3/7/13

#hpm - Healthcare Social Media Transcript

#hpm transcript
Healthcare Social Media Transcript
From: To: Wed Mar 06 18:00:00 PST 2013 Wed Mar 06 19:15:00 PST 2013 change time period

Who were the influencers during this time period? #hpm analytics Connecting the dots in healthcare social media: Healthcare Conference - Tweet Chats - Healthcare Analytics What is #hpm?

rfberry

I'm hosting tonight, I work @goBeMoRe in Menlo Park, passionate about increasing access to palliative care. Former hospice volunteer. #hpm
Wed Mar 6 18:01:42 PST 2013

oliverdr

Debbie Parker-Oliver University of Missouri- Columbia; researcher and former hospice Director and social worker #Hpm
Wed Mar 6 18:02:05 PST 2013

KnowYourWishes

Hi. LJ Van Scoy, pulmonary critical care physician, founder http://t.co/pgFjeKH0Oe, author of Last Wish and #eol researcher & advocate #hpm
Wed Mar 6 18:03:06 PST 2013

rfberry

Hey Debbie, Thanks for joining! RT @oliverdr Debbie Parker, researcher & former hospice Director and social worker #hpm
Wed Mar 6 18:03:44 PST 2013

KnowYourWishes

whoa, not sure why that link was like that. Meant to say founder of http://t.co/EcXsQEHhKj :( #hpm
Wed Mar 6 18:04:31 PST 2013

KnowYourWishes

@oliverdr Nice to meet you! #hpm
Wed Mar 6 18:04:47 PST 2013

rfberry

@KnowYourWishes Hey LJ! So happy your joining us tonight! We'll get started with

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=0…

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T1 in just a few more minutes. #hpm
Wed Mar 6 18:04:50 PST 2013

MsWZ

RT @rfberry: @JHARTFOUND @notesonnursing we'll be discussing this fantastic article tonight at #hpm http://t.co/YiYDCM8SaM
Wed Mar 6 18:05:24 PST 2013

GraniteDoc

Meredith MacMartin, palliative care MD/hospitalist at DHMC #hpm
Wed Mar 6 18:05:34 PST 2013

oliverdr

Diddo!RT @KnowYourWishes: @oliverdr Nice to meet you! #Hpm
Wed Mar 6 18:05:55 PST 2013

rfberry

Hi Meredith! RT @GraniteDoc: Meredith MacMartin, palliative care MD/hospitalist at DHMC #hpm
Wed Mar 6 18:06:07 PST 2013

rfberry

@MsWZ Hey Whitney! Thanks for the RT, are you joining us for the chat tonight? #hpm
Wed Mar 6 18:06:40 PST 2013

KnowYourWishes

@GraniteDoc Hello! #hpm
Wed Mar 6 18:06:45 PST 2013

rfberry

Pre-T1 Elaine Waples shared her story w/ @TEDMED #greatchallenges about truth at the #endoflife http://t.co/S2uPYimpJP #hpm
Wed Mar 6 18:06:55 PST 2013

GraniteDoc

@KnowYourWishes @rfberry @oliverdr Hi all! #hpm
Wed Mar 6 18:08:13 PST 2013

MsWZ

RT @rfberry: Pre-T1 Elaine Waples shared her story w/ @TEDMED #greatchallenges about truth at the #endoflife http://t.co/S2uPYimpJP #hpm
Wed Mar 6 18:08:19 PST 2013

oliverdr

RT @rfberry: Pre-T1 Elaine Waples shared her story w/ @TEDMED #greatchallenges about truth at the #endoflife http://t.co/pMI052JN2I #hpm
Wed Mar 6 18:08:54 PST 2013

rfberry

Take a couple mintes to read Elaine's story before we get started w/T1 http://t.co/S2uPYimpJP #hpm
Wed Mar 6 18:09:20 PST 2013

ctsinclair

RT @rfberry: Take a couple mintes to read Elaine's story before we get started w/T1 http://t.co/S2uPYimpJP #hpm
Wed Mar 6 18:11:27 PST 2013

rfberry

T1 What does truth at the end of life mean to you? (inspired by Elaine Waples

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=0…

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http://t.co/S2uPYimpJP ) #hpm
Wed Mar 6 18:11:52 PST 2013

KnowYourWishes

Honest, reflective, brave and inspired MT @rfberry: read Elaines story before we get started w/T1 http://t.co/1pL8UN8eeV #hpm
Wed Mar 6 18:11:52 PST 2013

MsWZ

@rfberry I can't. It still makes me cry and I had an advanced copy. It's so honest. Elaine is amazing. #hpm
Wed Mar 6 18:12:42 PST 2013

rfberry

@KnowYourWishes totally agree. I read it a couple of times, because I feel there is so much depth in what she is sharing. #hpm
Wed Mar 6 18:12:43 PST 2013

rfberry

Agree, it's very powerful. RT @MsWZ: @rfberry It still makes me cry and I had an advanced copy. Its so honest. Elaine is amazing. #hpm
Wed Mar 6 18:13:24 PST 2013

