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#sgshealth Twitter Archive

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All tweets from the Salzburg Global Seminar on Informed Medical Decision Making, held Dec. 12-17 2010, through 1/14/11 with the hashtag #sgshealth.

All tweets from the Salzburg Global Seminar on Informed Medical Decision Making, held Dec. 12-17 2010, through 1/14/11 with the hashtag #sgshealth.

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  • 1. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username Created@ePatientDave I was thinking #sgshealth. Sound good? mollytoba Sun 12 Dec 2010 15:00:56We have a winner! RT @mollytoba @ePatientDave I was thinking #sgshealth. Sound good? ePatientDave Sun 12 Dec 2010 15:03:27At Salzburg Global Seminar:greatest untapped resource in healthcare?Informing+involving patients in decisions about their care #sgshealth LaylaMcCay Sun 12 Dec 2010 15:24:29Fascinating collection of people from 19 nations at Salzburg Global Seminar on informing/involving patients. #sgshealth is proper hashtag garyschwitzer Sun 12 Dec 2010 15:36:03RT @garyschwitzer: Fascinating collection of people from 19 nations at Salzburg Global Seminar on informing/involving patients. #sgshealth is proper hashtag kgapo Sun 12 Dec 2010 15:45:09RT @garyschwitzer: Fascinating collection of people from 19 nations at Salzburg Global Seminar on informing/involving patients. #sgshealth is proper hashtag mollytoba Sun 12 Dec 2010 15:46:04RT @garyschwitzer: Fascinating collection of people from 19 nations at Salzburg Global Seminar on informing/involving patients. #sgshealth is proper hashtag FIMDM Sun 12 Dec 2010 15:52:13Hey @rawarrior one of the participants @ #sgshealth is a #RA patient since age 3. Currently using meditation & ayurvedic. ePatientDave Sun 12 Dec 2010 15:57:59Listening to the real Jack Wennberg describe founding @FIMDM #sgshealth ePatientDave Sun 12 Dec 2010 16:02:04http://yfrog.com/gzedrkj Presentations begin at #sgshealth: paternalism or partnership? Angela Coulter speaking. ePatientDave Sun 12 Dec 2010 16:20:06#sgshealth organizer @fimdm was formed in 1989 out of Dartmouths work on variations in care ePatientDave Sun 12 Dec 2010 16:20:08#sgshealth "make care evidence based by tackling avoidable ignorance" - love that term! ePatientDave Sun 12 Dec 2010 16:21:58Also *increase* *warranted* variation: make care patient centered by personalizing treatment decisions. #sgshealth ePatientDave Sun 12 Dec 2010 16:23:36http://yfrog.com/gz4qrzj Key components of shared decision making #sgshealth ePatientDave Sun 12 Dec 2010 16:27:10@SusannahFox small typo: @epatientdave is at #sgshealth not sqs. Im following too. :) jsperber Sun 12 Dec 2010 16:30:34@ElinSilveous Reminder thats #sGshealth not sqs ePatientDave Sun 12 Dec 2010 16:35:31Thank you Dave! Mind your Gs and qs folks. :) RT @ePatientDave: @ElinSilveous Reminder thats #sGshealth not sqs ElinSilveous Sun 12 Dec 2010 16:44:12(That period of silence was brought to you by break time at #sgshealth. *Marvelous* elbows to rub.) ePatientDave Sun 12 Dec 2010 16:51:06Jack was hated by mds. Glad progressed. RT @ePatientDave: #sgshealth organizer @fimdm 1989 Dartmouth work on variations in care health20Paris Sun 12 Dec 2010 16:55:04@health20Paris Was Wennberg hated by docs because he questioned their judgment? #sgshealth ePatientDave Sun 12 Dec 2010 16:55:43@ePatientDave Was hated because he demonstrated unjustified variation in quality. 1st crack in opacity. #sgshealth health20Paris Sun 12 Dec 2010 16:56:28@ePatientDave should decision aids b free openaccess+validated in trials e.g. http://kercards.e-bm.info or proprietary payperview?#sgshealth vmontori Sun 12 Dec 2010 16:58:55@epatientdave dartmouth atlas: 1st to show probability surgery depends on where US patient lives #sgshealth health20Paris Sun 12 Dec 2010 16:58:57@vmontori My opinion of course is that decision aids will never get used if theyre pay per view #sgshealth ePatientDave Sun 12 Dec 2010 16:59:47@health20Paris Yes see my post about this event http://bit.ly/gTwnUE #sgshealth ePatientDave Sun 12 Dec 2010 17:00:45@SusannahFox tweets fm salzburg also frm #sgs477 (shorter than #sgshealth).. kgapo Sun 12 Dec 2010 17:02:22Now speaking #sgshealth: @FIMDM co-founder Al Mulley and president Mike Barry ePatientDave Sun 12 Dec 2010 17:02:45Mike Barry on why practice variation is such a surprise to MDs: they operate in silos but assume that others are doing the same #sgshealth FIMDM Sun 12 Dec 2010 17:05:16@ePatientDave #sgshealth http://bit.ly/gRwHt8 my short video ending by Dr Fletcher "patient = 1st member medical team" health20Paris Sun 12 Dec 2010 17:06:18Just learned about intl alliance of patient advocacy organizations http://bit.ly/hWB7Et - president is @ #sgshealth ePatientDave Sun 12 Dec 2010 17:06:25On e-patients.net: Salzburg Global Seminar on shared medical decision makinghttp://bit.ly/h0bYYP. Help me represent you. #sgshealth ePatientDave Sun 12 Dec 2010 17:07:00Mulley: one unanticipated outcome of SDM (shared decision making) was: pts chose expensive treatmts less often #sgshealth ePatientDave Sun 12 Dec 2010 17:07:57RT @ePatientDave: Mulley: one unanticipated outcome of SDM (shared decision making) was: pts chose expensive treatmts less often #sgshealth Stelerix Sun 12 Dec 2010 17:08:52Barry: SDM is about *2* way communic: info on options *to* patient; expression of preferences *from* pt is harder. #sgshealth ePatientDave Sun 12 Dec 2010 17:09:02RT @ePatientDave: Mulley: one unanticipated outcome of SDM (shared decision making) was: pts chose expensive treatmts less often #sgshealth chukwumaonyeije Sun 12 Dec 2010 17:10:47@Colin_Hung Apologies URL for IAPO (pt alliance) is this http://bit.ly/dPJHRZ #sgshealth ePatientDave Sun 12 Dec 2010 17:11:08"Youve got a belief that docs r scientists who make the right decision w very little uncertainty all the time; just isnt true" #sgshealth ePatientDave Sun 12 Dec 2010 17:15:53There are now 96 randomized trials to test shared decision making #sgshealth ePatientDave Sun 12 Dec 2010 17:16:21RT @ePatientDave: There are now 96 randomized trials to test shared decision making #sgshealth #hcsmeu #health20fr health20Paris Sun 12 Dec 2010 17:16:45@health20Paris (Thats 96 clinical trials *now* underway) #sgshealth ePatientDave Sun 12 Dec 2010 17:17:15RT @ePatientDave: There are now 96 randomized trials to test shared decision making #sgshealth kgapo Sun 12 Dec 2010 17:17:15Re SDM (shared decision making) we say takes 2 to tango; "more like a square dance" - others are involved (payers family