#MDchat

Healthcare Hashtag Twitter Transcript

From: Tue Mar 08 18:00:00 PST 2011
To: Tue Mar 08 19:01:00 PST 2011
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Learn more about #MDchat at The Healthcare Hashtag Project

MD_Chat Welcome everyone to #MDchat! Hope you're doing well. We'll start in a few moments,
but first introduce yourselves!
Tue Mar 8 18:00:04 PST 2011

RichmondDoc Hey--Mark here, family doc in #RVA; multitasking as is so often the case; contributor
to smhcop.wordpress.com; glad to be here. #mdchat
Tue Mar 8 18:01:36 PST 2011

consultdoc Mark Browne here. Trying to chat from the friendly skies on my way to Omaha
#MDchat
Tue Mar 8 18:02:06 PST 2011

consultdoc #tweetchat=fail via gogo inflight internet tonight for #mdchat

Tue Mar 8 18:03:09 PST 2011

EllenRichter Hi folks! Been a few weeks but I am happy to join in tonight for #MDchat, even if its
just to read & listen! :)
Tue Mar 8 18:03:21 PST 2011

EOLnavigator Niamh van Meines, NP here #mdchat

Tue Mar 8 18:03:47 PST 2011

MD_chat @consultdoc Hi Mark! ...Could try TweetDeck or TweetGrid #mdchat

Tue Mar 8 18:03:53 PST 2011

MD_chat @EllenRichter Welcome back! #mdchat

Tue Mar 8 18:04:06 PST 2011

RyanMadanickMD Newbie here, Ryan at UNC (Chapel Hill), GI doc, esophageal specialist & fellowship
director #mdchat
Tue Mar 8 18:04:24 PST 2011

MD_chat @EOLnavigator @RichmondDoc Welcome & good evening! #mdchat

Tue Mar 8 18:04:37 PST 2011
EllenRichter @consultdoc Hi Mark! @RichmondDoc Hi Mark! Uh oh, an echo! :) #MDchat
Tue Mar 8 18:04:46 PST 2011

MD_chat OK, first topic coming up in one minute. Please prepend topics with T1, T2 etc. Good
luck! #MDchat
Tue Mar 8 18:05:02 PST 2011

EllenRichter @MD_Chat Howdy Phil! (it is Phil, right?) :) #MDchat

Tue Mar 8 18:05:14 PST 2011

holisticnurses Hi, everyone! Telehealth/Holistic RN from NY. Mostly lurking but happy to learn.
#MDChat
Tue Mar 8 18:05:20 PST 2011

RichmondDoc @EllenRichter :) #mdchat

Tue Mar 8 18:05:22 PST 2011

consultdoc #mdchat beginning now. Y'all come

Tue Mar 8 18:05:40 PST 2011

RyanMadanickMD Just checking...did my other tweet pop up?? #mdchat

Tue Mar 8 18:05:42 PST 2011

EllenRichter @EOLnavigator Oh welcome! Another nurse! :) I'm a critical care nurse. #MDchat
Tue Mar 8 18:05:44 PST 2011

MD_chat T1 The Reality of Transforming Physician Practices to Patient-Centered. See

http://hisoc.us/hbLXa1 Discuss challenges. #MDchat
Tue Mar 8 18:06:00 PST 2011

EllenRichter @JoeCascio Hi Joe! Come join us here! #MDchat

Tue Mar 8 18:06:33 PST 2011

RichmondDoc #MDChat now in progress. Be prepared for a run of tweets.

Tue Mar 8 18:06:37 PST 2011

thehealthmaven Hi everyone, Lea signing from DC area #mdchat

Tue Mar 8 18:06:52 PST 2011

EOLnavigator @EllenRichter Great to meet. HPM is my world. #mdchat

Tue Mar 8 18:07:04 PST 2011

RichmondDoc T1 I guess this really shouldn't be a surprise. After all, we have an established system
for some time now; change is tough. #mdchat
Tue Mar 8 18:07:57 PST 2011

drseisenberg Steven, San Diego. Hematology/Oncology. Hey there! #mdchat

Tue Mar 8 18:08:05 PST 2011
EllenRichter @EOLnavigator Thats a wonderful world, too. Hopefully you follow the terrific tweets
of the #hpm hashtag! :) #MDchat
Tue Mar 8 18:08:09 PST 2011

RichmondDoc T1 Even with best intentions and the right goals in mind, the process is difficult and
long and requires persistence and nurturing. #mdchat
Tue Mar 8 18:08:36 PST 2011

EllenRichter T1 As with any new change, you cant expect everyone to miraculously convert in the
blink of an eye. Learning curve will take years #MDchat
Tue Mar 8 18:08:57 PST 2011

miller7 Practice transformation is hard!! http://1.usa.gov/eH4ygv #MDchat

Tue Mar 8 18:09:07 PST 2011

MD_Chat @EllenRichter Yes, it's Phil ;) Hey @holisticnurses! #mdchat

Tue Mar 8 18:09:15 PST 2011

consultdoc T1 Too many are viewing pt centered care as a pymnt model. True pt centered care
means radical redesign, not just #EHR and more hrs #mdchat
Tue Mar 8 18:09:29 PST 2011