KnowYourWishes

T1: dealing with the uncomfortable issues in a way that does not permit avoidance, sugar coating or unrealistic expectations #hpm
Wed Mar 6 18:13:43 PST 2013

MsWZ

@rfberry I'm going to try! Just heard you were picking up on the piece from #GreatChallenges on #EOL being beyond forms. #hpm
Wed Mar 6 18:13:48 PST 2013

KnowYourWishes

RT @rfberry: T1 What does truth at the end of life mean to you? (inspired by Elaine Waples http://t.co/1pL8UN8eeV ) #hpm
Wed Mar 6 18:14:08 PST 2013

doctatum

Wow!!! RT @oliverdr @rfberry: Elaine Waples shared her story #greatchallenges about truth at the #endoflife http://t.co/BgOyDrVoFS #hpm
Wed Mar 6 18:14:52 PST 2013

rfberry

@KnowYourWishes I think that's really insightful. I feel like there are so many angles (&opportunities) for truth in EOL. #hpm
Wed Mar 6 18:15:04 PST 2013

MsWZ

T1: Taking a simple "I'm sorry" and not looking for more. #hpm #eol
Wed Mar 6 18:15:09 PST 2013

oliverdr

Truth is about being open and being willing to listen and talk about the reality rather than the fantasy #hpm
Wed Mar 6 18:15:53 PST 2013

doctatum

You CAN handle the truth! RT @rfberry T1 What does truth at the eol mean to you? (inspired by Elaine Waples http://t.co/BgOyDrVoFS ) #hpm
Wed Mar 6 18:16:02 PST 2013

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=0…

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rfberry

@MsWZ what do you mean? Could you expand a bit? #hpm
Wed Mar 6 18:16:05 PST 2013

KnowYourWishes

T1: Ignoring the "clutter in the closet" and dealing with the most important things #hpm
Wed Mar 6 18:16:07 PST 2013

GraniteDoc

T1 Full acceptance of self and articulation of personal task-work for life completion #hpm
Wed Mar 6 18:16:11 PST 2013

rfberry

T1 I think there are a lot of challenges in dealing with truth at EOL. (for family & clinicians) #hpm
Wed Mar 6 18:16:51 PST 2013

rfberry

RT @GraniteDoc: T1 Full acceptance of self and articulation of personal task-work for life completion #hpm
Wed Mar 6 18:17:05 PST 2013

MsWZ

@rfberry Regular life, people take an "I'm sorry" but still want to settle a score. Inappropriate but true. #HPM
Wed Mar 6 18:17:18 PST 2013

rfberry

@doctatum that's fantastic. I kind of want to frame that tweet for my office. #hpm
Wed Mar 6 18:17:27 PST 2013

KnowYourWishes

Clinician truth often met with anger MT @rfberry: T1 there are a lot of challenges in dealing w truth at EOL. (for family & clinicians) #hpm
Wed Mar 6 18:18:24 PST 2013

rfberry

Interesting. RT @MsWZ @rfberry Regular life, people take an "I'm sorry" but still want to settle a score. Inappropriate but true. #hpm
Wed Mar 6 18:18:25 PST 2013

MsWZ

@rfberry Active Dying requires consciousness of action. Accepting that sometimes just the words will be said and its enough. #hpm
Wed Mar 6 18:18:48 PST 2013

fischmd

Brilliant! Generalist plus Specialist Palliative Care — Creating a More Sustainable Model — NEJM http://t.co/5NSIws5hoP #hpm
Wed Mar 6 18:19:15 PST 2013

Kamiyamay

@KnowYourWishes That is true, I walk into so much anger, have to learn to calm the fires #hpm
Wed Mar 6 18:19:42 PST 2013

rfberry

@MsWZ I think you'd enjoy "The Four Things That Matter Most" - it discusses the importance of "I'm sorry." http://t.co/IAF9blm1LR #hpm
Wed Mar 6 18:20:06 PST 2013

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=0…

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TurnerWest

RT @fischmd: Brilliant! Generalist plus Specialist Palliative Care — Creating a More Sustainable Model — NEJM http://t.co/5NSIws5hoP #hpm
Wed Mar 6 18:20:10 PST 2013

MsWZ

@rfberry Sort of like how you might be athiest, the person passing believes in Heaven. You recognize their peace. It's not about you. #hpm
Wed Mar 6 18:20:16 PST 2013

GraniteDoc

@rfberry I agree, challenge to dealing with the literal truth ("you're dying"), and with the variety of personal truths that manifest #hpm
Wed Mar 6 18:20:20 PST 2013

