NJ #hpmWed Apr 11 18:05:39 PDT 2012

produceconsume RT @palliativecare: Informative! RT @hpmmsudo 3 Easy & Useful tools to start the#endoflife talk http://t.co/yXYuu32r#hpm

Wed Apr 11 18:05:55 PDT 2012

ctsinclair @crgonzalez@aliciabloom While I love marshmallow I have a mental block when eatinglittle chicks. They are too cute. #HPM

Wed Apr 11 18:06:21 PDT 2012

aliciabloom @crgonzalez oooh! i didn't see the chocolate mousse flavored ones, but i have had the

regular chocolate dipped peeps :) #hpmWed Apr 11 18:06:33 PDT 2012

rfberry @aliciabloom I visited the peep factory when I was in DC, it was amazing & hilarious, I'llsend you some pics #hpm

Wed Apr 11 18:06:33 PDT 2012

produceconsume RT @JenMarsh2: April 16th Awareness day puts focus on end-of-life wishes:http://t.co/6wWhDBoe#nhdd#eol#hpm

Wed Apr 11 18:06:36 PDT 2012

ctsinclair @produceconsume Might you join us for the #HPM tweetchat going on right now? #HPMWed Apr 11 18:06:39 PDT 2012

AfternoonNapper Hello to all and good evening. Lurking about tonight. #hpmWed Apr 11 18:06:47 PDT 2012

AnkurB_MD @rfberry@aliciabloom@schwartzbrown@crgonzalez great 2 have y'all here.. T1 in a fewmins.. #hpm

Wed Apr 11 18:07:11 PDT 2012

aliciabloom @AnkurB_MD excited for your hosting debut tonight! it's going to be a great hour! #hpmWed Apr 11 18:07:23 PDT 2012

aliciabloom thanks @rfberry :) #hpmWed Apr 11 18:07:47 PDT 2012

crgonzalez @ctsinclair I show no mercy to peeps; great for dipping in coffee! #HPMWed Apr 11 18:08:05 PDT 2012
http://twitter.com/11763132/status/190244867635544065http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/ctsinclairhttp://www.twitter.com/crgonzalezhttp://twitter.com/24399366/status/190244790774935552http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/rfberryhttp://www.twitter.com/aliciabloomhttp://twitter.com/24399366/status/190244688794615809http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/aliciabloomhttp://twitter.com/55394837/status/190244638421028864http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/crgonzalezhttp://www.twitter.com/schwartzbrownhttp://www.twitter.com/aliciabloomhttp://www.twitter.com/rfberryhttp://www.twitter.com/AnkurB_MDhttp://twitter.com/346151348/status/190244541582950400http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AfternoonNapperhttp://twitter.com/17206739/status/190244504798900224http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/produceconsumehttp://www.twitter.com/ctsinclairhttp://twitter.com/173520079/status/190244493428137984http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/eol/http://www.symplur.com/healthcare-hashtags/nhdd/http://t.co/6wWhDBoehttp://www.twitter.com/JenMarsh2http://www.twitter.com/produceconsumehttp://twitter.com/121558178/status/190244481021390848http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://www.twitter.com/rfberryhttp://twitter.com/24399366/status/190244482946564097http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/crgonzalezhttp://www.twitter.com/aliciabloomhttp://twitter.com/17206739/status/190244429221732352http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/aliciabloomhttp://www.twitter.com/crgonzalezhttp://www.twitter.com/ctsinclairhttp://twitter.com/173520079/status/190244323026145280http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/yXYuu32rhttp://www.symplur.com/healthcare-hashtags/endoflife/http://www.twitter.com/hpmmsudohttp://www.twitter.com/palliativecarehttp://www.twitter.com/produceconsumehttp://twitter.com/273605086/status/190244253396508673http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/schwartzbrownhttp://twitter.com/11763132/status/190244208278380545http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/ctsinclairhttp://www.twitter.com/crgonzalezhttp://twitter.com/24399366/status/190244149465849856

7/31/2019 #Hpm Tweet Chat 4:11:12

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rfberry Anatomy of a tweetchat #hpm :) http://t.co/eD4YRpheWed Apr 11 18:08:36 PDT 2012

AnkurB_MD Topic Tonight: Hospice & Palliative Medicine: How can we help Ourselves & Otherschoose wisely tests/ treatments/ practices? #hpm

Wed Apr 11 18:08:38 PDT 2012

GroundSwellAus Hi @keznoo tweeting as GroundSwell tonight! from Sydney #hpmWed Apr 11 18:08:38 PDT 2012

rfberry @crgonzalez also great to put in microwaves ;) #hpmWed Apr 11 18:08:56 PDT 2012

AfternoonNapper @crgonzalez HA! I have a box of purple (my favorite color) Peeps waiting for me at home#hpm

Wed Apr 11 18:08:57 PDT 2012

aliciabloom @crgonzalez i considered that this morning, but chickened out. i'm doing it tomorrow!#hpm

Wed Apr 11 18:09:01 PDT 2012

AnkurB_MD #ChoosingWisely Provides some perspective http://t.co/cj1uuZcl#hpmWed Apr 11 18:09:10 PDT 2012

ctsinclair @crgonzalez I have never heard of that practice, Waterboarding peeps. Sounds like itcould be tasty. #HPM

Wed Apr 11 18:09:11 PDT 2012

schwartzbrown I hope I can get some peeops after Passover #hpmWed Apr 11 18:09:43 PDT 2012

ctsinclair RT @AnkurB_MD: Topic: Hospice & Palliative Medicine: How can we help Ourselves &Others choose wisely tests/ treatments/ practices? #HPM

Wed Apr 11 18:09:43 PDT 2012

crgonzalez @AfternoonNapper Check this out http://t.co/PZU0cMy6#HPMWed Apr 11 18:09:50 PDT 2012

nursefriendly @IVchat I rarely finish a chat in the hour time slot, usually it is more like 2-3 in betweenother things. :) off to #HPM :) #ivchat

Wed Apr 11 18:10:02 PDT 2012

crgonzalez @ctsinclair LOL waterboarding! #HPMWed Apr 11 18:10:06 PDT 2012
http://twitter.com/11763132/status/190245373812551680http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/ctsinclairhttp://www.twitter.com/crgonzalezhttp://twitter.com/22638297/status/190245356653649920http://www.symplur.com/healthcare-hashtags/ivchat/http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/IVchathttp://www.twitter.com/nursefriendlyhttp://twitter.com/11763132/status/190245305831260160http://www.symplur.com/healthcare-hashtags/HPM/http://t.co/PZU0cMy6http://www.twitter.com/AfternoonNapperhttp://www.twitter.com/crgonzalezhttp://twitter.com/17206739/status/190245277645541377http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/ctsinclairhttp://twitter.com/273605086/status/190245279201636354http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/schwartzbrownhttp://twitter.com/17206739/status/190245145608863745http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/crgonzalezhttp://www.twitter.com/ctsinclairhttp://twitter.com/55394837/status/190245141179662336http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/cj1uuZclhttp://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/AnkurB_MDhttp://twitter.com/24399366/status/190245102604648448http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/crgonzalezhttp://www.twitter.com/aliciabloomhttp://twitter.com/346151348/status/190245085907136512http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/crgonzalezhttp://www.twitter.com/AfternoonNapperhttp://twitter.com/121558178/status/190245078722293760http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/crgonzalezhttp://www.twitter.com/rfberryhttp://twitter.com/91320531/status/190245005644935170http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/keznoohttp://www.twitter.com/GroundSwellAushttp://twitter.com/55394837/status/190245005481357312http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://twitter.com/121558178/status/190244997105336321http://t.co/eD4YRphehttp://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/rfberry

7/31/2019 #Hpm Tweet Chat 4:11:12

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AnkurB_MD @GroundSwellAus@AfternoonNapper Thanks for joining us! #hpmWed Apr 11 18:10:07 PDT 2012

AfternoonNapper @ctsinclair@crgonzalez@rfberry Microwaved Peeps make great s'mores. #hpmWed Apr 11 18:10:14 PDT 2012

crgonzalez RT @AnkurB_MD Hospice & Palliative Medicine: How can we help Ourselves & Otherschoose wisely tests/ treatments/ practices? #HPM

