#Hpm Tweet Chat 5:16:12

7/31/2019 #Hpm Tweet Chat 5:16:12

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

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Healthcare Social Media TranscriptFrom: Wed May 16 18:00:00 PDT 2012

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aliciabloom

7/31/2019 #Hpm Tweet Chat 5:16:12

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aliciabloom hi @April918! welcome @nursefriendly & @dianewolfePRx! #hpmWed May 16 18:02:52 PDT 2012

_lizzy_ Hi I'm Lizzy, MA, MSW, LSW mostly doing Thanatology research, hospice volunteeringand branching into community death education #hpm

Wed May 16 18:03:01 PDT 2012

KathyKastner @aliciabloom Greetings! Developer app for end of life decisions (just started workships forbest-endings .com (Woot) #hpmWed May 16 18:03:08 PDT 2012

aliciabloom hi @_lizzy_ & @KathyKastner! #hpmWed May 16 18:03:54 PDT 2012

dianewolfePRx Joining the #hpm chat as a board member, Coalition for Quality End-of-Life Care, NorthTexas.

Wed May 16 18:03:56 PDT 2012

aliciabloom expect a flurry of tweets from me for the next hour-- it's #hpm chat!Wed May 16 18:05:03 PDT 2012

nursefriendly Welcome :) RT @dianewolfePRx: Joining the #hpm chat as a board member, Coalition forQuality End-of-Life Care, North Texas.

Wed May 16 18:05:30 PDT 2012

aliciabloom lots of media attention recently on healthcare-- cost, quality & reform...oh my! (electionyear anyone?) #hpm

Wed May 16 18:05:53 PDT 2012

aliciabloom tonight, we will look at this & discuss opportunities for #hospice & #palliative care to makean impact #hpm

Wed May 16 18:06:34 PDT 2012

April918 RT @aliciabloom: expect a flurry of tweets from me for the next hour-- it's #hpm chat!Wed May 16 18:06:43 PDT 2012

nursefriendly RT @aliciabloom: lots of media attention recently on healthcare-- cost, quality &reform...oh my! (election year anyone?) #hpm

Wed May 16 18:06:44 PDT 2012

equijada I just backed The first Death Caf in the USA on @Kickstarterhttp://t.co/t3sRiFvM#hpmWed May 16 18:06:57 PDT 2012

nursefriendly RT @aliciabloom: tonight, we will look at this & discuss opportunities for #hospice palliative care to make an impact #hpm

Wed May 16 18:07:43 PDT 2012
http://twitter.com/22638297/status/202928350291959808http://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://www.twitter.com/nursefriendlyhttp://twitter.com/22651861/status/202928158335447041http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/t3sRiFvMhttp://www.twitter.com/Kickstarterhttp://www.twitter.com/equijadahttp://twitter.com/22638297/status/202928100835721216http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://www.twitter.com/nursefriendlyhttp://twitter.com/179338293/status/202928096821780480http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://www.twitter.com/April918http://twitter.com/24399366/status/202928059236622337http://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/24399366/status/202927886909444096http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/22638297/status/202927792759902210http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/dianewolfePRxhttp://www.twitter.com/nursefriendlyhttp://twitter.com/24399366/status/202927680486785024http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/23857098/status/202927399506153472http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/dianewolfePRxhttp://twitter.com/24399366/status/202927389355937794http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/_lizzy_http://www.twitter.com/aliciabloomhttp://twitter.com/101386174/status/202927198125047808http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://www.twitter.com/KathyKastnerhttp://twitter.com/15739043/status/202927168840400896http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/_lizzy_http://twitter.com/24399366/status/202927129887911936http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/dianewolfePRxhttp://www.twitter.com/nursefriendlyhttp://www.twitter.com/April918http://www.twitter.com/aliciabloom

7/31/2019 #Hpm Tweet Chat 5:16:12

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otherspoon RT @equijada: I just backed The first Death Caf in the USA on @kickstarterhttp://t.co/AZXcMOWt#hpm

Wed May 16 18:08:44 PDT 2012

_lizzy_ @equijada Holy cow! Why thank you! My goal is to get people thinking about death WAYbefore hospice time comes around. #hpm

Wed May 16 18:08:59 PDT 2012

aliciabloom pre-T1: Healthcare or a Hyundai? (http://t.co/vhVhlGwP) Families spending $20,000/yeaon medical care. #hpm