KnowYourWishes

Yep. Hard to not respond negatively MT @Kamiyamay: @KnowYourWishes That is true, I walk into so much anger, learn to calm the fires #hpm
Wed Mar 6 18:20:34 PST 2013

rfberry

@MsWZ being able to be fully present for patients in families in whatever way they need is crucial. #hpm
Wed Mar 6 18:21:03 PST 2013

doctatum

RT @oliverdr: Truth is about being open and being willing to listen and talk about the reality rather than the fantasy #hpm
Wed Mar 6 18:21:03 PST 2013

rfberry

RT @doctatum: RT @oliverdr: Truth is about being open and being willing to listen and talk about the reality rather than the fantasy #hpm
Wed Mar 6 18:21:27 PST 2013

Kamiyamay

@KnowYourWishes Amazing to be able to help, calm, comfort, aide, organize, deal with own feelings afterward too, important #hpm
Wed Mar 6 18:21:38 PST 2013

doctatum

RT @fischmd: Brilliant! Generalist plus Specialist Palliative Care — Creating a More Sustainable Model — NEJM http://t.co/5NSIws5hoP #hpm
Wed Mar 6 18:21:44 PST 2013

MsWZ

T1 I had to talk a lot about a trip to a beach that wasn't happening. But it was her truth. So I made it as real as we could. #hpm
Wed Mar 6 18:21:52 PST 2013

Kamiyamay

(a mustt) RT @rfberry: @MsWZ being able to be fully present for patients in families in whatever way they need is crucial. #hpm
Wed Mar 6 18:22:00 PST 2013

GraniteDoc

@KnowYourWishes @Kamiyamay Heard a saying recently, "when it's raining, it's not raining ON YOU". Angry response often not personal! #hpm
Wed Mar 6 18:22:20 PST 2013

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rfberry

We're going to move to T2 soon, please share any final thoughts about what truth at EOL means to you. #hpm
Wed Mar 6 18:22:43 PST 2013

oliverdr

No one said the truth is easy to give or to receive- but I believe it is necessary- the alternative is pretending- that violates trust #hpm
Wed Mar 6 18:23:24 PST 2013

Kamiyamay

@GraniteDoc You are right but when someone screaming in your face it is a little hard to gather thoughts, but magical to help #hpm
Wed Mar 6 18:23:34 PST 2013

KnowYourWishes

GREAT saying! RT GraniteDoc @KnowYourWishes @Kamiyamay Heard a saying recently, "when it's raining, it's not raining ON YOU". #hpm
Wed Mar 6 18:23:54 PST 2013

rfberry

@MsWZ that's a humble recognition of what her needs were & responding in exactly the way she needed. Her first, not you. #hpm
Wed Mar 6 18:23:56 PST 2013

DrkKalweit

RT @edubru: Early palliative care improves symptoms, lowers cost and may improve survival http://t.co/wX502jwbKI #hpm
Wed Mar 6 18:24:22 PST 2013

Kamiyamay

MT @oliverdr: No one said the truth is easy 2 give or 2 receive- but I believe it is necessary-alternative is pretending violates trust #hpm
Wed Mar 6 18:24:25 PST 2013

oliverdr

@Kamiyamay key is to remember those screams are for help #hpm
Wed Mar 6 18:24:43 PST 2013

rfberry

@oliverdr from a clinical perspective absolutely. Trust is especially important when family is relying on you for quality information #hpm
Wed Mar 6 18:24:52 PST 2013

GraniteDoc

@Kamiyamay Yes! Even if it's not raining on you, you still get wet! #hpm
Wed Mar 6 18:25:06 PST 2013

Kamiyamay

Truth, honesty, humility, assertiveness, self awareness....all so important #hpm
Wed Mar 6 18:25:24 PST 2013

rfberry

RT @Kamiyamay: Truth, honesty, humility, assertiveness, self awareness....all so important #hpm
Wed Mar 6 18:25:47 PST 2013

AmandaBinDC

RT @fischmd: Brilliant! Generalist plus Specialist Palliative Care — Creating a More Sustainable Model — NEJM http://t.co/5NSIws5hoP #hpm
Wed Mar 6 18:25:53 PST 2013

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=0…

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Kamiyamay

@oliverdr They are, and often indicate fear and terror at what is happening, I usually walk out with a hug, been an interesting week #hpm
Wed Mar 6 18:26:11 PST 2013

rfberry

T2 What challenges & opportunities have you seen with truth at the end of life? (for families & clinicians.. & why) #hpm
Wed Mar 6 18:26:19 PST 2013

oliverdr

@GraniteDoc the difference is that you have an umbrella and our role is to share ithearing the hard truth is tough alone #hpm
Wed Mar 6 18:26:24 PST 2013

KnowYourWishes

RT @rfberry: T2 What challenges & opportunities have you seen with truth at the end of life? (for families & clinicians.. & why) #hpm
Wed Mar 6 18:26:59 PST 2013