Wed Apr 11 18:10:48 PDT 2012

AnkurB_MD Our T1 Tonight: What "should" be the role of HPM as a field in the #ChoosingWiselyinitiative? Outside "Lists"? #hpm

Wed Apr 11 18:11:35 PDT 2012

jfclearywisc RT @richardhorton1: Evening w S Westin & MNylenna in Trondheim. Their view: trust isperhaps most essential value in a health system. #hpm

Wed Apr 11 18:12:36 PDT 2012

equijada @AnkurB_MD I think by truly knowing risks and truly knowing benefits in context of a truenarrative #hpm

Wed Apr 11 18:12:42 PDT 2012

crgonzalez I'm not sure what the choosing wisely initiative is, so I will lurk on this one #HPMWed Apr 11 18:12:52 PDT 2012

aliciabloom active engagement with patients/families & other clinicians about benefits vs burdens ofdiagnostics, treatments & interventions #hpm#hpm

Wed Apr 11 18:13:45 PDT 2012

produceconsume RT @AnkurB_MD: #ChoosingWisely Provides some perspective http://t.co/HcfP9EhN#hpm

Wed Apr 11 18:13:52 PDT 2012

nursefriendly Hello All, Andrew Lopez, RN :) #HPMWed Apr 11 18:14:06 PDT 2012

jfclearywisc @AnkurB_MD T1: most associations have raised ? about their field. Should @AAHPM do

this or question other fields? #ChoosingWisely#hpmWed Apr 11 18:14:33 PDT 2012

aliciabloom Donald Berwick on #ChoosingWisely (http://t.co/VU538ncn) #hpmWed Apr 11 18:14:38 PDT 2012

aliciabloom Donald Berwick on #ChoosingWisely (http://t.co/VU538ncn) #hpmWed Apr 11 18:14:38 PDT 2012
http://twitter.com/24399366/status/190246514965217281http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/aliciabloomhttp://twitter.com/24399366/status/190246514965217281http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/aliciabloomhttp://twitter.com/27231379/status/190246494136303616http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/AAHPMhttp://www.twitter.com/AnkurB_MDhttp://www.twitter.com/jfclearywischttp://twitter.com/22638297/status/190246381594746881http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/nursefriendlyhttp://twitter.com/173520079/status/190246321679110144http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/HcfP9EhNhttp://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/produceconsumehttp://twitter.com/24399366/status/190246292566454272http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/11763132/status/190246071698591744http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/crgonzalezhttp://twitter.com/22651861/status/190246030640562177http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/equijadahttp://twitter.com/27231379/status/190246003490816000http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/richardhorton1http://www.twitter.com/jfclearywischttp://twitter.com/55394837/status/190245745989926914http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/AnkurB_MDhttp://twitter.com/11763132/status/190245551172878338http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/crgonzalezhttp://twitter.com/346151348/status/190245409447350272http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/rfberryhttp://www.twitter.com/crgonzalezhttp://www.twitter.com/ctsinclairhttp://www.twitter.com/AfternoonNapperhttp://twitter.com/55394837/status/190245377994268673http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AfternoonNapperhttp://www.twitter.com/GroundSwellAushttp://www.twitter.com/AnkurB_MD

7/31/2019 #Hpm Tweet Chat 4:11:12

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AnkurB_MD @crgonzalez#Choosingwisely is an ABIM initiative http://t.co/TKKwJ7cM to encourageorgs to come up w/ Avoidable Interventions! #hpm

Wed Apr 11 18:14:39 PDT 2012

ctsinclair RT @AnkurB_MD: #Choosingwisely is an ABIM initiative http://t.co/mFRMCxhr toencourage orgs to come up w/ Avoidable Interventions! #HPM

Wed Apr 11 18:15:21 PDT 2012

BrianSMcGowan ahhh!! RT @rfberry: Anatomy of a tweetchat #hpm :) http://t.co/tZh5slkIWed Apr 11 18:15:25 PDT 2012

produceconsume RT @equijada: @AnkurB_MD I think by truly knowing risks and truly knowing benefits incontext of a true narrative #hpm

Wed Apr 11 18:15:26 PDT 2012

rfberry RT @AnkurB_MD: Our T1 Tonight: What "should" be the role of HPM as a field in the#ChoosingWisely initiative? Outside "Lists"? #hpm

Wed Apr 11 18:15:32 PDT 2012

jfclearywisc @AnkurB_MD So is the question what are avoidable interventions in #hpm?#Choosingwisely

Wed Apr 11 18:15:33 PDT 2012

ctsinclair @jfclearywisc@AAHPM is getting involved with #ChoosingWisely per email I saw thisweek. #HPM

Wed Apr 11 18:15:42 PDT 2012

AfternoonNapper Related to T1... can one adequately treat/manage a disease if one does not know thecause? Is exhaustive diagnositic testing necessary? #hpmWed Apr 11 18:15:50 PDT 2012

equijada @AnkurB_MD t1 does truth equal wisdom and since truth is relative, wisdom/wisely is alsorelative? #hpm

Wed Apr 11 18:16:04 PDT 2012

crgonzalez @AnkurB_MD@produceconsume Thanks #HPMWed Apr 11 18:16:13 PDT 2012

nursefriendly @AfternoonNapper Nothing wrong with #lurking :) do it often. #HPMWed Apr 11 18:16:17 PDT 2012

aliciabloom asking questions supports #ChoosingWisely-- how will this change the outcome? what wewill do with the information? #hpm

Wed Apr 11 18:16:20 PDT 2012

@AfternoonNapper Absolutely not; exhaustive testing rarely yields fruitful diagnostic
http://www.twitter.com/AfternoonNapperhttp://twitter.com/24399366/status/190246942582910976http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/aliciabloomhttp://twitter.com/22638297/status/190246929291149314http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/lurking/http://www.twitter.com/AfternoonNapperhttp://www.twitter.com/nursefriendlyhttp://twitter.com/11763132/status/190246914988589057http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/produceconsumehttp://www.twitter.com/AnkurB_MDhttp://www.twitter.com/crgonzalezhttp://twitter.com/22651861/status/190246877130792961http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/equijadahttp://twitter.com/346151348/status/190246817554907136http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AfternoonNapperhttp://twitter.com/17206739/status/190246781978808320http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/AAHPMhttp://www.twitter.com/jfclearywischttp://www.twitter.com/ctsinclairhttp://twitter.com/27231379/status/190246744964087808http://www.symplur.com/healthcare-hashtags/Choosingwisely/http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/jfclearywischttp://twitter.com/121558178/status/190246743726755840http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/rfberryhttp://twitter.com/173520079/status/190246715876589568http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/equijadahttp://www.twitter.com/produceconsumehttp://twitter.com/67164452/status/190246711141212160http://t.co/tZh5slkIhttp://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/rfberryhttp://www.twitter.com/BrianSMcGowanhttp://twitter.com/17206739/status/190246696184328192http://www.symplur.com/healthcare-hashtags/HPM/http://t.co/mFRMCxhrhttp://www.symplur.com/healthcare-hashtags/Choosingwisely/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/ctsinclairhttp://twitter.com/55394837/status/190246520388456448http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/TKKwJ7cMhttp://www.symplur.com/healthcare-hashtags/Choosingwisely/http://www.twitter.com/crgonzalezhttp://www.twitter.com/AnkurB_MD

7/31/2019 #Hpm Tweet Chat 4:11:12

7/31



RyanMadanickMD outcomes #hpmWed Apr 11 18:16:42 PDT 2012

jfclearywisc @ctsinclair T1 YEs in fall @AAHPM will release its #ChoosingWisely list #HPMWed Apr 11 18:16:45 PDT 2012

AnkurB_MD @jfclearywisc Yes! Lets Reframe T1: So is the question what are avoidable interventions i#hpm? #hpmWed Apr 11 18:17:03 PDT 2012

ctsinclair #ChoosingWisely key message is Informed Consent reduces wasteful & often harmfulmedical spending while keeping patient choice #HPM