Wed May 16 18:09:20 PDT 2012

apjonas Hi, Pat Jonas, MD Holistic Family Physician, Dayton, OH area. Caring for 3 hospice pts intheir homes presently. #hpm

Wed May 16 18:09:22 PDT 2012

aliciabloom thanks for joining us, @apjonas! #hpmWed May 16 18:10:20 PDT 2012

hospice_ceh RT @Kathy_Brandt: #Grief and #caregiving in the workplace-free tools for managers-including an online course. http://t.co/0SqGIPFY#HPM

Wed May 16 18:11:16 PDT 2012

_lizzy_ @apjonas Wooo hoo! Welcome to another Ohioan! (I live in Columbus). #hpmWed May 16 18:11:36 PDT 2012

aliciabloom T1: the rising cost of healthcare places a financial burden on patients-- what impact areyou seeing (personally or professionally)? #hpm

Wed May 16 18:11:44 PDT 2012

nursefriendly RT @_lizzy_: @equijada Holy cow! Why thank you! My goal is to get people thinking aboudeath WAY before hospice time comes around. #hpm

Wed May 16 18:13:02 PDT 2012

nursefriendly @aliciabloom T1 Patient are leaving #doctors offices, #hospitals with #prescriptions fordrugs, tests - no money to pay for them :( #hpmWed May 16 18:14:28 PDT 2012

aliciabloom financial burden of medical care definitely impacting patient access to treatment &appropriate services. #hpmWed May 16 18:15:35 PDT 2012

nursefriendly @aliciabloom Have friends, neighbors, family that are living with chronic pain, conditions,can't afford medical treatments #hpm

Wed May 16 18:16:09 PDT 2012

(using tweetchat tonight & feeling like it's very slow...anyone else having this challenge....?
http://twitter.com/22638297/status/202930470546194432http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://www.twitter.com/nursefriendlyhttp://twitter.com/24399366/status/202930327797248000http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/22638297/status/202930048905379840http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/prescriptions/http://www.symplur.com/healthcare-hashtags/hospitals/http://www.symplur.com/healthcare-hashtags/doctors/http://www.twitter.com/aliciabloomhttp://www.twitter.com/nursefriendlyhttp://twitter.com/22638297/status/202929687570296832http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/equijadahttp://www.twitter.com/_lizzy_http://www.twitter.com/nursefriendlyhttp://twitter.com/24399366/status/202929362675306496http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/15739043/status/202929329112498177http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/apjonashttp://www.twitter.com/_lizzy_http://twitter.com/249789879/status/202929244781805568http://www.symplur.com/healthcare-hashtags/HPM/http://t.co/0SqGIPFYhttp://www.symplur.com/healthcare-hashtags/caregiving/http://www.symplur.com/healthcare-hashtags/Grief/http://www.twitter.com/Kathy_Brandthttp://www.twitter.com/hospice_cehhttp://twitter.com/24399366/status/202929006549532672http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/apjonashttp://www.twitter.com/aliciabloomhttp://twitter.com/21540353/status/202928765981032449http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/apjonashttp://twitter.com/24399366/status/202928755029716992http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/15739043/status/202928670002778113http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/equijadahttp://www.twitter.com/_lizzy_http://twitter.com/86072573/status/202928607369236481http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/AZXcMOWthttp://www.twitter.com/kickstarterhttp://www.twitter.com/equijadahttp://www.twitter.com/otherspoon

7/31/2019 #Hpm Tweet Chat 5:16:12

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aliciabloom #hpmWed May 16 18:16:11 PDT 2012

nursefriendly @aliciabloom I'm on tweetdeck, not too much lag time. #hpmWed May 16 18:16:39 PDT 2012

dianewolfePRx T1: most I know are 1 medical emergency from financial crisis, even the insured, or can'tafford premiums + copays, so forgoing care. #hpmWed May 16 18:16:58 PDT 2012

_lizzy_ T1 Patients who have to live in lower quality LTC facilities because it's the best they canafford makes me sad. #hpm

Wed May 16 18:17:19 PDT 2012

nursefriendly RT @_lizzy_: T1 Patients who have to live in lower quality LTC facilities because it's thebest they can afford makes me sad. #hpm

Wed May 16 18:17:36 PDT 2012

aliciabloom @dianewolfePRx more & more patients, even with insurance, struggling with co-pays &deductibles. #hpmWed May 16 18:18:11 PDT 2012

apjonas @_lizzy_ Hi Lizzy. #hpmWed May 16 18:18:27 PDT 2012

aliciabloom @_lizzy_ great point about LTC facilities-- important for #hospice providers. #hpmWed May 16 18:18:54 PDT 2012