CozziePMP2B

RT @fischmd: Brilliant! Generalist plus Specialist Palliative Care — Creating a More Sustainable Model — NEJM http://t.co/5NSIws5hoP #hpm
Wed Mar 6 18:26:59 PST 2013

KnowYourWishes

T2: Truth often not welcomed by unprepared fan members. Fine line 2 walk in being gentle and being honest. Huge challenge 4 me in ICU #hpm
Wed Mar 6 18:27:52 PST 2013

Kamiyamay

T2-challenge: children who have MPOA state they do not want parent (who is debilitated but still aware) to know they are on hospice #hpm
Wed Mar 6 18:28:06 PST 2013

oliverdr

T2 Surgeon dancing around truth- I asked "what is best case scenario" rather than normal question worse case- he was stumped lol #hpm
Wed Mar 6 18:28:10 PST 2013

equijada

@rfberry Earl Q joining late. t2: truth is relative to context of narrative. Opportunity: obtain narrative. #hpm
Wed Mar 6 18:28:13 PST 2013

GraniteDoc

@oliverdr Perfect way to complete that metaphor. Palliare = to cloak or shield, sounds like an umbrella to me! #hpm
Wed Mar 6 18:28:16 PST 2013

rfberry

T2 I think there are ethical obligations for clinicians to gain comfort with truth at the end of life. #hpm
Wed Mar 6 18:28:28 PST 2013

oliverdr

Love it!RT @GraniteDoc: @oliverdr Perfect way to complete that metaphor. Palliare = to cloak or shield, sounds like an umbrella to me! #hpm
Wed Mar 6 18:28:59 PST 2013

KnowYourWishes

Wow. That' a huge challenge! MT @Kamiyamay: T2 children who have MPOA state

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=0…

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they do not want parent to know they are on hospice #hpm
Wed Mar 6 18:29:10 PST 2013

Kamiyamay

T2-The truth given in appropriate and compassionate way allows open trust and communication. I always look straight into eyes and.... #hpm
Wed Mar 6 18:29:57 PST 2013

rfberry

You are a poet. RT @equijada T2: Truth is relative to context of narrative. Opportunity: obtain narrative. #hpm
Wed Mar 6 18:30:08 PST 2013

rfberry

@oliverdr interesting. What happened post-being stumped? #hpm
Wed Mar 6 18:30:38 PST 2013

oliverdr

ETHICS!RT @Kamiyamay: T2-challenge: children who have MPOA state they do not want parent to know they are on hospice #hpm
Wed Mar 6 18:30:41 PST 2013

KnowYourWishes

@rfberry Diff clinicians have diff understanding of truth, what fams need/want to hear, each with diff ethical perspectives #hpm
Wed Mar 6 18:31:02 PST 2013

MsWZ

T2 Being told there were weeks left, maybe just days, at the busy nurses station in a public hallway at the hospital. #hpm
Wed Mar 6 18:31:27 PST 2013

oliverdr

Promised cure which was not possible-did not have all factsRT @rfberry: @oliverdr interesting. What happened post-being stumped? #hpm
Wed Mar 6 18:31:39 PST 2013

aliciabloom

@rfberry hoping to catch some of #hpm tweetchat tonight-- wearing my #basketballwife hat at the moment.
Wed Mar 6 18:31:55 PST 2013

KnowYourWishes

Not always ethics- sometimes cultural MT @oliverdr: ETHICS!RT @Kamiyamay: children who do not want parent to know they are on hospice #hpm
Wed Mar 6 18:31:58 PST 2013

Kamiyamay

@oliverdr What is interesting time after time, the children are duped: they one at end of life knows anyway. #hpm
Wed Mar 6 18:31:59 PST 2013

doctatum

RT @equijada: @rfberry Earl Q joining late. t2: truth is relative to context of narrative. Opportunity: obtain narrative. #hpm
Wed Mar 6 18:32:00 PST 2013

LGG1

RT @fischmd: Brilliant! Generalist plus Specialist Palliative Care — Creating a More Sustainable Model — NEJM http://t.co/YQWrs8wEy0 #hpm
Wed Mar 6 18:32:01 PST 2013

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=0…

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KnowYourWishes

T2: challenge. Telling fam's end is near...sometimes being wrong. #hpm
Wed Mar 6 18:32:32 PST 2013

MsWZ

T2: Opportunity - some way to make sure family is there if patient is getting bad news. Protocol gets confusing in oncology. Messy. #hpm
Wed Mar 6 18:32:41 PST 2013

equijada

OH today: "You tell it like it is, I like that" (but before I told it like it is, I had to listen like it is) #hpm
Wed Mar 6 18:32:42 PST 2013

Kamiyamay

(been there)RT @MsWZ: T2 Being told there were weeks left, maybe just days, at the busy nurses station in a public hallway in hospital. #hpm
Wed Mar 6 18:32:46 PST 2013

rfberry

@MsWZ I think it's sometimes challenging for clinicians to remember the context of an environment for family is different than theirs. #hpm
Wed Mar 6 18:32:52 PST 2013