etc) #sgshealth ePatientDave Sun 12 Dec 2010 17:19:05Establishment needs to prove value shared decisionmaking RT @ePatientDave: 96 clinical trials #sgshealth #health20fr #hcsmeu health20Paris Sun 12 Dec 2010 17:19:36Mulley: theres a diff between one-time decisions and chronic decisions. #sgshealth ePatientDave Sun 12 Dec 2010 17:20:09Mulley: "healthcare is a team sport." Often includes factors like family that influence health (smoker bad cooking...) #sgshealth ePatientDave Sun 12 Dec 2010 17:20:47Great: Mulley talking about realistic constraints e.g. pt saying "Doc I dont have bandwidth [or support] to do all that" #sgshealth ePatientDave Sun 12 Dec 2010 17:21:32RT @ePatientDave: Mulley: "healthcare is a team sport." Often includes factors like family that influence health (smoker bad cooking...) #sgshealth crgonzalez Sun 12 Dec 2010 17:25:05RT @ePatientDave: Mulley: one unanticipated outcome of SDM (shared decision making) was: pts chose expensive treatmts less often #sgshealth crgonzalez Sun 12 Dec 2010 17:25:16Barry: "If provider knows yr prefs & u dont WANT to decide the words can come out of providers mouth" <=very dicey imo #sgshealth ePatientDave Sun 12 Dec 2010 17:25:54#sgshealth Could an MD possibly make a less good decision when including patient input? health20Paris Sun 12 Dec 2010 17:26:37@health20Paris Gotta define "good" lady... #sgshealth ePatientDave Sun 12 Dec 2010 17:27:12Mike Barry: dangerous to only focus on tools better to think more about improving the process for shared-decision making. #sgshealth FIMDM Sun 12 Dec 2010 17:27:20Great: Mulley talking abt realistic constraints eg pt saying "Doc I dont have bandwidth [or support] to do all that" #sgshealth #sgs477 kgapo Sun 12 Dec 2010 17:27:58uh-oh my batterys pooping out- may have to switch to Droid #sgshealth ePatientDave Sun 12 Dec 2010 17:28:47Mulley: Some of Wennbergs earliest work was informing docs in Maine how they compared to norm. They changed w/no lever on them #sgshealth ePatientDave Sun 12 Dec 2010 17:30:34@sgs477 #opnHealth #hcsmeu Mike Barry: dangerous 2 only focus on tools better 2 think more abt improvng process for SDM #sgshealth kgapo Sun 12 Dec 2010 17:33:10From Salzburg seminar: imagine health care providers having to compete on the quality of the shared decision-making employed. #sgshealth garyschwitzer Sun 12 Dec 2010 17:36:02Robt Johnston pres of IAPO #sgshealth telling fabulous story of troubleshooting his own near-migraines. Total e-patient. #sgshealth ePatientDave Sun 12 Dec 2010 17:36:25Next pt speaking of how ovarian cancer *patients* were the ones to figure out it WASNT "silent killer" - they had symptoms #sgshealth ePatientDave Sun 12 Dec 2010 17:38:34If Bill can ask us to define "is" I can define "good" RT @ePatientDave: @health20Paris Gotta define "good" lady... #sgshealth health20Paris Sun 12 Dec 2010 17:44:07Thats a wrap for #sgshealth - its dinnertime in Salzburg. Post your thoughts on http://e-patkents.net! ePatientDave Sun 12 Dec 2010 17:46:19@garyschwitzer Multidisciplinary teams (shared decision) are common in academic medicine #sgshealth medcareerist Sun 12 Dec 2010 17:50:20@health20Paris Could an MD make a worse decision when including patient input? -> yes they could prescribe antibiotics for colds #sgshealth Dr_Bob Sun 12 Dec 2010 17:56:18RT @ePatientDave: @vmontori My opinion of course is that decision aids will never get used if theyre pay per view #sgshealth vmontori Sun 12 Dec 2010 17:57:37 Page  1
  • 2. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username Created@ePatientDave: OK. Long comment with no spell check. Hope its what youre looking for. #sgshealth #e-patient Annie_Stith Sun 12 Dec 2010 18:09:30RT @ePatientDave: There are now 96 randomized trials to test shared decision making #sgshealth cmeadvocate Sun 12 Dec 2010 18:33:02RT @ePatientDave "healthcare is a team sport." Often includes factors like family that influence health (smoker bad cooking...) #sgshealth CaringWise Sun 12 Dec 2010 19:13:00@dr_bob an informed patients input #sgshealth health20Paris Sun 12 Dec 2010 20:25:03Michael Barry: What we are really dealing with is an agency problem - who decides and who suffers the consequences. #sgshealth FIMDM Sun 12 Dec 2010 21:00:19Beginning day 2 of #sgshealth Salzburg Global Seminar on informed medical decision making. Post: http://bit.ly/gTwnUE ePatientDave Mon 13 Dec 2010 08:11:55Jack Wennberg lecturing: arrival of Medicare in LBJ administration raised concerns about system capacity. #sgshealth ePatientDave Mon 13 Dec 2010 08:13:41Millions joined the system (1960s); goal of original data gathering was to detect and eliminate underserving. #sgshealth ePatientDave Mon 13 Dec 2010 08:15:09RT @garyschwitzer: Salzburg seminar: imagine health care providers competing on quality of shared decision-making #sgshealth doctorblogs Mon 13 Dec 2010 08:15:48Wennberg: "What we found instead was chaotic patterns of service." [Note: w/o data u have no idea what to fix] #sgshealth ePatientDave Mon 13 Dec 2010 08:16:17RT @ePatientDave Al Mulley: Wennbergs earliest work compared docs in Maine to norm. They changed w/no lever on them #sgshealth doctorblogs Mon 13 Dec 2010 08:17:11Note: his data is *population* based (residence not where svc was done) #sgshealth ePatientDave Mon 13 Dec 2010 08:17:35RT @ePatientDave: Jack Wennberg lecturing: arrival of Medicare in LBJ administration raised concerns about system capacity. #sgshealth Infocept Mon 13 Dec 2010 08:19:10Jack Wennberg reviewing early health care variations research with intnl audience at global seminar in scenic snowy Salzburg. #sgshealth garyschwitzer Mon 13 Dec 2010 08:19:11RT @ePatientDave: Beginning day 2 of #sgshealth Salzburg Global Seminar on informed medical decision making. Post: http://bit.ly/gTwnUE Infocept Mon 13 Dec 2010 08:19:18A snowy Salzburg morning kicks off with John Wennberg on practice variation #sgshealth LaylaMcCay Mon 13 Dec 2010 08:19:45Agree. Its abt *process* RT @FIMDM: Mike Barry: dangerous to only focus on tools...think more re shared-decision making process #sgshealth doctorblogs Mon 13 Dec 2010 08:20:20Example of practice variation: In Wennbergs kids childhood 1/4 had tonsils out; next town over 3/4 would have. #sgshealth ePatientDave Mon 13 Dec 2010 08:21:59Tweetstream for #sgshealth Salzburg Global Seminar on health: http://wthashtag.com/Sgshealth ePatientDave Mon 13 Dec 2010 08:25:10RT @ePatientDave: Tweetstream for #sgshealth Salzburg Global Seminar on health: http://wthashtag.com/Sgshealth eczemasupport Mon 13 Dec 2010 08:26:53Tonsillectomy rates near Wennbergs home in