DeathwDignity What do you think? Frank/direct chats abt death w/children or should these discussionshave a different tone? http://t.co/CucJ8u0R#hpmWed May 16 18:19:01 PDT 2012

April918 Agreed!!!RT @_lizzy_: T1 Patients who have to live in lower quality LTC facilities becauseit's the best they can afford makes me sad. #hpm

Wed May 16 18:19:01 PDT 2012

nursefriendly @aliciabloom 1/3 bankruptcy proceedings is directly related to #medicalbills :( #hpmWed May 16 18:19:10 PDT 2012

apjonas Families willing to look at hospice earlier for pre-EOL due to finances. Seniors asking forgenerics to replace drugs rx by docs #hpm

Wed May 16 18:20:19 PDT 2012

aliciabloom seeing more patients with advanced cancer at time of diagnosis--they've been unable toaccess standard, preventive care. #hpm

Wed May 16 18:20:25 PDT 2012
http://twitter.com/24399366/status/202931547551186944http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/21540353/status/202931519168331777http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/apjonashttp://twitter.com/22638297/status/202931229509685250http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/medicalbills/http://www.twitter.com/aliciabloomhttp://www.twitter.com/nursefriendlyhttp://twitter.com/179338293/status/202931193975549952http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/_lizzy_http://www.twitter.com/April918http://twitter.com/164865277/status/202931191970676736http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/CucJ8u0Rhttp://www.twitter.com/DeathwDignityhttp://twitter.com/24399366/status/202931166024699904http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/hospice/http://www.twitter.com/_lizzy_http://www.twitter.com/aliciabloomhttp://twitter.com/21540353/status/202931051276926976http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/_lizzy_http://www.twitter.com/apjonashttp://twitter.com/24399366/status/202930983396311040http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/dianewolfePRxhttp://www.twitter.com/aliciabloomhttp://twitter.com/22638297/status/202930838713802752http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/_lizzy_http://www.twitter.com/nursefriendlyhttp://twitter.com/15739043/status/202930765741305856http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/_lizzy_http://twitter.com/23857098/status/202930679527391232http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/dianewolfePRxhttp://twitter.com/22638297/status/202930599093211136http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://www.twitter.com/nursefriendlyhttp://twitter.com/24399366/status/202930482600624128http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloom

7/31/2019 #Hpm Tweet Chat 5:16:12

5/13



aliciabloom MT @apjonas: Families willing to look at hospice earlier for pre-EOL due to finances.Seniors asking for generics to replace drugs Rx #hpm

Wed May 16 18:21:00 PDT 2012

_lizzy_ T1 More and more offices have eliminated live receptionists for family practice. Verydifficult for elders to navigate phone system. #hpm

Wed May 16 18:21:02 PDT 2012

nursefriendly @apjonas I'm only in my 40s, have prescription plan, still ask for generics. Don't trust FDAto screen dangerous drugs. #hpm

Wed May 16 18:21:34 PDT 2012

_lizzy_ @aliciabloom As I'm sure you've experienced, the range of quality of LTC is quite shockin(at least in my city). #hpm

Wed May 16 18:21:47 PDT 2012

apjonas Pts pressing docs for too much in each clinical encounter diluting quality and stressingsystems. Stress for all #hpm

Wed May 16 18:22:10 PDT 2012

aliciabloom @_lizzy_ same here in the greater Philadelphia area & it seems to be directly related tosocioeconomic status of the neighborhood. #hpm

Wed May 16 18:22:46 PDT 2012

aliciabloom @apjonas absolutely, great point-- wanting every test done, all questions answered in onevisit or hospitalization. #hpmWed May 16 18:23:31 PDT 2012

apjonas @nursefriendly Seniors used to press for brands after being taught by docs who weregulible to drug reps (my bias) #hpmWed May 16 18:23:42 PDT 2012

dianewolfePRx T1: we promote advance care planning but emphasize quality of life and care, not cost.There are savings, but that's not the point. #hpm

Wed May 16 18:23:42 PDT 2012

nursefriendly

7/31/2019 #Hpm Tweet Chat 5:16:12

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_lizzy_ T1 Also have seen redundant care because no one is noticing that elder not effectivelyself-managing multiple MD visits #hpm