KnowYourWishes

@aliciabloom Basketball and #eol go hand in hand (if your team loses...) <--life according to my husband #hpm
Wed Mar 6 18:33:08 PST 2013

oliverdr

@Kamiyamay How do we deliver hospice without being honest? I could only promise not to bring it up but to answer all questions honest #hpm
Wed Mar 6 18:33:11 PST 2013

GraniteDoc

T2 challenge = opportunity, to present truth in a way that is digestible, have to understand what and when pt/family need to know #hpm
Wed Mar 6 18:33:24 PST 2013

Kamiyamay

@KnowYourWishes I tell them I rather call you all here and be wrong than not to have called you #hpm
Wed Mar 6 18:33:34 PST 2013

MsWZ

Opportunity: No one "clinical" tells you about the human connection of watching someone pass. It's dark, yes, but its also incredible. #hpm
Wed Mar 6 18:33:48 PST 2013

rfberry

T2 Within families I think there's a benefit from embracing truth, but it's important to be supportive of the inter-family needs. #hpm
Wed Mar 6 18:33:56 PST 2013

MsWZ

@Kamiyamay ::hug:: #hpm
Wed Mar 6 18:33:58 PST 2013

oliverdr

Agree!RT @MsWZ: T2: some way to make sure family is there if patient is getting bad news. Protocol gets confusing in oncology. Messy. #hpm

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=0…

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Wed Mar 6 18:34:05 PST 2013

KnowYourWishes

Absolutely! MT @Kamiyamay: @KnowYourWishes I tell them I rather call you all here and be wrong than not to have called you #hpm
Wed Mar 6 18:34:11 PST 2013

MsWZ

@rfberry I agree. But I also remember days later that the sitting room was 11 steps away at that hospital. I counted. #hpm
Wed Mar 6 18:34:47 PST 2013

Kamiyamay

@rfberry Correct: In fact I tell them in community I am a guest in their home, we are no longer where HC is in charge #hpm
Wed Mar 6 18:34:51 PST 2013

oliverdr

Right on! RT @GraniteDoc: to present truth in a way that is digestible, have to understand what and when pt/family need to know #hpm
Wed Mar 6 18:35:08 PST 2013

rfberry

@MsWZ I think this community would very much embrace that & agree with you. #hpm
Wed Mar 6 18:35:25 PST 2013

oliverdr

RT @Kamiyamay: @KnowYourWishes I tell them I rather call you all here and be wrong than not to have called you #hpm
Wed Mar 6 18:35:35 PST 2013

Kamiyamay

MT @rfberry: T2 Within families theres a benefit from embracing truth, but its important to be supportive of the inter-family needs. #hpm
Wed Mar 6 18:35:38 PST 2013

rfberry

cute. RT @KnowYourWishes: @aliciabloom Basketball and #eol go hand in hand (if your team loses...) <--life according to my husband #hpm
Wed Mar 6 18:36:28 PST 2013

aliciabloom

RT @rfberry: T1 What does truth at the end of life mean to you? (inspired by Elaine Waples http://t.co/S2uPYimpJP ) #hpm
Wed Mar 6 18:37:03 PST 2013

hpmmsudo

RT @fischmd: Brilliant! Generalist plus Specialist Palliative Care — Creating a More Sustainable Model — NEJM http://t.co/5NSIws5hoP #hpm
Wed Mar 6 18:37:38 PST 2013

Kamiyamay

T2 challenge: recent-I saw pt active dying upon arrival home-took daughter in other room, she denied, I asked but if she goes.... #hpm
Wed Mar 6 18:37:51 PST 2013

rfberry

Awesome discussion so far, really appreciating everyone's perspective. We're about to move to T3, any other T2 thoughts? #hpm
Wed Mar 6 18:39:07 PST 2013

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=…

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Kamiyamay

Very last question after done tons of teaching, loving assessing everyone happier, smiling: have to ask-if he goes do U know what to do #hpm
Wed Mar 6 18:39:58 PST 2013

rfberry

T2 EOL Truth Challenge: Being present with your own end of life fears so you can really be fully there for others. #hpm
Wed Mar 6 18:41:01 PST 2013

aliciabloom

@rfberry i'm ready to jump in for T3! #hpm
Wed Mar 6 18:41:26 PST 2013

oliverdr

CourageRT @rfberry: T2 EOL Truth Challenge: Being present with your own end of life fears so you can really be fully there for others. #hpm
Wed Mar 6 18:41:50 PST 2013

Kamiyamay

(Right) RT @rfberry: T2 EOL Truth Challenge: Being present with your own end of life fears so you can really be fully there for others. #hpm
Wed Mar 6 18:41:51 PST 2013

rfberry

T2 It takes courage to be present with truth. It takes special courage at the end of life. #hpm
Wed Mar 6 18:41:59 PST 2013