Vermont before & after data was published #sgshealth http://yfrog.com/h0buvqj ePatientDave Mon 13 Dec 2010 08:27:41Wennberg:demographics of places with huge variation were almost identical-unwarranted variation and risk of iatrogenic harm #sgshealth LaylaMcCay Mon 13 Dec 2010 08:27:55http://yfrog.com/h3hb3tj Data showed overtreatmt led to as much risk of hosp-induced harm as risk of UNDERtreatmt #sgshealth ePatientDave Mon 13 Dec 2010 08:30:34RT @ePatientDave: http://yfrog.com/h3hb3tj Data showed overtreatmt led to as much risk of hosp-induced harm as risk of UNDERtreatmt #sgshealth eczemasupport Mon 13 Dec 2010 08:32:19Analysis of prostate surgery (TUR) outcomes showed it *didnt* improve survival did improve quality of life #sgshealth ePatientDave Mon 13 Dec 2010 08:33:29All that was from analyzing Vermont Medicare data. In 90s when HC reform was in process did the same nationally #sgshealth ePatientDave Mon 13 Dec 2010 08:35:41Prostate surgery is preference based issue-trade off:do you prefer good urination or good sex?How could doctors decide! #sgshealth LaylaMcCay Mon 13 Dec 2010 08:35:51Robert Wood Johnson Foundation gave grant to do it. They created 306 hospital referral regions. #sgshealth ePatientDave Mon 13 Dec 2010 08:36:56Then Clinton bill didnt pass; all the data became The Dartmouth Atlas. #sgshealth ePatientDave Mon 13 Dec 2010 08:37:16Variation that cant be explained by illness medical evidence or patient preferences is definition of unwarranted variation #sgshealth LaylaMcCay Mon 13 Dec 2010 08:37:23Definition challenged: medical evidence doesnt change by region; definition modified to remove that aspect #sgshealth LaylaMcCay Mon 13 Dec 2010 08:39:33Wennbergs work is about *unwarranted* variation in HC delivery both over AND under standard of care. #sgshealth ePatientDave Mon 13 Dec 2010 08:39:363 categories: Effective care preference-sensitive care ("matter of opinion") supply-sensitive. #sgshealth ePatientDave Mon 13 Dec 2010 08:40:323 types of unwarranted variation: effective care preference-sensitive care and supply sensitive care #sgshealth LaylaMcCay Mon 13 Dec 2010 08:41:02"Effective care" = no medical debate that the treatmt is justified e.g. beta blockers after heart attack. #sgshealth ePatientDave Mon 13 Dec 2010 08:41:39Note: the standard can change (e.g. whether hernia surgery is needed); this is about current std. #sgshealth ePatientDave Mon 13 Dec 2010 08:42:41RT @LaylaMcCay: 3 types of unwarranted variation: effective care preference-sensitive care & supply-sensitive care #sgshealth doctorblogs Mon 13 Dec 2010 08:43:34Preference-sensitive = tradeoffs exist: multiple options w diff. outcomes; shd be based on pts preferences. #sgshealth ePatientDave Mon 13 Dec 2010 08:43:37RT @ePatientDave: "Effective care" = no medical debate that the treatmt is justified e.g. beta blockers after heart attack. #sgshealth calliopeconsult Mon 13 Dec 2010 08:44:03No-brainer? Gentlemen:which wld you choose good sex or good peeing? RT @LaylaMcCay Prostate surgery is preference-based trade off #sgshealth doctorblogs Mon 13 Dec 2010 08:45:14RT @ePatientDave "Effective care"=no med Dbate that treatmt justified e.g. Œ≤ blockers after heart attack. #sgshealth #sgs477 #opnHealth kgapo Mon 13 Dec 2010 08:45:36Failure to base preference sensitive care options on patient preference is patient safety issueie operating on the wrong patient #sgshealth LaylaMcCay Mon 13 Dec 2010 08:45:52RT @ePatientDave: Preference-sensitive = tradeoffs exist: multiple options w diff. outcomes; shd be based on pts preferences. #sgshealth edrneelesh Mon 13 Dec 2010 08:47:01RT @doctorblogs: RT @LaylaMcCay: 3 types of unwarranted variation: effective care preference-sensitive care & supply-sensitive care #sgshealth edrneelesh Mon 13 Dec 2010 08:47:06btw Wennbergs work on population healthcare data is summarized in new book Tracking Medicine #sgshealth ePatientDave Mon 13 Dec 2010 08:48:00Is this Jack Wennberg talking? RT @LaylaMcCay Failure to base pref-sensitive care options on patient pref is patient safety issue #sgshealth doctorblogs Mon 13 Dec 2010 08:48:24RT @LaylaMcCay Failure 2 base prefrence senstve care options on pt prefrence is pt safty issueie opratng on the wrong pt #sgshealth #sgs477 kgapo Mon 13 Dec 2010 08:49:19@doctorblogs @LaylaMcCay yes Wennberg. Follow #sgshealth ePatientDave Mon 13 Dec 2010 08:50:15#sgs477 tweeting from Salzburg on Informing & Involving Pts in Decsions about their medical care moves to #sgshealth #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 08:51:47Salzberg shared-decision making conference this week: Follow #sgshealth & @ePatientDave @FIMDM @LaylaMcCay @garyschwitzer [cc @cebmblog] doctorblogs Mon 13 Dec 2010 08:55:15RT @LaylaMcCay: A snowy Salzburg morning kicks off with John Wennberg on practice variation #sgshealth mollytoba Mon 13 Dec 2010 08:57:25You cannot predict the rate of one procedure by knowing rates for different procedures. #sgshealth LaylaMcCay Mon 13 Dec 2010 08:57:35@UK_Urologist great! As long as its *patient* choice. Do your patients go through a shared-decision making process? #sgshealth cc @FIMDM doctorblogs Mon 13 Dec 2010 08:58:50RT @LaylaMcCay: Number of knee replacements directly relates to number of available orthopaedic surgeons #sgshealth kgapo Mon 13 Dec 2010 08:59:16Greek orthopedic surgeons: do ur patients go thru a shared decision making process? #sgsHealth #opnHealth kgapo Mon 13 Dec 2010 09:00:19RT @LaylaMcCay: You cannot predict the rate of one procedure by knowing rates for different procedures. #sgshealth doctorblogs Mon 13 Dec 2010 09:00:33@lancet1 Salzberg shared-decision making conference this wk: Follow #sgshealth & @ePatientDave @FIMDM @LaylaMcCay @garyschwitzer doctorblogs Mon 13 Dec 2010 09:01:18Greek orthopedic surgeons: do ur patients go thru a shared decision making process bfr knee/hip replacement? #sgsHealth #opnHealth kgapo Mon 13 Dec 2010 09:02:04@BMJ_latest Salzberg shared-decision making conference this wk: Follow #sgshealth & @ePatientDave @FIMDM @LaylaMcCay @garyschwitzer doctorblogs Mon 13 Dec 2010 09:02:05RT @ePatientDave: Beginning day 2 of #sgshealth Salzburg Global Seminar on informed medical decision making. Post: http://bit.ly/gTwnUE FIMDM Mon 13 Dec 2010 09:03:25Hawker et al 2011 15% of people eligible for hip and knee replacement actually wanted surgery when preferences tested #sgshealth LaylaMcCay Mon 13 Dec 2010 09:03:46RT @LaylaMcCay: A snowy Salzburg morning kicks off with John Wennberg on practice variation #sgshealth FIMDM Mon 13 Dec 2010 09:04:21Determining need 4 hip/knee arthroplasty: the role of clinical serverity & pts preferencs (Hawker) discussed by Prf. J Wennberg #sgsHealth kgapo Mon 13 Dec 2010 09:05:32RT @kgapo ‚Äúthe patient is the first member of the medical team‚Äù http://bit.ly/h9Uiu7 via @health20Paris #sgs477 #sgshealth doctorblogs Mon 13 Dec 2010 09:06:50 Page  2