EOLnavigator We are the transition generation, the difficulties are here & now....no such issue for
the future generations #mdchat
Tue Mar 8 18:09:48 PST 2011

RichmondDoc T1 Maybe the most telling issue: how hard it has been to integrate systems speaks to
how fragmented the system has been. #mdchat
Tue Mar 8 18:09:54 PST 2011

holisticnurses T1 Key phrase in that article "change fatigue". #MDChat

Tue Mar 8 18:10:08 PST 2011

JoeCascio @EllenRichter Here I yam. Like you, listening, although not above throwing down a
contrary opinion now an then. :) #MDchat
Tue Mar 8 18:10:16 PST 2011

EllenRichter T1 @RichmondDoc I agree. It is a long, uphill battle to convert medical practices into
a new type of patient-centered service #MDchat
Tue Mar 8 18:10:30 PST 2011

miller7 Often practices need "practice coaches" or facilitators to help ease transition or
change http://bit.ly/dHErqy #MDchat
Tue Mar 8 18:10:36 PST 2011

EOLnavigator @EllenRichter I do! Love them too! #mdchat

Tue Mar 8 18:10:43 PST 2011

hjluks howard luks... better late than never... #mdchat

Tue Mar 8 18:10:59 PST 2011

RichmondDoc @consultdoc Absolutely agree. This is not a simple payment reform: it is a complete
RichmondDoc @consultdoc Absolutely agree. This is not a simple payment reform: it is a complete
revamping of our current system/philosophy. #mdchat
Tue Mar 8 18:11:15 PST 2011

drsteventucker Steven Tucker - Oncology & International Medicine, in Singapore #mdchat

Tue Mar 8 18:11:28 PST 2011

hjluks T1 ? help pls! #mdchat

Tue Mar 8 18:11:34 PST 2011

thehealthmaven @consultdoc exactly, reengineering takes persistance n thinking like an innovator

#mdchat
Tue Mar 8 18:11:58 PST 2011

RichmondDoc @hjluks The Reality of Transforming Physician Practices to Patient-Centered. See

http://hisoc.us/hbLXa1 Discuss challenges. #mdchat
Tue Mar 8 18:12:06 PST 2011

drseisenberg @drsteventucker Nice! #mdchat

Tue Mar 8 18:12:27 PST 2011

EOLnavigator @RichmondDoc This is what happens when we let technology / money cloud the
mission..patient care. #mdchat
Tue Mar 8 18:12:48 PST 2011

MD_Chat @hjluks Look at @MD_chat's stream and scroll down ;) #mdchat

Tue Mar 8 18:13:08 PST 2011

drsteventucker Can anyone estimate scope of problem? How many practices are NOT patient-
centric? #mdchat
Tue Mar 8 18:13:11 PST 2011

EOLnavigator @hjluks Topic # 1 scroll back to see the Q for discussion #mdchat
Tue Mar 8 18:13:37 PST 2011

RichmondDoc @EOLnavigator I have a friend who wonders how patient-centered care morphed
into EMR reform and high-tech answers. #mdchat
Tue Mar 8 18:13:53 PST 2011

drsteventucker Also, is the problem a systems problem, or is it that some doctors are not "patient-
centric"? #mdchat
Tue Mar 8 18:14:17 PST 2011

drseisenberg Collaboration takes determination...and commitment by everyone. No more lone

ranger. #mdchat
Tue Mar 8 18:14:23 PST 2011

RichmondDoc @drsteventucker If you mean in the sense of #PCMH: the vast majority. In terms of
patient-centered care; probably all too many. #mdchat
Tue Mar 8 18:14:24 PST 2011

EOLnavigator @thehealthmaven @consultdoc Difficulty is...the innovators don't know how to teach
the average Joe to use the technology well. #mdchat
Tue Mar 8 18:14:36 PST 2011
 Tue Mar 8 18:14:36 PST 2011

doctorpreneur #mdchat Sorry bit late joining-its Emma, British Psychiatrist researching value in
health care @HarvardHSPH - whats T1? What have I missed?
Tue Mar 8 18:14:45 PST 2011

RichmondDoc @drsteventucker The idea of patient centered care in this case is that both systems
and docs aren't necessarily focused on the pt. #mdchat
Tue Mar 8 18:14:55 PST 2011

drsteventucker @RichmondDoc What is PCMH? - I have half of it , i think... #mdchat

Tue Mar 8 18:15:26 PST 2011

RyanMadanickMD The system for implementing the system also has to be in place... #mdchat
Tue Mar 8 18:15:32 PST 2011

EOLnavigator @RichmondDoc Regs & Data mining, I think.....innovation and business

development too. #mdchat
Tue Mar 8 18:15:36 PST 2011

EllenRichter @doctorpreneur The Reality of Transforming Physician Practices to Patient-

Centered. See http://hisoc.us/hbLXa1 Discuss challenges. #MDchat
Tue Mar 8 18:15:45 PST 2011

holisticnurses @drsteventucker Glad you ask. I was thinking the same. #MDChat
Tue Mar 8 18:15:51 PST 2011

RichmondDoc T1 I think another challenge is the time involved in the transition. It will take much
longer, and lead to significant disruption. #mdchat
Tue Mar 8 18:15:52 PST 2011

chukwumaonyeije @drsteventucker will jump in and say its systems. Most docs are patient centric.
Systems block this #mdchat
Tue Mar 8 18:16:20 PST 2011

RyanMadanickMD @drsteventucker @RichmondDoc pt-centered medical home #mdchat

Tue Mar 8 18:16:24 PST 2011

drsteventucker @RichmondDoc So what would be the first 3 simple steps in transforming to patient
centered care? #mdchat
Tue Mar 8 18:16:24 PST 2011

doctorpreneur #mdchat Ooooh you picked a big topic tonight..