Wed May 16 18:25:46 PDT 2012

apjonas RT @aliciabloom: financial burden of healthcare has serious implications for patients thruillness trajectory-- from diagnosis to death #hpm

Wed May 16 18:25:54 PDT 2012

nursefriendly @apjonas#Bigpharma is slick, they are still getting doctors to prescribe brand names vsgenerics :( #hpmWed May 16 18:26:02 PDT 2012

aliciabloom final thoughts on T1...? we'll be building on our conversation as we move on to T2. #hpmWed May 16 18:26:02 PDT 2012

aliciabloom @dianewolfePRx great point & a nice bridge to our next topic! #hpmWed May 16 18:26:40 PDT 2012

aliciabloom pre-T2: In healthcare, cheaper can mean better (http://t.co/yT6upVy6) #hpmWed May 16 18:27:10 PDT 2012

nursefriendly @aliciabloom The #elderly for decades have been deciding between food or #prescription#medications, nothing new :( #hpm

Wed May 16 18:27:52 PDT 2012

nursefriendly RT @_lizzy_: T1 Also have seen redundant care because no one is noticing that elder noteffectively self-managing multiple MD visits #hpm

Wed May 16 18:28:20 PDT 2012

aliciabloom @nursefriendly sad....but true. #hpmWed May 16 18:28:29 PDT 2012

apjonas pts don't realize hospitals are "frenemies" -profit seeking with expensive tech, esp CT inevery Starbucks to max profit #hpm

Wed May 16 18:28:35 PDT 2012

dianewolfePRx RT @nursefriendly: @aliciabloom The #elderly for decades have been deciding betweenfood or #prescription#medications, nothing new :( #hpm

Wed May 16 18:28:52 PDT 2012

aliciabloom T2: how do we help patients understand "more" medical care is not always appropriate,instead of them being fearful of this reality? #hpm

Wed May 16 18:30:37 PDT 2012

AnkurB_MD Hi #hpm folks.. joining in for the chat - for the next 1/2 hr!Wed May 16 18:31:53 PDT 2012
http://twitter.com/55394837/status/202934429826564098http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://twitter.com/24399366/status/202934113760587777http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/23857098/status/202933673627090944http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/medications/http://www.symplur.com/healthcare-hashtags/prescription/http://www.symplur.com/healthcare-hashtags/elderly/http://www.twitter.com/aliciabloomhttp://www.twitter.com/nursefriendlyhttp://www.twitter.com/dianewolfePRxhttp://twitter.com/21540353/status/202933599866060800http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/apjonashttp://twitter.com/24399366/status/202933574670884864http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/nursefriendlyhttp://www.twitter.com/aliciabloomhttp://twitter.com/22638297/status/202933538310455296http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/_lizzy_http://www.twitter.com/nursefriendlyhttp://twitter.com/22638297/status/202933418730856450http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/medications/http://www.symplur.com/healthcare-hashtags/prescription/http://www.symplur.com/healthcare-hashtags/elderly/http://www.twitter.com/aliciabloomhttp://www.twitter.com/nursefriendlyhttp://twitter.com/24399366/status/202933246433050625http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/24399366/status/202933118196391937http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/dianewolfePRxhttp://www.twitter.com/aliciabloomhttp://twitter.com/24399366/status/202932960016601089http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/22638297/status/202932961107128320http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/Bigpharma/http://www.twitter.com/apjonashttp://www.twitter.com/nursefriendlyhttp://twitter.com/21540353/status/202932925820452864http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://www.twitter.com/apjonashttp://twitter.com/15739043/status/202932891230027776http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/_lizzy_

7/31/2019 #Hpm Tweet Chat 5:16:12

7/13



dianewolfePRx T2: Better communication among physicians would be a big improvement. 3 doctors, 3opinions, no lead on working with the family. #hpm

Wed May 16 18:32:20 PDT 2012

aliciabloom welcome @AnkurB_MD! better late than not at all...thanks for joining! we're just starting onT2 #hpm

Wed May 16 18:32:58 PDT 2012

aliciabloom RT @aliciabloom: pre-T2: In healthcare, cheaper can mean better (http://t.co/yT6upVy6)#hpm

Wed May 16 18:33:10 PDT 2012

ravipm2000 T2: It seems that the art of a good history and physical exam is fading away. Testing ismore the rule than the exception in America. #hpm