  • 3. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedDo patient preferences vary by age? Probably: differing risk/benefit and side effect profile #sgshealth LaylaMcCay Mon 13 Dec 2010 09:11:54Only 15% patients choose surgery RT @LaylaMcCay 15% people eligible for hip/knee replcmnt wanted op when prefs tested.Hawker2011 #sgshealth doctorblogs Mon 13 Dec 2010 09:12:05Patient preferences vary depending on age #sgshealth #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 09:13:11@engagementstrat Salzberg shared-decision making conference: Follow #sgshealth & @ePatientDave @FIMDM @LaylaMcCay @garyschwitzer @glynelwyn doctorblogs Mon 13 Dec 2010 09:14:56Mike Barry of @FIMDM says theyve just published first large scale epidemiological study of decision quality #sgshealth (need link!) ePatientDave Mon 13 Dec 2010 09:15:32Informed consent current practice is flawed - asking people after process finds theyre not really very informed #sgshealth LaylaMcCay Mon 13 Dec 2010 09:15:38Wennberg: End of life variations - in some regions 30-40% of deaths happen in ICUs. (Ugh!) #sgshealth ePatientDave Mon 13 Dec 2010 09:17:56Jack Wennberg: variations in end of life care easiest for consumers to understand and relate to bc of their own experiences. #sgshealth mollytoba Mon 13 Dec 2010 09:19:03We should be cautious in assuming doctors understand the evidence;might this be a barrier to delivering shared decision making? #sgshealth LaylaMcCay Mon 13 Dec 2010 09:19:24integrate patient preferences in EBM guidelines M Barry #sgshealth #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 09:21:11@ePatientDave http://bit.ly/f53gMF link to @fimdm Decisions Study #sgshealth mollytoba Mon 13 Dec 2010 09:23:36Excerpt from Wennbergs new book "Tracking Medicine": http://www.trackingmedicine.com/excerpt.php #sgshealth ePatientDave Mon 13 Dec 2010 09:23:50RT @ePatientDave:1st large scale epidemiological study of decision quality #sgshealth (need link) here tis: http://bit.ly/f6hwEm #sgshealth garyschwitzer Mon 13 Dec 2010 09:23:54@LaylaMcCay #sgshealth correct not all docs undrstand or I wld say know the evidence: barrier not only 2 SDM but 2 hlth outcomes #opnHealth kgapo Mon 13 Dec 2010 09:24:48@garyschwitzer @mollytoba Oh THAT famous study! Heard of it hadnt seen it. Thanks! #sgshealth ePatientDave Mon 13 Dec 2010 09:24:58http://j.mp/gCPe1X ‚ôª @ePatientDave Note: his data is *population* based (residence not where svc was done) #sgshealth healthgist Mon 13 Dec 2010 09:25:18TY @kgapo 4 #sgshealth Salzburg Global Seminar Informing/Involving Pts in Decisions abt Their Med Care http://bit.ly/hfailv #hcsmeu #hcsm andrewspong Mon 13 Dec 2010 09:25:18Clinical appropriateness s/b based on evidence; medical necessity s/b based on informed pt choice #sgshealth ePatientDave Mon 13 Dec 2010 09:26:25The frequency of use is governed by the assumption that resources should be fully utilised #sgshealth LaylaMcCay Mon 13 Dec 2010 09:26:41@Tabloidmed its about understanding the pros & cons of treatment options & the patients view... *not* abt discouraging Tx #sgshealth doctorblogs Mon 13 Dec 2010 09:26:57RT @kgapo: integrate patient preferences in EBM guidelines M Barry #sgshealth #opnHealth #hcsmeu <-- What plans for this @cochranecollab? andrewspong Mon 13 Dec 2010 09:27:02Jack Wennberg: evidenced-based medicine alone does not define medical necessity should be based on informed patient choice. #sgshealth FIMDM Mon 13 Dec 2010 09:27:32Now the juicy stuff: supply-sensitive care: Frequency of use is governed by assumption resources s/b fully utilized #sgshealth ePatientDave Mon 13 Dec 2010 09:27:41RT @ePatientDave: Now the juicy stuff: supply-sensitive care: Frequency of use is governed by assumption resources s/b fully utilized #sgshealth andrewspong Mon 13 Dec 2010 09:28:39@Tabloidmed wow! Thats not my understanding. Surely patients views & inputs to their medical decisions is a good thing? #sgshealth doctorblogs Mon 13 Dec 2010 09:30:22RT @FIMDM: Jack Wennberg: evidenced-based medicine alone does not define medical necessity should be based on informed patient choice. #sgshealth andrewspong Mon 13 Dec 2010 09:30:45Specific medical theories & evidence play little role in governing use. #sgshealth ePatientDave Mon 13 Dec 2010 09:30:50RT @garyschwitzer @ePatientDave 1st large scale epdemiological study of decsion quality #sgshealth http://bit.ly/‚Ķ http://twishort.com/ab5gh kgapo Mon 13 Dec 2010 09:30:54RT @FIMDM: Jack Wennberg: evidenced-based medicine alone does not define medical necessity should be based on informed patient choice. #sgshealth kgapo Mon 13 Dec 2010 09:31:30@andrewspong Salzberg shared-decision making conference: Follow #sgshealth & @ePatientDave @FIMDM @LaylaMcCay @garyschwitzer @glynelwyn doctorblogs Mon 13 Dec 2010 09:31:43Jack Wennberg: in the absence of evidence and assuming that more is better available supply governs frequency of use. #sgshealth mollytoba Mon 13 Dec 2010 09:31:45Showed a graph of hip fracture vs bed census (no correlation) & chronic dx (very strong correlation) #sgshealth ePatientDave Mon 13 Dec 2010 09:32:00@FIMDM Yes! patient-oriented evidence & outcomes not surrogate markers. #sgshealth andrewspong Mon 13 Dec 2010 09:32:54RT @FIMDM Jack Wennberg: #EBM alone does not define medical necessity shld be based on informed patient choice #sgshealth doctorblogs Mon 13 Dec 2010 09:33:01Chronic care in last 2 years of life is helpful for comparing variation as cant argue my patients are deader than yours #sgshealth LaylaMcCay Mon 13 Dec 2010 09:33:16contrasting practice patterns in managing chronic illness during the last 2 yrs of life Prof. J. Wennberg #sgsHealth #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 09:33:55Physicians per 1000 deaths & % of deaths in ICU/by region: U of Wisconsin 17.3/16% UCLA Med Ctr 36.5/38%. Wow. #sgshealth ePatientDave Mon 13 Dec 2010 09:34:17RT @doctorblogs: @andrewspong Salzberg shared-decision making conference: Follow #sgshealth & @ePatientDave @FIMDM @LaylaMcCay @garyschwitzer @glynelwyn andrewspong Mon 13 Dec 2010 09:34:43@LaylaMcCay #sgshealth layla I like your phlegmatic humour!! kgapo Mon 13 Dec 2010 09:34:54RT @LaylaMcCay: Chronic care in last 2 years of life is helpful for comparing variation as cant argue my patients are deader than yours #sgshealth kgapo Mon 13 Dec 2010 09:35:09Mayo Clinic 20.3/21.8%. #sgshealth ePatientDave Mon 13 Dec 2010 09:35:38Jack Wennberg: #EBM alone does not define medical necessity shld be based on informed patient choice #sgshealth -via @doctorblogs @FIMDM bacigalupe Mon 13 Dec 2010 09:35:56The likelihood of dying in ICU is related to the number of ICU beds available in your area: supply-sensitive variation. #sgshealth LaylaMcCay Mon 13 Dec 2010 09:36:17Wennberg: theres pretty good evidence that more ICU beds in a region correlates w/ ignoring advance directives! #sgshealth ePatientDave Mon 13 Dec 2010 09:36:21@andrewspong #sgshealth #opnHealth #hcsmeu no more the medical type eg AHRQ kgapo Mon 13 Dec 2010 09:36:34Wennberg: costs of care at end of life at NYU twice that of U of Wisc driven by FTEs of MDs involved and %ICU admits.