KnowYourWishes

woot woot! RT @aliciabloom: @rfberry im ready to jump in for T3! #hpm
Wed Mar 6 18:42:00 PST 2013

Kamiyamay

RT @aliciabloom: @rfberry im ready to jump in for T3! #hpm
Wed Mar 6 18:42:00 PST 2013

rfberry

great!! RT @aliciabloom: @rfberry im ready to jump in for T3! #hpm
Wed Mar 6 18:42:09 PST 2013

Kamiyamay

Sounds like a pool party, Ha! #hpm
Wed Mar 6 18:43:08 PST 2013

rfberry

T3 What are your thoughts on this: "Short #hospice stays undermine the effectiveness of the model" @JHARTFOUND http://t.co/YiYDCM8SaM #hpm
Wed Mar 6 18:43:22 PST 2013

bacigalupe

“@KnowYourWishes @rfberry Tweetchat read this @TEDMED #greatchallenges article for pre-T1 http://t.co/KnoK1GfpKX #hpm”
Wed Mar 6 18:44:23 PST 2013

KnowYourWishes

RT T3 What are your thoughts on this: "Short #hospice stays undermine the effectiveness of the model" @JHARTFOUND #hpm
Wed Mar 6 18:44:40 PST 2013

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=…

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oliverdr

T3 understand but short stays still need help- maybe even more! Problem is we need to go upstream of course #hpm
Wed Mar 6 18:45:19 PST 2013

KnowYourWishes

T3: agree mostly but sometimes even inpatient hospice, short stays, still quite effective and beneficial. Depends on setting and family #hpm
Wed Mar 6 18:45:49 PST 2013

rfberry

@oliverdr I totally agree, short stays need help. For sure. #hpm
Wed Mar 6 18:46:10 PST 2013

doctatum

RT @oliverdr: T3 understand but short stays still need help- maybe even more! Problem is we need to go upstream of course #hpm
Wed Mar 6 18:46:22 PST 2013

rfberry

T3 I appreciated this quote because I think there are many lost opportunities in having a late referral to hospice. #hpm
Wed Mar 6 18:46:42 PST 2013

aliciabloom

T3 I agree. #Hospice cannot do all that intends if lengths of stays remain so short. Of course, these patients/families still need help #hpm
Wed Mar 6 18:46:46 PST 2013

Kamiyamay

T3-Denial discussed earlier, I admitted 7p and gone 8a....she was kept in hospital, had 12 admits in less year....no time for family #hpm
Wed Mar 6 18:46:58 PST 2013

KnowYourWishes

T3: esp from ICU perspective, sometimes end stage illness develops suddenly and without warning. #hpm
Wed Mar 6 18:47:13 PST 2013

aliciabloom

@KnowYourWishes T3 I believe in the ICU you see the acute phase of dying, most patients have entered the dying process months before #hpm
Wed Mar 6 18:48:07 PST 2013

doctatum

@oliverdr t1 some families who cant do hospice until very end need the bereavement support more than longer stay pts?? #hpm
Wed Mar 6 18:48:08 PST 2013

rfberry

T3 The way the #hospice model is set up though, while it still helps even with a few days, it seems underutilized. #hpm
Wed Mar 6 18:48:21 PST 2013

CERNfoundation

“RT@fischmd: Brilliant! Generalist plus Specialist Palliative Care — Creating a More Sustainable Model — NEJM http://t.co/Ojlcl09c1S #hpm”
Wed Mar 6 18:48:21 PST 2013

KnowYourWishes

T3: hospice referral timing not one size fits all. Earliest possible referral, however, is always best if family willing #hpm

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=…

12/17

3/7/13

#hpm - Healthcare Social Media Transcript
Wed Mar 6 18:48:32 PST 2013

oliverdr

RT @KnowYourWishes: T3: esp from ICU perspective, sometimes end stage illness develops suddenly and without warning. #hpm
Wed Mar 6 18:48:33 PST 2013

Kamiyamay

T3-families I have served have been angry after fact because they realized they were robbed of precious family time home with loved one #hpm
Wed Mar 6 18:49:21 PST 2013

aliciabloom

T3 #Hospice as a model of care for patients w/ advanced illness cannot impact the healthcare system with late referral/short LOS #hpm
Wed Mar 6 18:49:23 PST 2013