Wed Apr 11 18:17:10 PDT 2012

crgonzalez Choosing Wisely is an initiative to help docs and patients talk about the overuse of testsand procedures & make better decisions #HPM

Wed Apr 11 18:17:10 PDT 2012

produceconsume @crgonzalez Short one page overview: http://t.co/HcfP9EhN#hpmWed Apr 11 18:17:13 PDT 2012

rfberry T1 hpm professionals can advocate for care centralized around goals of care, that willnaturally align w/the Choose Wisely initiative #hpm

Wed Apr 11 18:17:19 PDT 2012

ctsinclair RT @rfberry: T1 hpm professionals can advocate for care centralized around goals of careWill naturally align w/#ChooseWisely#HPM

Wed Apr 11 18:18:31 PDT 2012

aliciabloom +1 MT @rfberry: hpm professionals can advocate for care centralized around goals ofcare, that will naturally align w/#ChoosingWisely#hpm

Wed Apr 11 18:18:35 PDT 2012

AfternoonNapper @RyanMadanickMD So then how do we best treat/manage diseases we don't know thecause of? Is this a role for palliative med? #hpm

Wed Apr 11 18:18:39 PDT 2012

April918 Hi peeps, I mean tweeps! April Parks #HPM fellow in Kansas CityWed Apr 11 18:19:06 PDT 2012

jfclearywisc @AnkurB_MD T1: I will put my neck out. Don't sign on to hospice medicare benefit withoureally understanding implications #hpm

Wed Apr 11 18:19:06 PDT 2012

crgonzalez T1: It helps to focus on what palliative care can be provided apart from treatment #HPMWed Apr 11 18:19:14 PDT 2012
http://twitter.com/11763132/status/190247671745888257http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/crgonzalezhttp://twitter.com/27231379/status/190247639835615232http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/jfclearywischttp://twitter.com/179338293/status/190247640481529856http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/April918http://twitter.com/346151348/status/190247527071748096http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/RyanMadanickMDhttp://www.twitter.com/AfternoonNapperhttp://twitter.com/24399366/status/190247507949912064http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/rfberryhttp://www.twitter.com/aliciabloomhttp://twitter.com/17206739/status/190247490950402048http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/ChooseWisely/http://www.twitter.com/rfberryhttp://www.twitter.com/ctsinclairhttp://twitter.com/121558178/status/190247189581275137http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/rfberryhttp://twitter.com/173520079/status/190247164755197954http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/HcfP9EhNhttp://www.twitter.com/crgonzalezhttp://www.twitter.com/produceconsumehttp://twitter.com/11763132/status/190247153417981952http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/crgonzalezhttp://twitter.com/17206739/status/190247151400529921http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/ctsinclairhttp://twitter.com/55394837/status/190247123953000449http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/jfclearywischttp://www.twitter.com/AnkurB_MDhttp://twitter.com/27231379/status/190247049223086080http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/AAHPMhttp://www.twitter.com/ctsinclairhttp://www.twitter.com/jfclearywischttp://twitter.com/233358828/status/190247033481871360http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/RyanMadanickMD

7/31/2019 #Hpm Tweet Chat 4:11:12

8/31



produceconsume t1: On its face, it appears to be an open door for better comm, pt engagement, betterhcp/pt relationship building #hpm

Wed Apr 11 18:19:15 PDT 2012

Robert_Fried Longest 5 minutes of my day: silently holding a patient's hand while she wept over newsher condition is terminal. #palliative#hpm

Wed Apr 11 18:19:48 PDT 2012

crgonzalez @produceconsume Good point. Anything that spurs the conversation around possibleoutcomes allows for better decision making #HPM

Wed Apr 11 18:20:24 PDT 2012

AfternoonNapper @Robert_Fried But I see that as being the most meaningful part of your day. #hpmWed Apr 11 18:20:41 PDT 2012

aliciabloom active engagement w/ patients/families & clinicians re: benefits vs burdens of diagnostics,treatments & interventions #hpm#ChoosingWisely

Wed Apr 11 18:20:46 PDT 2012

crgonzalez @Robert_Fried Cyber hug to you. :) #HPMWed Apr 11 18:20:53 PDT 2012

schwartzbrown Could one not argue that hospice/palliative care already is wise choice? #hpmWed Apr 11 18:20:59 PDT 2012

RyanMadanickMD @AfternoonNapper See examples in #IBS#migraines#fibro; try to understandpathophysiology and help pts manage illness #hpm

Wed Apr 11 18:21:01 PDT 2012

SrCareCorner RT @NHDD: Discussion on @NPR about Advance Healthcare Directiveshttp://t.co/Mz1Oq5uG via @HealthLitMO#NHDD#hpm#healthlit#s4pm

Wed Apr 11 18:21:16 PDT 2012

hockings RT @JenMarsh2: April 16th Awareness day puts focus on end-of-life wishes:http://t.co/6wWhDBoe#nhdd#eol#hpm

Wed Apr 11 18:21:29 PDT 2012

crgonzalez RT @aliciabloom: active engagement w/ patients/families & clinicians re: benefits vs

burdens of diagnostics, treatments & interventions #HPMWed Apr 11 18:21:32 PDT 2012

equijada RT @AfternoonNapper: @Robert_Fried But I see that as being the most meaningful part oyour day. #hpm

Wed Apr 11 18:21:41 PDT 2012

GroundSwellAus *feeling under prepared for this chat* can someone send me a link on #choosingwisely
http://www.symplur.com/healthcare-hashtags/choosingwisely/http://www.twitter.com/GroundSwellAushttp://twitter.com/22651861/status/190248287956250625http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/Robert_Friedhttp://www.twitter.com/AfternoonNapperhttp://www.twitter.com/equijadahttp://twitter.com/11763132/status/190248252552122370http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/aliciabloomhttp://www.twitter.com/crgonzalezhttp://twitter.com/28440062/status/190248238434103296http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/eol/http://www.symplur.com/healthcare-hashtags/nhdd/http://t.co/6wWhDBoehttp://www.twitter.com/JenMarsh2http://www.twitter.com/hockingshttp://twitter.com/84430599/status/190248185229352961http://www.symplur.com/healthcare-hashtags/s4pm/http://www.symplur.com/healthcare-hashtags/healthlit/http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/NHDD/http://www.twitter.com/HealthLitMOhttp://t.co/Mz1Oq5uGhttp://www.twitter.com/NPRhttp://www.twitter.com/NHDDhttp://www.twitter.com/SrCareCornerhttp://twitter.com/233358828/status/190248120804839426http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/fibro/http://www.symplur.com/healthcare-hashtags/migraines/http://www.symplur.com/healthcare-hashtags/IBS/http://www.twitter.com/AfternoonNapperhttp://www.twitter.com/RyanMadanickMDhttp://twitter.com/273605086/status/190248113217347584http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/schwartzbrownhttp://twitter.com/11763132/status/190248089997688832http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/Robert_Friedhttp://www.twitter.com/crgonzalezhttp://twitter.com/24399366/status/190248060016791552http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/346151348/status/190248038877503488http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/Robert_Friedhttp://www.twitter.com/AfternoonNapperhttp://twitter.com/11763132/status/190247965170999297http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/produceconsumehttp://www.twitter.com/crgonzalezhttp://twitter.com/33042135/status/190247816596164608http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/palliative/http://www.twitter.com/Robert_Friedhttp://twitter.com/173520079/status/190247677550788608http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/produceconsume

7/31/2019 #Hpm Tweet Chat 4:11:12

9/31



please... #hpm

Wed Apr 11 18:21:46 PDT 2012

April918 T1 some test are ordered or treatments continued when outspoken family is not alignedwith pt goals of care #HPM

Wed Apr 11 18:21:59 PDT 2012

crgonzalez @schwartzbrown Excellent point. #HPMWed Apr 11 18:21:59 PDT 2012

RyanMadanickMD @AfternoonNapper we actually don't know the root cause of most diseases (when youthink deeply enough about it) #hpm

Wed Apr 11 18:22:08 PDT 2012

aliciabloom @GroundSwellAus Donald Berwick on #ChoosingWisely (http://t.co/VU538ncn) #hpmWed Apr 11 18:22:35 PDT 2012

produceconsume @GroundSwellAus Short one page overview: http://t.co/HcfP9EhN#hpmWed Apr 11 18:22:35 PDT 2012