#sgshealth FIMDM Mon 13 Dec 2010 09:36:49Patients...The Greatest Untapped Resource in Healthcare? SharedDecisionMaking conf 12-17Dec http://bit.ly/eXV9qc #sgshealth doctorblogs Mon 13 Dec 2010 09:37:43Likelihood of dying in ICU related to # of ICU beds available in your area: supply-sensitive variation #sgshealth -via @LaylaMcCay bacigalupe Mon 13 Dec 2010 09:37:57RT @doctorblogs: Patients...The Greatest Untapped Resource in Healthcare? SharedDecisionMaking conf 12-17Dec http://bit.ly/eXV9qc #sgshealth shakingtree Mon 13 Dec 2010 09:38:03Wennberg: even if there are advanced directives they are often ignored. #sgshealth FIMDM Mon 13 Dec 2010 09:38:15RT @FIMDM: Wennberg: costs of care at end of life at NYU twice that of U of Wisc driven by FTEs of MDs involved and %ICU admits.#sgshealth kgapo Mon 13 Dec 2010 09:38:15@kgapo @epatientdave @LaylaMcCay hadnt even heard of this event. TY for bringing us into the room at #sgshealth :) #hcsmeu #hcsm andrewspong Mon 13 Dec 2010 09:38:22Wennberg: variations in end of life care easiest for consumers to understand/relate to bc of own experiences #sgshealth -RT @mollytoba bacigalupe Mon 13 Dec 2010 09:38:50@ePatientDave #sgshealth Dave advance directives do not exist in many countries #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 09:39:26Copayment (familys out of pocket expense) at end of life varies directly with those ICU numbers. Not just insurance issue. #sgshealth ePatientDave Mon 13 Dec 2010 09:39:38RT @bacigalupe Wennberg #EBM not define medical necessity shd be based on informd patient choice #sgshealth via @doctorblogs @FIMDM health20Paris Mon 13 Dec 2010 09:40:02@kgapo OK but Im hoping to hear more about clinical integration of patient reported *information* (PRI not the same as PRO) #sgshealth andrewspong Mon 13 Dec 2010 09:40:14RT @doctorblogs: Patients...The Greatest Untapped Resource in Healthcare? SharedDecisionMaking conf 12-17Dec http://bit.ly/eXV9qc #sgshealth Scottishpolicy Mon 13 Dec 2010 09:41:00@bacigalupe Salzberg shared-decision making conf:follow #sgshealth @ePatientDave @FIMDM @LaylaMcCay @garyschwitzer @glynelwyn @rmoynihan too doctorblogs Mon 13 Dec 2010 09:42:43@andrewspong #sgshealth #hcsm haha! I caught U! U dont read me carfully had alrdy told #hcsmeu I was going & asked abt other participants! kgapo Mon 13 Dec 2010 09:43:03@@LaylaMcCay #sgshealth Layla was sitting just next to me tweeting fm blackberry and hd not realised it till now that we spoke abt twitting! kgapo Mon 13 Dec 2010 09:46:03@dianthusmed Patients...The Greatest Untapped Resource in Healthcare? SharedDecisionMaking conf 12-17Dec http://bit.ly/eXV9qc #sgshealth doctorblogs Mon 13 Dec 2010 09:46:33@dianthusmed Salzberg shared-decision making conf:follow #sgshealth @ePatientDave @FIMDM @LaylaMcCay @garyschwitzer @glynelwyn @rmoynihan doctorblogs Mon 13 Dec 2010 09:47:48@mjrobbins Patients...The Greatest Untapped Resource in Healthcare? SharedDecisionMaking conf12-17Dec http://bit.ly/eXV9qc #sgshealth doctorblogs Mon 13 Dec 2010 09:48:28 Page  3
  • 4. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedRT @doctorblogs: Patients...The Greatest Untapped Resource in Healthcare? SharedDecisionMaking conf 12-17Dec http://bit.ly/eXV9qc #sgshealth manteln Mon 13 Dec 2010 09:48:53New 2 me via @doctorblogs Patients..Greatest Untapped Resource in Healthcare? Conf 12-17 Dec http://bit.ly/eXV9qc #sgshealth #hcsmeu #hcsm lenstarnes Mon 13 Dec 2010 09:54:21@lenstarnes Salzberg shared-decision making conf:follow #sgshealth @ePatientDave @FIMDM @LaylaMcCay @garyschwitzer @glynelwyn @rmoynihan doctorblogs Mon 13 Dec 2010 09:59:56@manteln Salzberg shared-decision making conf:follow #sgshealth @ePatientDave @FIMDM @LaylaMcCay @garyschwitzer @glynelwyn @rmoynihan doctorblogs Mon 13 Dec 2010 10:00:19@dr_fiona Patients...The Greatest Untapped Resource in Healthcare? SharedDecisionMaking conf 12-17Dec http://bit.ly/eXV9qc follow #sgshealth doctorblogs Mon 13 Dec 2010 10:03:27RT @kgapo: #sgs477 tweeting from Salzburg on Informing & Involving Pts in Decsions about their medical care moves to #sgshealth #opnHealth #hcsmeu ehealthgr Mon 13 Dec 2010 10:12:55RT @kgapo: @sgs477 #opnHealth #hcsmeu Mike Barry: dangerous 2 only focus on tools better 2 think more abt improvng process for SDM #sgshealth ehealthgr Mon 13 Dec 2010 10:13:25Next: Angela Coulter author of "The Autonomous Patient: Ending Paternalism in Medical Care" http://amzn.to/hGvUeF #sgshealth ePatientDave Mon 13 Dec 2010 10:17:54RT @ePatientDave: Next: Angela Coulter author of "The Autonomous Patient: Ending Paternalism in Medical Care" http://amzn.to/hGvUeF #sgshealth jkerrstevens Mon 13 Dec 2010 10:18:49Coulter introduces Jennifer Dixon of UKs Nuffield Trust for Resch&Policy Studies http://bit.ly/9rCD69 by video #sgshealth ePatientDave Mon 13 Dec 2010 10:21:08RT @ePatientDave: Coulter introduces Jennifer Dixon of UKs Nuffield Trust for Resch&Policy Studies http://bit.ly/9rCD69 by video #sgshealth FIMDM Mon 13 Dec 2010 10:22:05#sgshealth #opnHealth #hcsmeu Jennifer Dixon/Nuffield Trust Political economic and ethical consequences of practice variations kgapo Mon 13 Dec 2010 10:22:14Nuffield Trust set out to study how health systems across the globe are dealing w/economic downturn #sgshealth ePatientDave Mon 13 Dec 2010 10:23:47(typo fix) Surprising similarity in all *countries*. One item: common need to get more value from HC pound/$. #sgshealth ePatientDave Mon 13 Dec 2010 10:25:23Another common finding: the need to boost primary care in developed and poorer countries (e.g. UK and Uganda) #sgshealth ePatientDave Mon 13 Dec 2010 10:26:36Angela Coulter The Autonomous Patient: Ending Paternalism in Medical Care http://amzn.to/hGv #sgsHealth #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 