Tue Mar 8 18:16:39 PST 2011

consultdoc T1 - Change certainly takes time, but we as MD's are letting others dictate the
timeline to a great extent #mdchat
Tue Mar 8 18:17:20 PST 2011

drsteventucker @chukwumaonyeije Maybe progress can happen if we ASSUME the docs are
patient centric and just alter the system? #mdchat
Tue Mar 8 18:17:33 PST 2011
doctorpreneur @EOLnavigator @RichmondDoc #mdchat Think you are right re. being business-
focused in transition to more patient focus:align incentives
Tue Mar 8 18:17:43 PST 2011

chukwumaonyeije Late to the chat tonight after a (long) forced hiatus. Will mostly be lurking. #MDCHAT
Tue Mar 8 18:17:51 PST 2011

EOLnavigator @doctorpreneur You betcha! #mdchat

Tue Mar 8 18:18:13 PST 2011

thehealthmaven @eolnavigator so true..the execution is so mission critical #mdchat

Tue Mar 8 18:18:24 PST 2011

RichmondDoc @drsteventucker T1 step 1: ensure patients have a strong, central primary care
foundation to coordinate care #mdchat
Tue Mar 8 18:18:29 PST 2011

EllenRichter @chukwumaonyeije Welcome back, even as a lurker! :) #MDchat

Tue Mar 8 18:18:38 PST 2011

chukwumaonyeije True. RT @consultdoc T1 - Change certainly takes time, but we as MD's are letting
others dictate the timeline to a great extent #mdchat
Tue Mar 8 18:18:46 PST 2011

doctorpreneur #mdchat Big challenge is just sheer "resistance to change":thats not just amongst
doctors-its a human trait!
Tue Mar 8 18:18:50 PST 2011

KathyKastner Sry late 2 good not 2 RT @RichmondDoc: @EOLnavigator I have frnd who wonders
how pt-cntred mrphd into EMR refrm + high-tech answers.#mdchat
Tue Mar 8 18:19:02 PST 2011

faisal_q @RichmondDoc bottom up turned into top down... isn't gov. grand :-) #mdchat
Tue Mar 8 18:19:05 PST 2011

RichmondDoc @drsteventucker T1 step 2: give providers and patients time to address concerns,
de-emphasize imaging/intervention #mdchat
Tue Mar 8 18:19:13 PST 2011

drseisenberg Step 1: Create a tribe. Step 2: Create a vision. Step 3: Create helping patients.
#mdchat
Tue Mar 8 18:19:20 PST 2011

holisticnurses @drsteventucker @RichmondDoc T1 1. An interdisplinary team approach. 2. More

opps & methods for patient education. 3.Improved access #MDChat
Tue Mar 8 18:19:38 PST 2011

RichmondDoc @faisal_q For what it's worth: PCMH isn't a gov't sponsored thing. #mdchat
Tue Mar 8 18:19:42 PST 2011

gunterwessels Tribes are positive and negative.RT @drseisenberg: Step 1: Create a tribe. Step 2:
gunterwessels Tribes are positive and negative.RT @drseisenberg: Step 1: Create a tribe. Step 2:
Create a vision. Step 3: Create helping patients. #mdchat
Tue Mar 8 18:19:49 PST 2011

ryanmadanickmd we also have so many systems in place, i might ask why this system is better than
others already in place (devil's advocate) #mdchat
Tue Mar 8 18:20:07 PST 2011

RichmondDoc @drsteventucker T1 step 3: team-based approach to care, empower team members

to work at highest levels and empower pts in team. #mdchat
Tue Mar 8 18:20:19 PST 2011

chukwumaonyeije @drsteventucker Absolutely. Change the system to facilitate a patient-centric

approach and train young docs to insist upon it. #mdchat
Tue Mar 8 18:20:36 PST 2011

gunterwessels Rituals define community. How do we foster a better service script #mdchat
Tue Mar 8 18:20:45 PST 2011

doctorpreneur @drseisenberg #mdchat Part of creating tribe (not in an exclusive sense) is starting
"early" in health professional training careers..
Tue Mar 8 18:20:50 PST 2011

EllenRichter T1 Its not only a change in focus for the practitioner, its a change in behavior &
commitment by patient/family to =ly participate #MDchat
Tue Mar 8 18:21:15 PST 2011

drsteventucker T1 - Step 1 - Incentivize wellness. This is all moot if patients only want pills, must eat
right, be active, lose weight. #mdchat
Tue Mar 8 18:21:29 PST 2011