AnkurB_MD T1 AAHPM's general perspective on being a good steward to the #ChoosingWiselyInitiative?? #hpm

Wed Apr 11 18:22:45 PDT 2012

AfternoonNapper @schwartzbrown Absolutely agree! Wise choices are the choices that are right for thepatient's chosen course of action. #hpm

Wed Apr 11 18:23:19 PDT 2012

crgonzalez @April918 The proper consideration of family opinions that don't override the patient'swishes is important to strike right balance #HPM

Wed Apr 11 18:24:08 PDT 2012

GroundSwellAus @produceconsume thanks but for some reason the link isn't working for me #hpmWed Apr 11 18:24:16 PDT 2012

AfternoonNapper @RyanMadanickMD Interesting point... I'm going to be mulling that one over in relation to#raredisease. #hpm

Wed Apr 11 18:24:42 PDT 2012

produceconsume @GroundSwellAus pdf file http://t.co/HcfP9EhN#hpmWed Apr 11 18:25:10 PDT 2012

aliciabloom #palliative care focus = matching patient goals & treatments while minimizing & treatingdistress. naturally aligned w/#ChoosingWisely#hpm

Wed Apr 11 18:25:12 PDT 2012
http://twitter.com/24399366/status/190249173189279744http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.symplur.com/healthcare-hashtags/palliative/http://www.twitter.com/aliciabloomhttp://twitter.com/173520079/status/190249167988330497http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/HcfP9EhNhttp://www.twitter.com/GroundSwellAushttp://www.twitter.com/produceconsumehttp://twitter.com/346151348/status/190249046630350848http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/raredisease/http://www.twitter.com/RyanMadanickMDhttp://www.twitter.com/AfternoonNapperhttp://twitter.com/91320531/status/190248939583307776http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/produceconsumehttp://www.twitter.com/GroundSwellAushttp://twitter.com/11763132/status/190248905273909249http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/April918http://www.twitter.com/crgonzalezhttp://twitter.com/346151348/status/190248700914835456http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/schwartzbrownhttp://www.twitter.com/AfternoonNapperhttp://twitter.com/55394837/status/190248558488850432http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/AnkurB_MDhttp://twitter.com/173520079/status/190248517963489282http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/HcfP9EhNhttp://www.twitter.com/GroundSwellAushttp://www.twitter.com/produceconsumehttp://twitter.com/24399366/status/190248515698565121http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/GroundSwellAushttp://www.twitter.com/aliciabloomhttp://twitter.com/233358828/status/190248402422988800http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AfternoonNapperhttp://www.twitter.com/RyanMadanickMDhttp://twitter.com/11763132/status/190248366247129090http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/schwartzbrownhttp://www.twitter.com/crgonzalezhttp://twitter.com/179338293/status/190248363495669760http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/April918http://twitter.com/91320531/status/190248309514973184http://www.symplur.com/healthcare-hashtags/hpm/

7/31/2019 #Hpm Tweet Chat 4:11:12

10/31


Page 10ttp://hashtags.symplur.com/healthcare-hashtag-transcript.php?h&smin=0&tdate=04-11-2012&thour=19&tmin=15&ssec=00&tsec=00&img=1

AnkurB_MD Lets jump to T2: Potentially Avoidable Tests/ Treatments in Palliative Medicine ?? #hpmWed Apr 11 18:25:24 PDT 2012

produceconsume @GroundSwellAus Or website http://t.co/UqFXup44#hpmWed Apr 11 18:25:38 PDT 2012

RyanMadanickMD @AfternoonNapper we don't know the cause of most GI diseases, incl. cancers, but we sttx them #hpmWed Apr 11 18:25:49 PDT 2012

crgonzalez RT @aliciabloom#palliative care focus =matching patient goals & treatments whileminimizing & treating distress,naturally aligned w/CW #HPM

Wed Apr 11 18:26:30 PDT 2012

produceconsume @GroundSwellAushttp://t.co/4RqEPQ0Y#hpmWed Apr 11 18:26:40 PDT 2012

equijada @AfternoonNapper@schwartzbrown yes. Totally agree #hpmWed Apr 11 18:26:42 PDT 2012

AnkurB_MD T2: Avoidable Interventions & #Palliative Care -Perspective: http://t.co/r3Moyz58#hpmWed Apr 11 18:26:42 PDT 2012

jfclearywisc @AnkurB_MD T2: IV opioids, inpatient hospice deaths...... #hpmWed Apr 11 18:26:57 PDT 2012

ctsinclair RT @schwartzbrown: Could one not argue that hospice/palliative care already is wisechoice? "Some would argue against that" #HPMWed Apr 11 18:27:17 PDT 2012

DocComLtd RT @aliciabloom: Donald Berwick on #ChoosingWisely (http://t.co/VU538ncn) #hpmWed Apr 11 18:27:20 PDT 2012

schwartzbrown As I understand it, H/PM is not concerned with diagnosis or understanding of disease, butwith maintaining comfort in advanced illness #hpm

Wed Apr 11 18:27:23 PDT 2012

produceconsume RT @AnkurB_MD: Lets jump to T2: Potentially Avoidable Tests/ Treatments in PalliativeMedicine ?? #hpm

Wed Apr 11 18:27:26 PDT 2012

ctsinclair RT @jfclearywisc: @AnkurB_MD T2: IV opioids, inpatient hospice deaths... "I think theinpatient #hospice death issue is more complex" #HPM

Wed Apr 11 18:28:03 PDT 2012
http://twitter.com/17206739/status/190249890788544512http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/hospice/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/jfclearywischttp://www.twitter.com/ctsinclairhttp://twitter.com/173520079/status/190249734613639168http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/produceconsumehttp://twitter.com/273605086/status/190249723272237057http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/schwartzbrownhttp://twitter.com/168679723/status/190249712799068160http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/aliciabloomhttp://www.twitter.com/DocComLtdhttp://twitter.com/17206739/status/190249700081930240http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/schwartzbrownhttp://www.twitter.com/ctsinclairhttp://twitter.com/27231379/status/190249613050130432http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/jfclearywischttp://twitter.com/55394837/status/190249550508867584http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/r3Moyz58http://www.symplur.com/healthcare-hashtags/Palliative/http://www.twitter.com/AnkurB_MDhttp://twitter.com/22651861/status/190249552685711360http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/schwartzbrownhttp://www.twitter.com/AfternoonNapperhttp://www.twitter.com/equijadahttp://twitter.com/173520079/status/190249542187356161http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/4RqEPQ0Yhttp://www.twitter.com/GroundSwellAushttp://www.twitter.com/produceconsumehttp://twitter.com/11763132/status/190249499854249985http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/palliative/http://www.twitter.com/aliciabloomhttp://www.twitter.com/crgonzalezhttp://twitter.com/233358828/status/190249329318035456http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AfternoonNapperhttp://www.twitter.com/RyanMadanickMDhttp://twitter.com/173520079/status/190249283109392384http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/UqFXup44http://www.twitter.com/GroundSwellAushttp://www.twitter.com/produceconsumehttp://twitter.com/55394837/status/190249225391587328http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MD

7/31/2019 #Hpm Tweet Chat 4:11:12

11/31



GroundSwellAus thanks for the links everyone.... #hpmWed Apr 11 18:28:23 PDT 2012

produceconsume RT @AnkurB_MD: T2: Avoidable Interventions & #Palliative Care -Perspective:http://t.co/Jz8yVC0Z#hpm

Wed Apr 11 18:28:33 PDT 2012

aliciabloomavoidable tests #palliative medicine: anything that doesn't reduce distress or provideinformation that will impact an outcome or QoL #hpm

Wed Apr 11 18:28:36 PDT 2012

AfternoonNapper @schwartzbrown We are all seeking comfort. I wish for comfort for myself and my fellowpatients, now & in the future. #hpm

Wed Apr 11 18:28:57 PDT 2012

jfclearywisc @ctsinclair: T2: "I think the inpatient #hospice death issue is more complex" Agree but sois chemo to poor PS cancer patients #hpm