10:27:32Jen Dixon howto involve individuals in SDM examples fm various countries #sgsHealth #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 10:28:32Singapore talked about variety of insur systems state pays for; they use health savings accts. #sgshealth ePatientDave Mon 13 Dec 2010 10:28:43I believe this is the Nuffield Trust report Jens talking about http://bit.ly/gyblna #sgshealth Sept 2010 ePatientDave Mon 13 Dec 2010 10:29:55Finland in cutting deficit cut HC slowly. India cut cardiac care by streamlining hospital processes #sgshealth ePatientDave Mon 13 Dec 2010 10:31:40Sweden: Community engagement in *design of new hospital* was crucial; result was *consumer* value for money. #sgshealth ePatientDave Mon 13 Dec 2010 10:32:57Lesson fm Finland: if u wnt 2 keep social solidarity u dont cut on hc cost when defcit grows-kept hc during downturn in 90s-now #sgshealth kgapo Mon 13 Dec 2010 10:33:08Community engagement in designing local hospitals seems to improve efficiency (Sweden) #sgshealth LaylaMcCay Mon 13 Dec 2010 10:33:11Good ideas should be adapted not just adopted (in different countries) #sgshealth LaylaMcCay Mon 13 Dec 2010 10:34:04Variations in clinical practice: now more than ever must focus not just on cost but on *value* for the money #sgshealth ePatientDave Mon 13 Dec 2010 10:34:46Design of the system can have significant effect on value - how we organize the care #sgshealth ePatientDave Mon 13 Dec 2010 10:35:12Report last summer: emergency admissions in UK are growing 3-4%/yr - no justification for this #sgshealth. Most=0-1 day. ePatientDave Mon 13 Dec 2010 10:35:56Emergency admissions rise by 3-4% each year in England; not related to increased illnessand most for <1 day #sgshealth LaylaMcCay Mon 13 Dec 2010 10:37:58Dixon: a large amount of quality of care simply cant be measured. One reason for large variations in care. #sgshealth ePatientDave Mon 13 Dec 2010 10:39:10discretion variotions due 2 lack of evidence based medicine - NICE in UK is doing vry work in ths field #sgshealth #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 10:39:14Jennifer Dixon: in times of economic dowturn more imp to focus on drivers of healthcare costs and getting value for $. #sgshealth FIMDM Mon 13 Dec 2010 10:39:22Payment systems can enourage inflated use of care (supplier-induced demand) #sgshealth LaylaMcCay Mon 13 Dec 2010 10:39:37in Europe gov R unlikely 2 tackle the medical profession 4 variations in profession #sgshealth #opnHealth #hcsmeu any relation 2 Greece? kgapo Mon 13 Dec 2010 10:40:22Govt has been unlikely to attack variation by going at medical profession; more likely to use hospital payment as lever #sgshealth ePatientDave Mon 13 Dec 2010 10:40:27RT @LaylaMcCay: Payment systems can enourage inflated use of care (supplier-induced demand) #sgshealth #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 10:41:23Governments would rather change systems than address physician behaviour.What other professional groups incite such reticence? #sgshealth LaylaMcCay Mon 13 Dec 2010 10:42:08Dixon: govts in Europe reluctant to tackle clinical behavior/variation instead focus on payment reform and cost-sharing #sgshealth FIMDM Mon 13 Dec 2010 10:42:18RT @FIMDM Jen Dixon in times of economic dowturn more imp 2 focus on drivers of healthcare costs & getting value 4 $. #sgshealth #opnHealth kgapo Mon 13 Dec 2010 10:42:50Coulter: plenty of data that variations exist; far less on what we can do about it. #sgshealth <=This is our task. ePatientDave Mon 13 Dec 2010 10:47:25Need to adapt good practices from various countries and not just adopt them #sgshealth #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 10:47:56RT @LaylaMcCay: Community engagement in designing local hospitals seems to improve efficiency (Sweden) #sgshealth kgapo Mon 13 Dec 2010 10:48:41Dixon: learned one reason for surging ED admissions: doc not confident about out of hospital care. #sgshealth ePatientDave Mon 13 Dec 2010 10:49:31Jennifer Nixon UK Nuffield Trust: time when govts. can ignore huge variations in health care is long gone. #sgshealth garyschwitzer Mon 13 Dec 2010 10:49:34The way we pay hospitals encourages reduction in length of stay and filling beds with more patients (plus risk averse culture) #sgshealth LaylaMcCay Mon 13 Dec 2010 10:49:48RT @FIMDM: Dixon: govts in Europe reluctant to tackle clinical behavior/variation instead focus on payment reform and cost-sharing #sgshealth kgapo Mon 13 Dec 2010 10:50:11Dixon: it appears (not confirmed) ER admission rates are related to whether beds are available. Lower where beds were cut. #sgshealth ePatientDave Mon 13 Dec 2010 10:50:18RT @ePatientDave: Clinical appropriateness s/b based on evidence; medical necessity s/b based on informed pt choice #sgshealth drtonyah Mon 13 Dec 2010 10:51:28Dixon video finishes; Coulter leading discussion. #sgshealth ePatientDave Mon 13 Dec 2010 10:52:32@KGApo: in Greece practice variation is NOT denied/debated - its just taken as "this stuff happens" #sgshealth ePatientDave Mon 13 Dec 2010 10:52:52@KGApo: Greece 1 of first nations to legislate patient rights (1992). Can select hospital & specialist they want #sgshealth ePatientDave Mon 13 Dec 2010 10:53:37RT @kgapo: Lesson fm Finland: 2 keep social solidarity u dont cut on hc cost when defcit grows-kept hc during downturn in 90s-#sgshealth drtonyah Mon 13 Dec 2010 10:54:23Jennifer Dixon (correct) UK Nuffield Trust: time when govts. can ignore huge variations in health care is long gone. #sgshealth garyschwitzer Mon 13 Dec 2010 10:55:41Greek patients gaming the system: 2-3 month delay to see oncologist(!) so pts go to ED w/fictional complaint #sgshealth ePatientDave Mon 13 Dec 2010 10:55:53RT @kgapo: integrate patient preferences in EBM guidelines M Barry #sgshealth @FIMDM drtonyah Mon 13 Dec 2010 10:56:53In Greece people use walk-in outpatient clinics to skip long waiting lists; government trying to instate gatekeeping #sgshealth LaylaMcCay Mon 13 Dec 2010 10:57:54@KGApo No shared decision making in Greece - doc says "Youre getting this surgery" no discussion allowed #sgshealth ePatientDave Mon 13 Dec 2010 10:58:05RT @ePatientDave: Greek patients gaming the system: 2-3 month delay to see oncologist(!) so pts go to ED w/fictional complaint #sgshealth Carolde Mon 13 Dec 2010 10:58:09Is shared decision making too much of a luxury to implement in resource-poor countries? #sgshealth LaylaMcCay Mon 13 Dec 2010 10:59:33RT @ePatientDave: @KGApo No shared decision making in Greece - doc says "Youre getting this surgery" no discussion allowed #sgshealth kgapo Mon 13 Dec 2010 10:59:42RT @ePatientDave: Greek patients gaming the system: 2-3 month delay to see oncologist(!) so pts go to ED w/fictional complaint #sgshealth meducate Mon 13 Dec 2010 11:00:26How can this data follow the pt? RT @FIMDM: Wennberg: even if there are advanced directives they are often ignored. #sgshealth drtonyah Mon 13 Dec 2010 11:00:32RT @LaylaMcCay: In GR ppl use walk-in outpatient clinics 2 skip long waiting lists; gov trying 2 instate gatkeeping #sgshealth #opnhealth kgapo Mon 13 Dec 2010 11:00:46@kgapo doctors in Greece limited in # of test and treatments - neg effect of recent "austerity" measures or an existing prob? #sgshealth mollytoba Mon 13 Dec 2010 11:00:53@kgapo Wennbergs point was about cases where the hosp HAS the advanced directive and ignores it #sgshealth ePatientDave Mon 13 Dec 2010 11:01:31 Page  4