RichmondDoc T1 We also need to work to ensure patient-centered and humanistic care is taught
and sustained during med school. Easily lost. #mdchat
Tue Mar 8 18:21:38 PST 2011

apjonas T1 Pt ctred needs upgrade to human centered. PCP gets dehumanized in tech style
practice upgrade= pt care quality drop. pt=dr=humans#mdchat
Tue Mar 8 18:22:05 PST 2011

drsteventucker @RichmondDoc I like your step 3. I think we need more advocates, more techies in
the office teaching patient empowerment. #mdchat
Tue Mar 8 18:22:28 PST 2011

chukwumaonyeije @EllenRichter thanks. Its great to be back in the country and back online. #MDCHAT
Tue Mar 8 18:22:44 PST 2011

drsteventucker In my practice I feel increasingly like a health/med librarian. I can help you sort the
data, place it in context #mdchat
Tue Mar 8 18:23:23 PST 2011

thehealthmaven @doctorpreneur true, strong visionary leadership key for tribes #mdchat
Tue Mar 8 18:23:45 PST 2011

hjluks @gunterwessels We can all the tech we want... unless we know how to use it and
hjluks @gunterwessels We can all the tech we want... unless we know how to use it and
teach how to use it and hv guidelines... it useless #mdchat
Tue Mar 8 18:24:15 PST 2011

hjluks @drsteventucker health literacy is a huge issue. We can give patients tons of
information... but how mny can truly digest it ? #mdchat
Tue Mar 8 18:25:01 PST 2011

hjluks @drsteventucker health literacy is a huge issue. We can give patients tons of
information... but how mny can truly digest it ? #mdchat
Tue Mar 8 18:25:01 PST 2011

RyanMadanickMD What about subspecialists? how do we/they fit in to a new system of PCMHs?
#mdchat
Tue Mar 8 18:25:16 PST 2011

RichmondDoc @drsteventucker Thanks. Headed forward, patients will be partners in care vs.
recipients of care; need to help develop skills #mdchat
Tue Mar 8 18:25:19 PST 2011

KathyKastner +1 RT @hjluks: @drsteventucker health literacy is a huge issue. We can give

patients tons of info.but how mny can truly digest it ? #mdchat
Tue Mar 8 18:25:29 PST 2011

hjluks @chukwumaonyeije @doctorpreneur yup... #mdchat

Tue Mar 8 18:25:41 PST 2011

apjonas T1 Pt ctred needs upgrade to human centered. PCP gets dehumanized in tech style
practice upgrade= pt care quality drop. pt=dr=humans #mdchat
Tue Mar 8 18:26:15 PST 2011

drsteventucker @hjluks I dont think we should give the information. They need to get it to learn it. We
help them interpret that info. #mdchat
Tue Mar 8 18:26:15 PST 2011

JoeCascio @drsteventucker Can you say more about "techies" teaching? I consider myself a
techie, but I think you mean something different. #mdchat
Tue Mar 8 18:26:36 PST 2011

hjluks @drsteventucker @hjluks I think we should also be source... search terms, links, etc...
give them homework !! :-) #mdchat
Tue Mar 8 18:27:25 PST 2011

drsteventucker @RichmondDoc LOVE that! Patients are partners in care, not recipients of care.
#mdchat
Tue Mar 8 18:27:32 PST 2011

apjonas T1 The PCMH is a primary care model. Non PCP are outside this model, need 2
make own #mdchat
Tue Mar 8 18:27:36 PST 2011

KathyKastner Principles of adult ed :)RT @drsteventucker: @hjluks I dont think we should give
info.pts need to get it to learn.We help interpret #mdchat
Tue Mar 8 18:27:50 PST 2011

EOLnavigator @hjluks @gunterwessels AGREE #mdchat

EOLnavigator @hjluks @gunterwessels AGREE #mdchat
Tue Mar 8 18:28:03 PST 2011

RyanMadanickMD @drsteventucker @hjluks interesting recent article in Newsweek says too much info
actually backfires http://t.co/1XQdZIe #mdchat
Tue Mar 8 18:28:03 PST 2011

chukwumaonyeije @RichmondDoc you are on the money tonight doc. #MDCHAT

Tue Mar 8 18:28:03 PST 2011

MD_chat @chukwumaonyeije Great to see you here! #mdchat

Tue Mar 8 18:28:30 PST 2011

drsteventucker @JoeCascio patient advocates. Chat room oderators. Support group leaders, etc
#mdchat
Tue Mar 8 18:28:37 PST 2011

RichmondDoc @apjonas A lot of thought that #PMCH can fit within #ACO models; this allows better
coordination of care across specialties. #mdchat
Tue Mar 8 18:28:54 PST 2011

gunterwessels Engagement is that>RT @hjluks: RT @drsteventucker: @RichmondDoc LOVE that!