Wed May 16 18:33:13 PDT 2012

aliciabloom yes! MT @dianewolfePRx: Better communication among physicians would beimprovement. 3 doctors, 3 opinions, no lead on working w/ family #hpm

Wed May 16 18:34:11 PDT 2012

apjonas T2 Early education about Benefits and Harms of all medical testing and technology.Spread the word about False Positives from tests. #hpm

Wed May 16 18:34:13 PDT 2012

aliciabloom great point, @ravipm2000! huge amount of $ spent on unnecessary tests & not enoughtime spent listening to the patient's history. #hpmWed May 16 18:35:05 PDT 2012

_lizzy_ @dianewolfePRx Agree! Though my elder patient just made her own random appts wmultiple MDs. They didn't know others existed. #hpmWed May 16 18:35:37 PDT 2012

apjonas T2 Re-emphasize value of pt-phys relationship as a protection against money suckingpotential of med-industrial complex #hpm

Wed May 16 18:36:04 PDT 2012

aliciabloom if going to do additional diagnostic work-up, we should ask: what are we going to do withthe information? how will it help patient? #hpm

Wed May 16 18:36:14 PDT 2012

apjonas T2 I now warn pts about dangers of my profession being misaligned w/health needs ofpeople and populations. #hpm

Wed May 16 18:37:29 PDT 2012

dianewolfePRx T2: Telling family and patient stories to explain burdens/benefits of care in layman's termsseems effective when less is more. #hpmWed May 16 18:37:30 PDT 2012
http://twitter.com/23857098/status/202935844024233984http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/dianewolfePRxhttp://twitter.com/21540353/status/202935839406309376http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/apjonashttp://twitter.com/24399366/status/202935524359548928http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/21540353/status/202935484282966016http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/apjonashttp://twitter.com/15739043/status/202935371904974849http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/dianewolfePRxhttp://www.twitter.com/_lizzy_http://twitter.com/24399366/status/202935238534496256http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/ravipm2000http://www.twitter.com/aliciabloomhttp://twitter.com/21540353/status/202935019063357441http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/apjonashttp://twitter.com/24399366/status/202935011006091264http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/dianewolfePRxhttp://www.twitter.com/aliciabloomhttp://twitter.com/390759406/status/202934765509279744http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/ravipm2000http://twitter.com/24399366/status/202934754671202306http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://www.twitter.com/aliciabloomhttp://twitter.com/24399366/status/202934705094537216http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://www.twitter.com/aliciabloomhttp://twitter.com/23857098/status/202934546012971009http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/dianewolfePRx

7/31/2019 #Hpm Tweet Chat 5:16:12

8/13



ravipm2000 T2: Good history and phys exam should reveal the diagnosis in most cases. Tests arethere for confirmation, not to "figure out" probs. #hpm

Wed May 16 18:39:00 PDT 2012

aliciabloom language matters. honest conversation, easy to understand words = essential. patientswant what's helpful-- discuss benefit vs burden #hpm

Wed May 16 18:39:19 PDT 2012

April918 T2: make healthcare not-for-profit! Oh sorry did I get to ambitious?? #HPMWed May 16 18:39:45 PDT 2012

AnkurB_MD T2: 'Fear of Abandonment' & feeling 'lonely' in this gigantic Healthcare 'system' -> patientspicking the Default "More Care" option! #hpmWed May 16 18:40:02 PDT 2012

_lizzy_ T2 Sometimes patients want "more" because they believe QOL will return to a level that itwon't. Explaining real outcome is key. #hpm

Wed May 16 18:40:26 PDT 2012

apjonas T2 Repeatedly warn pts against allowing others to refer them to other specs. (YES! HRReds B8 vs Mets). #hpm

Wed May 16 18:41:07 PDT 2012

AnkurB_MD RT @ravipm2000: T2: Good history and phys exam should reveal the diagnosis in mostcases. Tests to confirm, not to "figure out" probs. #hpm

Wed May 16 18:41:11 PDT 2012

April918 t2: teach doctors to discuss #HPM when patients ask for more treatment that will have nobenefit

Wed May 16 18:41:38 PDT 2012

dianewolfePRx T2: we're talking about some very difficult conversations now. How many providers feelprepared for these? #hpmWed May 16 18:42:34 PDT 2012

aliciabloom when we give people options: full treatment or withdrawal of care. it feels like everythingvs. nothing & that's an impossible choice! #hpm