KnowYourWishes

agree! RT @rfberry: T3 The way the #hospice model is set up though, while it still helps even with a few days, it seems underutilized. #hpm
Wed Mar 6 18:49:24 PST 2013

oliverdr

Must not forget value of bereavement #hpm
Wed Mar 6 18:49:54 PST 2013

GraniteDoc

T3 I think more hospice does not = better necessarily, my bias is that RELATIONSHIP = better, whether it's hospice or other #Hpm
Wed Mar 6 18:49:59 PST 2013

rfberry

T3 I think from a 'big picture' policy perspective on the hospice medicare benefitShort utilization of hospice misses so much. #hpm
Wed Mar 6 18:50:13 PST 2013

aliciabloom

T3 I have heard, far too often, "I wish we had done this sooner" or "Why didn't we know this was an option months ago?" #hpm
Wed Mar 6 18:50:19 PST 2013

jodyms

RT @bacigalupe: “@KnowYourWishes @rfberry Tweetchat read this @TEDMED #greatchallenges article for pre-T1 http://t.co/KnoK1GfpKX #hpm”
Wed Mar 6 18:50:49 PST 2013

Kamiyamay

@aliciabloom How do we invoke change. Frustrated when I see people bruised and battered, begging me "please I don't want to go back" #hpm
Wed Mar 6 18:50:58 PST 2013

aliciabloom

@oliverdr bereavement is absolutely valuable, however many families do not want it or utilize it, even if needed #hpm
Wed Mar 6 18:51:16 PST 2013

oliverdr

Never heard a family complain about being in hospice too soon- so true! #hpm
Wed Mar 6 18:51:22 PST 2013

@GraniteDoc I totally agree. I think it's the relationship being shorter is what breaks

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=…

13/17

3/7/13

#hpm - Healthcare Social Media Transcript

rfberry

my heart. #hpm
Wed Mar 6 18:51:40 PST 2013

GraniteDoc

@aliciabloom @KnowYourWishes Yes! Very hard when pts/families blindsided by EOL that MDs saw coming long ago #hpm
Wed Mar 6 18:51:42 PST 2013

rfberry

RT @oliverdr: Never heard a family complain about being in hospice too soon- so true! #hpm
Wed Mar 6 18:51:46 PST 2013

aliciabloom

@Kamiyamay patient directed education is critical. the growth of #palliative care will make an impact, too. #hpm
Wed Mar 6 18:52:03 PST 2013

milhealth

@rfberry #hpm I just can’t wrap my mind around “why” #hospice is underutilized?
Wed Mar 6 18:52:34 PST 2013

rfberry

RT @GraniteDoc: @aliciabloom @KnowYourWishes Yes! Very hard when pts/families blindsided by EOL that MDs saw coming long ago #hpm
Wed Mar 6 18:52:39 PST 2013

Kamiyamay

T3 - Education and advocacy. Training for hospitalist. Best practices when considering procedure, rehab and family guidance! #hpm
Wed Mar 6 18:52:54 PST 2013

KnowYourWishes

Fear of admitting end is near, i think RT @milhealth: @rfberry #hpm I just can’t wrap my mind around “why” #hospice is underutilized? #hpm
Wed Mar 6 18:53:23 PST 2013

GraniteDoc

@rfberry Yes, reflected in the linked article by increasing # of transitions of care and increased ICU use, getting worse not better! #hpm
Wed Mar 6 18:53:25 PST 2013

rfberry

RT @aliciabloom: @Kamiyamay patient directed education is critical. the growth of #palliative care will make an impact, too. #hpm
Wed Mar 6 18:53:27 PST 2013

Kamiyamay

RT @aliciabloom: @Kamiyamay patient directed education is critical. the growth of #palliative care will make an impact, too. #hpm
Wed Mar 6 18:53:38 PST 2013

RachelleNorman

RT @equijada: OH today: "You tell it like it is, I like that" (but before I told it like it is, I had to listen like it is) #hpm
Wed Mar 6 18:53:49 PST 2013

rfberry

RT @KnowYourWishes: Fear of admitting end is near, i think RT @milhealth: @rfberry #hpm I just can’t wrap my mind around “why” #hospice ...

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=…

14/17

3/7/13

#hpm - Healthcare Social Media Transcript
Wed Mar 6 18:54:04 PST 2013

oliverdr

Lack of truth or acceptance of itRT @milhealth: @rfberry #hpm I just can’t wrap my mind around “why” #hospice is underutilized? #hpm
Wed Mar 6 18:54:31 PST 2013

aliciabloom

@milhealth so many reasons: death denying culture, technological imperative of the medical model, clinician fear of discussing EOL care #hpm
Wed Mar 6 18:54:46 PST 2013

KnowYourWishes

Ok, folks. I unfortuantely have to go. Great chat tonight. #hpm
Wed Mar 6 18:55:02 PST 2013

doctatum

@rfberry wow. Great topics #hpm
Wed Mar 6 18:55:41 PST 2013

oliverdr

Agree!RT @GraniteDoc: @KnowYourWishes @milhealth @rfberry Also, some MDs genuinely dont recognize approaching death in non-CA pts. #hpm
Wed Mar 6 18:55:54 PST 2013

rfberry

Thanks!! Had great perspectives shared tonight for sure! RT @doctatum: @rfberry wow. Great topics #hpm
Wed Mar 6 18:56:34 PST 2013