Patients are partners in care, not recipients of care. #mdchat
Tue Mar 8 18:28:57 PST 2011

RichmondDoc @chukwumaonyeije Thanks! #mdchat

Tue Mar 8 18:29:06 PST 2011

EOLnavigator @hjluks @drsteventucker I think patients are not interested in this info...they want the
personal relationship with the HCP #mdchat
Tue Mar 8 18:29:24 PST 2011

hjluks @gunterwessels @hjluks @drsteventucker @hjluks Mny of my patients receive

homework... if they wont do that-- then post op success??? #mdchat
Tue Mar 8 18:29:34 PST 2011

RichmondDoc @EOLnavigator @hjluks @drsteventucker I would argue information is valued by

some patients, not others; relationship is universal. #mdchat
Tue Mar 8 18:30:00 PST 2011

MD_chat Shoulder tap: next topic coming up in a few moments. #MDchat

Tue Mar 8 18:30:02 PST 2011

gunterwessels <3RT @hjluks: @hjluks @drsteventucker @hjluks Mny of my patients receive

homework... if they wont do that-- then post op success??? #mdchat
Tue Mar 8 18:30:09 PST 2011

apjonas @consultdoc @KathyKastner @hjluks @drsteventucker Docs need to translate info

to pt speak. We can do it or should be replaced. #mdchat
Tue Mar 8 18:30:18 PST 2011

drsteventucker @hjluks Agree - give homework; also happy to be given an assignment myself.

#mdchat
 #mdchat
Tue Mar 8 18:30:26 PST 2011

RichmondDoc @EOLnavigator @hjluks @drsteventucker So: assessing how much info pts
want/need, but form a therapeutic bond with them regardless. #mdchat
Tue Mar 8 18:30:29 PST 2011

hjluks @EOLnavigator @hjluks @drsteventucker Both ... they enjoy the relationship... but
information is important too... #mdchat
Tue Mar 8 18:30:32 PST 2011

gunterwessels Many pts walk away not knowing what to do...Homework is GREAT!!! #mdchat
Tue Mar 8 18:31:06 PST 2011

hjluks @RichmondDoc @EOLnavigator @hjluks @drsteventucker exactly... some patients

want info.. some paternalistic relationship #mdchat
Tue Mar 8 18:31:19 PST 2011

drseisenberg @thehealthmaven @EOLnavigator @hjluks @drsteventucker Connect first and

communicate the importance of partnership. #mdchat
Tue Mar 8 18:31:19 PST 2011

thehealthmaven @hjluks yes, the relationship moves the conversation & potential for behavior
change forward #mdchat
Tue Mar 8 18:31:53 PST 2011

drsteventucker @RichmondDoc @EOLnavigator @hjluks But they need to be in the relationship.

And they have responsibility to the relationship. #mdchat
Tue Mar 8 18:31:57 PST 2011

chukwumaonyeije Def a tipping point where too much info becomes counterproductive. RT
@ryanmadanickmd @drsteventucker @hjluks http://t.co/1XQdZIe #mdchat
Tue Mar 8 18:32:12 PST 2011

RyanMadanickMD Yep! RT @hjluks: Cant cookbook a doctor-patient relationship,,, not one size fits all
#mdchat
Tue Mar 8 18:32:24 PST 2011

consultdoc @RyanMadanickMD @hjluks Homework idea is good, but big culture change for
both docs and pts #mdchat
Tue Mar 8 18:32:25 PST 2011

RichmondDoc @RyanMadanickMD @hjluks @drsteventucker True that there that "tradition"

continues, but times (and pts) are demanding change. #MDChat
Tue Mar 8 18:32:42 PST 2011

hjluks @gunterwessels correct :-) #mdchat

Tue Mar 8 18:32:49 PST 2011

drseisenberg Each a unique creation RT @hjluks: Cant cookbook a doctor-patient relationship,,,

not one size fits all #mdchat
Tue Mar 8 18:33:00 PST 2011

MD_chat T2 Social Media to Enhance Patient Care: See @RichmondDocʼs

http://hisoc.us/gUZtAJ Discuss case uses for SM in medicine. #MDchat

 http://hisoc.us/gUZtAJ Discuss case uses for SM in medicine. #MDchat
Tue Mar 8 18:33:02 PST 2011

gunterwessels ACO concept demands segmentation and differentiation in service delivery RT

@hjluks: @gunterwessels correct :-) #mdchat
Tue Mar 8 18:33:24 PST 2011

hjluks @chukwumaonyeije @ryanmadanickmd @drsteventucker @hjluks Analysis

paralysis is always a possibility... need to balance amt of data #mdchat
Tue Mar 8 18:33:29 PST 2011

EOLnavigator @apjonas @consultdoc @KathyKastner @hjluks @drsteventucker Need also to

move into social media platforms. #mdchat
Tue Mar 8 18:33:35 PST 2011

consultdoc signing off now. Landing in Omaha. Thanks for the great conversation! #mdchat
Tue Mar 8 18:34:11 PST 2011

hjluks @RaganHealth welcome #mdchat

Tue Mar 8 18:34:27 PST 2011

EOLnavigator @drseisenberg @thehealthmaven @EOLnavigator @hjluks @drsteventucker I

agree. #mdchat
Tue Mar 8 18:34:35 PST 2011

faisal_q @EOLnavigator how is 3-4 minute in exam room a relationship w/ HCP? Must add
"Value beyond the visit" #mdchat #homework
Tue Mar 8 18:34:44 PST 2011