Wed May 16 18:42:59 PDT 2012

apjonas RT @aliciabloom: language matters. honest conversation, easy to understand words =essential. pts want helpful-- disc benefit vs burden #hpmWed May 16 18:43:00 PDT 2012

DennyDkellyrn RT @Pallimed: RT @GeriPalblog Mostly Dead vs Completely Dead: A Distinction Best Leto Hollywood http://t.co/TBqsJ02R#hpm

Wed May 16 18:43:20 PDT 2012
http://twitter.com/390698840/status/202937312978538497http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/TBqsJ02Rhttp://www.twitter.com/GeriPalbloghttp://www.twitter.com/Pallimedhttp://www.twitter.com/DennyDkellyrnhttp://twitter.com/21540353/status/202937230220722177http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://www.twitter.com/apjonashttp://twitter.com/24399366/status/202937223073644546http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/23857098/status/202937118618689536http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/dianewolfePRxhttp://twitter.com/179338293/status/202936884186464256http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/April918http://twitter.com/55394837/status/202936771691020289http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/ravipm2000http://www.twitter.com/AnkurB_MDhttp://twitter.com/21540353/status/202936753894604801http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/apjonashttp://twitter.com/15739043/status/202936581441585155http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/_lizzy_http://twitter.com/55394837/status/202936481701048320http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/AnkurB_MDhttp://twitter.com/179338293/status/202936410133643265http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/April918http://twitter.com/24399366/status/202936303757688832http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://twitter.com/390759406/status/202936223545819136http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/ravipm2000

7/31/2019 #Hpm Tweet Chat 5:16:12

9/13



aliciabloom @dianewolfePRx i think many providers are not armed with the skills to lead difficultconversations. #palliative care can help! #hpm

Wed May 16 18:43:45 PDT 2012

_lizzy_ RT @aliciabloom: language matters. honest conversation, easy to understand words =essential. pts want helpful-- disc benefit vs burden #hpm

Wed May 16 18:44:02 PDT 2012

AnkurB_MD Yes! Communication is key! MT @dianewolfePRx: T2: Explaining care burdens/benefits inlayman's terms by telling stories seems effective #hpmWed May 16 18:44:47 PDT 2012

jfclearywisc MT @ravipm2000: T2: Good H&E should reveal diagnosis in most cases. Tests are therefor confirmation, not to "figure out" probs. #hpm

Wed May 16 18:45:17 PDT 2012

apjonas @dianewolfePRx All Family docs trained in EOL discussion. Most R comfortable #hpmWed May 16 18:45:35 PDT 2012

CHPCC RT @doclake: Clearing up confusion about #palliative care- nice interview from MN publicradio http://t.co/MhXJHyEs#hpm

Wed May 16 18:45:52 PDT 2012

jfclearywisc MT @ravipm2000: T2: The art of good history &physical exam is fading away. Testing ismore the rule than the exception in America. #hpm

Wed May 16 18:46:19 PDT 2012

jfclearywisc Yes joining #Hpm late. Jim Cleary UW palliative care and Pain and Policy Study Group@painpolicy

Wed May 16 18:47:08 PDT 2012

dianewolfePRx @apjonas So the family practice or PCP is where this should happen? #hpmWed May 16 18:47:17 PDT 2012

April918 @aliciabloom#HPM allows our HC system to continue appropriate care....not withdrawcare.

Wed May 16 18:47:18 PDT 2012

jfclearywisc @aliciabloom T@ Patients are beginning. Early breast cancer patient on Tamoxifen.

"Probably did U/Sound of uterus because they make $$" #hpmWed May 16 18:48:47 PDT 2012

aliciabloom hi @jfclearywisc! we're talking about helping pts understand "more" care isn't always bettein the setting of major media focus on $ #hpm