GraniteDoc

@rfberry Really thought provoking topics, thank you! #hpm
Wed Mar 6 18:56:44 PST 2013

bdmoses

RT @equijada: OH today: "You tell it like it is, I like that" (but before I told it like it is, I had to listen like it is) #hpm
Wed Mar 6 18:56:58 PST 2013

oliverdr

Great chat-hope to see everyone in NO! #hpm
Wed Mar 6 18:57:13 PST 2013

Kamiyamay

I also teach the nurses and all come in contact....end of life is not a crisis if handled appropriately, family given time, pt comfort #hpm
Wed Mar 6 18:57:32 PST 2013

oliverdr

Going to be thinking more about "truth" and lack of it! #hpm
Wed Mar 6 18:57:32 PST 2013

SarahVarga

RT @KnowYourWishes: Fear of admitting end is near, i think RT @milhealth: @rfberry #hpm I just can’t wrap my mind around “why” #hospice ...
Wed Mar 6 18:57:46 PST 2013

doctatum

#hpm chat folk. If you are at @AAHPM in NoLa next wed night 5:30-7:00 drop by the support the future campaign booth and say hi!

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=…

15/17

3/7/13

#hpm - Healthcare Social Media Transcript
Wed Mar 6 18:57:51 PST 2013

Kamiyamay

Yes!!!RT @oliverdr: Great chat-hope to see everyone in NO! #hpm
Wed Mar 6 18:57:57 PST 2013

aliciabloom

excellent topics tonight @rfberry! #hpm
Wed Mar 6 18:58:07 PST 2013

Kamiyamay

Lth: walked in to check pt declining...It was perfect, she took three sweet peaceful breaths, the family were pleased, such an honor! #hpm
Wed Mar 6 18:59:13 PST 2013

rfberry

Me Too, Thanks to Elaine Waples brave @TEDMED #greatchallenges story RT @oliverdr Going to be thinking more about "truth" & lack of it! #hpm
Wed Mar 6 18:59:45 PST 2013

Kamiyamay

@GraniteDoc True, and lots of new docs in town....been taking peeps 30+yrs so assessment just part of my life...we live, love, learn!!! #hpm
Wed Mar 6 19:00:21 PST 2013

rfberry

Thanks so much for joining the chat tonight! Really great discussion, I so appreciated everyone sharing their perspective. #hpm
Wed Mar 6 19:00:42 PST 2013

aliciabloom

@GraniteDoc @Kamiyamay clinical criteria for hospice eligibility give us nice guidelines to identify symptoms of end-stage illness #hpm
Wed Mar 6 19:00:45 PST 2013

bdmoses

RT @fischmd: Brilliant! Generalist plus Specialist Palliative Care — Creating a More Sustainable Model — NEJM http://t.co/5NSIws5hoP #hpm
Wed Mar 6 19:01:00 PST 2013

Kamiyamay

@rfberry Humble gratitude....truly learn so much and embrace any change that we can make for the good...looking forward learning AAHPM #hpm
Wed Mar 6 19:01:45 PST 2013

GraniteDoc

@aliciabloom @Kamiyamay Yes, just have to get ppl to think of looking at those clinical criteria! (so much work to do!) #hpm
Wed Mar 6 19:02:42 PST 2013

aliciabloom

@GraniteDoc yes! much education needed. #hpm
Wed Mar 6 19:03:20 PST 2013

milhealth

@aliciabloom @rfberry #hpm we’re a military family, I’ve had 2 have that conversation w/my son (about his wishes) That’s very hard! #army
Wed Mar 6 19:03:29 PST 2013

Kamiyamay

@GraniteDoc yes work but when I look into the eyes of a dear patient who has been

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=…

16/17

3/7/13

#hpm - Healthcare Social Media Transcript

through much and connect: all this vol time worth it! #hpm
Wed Mar 6 19:07:35 PST 2013

milhealth

@aliciabloom thanks :-) Its important for families 2 talk about the inevitable. My son has-bizarre sense of humor about it all too! #hpm
Wed Mar 6 19:08:15 PST 2013

Kamiyamay

@milhealth It takes courage, especially when they are young, had to face choices when my son was in an accident #hpm
Wed Mar 6 19:08:45 PST 2013

ssmithaahpm

Examined Lives: Truth at the end of life http://t.co/1JITIv7DM1 #hpm
Wed Mar 6 19:11:32 PST 2013

milhealth

@Kamiyamay that is hard when you’re not expecting something to happen to a young person, like your son. May I ask about your son? #hpm
Wed Mar 6 19:11:45 PST 2013

kpedmonds

Palliative Care Success: A Closer Look at San Diego Hospice http://t.co/KWnNyN2fnp #hpm #hospice
Wed Mar 6 19:13:06 PST 2013

hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=hpm&fdate=03-06-2013&shour=18&smin=0&tdate=03-06-2013&thour=19&tmin=15&ssec=…

17/17

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