RichmondDoc @consultdoc Safe travels! #mdchat

Tue Mar 8 18:34:47 PST 2011

KathyKastner 4 sureRT @EOLnavigator: @apjonas @consultdoc @KathyKastner @hjluks

@drsteventucker Need also to move into social media platforms. #mdchat
Tue Mar 8 18:35:04 PST 2011

EOLnavigator @RichmondDoc @EOLnavigator @hjluks @drsteventucker Present the info in a way

& forum that they can hear it. #mdchat
Tue Mar 8 18:35:07 PST 2011

RaganHealth @hjluks Thanks, Howard! #mdchat

Tue Mar 8 18:35:16 PST 2011

thehealthmaven @Md_chat excellent framing post http://hisoc.us/gUZtAJ #MDchat

Tue Mar 8 18:35:41 PST 2011

chukwumaonyeije @hjluks looking for a blog post you wrote maybe a year ago regarding balance of
paternalism with needed info. Will post when found #mdchat
Tue Mar 8 18:35:49 PST 2011

drsteventucker @controversiesSW Nice one! sweet... #mdchat

Tue Mar 8 18:35:55 PST 2011
RichmondDoc @faisal_q @EOLnavigator T1 a 4 min visit is not a relationship. Our system does not
make this a priority. Needs to change. #mdchat
Tue Mar 8 18:36:05 PST 2011

hjluks @chukwumaonyeije k new site has search :-) #mdchat

Tue Mar 8 18:36:37 PST 2011

doctorpreneur #mdchat surely we only really want to use SM *when* & *if* the patient wants
it..rather than aim to provide for all pts all of the time
Tue Mar 8 18:37:12 PST 2011

drsteventucker Gotta go see some real patients, it is 1036AM in Singapore! Hope to lurk... Thanks
#mdchat
Tue Mar 8 18:37:13 PST 2011

EllenRichter Very good piece @RichmondDoc ~I thoroughly enjoyed reading about your steps of
the process~ http://hisoc.us/gUZtAJ #MDchat
Tue Mar 8 18:37:15 PST 2011

hjluks @consultdoc is that in the US ;-) #mdchat

Tue Mar 8 18:37:23 PST 2011

hjluks @drsteventucker enjoy... have a gr8 day! #mdchat

Tue Mar 8 18:38:00 PST 2011

RichmondDoc @EllenRichter Thanks. Totally just thinking things out. Hope to generate debate,
discussion, new ideas. #mdchat
Tue Mar 8 18:38:35 PST 2011

chukwumaonyeije @drsteventucker agree. The homework paradigm is appropriate. Easy to overwhelm

in a 15mimute visit. #mdchat
Tue Mar 8 18:39:07 PST 2011

EllenRichter T1 Most of my providers use text messaging for appointment reminders & frequent
health tips. Thats a good start! #MDchat
Tue Mar 8 18:39:10 PST 2011

RyanMadanickMD @RichmondDoc you may have come up with all of the good ideas... #mdchat
Tue Mar 8 18:39:21 PST 2011

EllenRichter @RichmondDoc You give others a good foundation of ideas for where to start! I like
that! #MDchat
Tue Mar 8 18:39:44 PST 2011

hjluks @EllenRichter Tiger Text... new svc very interesting... set text to vaporize in 10-120
seconds... doesnt stay on server #mdchat
Tue Mar 8 18:40:15 PST 2011

EllenRichter T1 I think that the more ways health care providers can connect with patients, the
more meaningful the social media experiences #MDchat
Tue Mar 8 18:40:49 PST 2011

hjluks tiger text cld be gr8 way to communicate to patients... We will start using it soon for
hjluks tiger text cld be gr8 way to communicate to patients... We will start using it soon for
MD2MD comm #mdchat
Tue Mar 8 18:40:52 PST 2011

MD_chat @holisticnurses You failed the homework assignment ;) #mdchat

Tue Mar 8 18:41:01 PST 2011

drseisenberg Yes! RT @EOLnavigator: @faisal_q @EOLnavigator Its the content, connection & the
meaning of the relationship #mdchat
Tue Mar 8 18:41:14 PST 2011

RichmondDoc @RyanMadanickMD I know there are other great ideas out there, and I hope this
post will allow some deeper conversation. #MDChat
Tue Mar 8 18:41:36 PST 2011

hjluks @holisticnurses why so... if u give them links and search terms about topic, possible
controversial, then bring back in 1 wk... etc #mdchat
Tue Mar 8 18:41:45 PST 2011

thehealthmaven Key that the social media content remain relevant & goes to "where the pt. is"
#mdchat...different layers of texture #mdchat
Tue Mar 8 18:42:43 PST 2011

EllenRichter T2 @controversiesSW Thats good to hear. Give SM another 5-10 years & it will be a
mainstay of healthcare communication #MDchat
Tue Mar 8 18:43:41 PST 2011

EOLnavigator @thehealthmaven the generation behind us are already completely dependent on