Wed Apr 11 18:29:08 PDT 2012

rfberry RT @AnkurB_MD: T2: Avoidable Interventions & #Palliative Care -Perspective:http://t.co/r3Moyz58#hpm

Wed Apr 11 18:29:10 PDT 2012

aliciabloom RT @jfclearywisc: @AnkurB_MD T2: IV opioids, inpatient hospice deaths...... "sometimesthe inpatient hospice death is appropriate" #hpm

Wed Apr 11 18:29:18 PDT 2012

AnkurB_MD T2: What about checking CXR, labs on Hospice patients? if clinical suspicion strong fortreatable UTI, PNA? #hpm

Wed Apr 11 18:29:20 PDT 2012

ctsinclair Dying in a medical facility is often universally derided in #hospice circles, but I know manyfamilies/patients would prefer it #HPM

Wed Apr 11 18:29:22 PDT 2012

ctsinclair ...if the medical facility was very family and patient-centric, with a strong palliative focus.Many are afraid to see death at home #HPM

Wed Apr 11 18:30:14 PDT 2012

jfclearywisc @ctsinclair T2: inpatient deaths. Agree families may prefer. Sometimes worry it is anursing decision! #HPMWed Apr 11 18:30:31 PDT 2012

AfternoonNapper @AnkurB_MD Checking labs as such in order to treat issues that cause discomfort seemsreasonable. #hpm

Wed Apr 11 18:30:32 PDT 2012

crgonzalez T2: Ignored advance directives leads to lots of unnecessary treatments. Occurrences at
http://www.twitter.com/crgonzalezhttp://twitter.com/346151348/status/190250518143172608http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/AfternoonNapperhttp://twitter.com/27231379/status/190250511423905792http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/ctsinclairhttp://www.twitter.com/jfclearywischttp://twitter.com/17206739/status/190250440141705217http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/ctsinclairhttp://twitter.com/17206739/status/190250223736598528http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/hospice/http://www.twitter.com/ctsinclairhttp://twitter.com/55394837/status/190250216170065923http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://twitter.com/24399366/status/190250208024739840http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/jfclearywischttp://www.twitter.com/aliciabloomhttp://twitter.com/121558178/status/190250170829639680http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/r3Moyz58http://www.symplur.com/healthcare-hashtags/Palliative/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/rfberryhttp://twitter.com/27231379/status/190250163707715584http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/hospice/http://www.twitter.com/ctsinclairhttp://www.twitter.com/jfclearywischttp://twitter.com/346151348/status/190250118920929280http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/schwartzbrownhttp://www.twitter.com/AfternoonNapperhttp://twitter.com/24399366/status/190250028227506176http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/palliative/http://www.twitter.com/aliciabloomhttp://twitter.com/173520079/status/190250018622545920http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/Jz8yVC0Zhttp://www.symplur.com/healthcare-hashtags/Palliative/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/produceconsumehttp://twitter.com/91320531/status/190249975186325505http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/GroundSwellAus

7/31/2019 #Hpm Tweet Chat 4:11:12

12/31



religious-run hospitals is a big worry #HPM

Wed Apr 11 18:30:59 PDT 2012

equijada @AnkurB_MD t2: None. I don't believe in blanket statements (hey, that's ironic) #hpmWed Apr 11 18:31:02 PDT 2012

ctsinclair @AnkurB_MD I actually think there are some situations where we should be checking

labs/xrays in #Hospice, might be underutilized #HPMWed Apr 11 18:31:08 PDT 2012

ctsinclair RT @AfternoonNapper: @AnkurB_MD Checking labs as such in order to treat issues thatcause discomfort seems reasonable. "I concur" #HPM

Wed Apr 11 18:31:18 PDT 2012

ctsinclair @jfclearywisc True, also the idea of encouraging families to think they may not be able tohandle it at home because it is too hard #HPM

Wed Apr 11 18:31:52 PDT 2012

aliciabloom checking CXR or labs on hospice patient with suspicion for treatable UTI or PNA can beappropriate. case by case, patient centered #hpm

Wed Apr 11 18:31:56 PDT 2012

jfclearywisc #choosingwisely is designed to have us (through @AAHPM) address some toughquestions about our practice! WE should feel some discomfort #hpm

Wed Apr 11 18:32:12 PDT 2012

colleen_young I hate to be missing with #hpm tonight. I watching the stream in my periphery whilst tryingto get something edited.

Wed Apr 11 18:32:21 PDT 2012

produceconsume MT @crgonzalez: T2: Ignored advance directives = lots of unnecessary treatments.Occurrences at religious-run hospitals is big worry #hpm

Wed Apr 11 18:32:22 PDT 2012

ctsinclair RT @equijada: @AnkurB_MD t2: None. I dont believe in blanket statements (hey, thatsironic) "Always beware the always statement!" #HPM

Wed Apr 11 18:32:30 PDT 2012

crgonzalez When religion collides with medical care http://t.co/wxqDSs0P Great examples #HPMWed Apr 11 18:32:36 PDT 2012

AnkurB_MD @ctsinclair It seems these decisions re Labs etc need individualized perspective soguidelines may be misleading! #hpm

Wed Apr 11 18:33:14 PDT 2012

ctsinclair #ChoosingWisely is about professionals confronting their 'common wisdom' that lacksevidence. Might hurt some pocketbooks. #HPM

Wed Apr 11 18:33:18 PDT 2012
http://twitter.com/17206739/status/190251214334726145http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/ctsinclairhttp://twitter.com/55394837/status/190251195766542336http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/ctsinclairhttp://www.twitter.com/AnkurB_MDhttp://twitter.com/11763132/status/190251036055830528http://www.symplur.com/healthcare-hashtags/HPM/http://t.co/wxqDSs0Phttp://www.twitter.com/crgonzalezhttp://twitter.com/17206739/status/190251010877427712http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/equijadahttp://www.twitter.com/ctsinclairhttp://twitter.com/173520079/status/190250978547740674http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/crgonzalezhttp://www.twitter.com/produceconsumehttp://twitter.com/28366957/status/190250971920744449http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/colleen_younghttp://twitter.com/27231379/status/190250934008414208http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AAHPMhttp://www.symplur.com/healthcare-hashtags/choosingwisely/http://www.twitter.com/jfclearywischttp://twitter.com/24399366/status/190250870062063617http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/17206739/status/190250854090149888http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/jfclearywischttp://www.twitter.com/ctsinclairhttp://twitter.com/17206739/status/190250707742498817http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/AfternoonNapperhttp://www.twitter.com/ctsinclairhttp://twitter.com/17206739/status/190250668437667841http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/Hospice/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/ctsinclairhttp://twitter.com/22651861/status/190250643313795072http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/equijadahttp://twitter.com/11763132/status/190250628096860160http://www.symplur.com/healthcare-hashtags/HPM/

7/31/2019 #Hpm Tweet Chat 4:11:12

13/31



nathankottkamp RT @NHDD: Discussion on @NPR about Advance Healthcare Directiveshttp://t.co/Mz1Oq5uG via @HealthLitMO#NHDD#hpm#healthlit#s4pm

Wed Apr 11 18:33:23 PDT 2012

AfternoonNapper Best friend's grandfather recently died--wanted to take him home to pass but feared for hisdiscomfort=big issue for all #hpm concerns. #hpm

Wed Apr 11 18:33:41 PDT 2012

crgonzalez T2: I suppose it is worth discussing advanced directives with hospitals upon admission sothere is clarity #HPM

Wed Apr 11 18:33:55 PDT 2012

AnkurB_MD RT @ctsinclair: #ChoosingWisely is about professionals confronting their common wisdomthat lacks evidence.Might hurt some pocketbooks #hpm

Wed Apr 11 18:34:04 PDT 2012

ctsinclair @nathankottkamp Oh Nathan come join us in #HPM tweetchat: http://t.co/KJDm5O5M#HPMWed Apr 11 18:34:21 PDT 2012

GroundSwellAus RT @crgonzalez: T2: I suppose it is worth discussing advanced directives with hospitalsupon admission so there is clarity #hpm

Wed Apr 11 18:34:22 PDT 2012

jfclearywisc RT @ctsinclair#ChoosingWisely: about professionals confronting 'common wisdom' thatlacks evidence. Might hurt pocketbooks. #HPM Egos too!