  • 5. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedRT @mollytoba @kgapo GRdocs limited in # of test/treatments/neg effect of Rcent austerty measures or an existng prob? #sgshealth #opnHealth kgapo Mon 13 Dec 2010 11:03:02China uses all different payment models. Big problem with shared decision making is widespread poor education #sgshealth ePatientDave Mon 13 Dec 2010 11:03:14@ePatientDave #sgshealth txfor clarification kgapo Mon 13 Dec 2010 11:03:34@ePatientDave #sgshealth its not fictional rather complaints that cld be dealt w outside ED kgapo Mon 13 Dec 2010 11:05:05China also has big issue with citizens not trusting docs thinking theyre milking them for $ #sgshealth ePatientDave Mon 13 Dec 2010 11:05:25@ePatientDave TU for the terrific tweets hope you make it to the Cafe Mozart Xmas market and Marionetten #I<3Salzburg #sgshealth drtonyah Mon 13 Dec 2010 11:05:34Can people with low health literacy meaningfully engage in shared decision making? Should we take a step back? #sgshealth LaylaMcCay Mon 13 Dec 2010 11:06:29@drtonyah Got to Weinachtmarkt on Sunday before seminar started @ 3:30 #sgshealth ePatientDave Mon 13 Dec 2010 11:06:47A. Coulter: cn pts w/ low educ level particpate in SDM?issue of health+digital literacy introducd #sgshealth #opnHealth #hcsmeu #healthlit kgapo Mon 13 Dec 2010 11:08:49South Africa uses shared decision making in HIV/AIDS:a readiness programme for starting ARVs to help decide when/if to start. #sgshealth LaylaMcCay Mon 13 Dec 2010 11:10:13In denial of death RT @ePatientDave: Wennberg: End of life variations - in some regions 30-40% of deaths happen in ICUs. (Ugh!) #sgshealth drtonyah Mon 13 Dec 2010 11:12:22Its fascinating to hear delegates from different countries discussing their systems. #sgshealth ePatientDave Mon 13 Dec 2010 11:12:46RT @andrewspong: @kgapo @epatientdave @LaylaMcCay hadnt even heard event. TY for bringing us into the room at #sgshealth :) #hcsmeu #hcsm MatthewBrowning Mon 13 Dec 2010 11:13:48South africa: innov in HIV bc of resource constraints all pts on ARBs undergo a "readiness" program to educ on disease and tx #sgshealth FIMDM Mon 13 Dec 2010 11:14:31RT @doctorblogs: Patients...The Greatest Untapped Resource in Healthcare? SharedDecisionMaking conf 12-17Dec http://bit.ly/eXV9qc #sgshealth JulieLeask Mon 13 Dec 2010 11:14:54#hcsmeu heads-up: great content coming out of #sgshealth c/o @kgapo @fimdm @epatientdave @laylamccay #hcsm andrewspong Mon 13 Dec 2010 11:15:12RT @LaylaMcCay: South Africa uses shared decision making in HIV/AIDS:a readiness programme for starting ARVs to help decide when/if to start. #sgshealth mollytoba Mon 13 Dec 2010 11:15:59RT @meducate: RT @ePatientDave: Greek patients gaming the system: 2-3 month delay to see oncologist(!) so pts go to ED w/fictional complaint #sgshealth KateEversole Mon 13 Dec 2010 11:16:03@MatthewBrowning #sgshealth #hcsm solution: check #opnHealth #hcsmeu more closely hv twtd I was attending more than 3 times!! hv 2 find them kgapo Mon 13 Dec 2010 11:16:16RT @andrewspong: #hcsmeu heads-up: great content coming out of #sgshealth c/o @kgapo @fimdm @epatientdave @laylamccay #hcsm kgapo Mon 13 Dec 2010 11:16:31@andrewspong: WTHashtag stream http://bit.ly/eY2Vsp; my intro post http://bit.ly/gTwnUE #sgshealth #hcsmeu #hcsm ePatientDave Mon 13 Dec 2010 11:16:45RT @ePatientDave: @andrewspong: WTHashtag stream http://bit.ly/eY2Vsp; my intro post http://bit.ly/gTwnUE #sgshealth #hcsmeu #hcsm andrewspong Mon 13 Dec 2010 11:18:11In India too there is confrontation of traditional v. modern medicine #sgshealth #hcsmeu #opnHealth kgapo Mon 13 Dec 2010 11:18:14Greece China S.Africa India so far. RT @ePatientDave: fascinating to hear diff. countries delegates discussing their systems. #sgshealth garyschwitzer Mon 13 Dec 2010 11:18:21@garyschwitzer Yeah it appears "global seminar" is truth in advertising! So glad to be here. #sgshealth ePatientDave Mon 13 Dec 2010 11:18:58Interesting discussion of health decision making in different countries at #sgshealth. Thanks for the RT @vmontori cj_pope Mon 13 Dec 2010 11:19:03huge disparities in health in India btwn rural and urban areas #sgshealth #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 11:20:33RT @ePatientDave: @andrewspong: WTHashtag stream http://bit.ly/eY2Vsp; my intro post http://bit.ly/gTwnUE #sgshealth #hcsmeu #hcsm MatthewBrowning Mon 13 Dec 2010 11:22:09India: rich patients tell doctors what they want but have sadly adopted the idea that "more is better" in terms of medical tech #sgshealth mollytoba Mon 13 Dec 2010 11:22:37in India docs vry much trusted treated as "gods"-little legislation on private hc-not monitoring of outcomes #sgshealth #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 11:23:14RT @mollytoba: India: rich patients tell doctors what they want but have sadly adopted the idea that "more is better" in terms of medical tech #sgshealth kgapo Mon 13 Dec 2010 11:23:24My vote 4 "tweet of the day" #totd RT @andrewspong Yes!patient-oriented evidence&outcomesnot surrogate markers #sgshealth doctorblogs Mon 13 Dec 2010 11:24:47RT @garyschwitzer: Greece China S.Africa India so far. RT @ePatientDave: fascinating to hear diff. countries delegates discussing their systems. #sgshealth FIMDM Mon 13 Dec 2010 11:25:12RT @doctorblogs: My vote 4 "tweet of the day" #totd RT @andrewspong Yes!patient-oriented evidence&outcomesnot surrogate markers #sgshealth kgapo Mon 13 Dec 2010 11:25:32Phillipines: Catholic church attempting to intervene to block reproductive health billl to limit choice #sgshealth mollytoba Mon 13 Dec 2010 11:29:05very good presentation of hc system in Philippines #sgshealth #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 11:30:35This has been one of those sessions where