SM...health info / guidance must participate too #mdchat
Tue Mar 8 18:44:20 PST 2011

gunterwessels Emerging but small segment...RT @thehealthmaven: Key that the social media
content remain relevant & goes to "where the pt. is" #mdchat...
Tue Mar 8 18:44:23 PST 2011

hjluks @holisticnurses OK... fair enuf... what should I call it ;-) ?? Ur learning, u have terms,
u have incentive... u are empowered..no? #mdchat
Tue Mar 8 18:45:16 PST 2011

blogbrevity Joining late ... would like 2 say @EllenRichter should get the @shortyvotes 4 Nurses
> http://bit.ly/gQRy2T #mdchat #rnchat
Tue Mar 8 18:45:32 PST 2011

holisticnurses @MD_Chat my point exactly. :) #MDChat

Tue Mar 8 18:45:35 PST 2011

DoctorFisher SM: useful to promote my practice by developing a general public trust, not sure how
useful for individual pt relationships #mdchat
Tue Mar 8 18:45:44 PST 2011

EOLnavigator @EllenRichter @controversiesSW Need it now! Yesterday. #mdchat

Tue Mar 8 18:45:54 PST 2011

hjluks @EOLnavigator YIKES... #mdchat

hjluks @EOLnavigator YIKES... #mdchat
Tue Mar 8 18:46:02 PST 2011

thehealthmaven @gunterwessels you are right, emerging..the "influencer" segment is growing

#mdchat
Tue Mar 8 18:46:04 PST 2011

gunterwessels Guide the guiding hand...RT @thehealthmaven: @gunterwessels you are right,
emerging..the "influencer" segment is growing #mdchat
Tue Mar 8 18:46:31 PST 2011

thehealthmaven @gunterwessels well said! #mdchat

Tue Mar 8 18:47:17 PST 2011

controversiesSW Agreed. Almost none in mental health yet. RT @EOLnavigator: @EllenRichter

@controversiesSW Need it now! Yesterday. #mdchat
Tue Mar 8 18:47:30 PST 2011

hjluks @faisal_q @hjluks @holisticnurses U wld be amazed... almost never happens...

#mdchat
Tue Mar 8 18:47:38 PST 2011

drseisenberg Connection, engagement, social media for patients starts with heart. #mdchat
Tue Mar 8 18:47:48 PST 2011

gunterwessels Emos...Fear, Need, Greed are useful...RT @drseisenberg: Connection, engagement,

social media for patients starts with heart. #mdchat
Tue Mar 8 18:48:22 PST 2011

KathyKastner and time :) RT @drseisenberg: Connection, engagement, social media for patients
starts with heart. #mdchat
Tue Mar 8 18:48:46 PST 2011

gunterwessels Hard, but good>RT @MandisHeroes: RT @drseisenberg: Step 1: Create a tribe. Step
2: Create a vision. Step 3: Create helping patients. #mdchat
Tue Mar 8 18:49:09 PST 2011

thehealthmaven @mandisheroes luckily, transparency seems to have helped lone ranger syndrome :)
#mdchat
Tue Mar 8 18:49:35 PST 2011

RaganHealth @DoctorFisher Trust is good, though. So if you can build it with public, it translates
eventually to individual trust, relationship #mdchat
Tue Mar 8 18:50:05 PST 2011

gunterwessels Emotion--> shame?RT @thehealthmaven: @mandisheroes luckily, transparency

seems to have helped lone ranger syndrome :) #mdchat
Tue Mar 8 18:50:08 PST 2011

chukwumaonyeije Personally i still like the homework metaphor. Absolutely empowering despite feeling
punative. @holisticnurses @hjluks . #MDChat
Tue Mar 8 18:50:13 PST 2011

EllenRichter Everything starts with the heart, no? :) RT @drseisenberg: Connection, engagement,
EllenRichter Everything starts with the heart, no? :) RT @drseisenberg: Connection, engagement,
social media for patients starts with heart. #MDchat
Tue Mar 8 18:50:30 PST 2011

hjluks @drseisenberg and a guitar :-) #mdchat

Tue Mar 8 18:50:37 PST 2011

gunterwessels LOL!!RT @hjluks: @drseisenberg and a guitar :-) #mdchat

Tue Mar 8 18:50:51 PST 2011

chukwumaonyeije At least thats what i hope my kids will think about homework one day. LOL. RT
@holisticnurses @hjluks #MDChat
Tue Mar 8 18:51:26 PST 2011

gunterwessels Your best sales reps engage you with emotion...use it on your patients #mdchat
Tue Mar 8 18:51:41 PST 2011

RyanMadanickMD Exhausted, gn all thx for 1st #mdchat

Tue Mar 8 18:51:41 PST 2011

unxpctdblessing @chukwumaonyeije As an empowered patient, I find the term "homework" to be

absolutely punative. @holisticnurses @hjluks #MDChat
Tue Mar 8 18:52:13 PST 2011

EOLnavigator @KathyKastner @drseisenberg Time issue can be managed with social media
platforms. #mdchat
Tue Mar 8 18:52:13 PST 2011

thehealthmaven @gunterwessels accountability? #mdchat

Tue Mar 8 18:52:15 PST 2011

gunterwessels Emotionally valent concept-->RT @thehealthmaven: @gunterwessels

accountability? #mdchat
Tue Mar 8 18:52:40 PST 2011

hjluks @holisticnurses :-) agree... sorry.. just had to do homework with 10, 8 and 6 yr olds :-)
LOL #mdchat Nice to meet you
Tue Mar 8 18:53:05 PST 2011

thehealthmaven @gunterwessels yes, passion is what gets passed on & evoking emotion is what
goes viral #mdchat
Tue Mar 8 18:53:21 PST 2011

controversiesSW Noticed that many here have hundreds, thousands of followers! So there is some
trust in SM developed somehow, right? #mdchat
Tue Mar 8 18:54:06 PST 2011

gunterwessels Agree, and gets acted on>RT @thehealthmaven: @gunterwessels yes, passion is
what gets passed on & evoking emotion is what goes viral #mdchat
Tue Mar 8 18:54:11 PST 2011