Wed May 16 18:48:50 PDT 2012

aliciabloom RT @April918: @aliciabloom#HPM allows our HC system to continue appropriate
http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/aliciabloomhttp://www.twitter.com/April918http://www.twitter.com/aliciabloomhttp://twitter.com/24399366/status/202938699028234241http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/jfclearywischttp://www.twitter.com/aliciabloomhttp://twitter.com/27231379/status/202938684432064514http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://www.twitter.com/jfclearywischttp://twitter.com/179338293/status/202938311839457281http://www.symplur.com/healthcare-hashtags/HPM/http://www.twitter.com/aliciabloomhttp://www.twitter.com/April918http://twitter.com/23857098/status/202938309155098624http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/apjonashttp://www.twitter.com/dianewolfePRxhttp://twitter.com/27231379/status/202938270634622976http://www.twitter.com/painpolicyhttp://www.symplur.com/healthcare-hashtags/Hpm/http://www.twitter.com/jfclearywischttp://twitter.com/27231379/status/202938061892489216http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/ravipm2000http://www.twitter.com/jfclearywischttp://twitter.com/65495542/status/202937951804604417http://www.symplur.com/healthcare-hashtags/hpm/http://t.co/MhXJHyEshttp://www.symplur.com/healthcare-hashtags/palliative/http://www.twitter.com/doclakehttp://www.twitter.com/CHPCChttp://twitter.com/21540353/status/202937877825458178http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/dianewolfePRxhttp://www.twitter.com/apjonashttp://twitter.com/27231379/status/202937802265075714http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/ravipm2000http://www.twitter.com/jfclearywischttp://twitter.com/55394837/status/202937677119623170http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/dianewolfePRxhttp://www.twitter.com/AnkurB_MDhttp://twitter.com/15739043/status/202937488929587200http://www.symplur.com/healthcare-hashtags/hpm/http://www.twitter.com/aliciabloomhttp://www.twitter.com/_lizzy_http://twitter.com/24399366/status/202937419182510081http://www.symplur.com/healthcare-hashtags/hpm/http://www.symplur.com/healthcare-hashtags/palliative/http://www.twitter.com/dianewolfePRxhttp://www.twitter.com/aliciabloom

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care....not withdraw care. #hpm

Wed May 16 18:49:03 PDT 2012

apjonas @dianewolfePRx The family and clergy have the first shot. If not used, Family Doc is readwith reality when pt & fam ready #hpm

Wed May 16 18:49:44 PDT 2012

jfclearywisc @aliciabloom T2 Patients are getting it Early breast Ca patient on Tamoxifen. "Probablydid U/Sound of uterus because they make $$" #hpmWed May 16 18:50:01 PDT 2012

dianewolfePRx RT @aliciabloom: RT @April918: @aliciabloom#HPM allows our HC system to continueappropriate care....not withdraw care. #hpmWed May 16 18:50:08 PDT 2012

aliciabloom as we wrap up our hour together, i'd like to get some feedback from the group about future#hpm chats. please share thoughts & ideas...

Wed May 16 18:52:53 PDT 2012

jfclearywisc @aliciabloom thanks #hpmWed May 16 18:53:54 PDT 2012

AnkurB_MD T2: We need a #CultureChange of #LessIsMore not only in Healthcare but in other choicein Life as well... #hpm

Wed May 16 18:54:24 PDT 2012

dianewolfePRx @aliciabloom Effective #hpm public education strategies, case studies. What's working?Wed May 16 18:54:32 PDT 2012

aliciabloom suggestions for future topics or focus of the chats...? #hpmWed May 16 18:55:00 PDT 2012

aliciabloom thanks, @dianewolfePRx. i like the idea of focusing some discussion on public educationstrategies. we could engage @NHDD. #hpmWed May 16 18:56:02 PDT 2012

dianewolfePRx RT @AnkurB_MD: T2: We need a #CultureChange of #LessIsMore not only in Healthcarebut in other choices in Life as well... #hpm

Wed May 16 18:56:02 PDT 2012

aliciabloom true!! RT @AnkurB_MD: T2: We need a #CultureChange of #LessIsMore not only inHealthcare but in other choices in Life as well... #hpmWed May 16 18:56:11 PDT 2012

_lizzy_ @aliciabloom I'd love to hear specific best practices that have worked for others for variouideals we all state i.e. the HOW part #hpm

Wed May 16 18:56:23 PDT 2012
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7/31/2019 #Hpm Tweet Chat 5:16:12

11/13



AnkurB_MD .@aliciabloom Agree! Need to reframe delivery of healthcare options as "What'sAppropriate?" & NOT "Everything OR Nothing?" #hpm#palliative

Wed May 16 18:56:36 PDT 2012

jfclearywisc RT @aliciabloom: more combination chats with other hashtags..? #hpmWed May 16 18:57:35 PDT 2012

aliciabloom @_lizzy_ in terms of patient interaction, community education....expand on this a littlemore...? #hpmWed May 16 18:57:42 PDT 2012