Wed Apr 11 18:34:23 PDT 2012

rfberry T2 I agree with the article where it says rationing is not necessary if you just do the thingsthat help, this is so true! #hpm

Wed Apr 11 18:34:38 PDT 2012

GroundSwellAus RT @ctsinclair: #ChoosingWisely is about professionals confronting their common wisdomthat lacks evidence.Might hurt some pocketbooks. #hpm

Wed Apr 11 18:34:40 PDT 2012

rfberry :) RT @ctsinclair@nathankottkamp Oh Nathan come join us in #HPM tweetchat:http://t.co/Jc6s83tf#hpm

Wed Apr 11 18:34:51 PDT 2012

aliciabloom appropriate thing is different for each patient. need to consider benefit vs burden ofinterventions before just doing #ChoosingWisely#hpm

Wed Apr 11 18:34:51 PDT 2012

jfclearywisc RT @rfberry: T2 I agree with the article where it says rationing is not necessary if you justdo the things that help, this is so true! #hpm

Wed Apr 11 18:34:57 PDT 2012
http://twitter.com/27231379/status/190251627909873665http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/rfberryhttp://www.twitter.com/jfclearywischttp://twitter.com/24399366/status/190251604803465216http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/aliciabloomhttp://twitter.com/121558178/status/190251601716449281http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/Jc6s83tfhttp://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/nathankottkamphttp://www.twitter.com/ctsinclairhttp://www.twitter.com/rfberryhttp://twitter.com/91320531/status/190251555621056513http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/ctsinclairhttp://www.twitter.com/GroundSwellAushttp://twitter.com/121558178/status/190251549304430592http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/rfberryhttp://twitter.com/27231379/status/190251487170007041http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/ctsinclairhttp://www.twitter.com/jfclearywischttp://twitter.com/91320531/status/190251479544770560http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/crgonzalezhttp://www.twitter.com/GroundSwellAushttp://twitter.com/17206739/status/190251475954438144http://www.symplur.com/healthcare-hashtags/HPM/http://t.co/KJDm5O5Mhttp://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/nathankottkamphttp://www.twitter.com/ctsinclairhttp://twitter.com/55394837/status/190251406580662272http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/ChoosingWisely/http://www.twitter.com/ctsinclairhttp://www.twitter.com/AnkurB_MDhttp://twitter.com/11763132/status/190251369834360832http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/crgonzalezhttp://twitter.com/346151348/status/190251310954708992http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AfternoonNapperhttp://twitter.com/226028258/status/190251234719051777http://www.symplur.com/healthcare-hashtags/s4pm/http://www.symplur.com/healthcare-hashtags/healthlit/http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/NHDD/http://www.twitter.com/HealthLitMOhttp://t.co/Mz1Oq5uGhttp://www.twitter.com/NPRhttp://www.twitter.com/NHDDhttp://www.twitter.com/nathankottkamp

7/31/2019 #Hpm Tweet Chat 4:11:12

14/31



rfberry RT @crgonzalez: T2: I suppose it is worth discussing advanced directives with hospitalsupon admission so there is clarity #hpm

Wed Apr 11 18:34:58 PDT 2012

AfternoonNapper @crgonzalez Is that not common practice now? Even my rural hospital asks if a pt has anAD upon admission for routine testing. #hpm

Wed Apr 11 18:34:58 PDT 2012

ctsinclair Everyone say hello and follow @nathankottkamp, founder of @NHDD National HealthcareDecisions Day #HPM

Wed Apr 11 18:34:58 PDT 2012

mkow86 @schwartzbrown just"listening"& like ur thoughtprocess not being concerned re dx & focuon comfort, if only Medicare thought like that #hpm

Wed Apr 11 18:35:22 PDT 2012

aliciabloom +1 MT @rfberry: agree with the article where it says rationing is not necessary if you just

do the things that help, this is so true! #hpmWed Apr 11 18:35:22 PDT 2012

rfberry @crgonzalez though I think there needs to be more emphasis on really facilitatingdiscussions on advance directives in hospitals #hpm

Wed Apr 11 18:35:28 PDT 2012

rfberry @crgonzalez though I think there needs to be more emphasis on really facilitatingdiscussions on advance directives in hospitals #hpm

Wed Apr 11 18:35:28 PDT 2012

GroundSwellAus RT @ctsinclair: Everyone say hello and follow @nathankottkamp, founder of @NHDDNational Healthcare Decisions Day #hpm

Wed Apr 11 18:35:31 PDT 2012

aliciabloom RT @ctsinclair: Everyone say hello and follow @nathankottkamp, founder of @NHDDNational Healthcare Decisions Day

7/31/2019 #Hpm Tweet Chat 4:11:12

15/31



GroundSwellAus advance care directives are something that everyone should talk about yet awareness isso low (at least here in oz) #hpm

Wed Apr 11 18:36:54 PDT 2012

rfberry @crgonzalez as opposed to a processess for signing documnts & designating a durablepower of attorney who doesn't know wht the pt wants #hpm

Wed Apr 11 18:36:58 PDT 2012

jfclearywisc @AnkurB_MD T2: Another thing we can stop fuzzing about: Accepting when someone stilwants to be full code #hpm

Wed Apr 11 18:37:02 PDT 2012

crgonzalez RT @ctsinclair: Everyone say hello and follow @nathankottkamp, founder of @NHDDNational Healthcare Decisions Day #HPM

Wed Apr 11 18:37:07 PDT 2012

AfternoonNapper @crgonzalez O.M.G. Are you serious? How is that even legal? It's not supposed to belegal! #hpm

Wed Apr 11 18:37:17 PDT 2012

crgonzalez @aliciabloom Absolutely #HPMWed Apr 11 18:37:25 PDT 2012

ctsinclair (Sorry for the offtopic with Nathan, but he is a great guy and I was hoping we couldconvince him to join us!) #HPM

Wed Apr 11 18:37:37 PDT 2012

rfberryRT @AfternoonNapper: @nathankottkamp Thank you for all you do! You have directly

impacted my family. Looking forward to the 16th. #hpmWed Apr 11 18:37:45 PDT 2012

ctsinclair RT @jfclearywisc: @AnkurB_MD T2: Another thing we can stop fuzzing about: Acceptingwhen someone still wants to be full code #HPM

Wed Apr 11 18:37:45 PDT 2012

mkow86 @AnkurB_MD typically w strong suspicions of UTI/URI etc, we will treat w ABT withouttesting our hospice patients #hpm

Wed Apr 11 18:37:47 PDT 2012

GroundSwellAus @crgonzalez wow really? #hpmWed Apr 11 18:38:07 PDT 2012

produceconsume @GroundSwellAus Everywhere... global. We are a 'live forever' people. "Proactive" oftennot in the vocabulary. #hpm

Wed Apr 11 18:38:17 PDT 2012
http://twitter.com/173520079/status/190252467253026816http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/GroundSwellAushttp://www.twitter.com/produceconsumehttp://twitter.com/91320531/status/190252426564091905http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/crgonzalezhttp://www.twitter.com/GroundSwellAushttp://twitter.com/23881118/status/190252341335826432http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/mkow86http://twitter.com/17206739/status/190252334218088448http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/jfclearywischttp://www.twitter.com/ctsinclairhttp://twitter.com/121558178/status/190252332506820608http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/nathankottkamphttp://www.twitter.com/AfternoonNapperhttp://www.twitter.com/rfberryhttp://twitter.com/17206739/status/190252299703169025http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/ctsinclairhttp://twitter.com/11763132/status/190252247601516545http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/aliciabloomhttp://www.twitter.com/crgonzalezhttp://twitter.com/346151348/status/190252213950611456http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/crgonzalezhttp://www.twitter.com/AfternoonNapperhttp://twitter.com/11763132/status/190252174838743040http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/NHDDhttp://www.twitter.com/nathankottkamphttp://www.twitter.com/ctsinclairhttp://www.twitter.com/crgonzalezhttp://twitter.com/27231379/status/190252151568740352http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/jfclearywischttp://twitter.com/121558178/status/190252134539853825http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/crgonzalezhttp://www.twitter.com/rfberryhttp://twitter.com/91320531/status/190252118542786561http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/GroundSwellAus