@shortyvotes No NOT me !-- the award is a nomination 4 --> @EllenRichter #mdchat

blogbrevity #rnchat
Tue Mar 8 18:55:00 PST 2011
blogbrevity Tue Mar 8 18:55:00 PST 2011

hjluks Six Rules Doctors Need to Know: *Amended* #F4P, #FLOWR #whypm
http://t.co/ASfnqSy #mdchat
Tue Mar 8 18:55:04 PST 2011

EOLnavigator AgreeRT @thehealthmaven: @gunterwessels yes, passion is what gets passed on &
evoking emotion is what goes viral #mdchat
Tue Mar 8 18:55:28 PST 2011

drsteventucker What did I miss? ;) #mdchat

Tue Mar 8 18:55:35 PST 2011

holisticnurses @unxpctdblessing @chukwumaonyeije @hjluks Fair enough. It may work for some
individuals. #MDChat
Tue Mar 8 18:56:02 PST 2011

drsteventucker Dream (my reality) - get all the patients with similar diagnosis in one room; give them
a lecture and answer all questions #mdchat
Tue Mar 8 18:56:28 PST 2011

EllenRichter @hjluks I dont think you need to beat yourself up on the "homework" term. Its just
another way to introduce info to your pts #MDchat
Tue Mar 8 18:56:46 PST 2011

drsteventucker Better approach still - start with open mike questions, then pull up a small
lecture/slide set to emphasize points #mdchat
Tue Mar 8 18:57:02 PST 2011

drsteventucker Tape it, youtube it, run it on iPads in your office while people wait. #mdchat
Tue Mar 8 18:57:31 PST 2011

hjluks @drsteventucker me getting yelled at over homework :-( ;-) #mdchat

Tue Mar 8 18:57:37 PST 2011

gunterwessels Homework, assignment, medical adivce; same...RT @EllenRichter: @hjluks I dont

think you need to beat yourself up on the "homework" #MDchat
Tue Mar 8 18:57:42 PST 2011

thehealthmaven @drsteventucker well, it is late, so you can dream..:) #mdchat

Tue Mar 8 18:57:42 PST 2011

EOLnavigator The virtual visit! #mdchat

Tue Mar 8 18:57:53 PST 2011

blogbrevity Plz RT -- I nominate @EllenRichter head of #RNchat 4 a @shortyaward in nursing >

http://bit.ly/gQRy2T #mdchat
Tue Mar 8 18:58:11 PST 2011

EOLnavigator @drsteventucker They are in the social media room! #mdchat

Tue Mar 8 18:58:52 PST 2011
doctorpreneur @controversiesSW @EOLnavigator @EllenRichter #MDChat Agree-More mental
health attention in this area is my *dream*:huge potential
Tue Mar 8 18:58:55 PST 2011

controversiesSW Thanks guys for terrific chat, and for letting a non-doc sit in. #mdchat
Tue Mar 8 18:59:00 PST 2011

drsteventucker @JoeCascio @EllenRichter That honestly shocks me. It is 2010! Do they have a
coin-operated telephone in the office? #mdchat
Tue Mar 8 18:59:13 PST 2011

hjluks @faisal_q @holisticnurses no question... vry few ppl follow "doctors orders" If pt is
engaged they will seek out info (homework) #mdchat
Tue Mar 8 18:59:19 PST 2011

thehealthmaven Having a video landing page goes a long way 4 your patients..patients want to "see"
#mdchat pic is worth a thousand words
Tue Mar 8 18:59:25 PST 2011

RichmondDoc Lastly: Health care is about the patient, and the provider-patient team. We need to
find tools to facilitate that: #PCMH, SocMed... #mdchat
Tue Mar 8 18:59:38 PST 2011

ElinSilveous Two gr8 chats going on #MDChat & #AgChat. Thanks for sharing & for letting me sit
in.
Tue Mar 8 18:59:44 PST 2011

EOLnavigator @drsteventucker Need an Ipad 2 for that!!! #mdchat

Tue Mar 8 18:59:58 PST 2011

gunterwessels @RaganHealth employ emotions when influencing your patients behavior #mdchat
Tue Mar 8 19:00:18 PST 2011

faisal_q +1 RT @hjluks: @faisal_q @holisticnurses vry few ppl follow "doctors orders" If pt is
engaged they will seek out info (homework) #mdchat
Tue Mar 8 19:00:18 PST 2011

EllenRichter @JoeCascio Currently, my healthcare providers who DO use texting dont allow it
both ways yet. That will be a big improvement! #MDchat
Tue Mar 8 19:00:35 PST 2011