April918 RT: @AnkurB_MD T2: We need a #CultureChange of #LessIsMore not only in Healthcarebut in other choices in Life as well... #hpm

Wed May 16 18:57:48 PDT 2012

aliciabloom great idea-- collaboration in the twitterverse! RT @jfclearywisc: RT @aliciabloom: morecombination chats with other hashtags..? #hpm

Wed May 16 18:58:32 PDT 2012

_lizzy_ Common themes that seem to come up frequently here: "More education" and "Bettercommunication" #hpm

Wed May 16 18:58:50 PDT 2012

AnkurB_MD @aliciabloom Cud invite pro Patient-engagement tweeps to join us and get patients/caregivers' perspective on better convos. #hpm#epatient

Wed May 16 18:59:46 PDT 2012

apjonasTopic 4 chat:Finding meaning for pts, families, providers, communities in EOL situations#hpmWed May 16 18:59:54 PDT 2012

_lizzy_ There are so many amazing peeps participating in this chat that I know with us allcombining our knowledge we can solve issues :) #hpm

Wed May 16 19:00:06 PDT 2012

aliciabloom @_lizzy_ got it...thanks! i'm thinking we can pull in some literature (evidence base) & lookat some cases. #hpmWed May 16 19:00:18 PDT 2012

aliciabloom i like this idea, @AnkurB_MD. kind of like @jfclearywisc suggestion around combinationchats with other hashtags. #hpm

Wed May 16 19:01:51 PDT 2012

apjonas @aliciabloom Thanks for a great chat and your leadership. #hpmWed May 16 19:01:51 PDT 2012
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7/31/2019 #Hpm Tweet Chat 5:16:12

12/13



_lizzy_ I also loved chat we had where people told stories -who inspired them, best advice. I thinkthose were still educational discussions #hpm

Wed May 16 19:02:05 PDT 2012

aliciabloom thank you so much, @apjonas! i'm glad you joined us tonight, hope to have you hereagain. #hpm

Wed May 16 19:02:45 PDT 2012

_lizzy_ Yes, Alicia - this was a good talk tonight! RT @apjonas: @aliciabloom Thanks for a greatchat and your leadership. #hpm

Wed May 16 19:02:50 PDT 2012

AnkurB_MD @aliciabloom@jfclearywisc#epatient#s4pm#caregivers for combination chats with#hpm...

Wed May 16 19:03:19 PDT 2012

aliciabloom @_lizzy_ i'll be bringing that back...i loved that chat, too! #hpmWed May 16 19:03:47 PDT 2012

jfclearywisc @AnkurB_MD: @aliciabloom@jfclearywisc#epatient#s4pm#caregivers for combinationchats with #hpm. Great suggestion. #meded?

Wed May 16 19:04:30 PDT 2012

April918 @aliciabloom What about difficult one-liners from patients/clinicians, then come up withresponses? #HPM

Wed May 16 19:04:33 PDT 2012

aliciabloom thank you all for a lively chat & your input on future chats! hope to see you all next week--same time, same place... #hpm

Wed May 16 19:04:43 PDT 2012

April918 See y'all next week!! #HPMWed May 16 19:05:08 PDT 2012

jollyasinhappy RT @AnkurB_MD: T2: We need a #CultureChange of #LessIsMore not only in Healthcarebut in other choices in Life as well... #hpmWed May 16 19:06:33 PDT 2012

dianewolfePRx RT @_lizzy_: Yes, Alicia - this was a good talk tonight! RT @apjonas: @aliciabloom

Thanks for a great chat and your leadership. #hpmWed May 16 19:06:47 PDT 2012

AnkurB_MD @jfclearywisc@aliciabloom Good one! #Meded#Hpm combination chat... much needed!Wed May 16 19:06:49 PDT 2012

aliciabloom @AnkurB_MD@jfclearywisc that would be great. let's get the #meded folks here with us#hpm'ers!
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7/31/2019 #Hpm Tweet Chat 5:16:12

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Wed May 16 19:09:24 PDT 2012

RyanMadanickMD @AnkurB_MD@jfclearywisc@aliciabloom it could be done... #Meded#HpmWed May 16 19:10:06 PDT 2012

aliciabloom hi @RyanMadanickMD...we should make it happen! @AnkurB_MD, @jfclearywisc & I thinthis would be awesome #hpm + #meded

Wed May 16 19:14:18 PDT 2012
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#Hpm Tweet Chat 5:16:12