7/31/2019 #Hpm Tweet Chat 4:11:12

16/31



crgonzalez @AfternoonNapper Dr Stone documents examples in her Scientific American articlehttp://t.co/wxqDSs0P#HPM

Wed Apr 11 18:38:29 PDT 2012

ctsinclair @crgonzalez Yes I can see where conscience clauses could cause advance directives topossibly be refused/ignored #HPM

Wed Apr 11 18:38:33 PDT 2012

AnkurB_MD @jfclearywisc Yes! Next in T3 we talk about Avoidable 'Practices' in #Palliative MedicineNOT Test/ treatments!! #hpm

Wed Apr 11 18:38:44 PDT 2012

ctsinclair @mkow86 Great point about treating empirically for UTI if strong clinical indicators #HPMWed Apr 11 18:38:57 PDT 2012

crgonzalez @GroundSwellAus Yeah, really. It is ugly. Read @DrJudyStone article in ScientificAmerican http://t.co/wxqDSs0P#HPM

Wed Apr 11 18:39:02 PDT 2012

GroundSwellAus @produceconsume maybe but I think its also a lack of awreness thing- can do what youdon't know about #hpm

Wed Apr 11 18:39:19 PDT 2012

AnkurB_MD So rapping up T2: Any final thoughts on Tests/ Medications/ Procedures we do daily thatmay be Avoidable! #hpm

Wed Apr 11 18:39:37 PDT 2012

crgonzalez @ctsinclair It is rather unconscionable to override a patient's wish. Talk about doingharm...whew #HPM

Wed Apr 11 18:40:02 PDT 2012

GroundSwellAus thanks RT @crgonzalez: @GroundSwellAus Yeah, really. It is ugly. Read @DrJudyStonearticle in Scientific American http://t.co/PslA8Tln#hpm

Wed Apr 11 18:40:11 PDT 2012

produceconsume @GroundSwellAus I think it's d)all of the above. #hpmWed Apr 11 18:40:29 PDT 2012

AnkurB_MD @nathankottkamp Thanks for joining us! Look fwd to April16th #NHDD#hpmWed Apr 11 18:40:31 PDT 2012

ctsinclair RT @AnkurB_MD: So rapping up T2: Any final thoughts on Tests/ Medications/Procedures we do daily that may be Avoidable! #HPM

Wed Apr 11 18:40:53 PDT 2012

AfternoonNapper @AnkurB_MD I'll make a motion for a new way to take BP and temp instead of waking meup every 2 hours - thankyouverymuch. #hpm
http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/AfternoonNapperhttp://twitter.com/17206739/status/190253119832211456http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/ctsinclairhttp://twitter.com/55394837/status/190253028329263104http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/NHDD/http://www.twitter.com/nathankottkamphttp://www.twitter.com/AnkurB_MDhttp://twitter.com/173520079/status/190253018560724992http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/GroundSwellAushttp://www.twitter.com/produceconsumehttp://twitter.com/91320531/status/190252943973421056http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/PslA8Tlnhttp://www.twitter.com/DrJudyStonehttp://www.twitter.com/GroundSwellAushttp://www.twitter.com/crgonzalezhttp://www.twitter.com/GroundSwellAushttp://twitter.com/11763132/status/190252908305072128http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/ctsinclairhttp://www.twitter.com/crgonzalezhttp://twitter.com/55394837/status/190252804265361408http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://twitter.com/91320531/status/190252728616894464http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/produceconsumehttp://www.twitter.com/GroundSwellAushttp://twitter.com/11763132/status/190252656999141377http://www.symplur.com/healthcare-hashtags/HPM/http://t.co/wxqDSs0Phttp://www.twitter.com/DrJudyStonehttp://www.twitter.com/GroundSwellAushttp://www.twitter.com/crgonzalezhttp://twitter.com/17206739/status/190252636551909376http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/mkow86http://www.twitter.com/ctsinclairhttp://twitter.com/55394837/status/190252581816246272http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/Palliative/http://www.twitter.com/jfclearywischttp://www.twitter.com/AnkurB_MDhttp://twitter.com/17206739/status/190252536136081410http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/crgonzalezhttp://www.twitter.com/ctsinclairhttp://twitter.com/11763132/status/190252517916020736http://www.symplur.com/healthcare-hashtags/HPM/http://t.co/wxqDSs0Phttp://www.twitter.com/AfternoonNapperhttp://www.twitter.com/crgonzalez

7/31/2019 #Hpm Tweet Chat 4:11:12

17/31



Wed Apr 11 18:40:53 PDT 2012

aliciabloom tests, treatments, procedures: consider benefits vs burdens, patient goals & impact onoutcome. more isn't always more #ChoosingWisely#hpm

Wed Apr 11 18:41:14 PDT 2012

produceconsume @AnkurB_MD Impor to let pts know they CAN ask questions. Impor for hcp to participatein convo, ego aside. #hpm

Wed Apr 11 18:41:20 PDT 2012

crgonzalez RT @aliciabloom: tests, treatments, procedures: consider benefits vs burdens, patientgoals & impact on outcome. more isnt always more #HPM

Wed Apr 11 18:41:44 PDT 2012

GroundSwellAus @produceconsume yep! #hpmWed Apr 11 18:41:45 PDT 2012

jfclearywisc @aliciabloom T2: YEs and @AAHPM needs your help to assemble a specific list!!!!#ChoosingWisely#hpmWed Apr 11 18:42:14 PDT 2012

produceconsume MT @aliciabloom: tests, treatments, procedures: consider benefits vs burdens, patientgoals & impact on outcome. more isnt always more #hpm

Wed Apr 11 18:42:19 PDT 2012

AnkurB_MD Yes! RT @produceconsume: @AnkurB_MD Impor to let pts know they CAN ask questionsImpor for hcp to participate in convo, ego aside. #hpm

Wed Apr 11 18:42:22 PDT 2012

ctsinclair T2: #ChoosingWisely: maybe unecessary to send an e-kit home w every patient onhospice. Should be more precise, order what you expect #HPM

Wed Apr 11 18:42:27 PDT 2012

AnkurB_MD Amen! RT @aliciabloom: tests, treatments: consider benefits vs burdens, patient goals &impact on outcome. more isnt always more #hpm

Wed Apr 11 18:42:58 PDT 2012

jfclearywisc @ctsinclair T2: Agree with selective e-kit. Even some may not need one at all !!!#ChoosingWisely#HPM

Wed Apr 11 18:43:21 PDT 2012

ctsinclair RT @AfternoonNapper: Ill make a motion for a new way to take BP and temp instead ofwaking me up every 2 hours - thankyouverymuch. #HPM

Wed Apr 11 18:43:26 PDT 2012

AnkurB_MD @ctsinclair yes! Anticipating Complications and Educating Them in Advance key! #hpmWed Apr 11 18:43:46 PDT 2012
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7/31/2019 #Hpm Tweet Chat 4:11:12

18/31



uvmer @ctsinclair As long as there is nothing going on in hospital that someone couldn't do athome,home is a MUCH better.Experience speaking #HPM

Wed Apr 11 18:43:54 PDT 2012

ctsinclair RT @AliciaBloom More isn't always more. "I think we can all see how this resonates inmany aspects of our life" #HPM

Wed Apr 11 18:44:07 PDT 2012

aliciabloom YES! MT @ctsinclair: #ChoosingWisely: maybe unecessary to send e-kit w every hospicepatient. be more precise, order what you expect #hpm

Wed Apr 11 18:44:12 PDT 2012

aliciabloom RT @jfclearywisc: @aliciabloom T2: YEs and @AAHPM needs your help to assemble aspecific list!!!! #ChoosingWisely "would love to help!" #hpm

Wed Apr 11 18:44:26 PDT 2012

AfternoonNapper Devil's advocate for a moment - what if patients want more/need more "info" to feel "betterabt situation vs. what doc actually needs? #hpm

Wed Apr 11 18:44:26 PDT 2012

schwartzbrown Need to educate family on signs and sx of distress and how to manage pt and their ownreactions #hpm

Wed Apr 11 18:44:37 PDT 2012

RyanMadanickMD @AfternoonNapper why not? Info is power! #hpmWed Apr 11 18:44:47 PDT 2012

ctsinclair @jfclearywisc Selective e-kit one way to show reducing unneeded opioids in thecommunity #HPMWed Apr 11 18:44:49 PDT 2012

GroundSwellAus RT @uvmer: @ctsinclair As long as there is nothing going on in hospital that someonecouldnt do at home,home is a MUCH better. #hpm

Wed Apr 11 18:45:00 PDT 2012

equijada @ctsinclair yes, E-kit paradoxically becomes reactive rather than proactive #hpmWed Apr 11 18:45:05 PDT 2012

AnkurB_MD OK T3: Avoidable 'Practices' in HPM that may cause unintentional harm? Eg.. Avoiding th'Conflict Scenarios' etc.. #hpmWed Apr 11 18:45:17 PDT 2012

aliciabloom @uvmer@ctsinclair AND if the patient wishes to be at home & the family can safely andcomfortably manage the care needs. #hpm

Wed Apr 11 18:45:29 PDT 2012

@jfclearywisc@ctsinclair e-kit same as comfort kit? #HPM if so, I agree. End up wasting
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7/31/2019 #Hpm Tweet Chat 4:11:12

19/31



mkow86 half of the meds, know allergies before hand tooWed Apr 11 18:45:39 PDT 2012

ctsinclair @AfternoonNapper That is a tough conundrum "The 'I want an MRI to see if the #Cancergrowing' conundrum" #HPM

Wed Apr 11 18:45:45 PDT 2012

produceconsume MT @AfternoonNapper what if patients want more/need more "info" to feel "better" abtsituation vs. what doc actually needs? #hpm

Wed Apr 11 18:46:00 PDT 2012

equijada @AfternoonNapper I love your perspective! Keep it up. #hpmWed Apr 11 18:46:02 PDT 2012

AfternoonNapper @RyanMadanickMD Ex: many FMD patients like me would love a full-body angio to ruleout other arteries being effected but no med need. #hpm

Wed Apr 11 18:46:05 PDT 2012

aliciabloom @ctsinclair like with peeps! seriously though, i agree. #hpmWed Apr 11 18:46:22 PDT 2012

produceconsume @AnkurB_MD Elaborate? #hpmWed Apr 11 18:46:23 PDT 2012

rfberry RT @AnkurB_MD: @ctsinclair yes! Anticipating Complications and Educating Them inAdvance key! #hpm

Wed Apr 11 18:46:25 PDT 2012

GroundSwellAus RE: ACD's shouldn't we also be thinking beyond "hospice" users... what about people withcardiac & other peeps who can die suddenly #hpm

Wed Apr 11 18:46:25 PDT 2012

ctsinclair @mkow86 yup e-kit = emergency kit = comfort care kit #HPMWed Apr 11 18:46:26 PDT 2012

RyanMadanickMD @AfternoonNapper that's when weighing risk v benefit ratio is important #hpmWed Apr 11 18:46:39 PDT 2012

equijada RT @jfclearywisc: @ctsinclair T2: Agree with selective e-kit. Even some may not need onat all !!! #ChoosingWisely#HPM

Wed Apr 11 18:46:50 PDT 2012

GroundSwellAus RT @ctsinclair: @mkow86 yup e-kit = emergency kit = comfort care kit #hpmWed Apr 11 18:46:51 PDT 2012
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7/31/2019 #Hpm Tweet Chat 4:11:12

20/31



produceconsume MT @mkow86 e-kit same as comfort kit? #HPM if so, I agree. End up wasting half of themeds, know allergies before hand too #hpm

Wed Apr 11 18:46:59 PDT 2012

jfclearywisc @ctsinclair@afternoonNapper T2: so doing tests (eg. MRI) when symptoms clearlyindicate progression of disease. #Cancer#HPM

Wed Apr 11 18:47:01 PDT 2012

AfternoonNapper @equijada Thank you. : ) #hpmWed Apr 11 18:47:04 PDT 2012

schwartzbrown Nobody told me about air-hunger sx in end stage lung cancer with my mother. #hpmWed Apr 11 18:47:14 PDT 2012

ctsinclair @AfternoonNapper I think the 'tests for info' conundrum has to be weighted against whatoutcome it will potentially affect #HPM

Wed Apr 11 18:47:32 PDT 2012

rfberry RT @AnkurB_MD: OK T3: Avoidable 'Practices' in HPM that may cause unintentionalharm? Eg.. Avoiding the 'Conflict Scenarios' etc.. #hpm

Wed Apr 11 18:47:35 PDT 2012

aliciabloom @AfternoonNapper supportive education & counseling is critically important. need toestablish appropriate plan of care for each patient #hpm

Wed Apr 11 18:47:45 PDT 2012

RyanMadanickMD @AfternoonNapper risk can also be more than physical risk to pt; cost, extraneousinformation (can ==> more tests/anxiety), etc #hpm

Wed Apr 11 18:47:49 PDT 2012

ctsinclair RT @AnkurB_MD: OK T3: Avoidable Practices in HPM that may cause unintentionalharm? Eg.. Avoiding the Conflict Scenarios etc.. #HPM

Wed Apr 11 18:48:01 PDT 2012

GroundSwellAus is a comfort kit at home meds for pall care? #hpmWed Apr 11 18:48:11 PDT 2012

AfternoonNapper @RyanMadanickMD What if the only identifiable benefit pre-test is a patient's mental

security? #hpmWed Apr 11 18:48:17 PDT 2012

jfclearywisc @AnkurB_MD T3 Avoidable practices. Declining to admit patients who wish to be full code#hpm

Wed Apr 11 18:48:29 PDT 2012

schwartzbrown Lack of education/prep is what causes people to give up on hospice decision #hpm
http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/schwartzbrownhttp://twitter.com/27231379/status/190255032380305408http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/jfclearywischttp://twitter.com/346151348/status/190254984229695489http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/RyanMadanickMDhttp://www.twitter.com/AfternoonNapperhttp://twitter.com/91320531/status/190254956949929984http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/GroundSwellAushttp://twitter.com/17206739/status/190254916915310592http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/ctsinclairhttp://twitter.com/233358828/status/190254864142569472http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AfternoonNapperhttp://www.twitter.com/RyanMadanickMDhttp://twitter.com/24399366/status/190254851039571968http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AfternoonNapperhttp://www.twitter.com/aliciabloomhttp://twitter.com/121558178/status/190254808987484161http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/rfberryhttp://twitter.com/17206739/status/190254795205001216http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/AfternoonNapperhttp://www.twitter.com/ctsinclairhttp://twitter.com/273605086/status/190254718252089344http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/schwartzbrownhttp://twitter.com/346151348/status/190254676120309762http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/equijadahttp://www.twitter.com/AfternoonNapperhttp://twitter.com/27231379/status/190254664040722432http://www.symplur.com/healthcare-hashtags/HPM/http://www.symplur.com/healthcare-hashtags/Cancer/http://www.twitter.com/afternoonNapperhttp://www.twitter.com/ctsinclairhttp://www.twitter.com/jfclearywischttp://twitter.com/173520079/status/190254655459168256http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/mkow86http://www.twitter.com/produceconsume

7/31/2019 #Hpm Tweet Chat 4:11:12

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Wed Apr 11 18:48:30 PDT 2012

ctsinclair T3: Avoidable practice: feeling like you MUST tell a patient they are dying, or theirprognosis. Ask them what they want to know #HPM

Wed Apr 11 18:48:49 PDT 2012

uvmer @aliciabloom@ctsinclair of course.. patient must be comfortable w/it...hopefully somethindiscussed before,& it is the patient's wish #hpm

Wed Apr 11 18:49:01 PDT 2012

jfclearywisc @GroundSwellAus yes #hpmWed Apr 11 18:49:05 PDT 2012

aliciabloom @AfternoonNapper@RyanMadanickMD need to explore why the patie

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#Hpm Tweet Chat 4:11:12