theres so much to think about its hard to live tweet. Lunch break now. #sgshealth ePatientDave Mon 13 Dec 2010 11:31:26after lunch exercise in SDM to understand political background #sgshealth #opnHealth #hcsmeu kgapo Mon 13 Dec 2010 11:32:36Is there room for shared decision making in child #vaccination? Could even encourg http://bit.ly/fAi9cB But needs more discussion #sgshealth JulieLeask Mon 13 Dec 2010 11:43:07RT @LaylaMcCay Good ideas should be adapted not just adopted (in different countries) #sgshealth #hcsmeu wissit Mon 13 Dec 2010 11:43:25RT @andrewspong: #hcsmeu heads-up: great content coming out of #sgshealth c/o @kgapo @fimdm @epatientdave @laylamccay #hcsm QiCProgramme Mon 13 Dec 2010 11:43:42@kgapo hi thx for tweeting from #sgshealth ! wissit Mon 13 Dec 2010 11:43:56Morning US! #sgshealth Salzburg Global Seminar @ lunch til 8am ET. Tweet stream & event info links: http://bit.ly/eY2Vsp ePatientDave Mon 13 Dec 2010 11:44:34Via @epatientdave - intro to #sgshealth http://bit.ly/gTwnUE ‚Äúthe most under-utilized resource in our info systems ‚Äì the patient.‚Äù #hcsmeu QiCProgramme Mon 13 Dec 2010 11:45:39RT @cj_pope: Interesting discussion of health decision making in different countries at #sgshealth. Thanks for the RT @vmontori vmontori Mon 13 Dec 2010 11:47:48Okay help me now. Whats #sgshealth? Doctor_V Mon 13 Dec 2010 11:54:18RT @Doctor_V: Okay help me now. Whats #sgshealth? <-- See @epatientdaves tweet: http://bit.ly/fWHIfN #hcsm andrewspong Mon 13 Dec 2010 11:56:27@Doctor_V: Guess? Telemedicine/ HealthIT Salzburg Global Seminar Tweet stream & event info links: http://wthashtag.com/Sgshealth PracticalWisdom Mon 13 Dec 2010 11:56:40@Doctor_V #sgshealth faculty abstract agenda: http://bit.ly/hfailv #hcsm andrewspong Mon 13 Dec 2010 11:58:11RT @ePatientDave: Morning US! #sgshealth Salzburg Global Seminar @ lunch til 8am ET. Tweet stream & event info links: http://bit.ly/eY2Vsp MatthewBrowning Mon 13 Dec 2010 12:15:01RT @andrewspong: RT @Doctor_V: Okay help me now. Whats #sgshealth? <-- See @epatientdaves tweet: http://bit.ly/fWHIfN #hcsm MatthewBrowning Mon 13 Dec 2010 12:17:13RT @garyschwitzer: Jennifer Dixon (correct) UK Nuffield Trust: time when govts. can ignore huge variations in health care is long gone. #sgshealth rvaughnmd Mon 13 Dec 2010 12:21:07RT @ePatientDave: @andrewspong: WTHashtag stream http://bit.ly/eY2Vsp; my intro post http://bit.ly/gTwnUE #sgshealth #hcsmeu #hcsm zenofbass Mon 13 Dec 2010 12:27:15Repeat: #sgshealth Salzburg Global Seminar @ lunch til 8am ET. Tweet stream & event info links: http://bit.ly/eY2Vsp ePatientDave Mon 13 Dec 2010 12:31:41RT @ePatientDave: Physicians per 1000 deaths & % of deaths in ICU/by region: U of Wisconsin 17.3/16% UCLA Med Ctr 36.5/38%. Wow. #sgshealth swisshealth20 Mon 13 Dec 2010 12:40:21RT @QiCProgramme: Via @epatientdave - intro to #sgshealth http://bit.ly/gTwnUE ‚Äúthe most under-utilized resource in our info systems ‚Äì the patient.‚Äù #hcsmeu rainmakertom Mon 13 Dec 2010 12:40:31RT @ePatientDave: Repeat: #sgshealth Salzburg Global Seminar @ lunch til 8am ET. Tweet stream & event info links: http://bit.ly/eY2Vsp mkmackey Mon 13 Dec 2010 13:02:00Were back. Woot - BMJ just invited 400 word blog posts from participants. Will I? Lemme think. :-) #sgshealth ePatientDave Mon 13 Dec 2010 13:08:23Whoo: were getting a group case study to work on - writing a memo to minister of health in an election year #sgshealth ePatientDave Mon 13 Dec 2010 13:09:38By all means RT @ePatientDave: Were back. Woot - BMJ just invited 400 word blog posts from participants. Will I? Lemme think :-) #sgshealth westr Mon 13 Dec 2010 13:10:11RT @ePatientDave:Were back. Woot - BMJ just nvited 400 word blog posts frm participants. Will I? Lemme think. :-) #sgshealth I suspect yes LeanThinker Mon 13 Dec 2010 13:12:03RT @ePatientDave: Woot - BMJ just invited 400 word blog posts from participants. Will I? Lemme think. :-) #sgshealth <-- Nice idea BMJ #STM andrewspong Mon 13 Dec 2010 13:19:26Is this on @doc2doc Dave? RT @ePatientDave: Woot - BMJ just invited 400 word blog posts from participants. #sgshealth Colleen_Young Mon 13 Dec 2010 13:21:40RT @garyschwitzer: Greece China S.Africa India so far. RT @ePatientDave: fascinating to hear diff. countries delegates discussing their systems. #sgshealth chcradio Mon 13 Dec 2010 13:22:12 Page  5
  • 6. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedRT @ePatientDave Variations in clinical practice: now more than ever must focus not just on cost but on *value* for the money #sgshealth susangiurleo Mon 13 Dec 2010 13:35:05RT @ePatientDave: Were back. Woot - BMJ just invited 400 word blog posts from participants. Will I? Lemme think. :-) #sgshealth MatthewBrowning Mon 13 Dec 2010 13:48:01RT RT @ePatientDave: Were back. Woot - BMJ just invited 400 word blog posts from participants. Will I? Lemme think. :-) #sgshealth Seanlogok Mon 13 Dec 2010 13:48:30RT @cj_pope: Interesting discussion of health decision making in different countries at #sgshealth. Thanks for the RT @vmontori #healthcare consultdoc Mon 13 Dec 2010 14:32:25Were back from the case study (and tea) - I just got to present a simulated PSA for "You Deserve The Care You Need"! #sgshealth ePatientDave Mon 13 Dec 2010 15:18:14#sgshealth #opnHealth #hcsmeu 1st group @ePatientDave & Nadia Sawicki presenting kgapo Mon 13 Dec 2010 15:19:04@Colleen_Young No clue. #sgshealth ePatientDave Mon 13 Dec 2010 15:19:25@RAWarrior you really gotta e-meet 50 yr RA patient Richard Johnston of IAPO. You do skype? #sgshealth ePatientDave Mon 13 Dec 2010 15:20:27@ePatientDave Dave you really sold your 30 sec spot! I think @fimdm needs to hire you to produce it! Priceless #sgshealth mollytoba Mon 13 Dec 2010 15:21:11Wow Johnstons a smooth spokesman! Hes simulating press conference for his case study group. #sgshealth ePatientDave Mon 13 Dec 2010 15:21:26#sgshealth #opnHealth #hcsmeu 2nd group presenting Robert Johnstone and SAnjay Biwje addressing the "Minister" kgapo Mon 13 Dec 2010 15:22:36Johnston has chronic pain uses cane/wheelchair walks w/difficulty; gentle smile humor. Impressive. #sgshealth ePatientDave Mon 13 Dec 2010 15:22:41Gr8 coverage by @ePatientDave of Salzburg Global Health: http://bit.ly/gTwnUE |Twitter stream http://bit.ly/eY2Vsp #sgshealth #patiented janicemccallum Mon 13 Dec 2010 15:22:45RT @kgapo: #sgshealth #opnHealth #hcsmeu SAnjay Biwje working with gov made a good point addressing the "Minister" kgapo Mon 13 Dec 2010 15:24:03Now in day 2: #sgshealth Salzburg Global Seminar on informed medical decision making. Tweets & info links: http://bit.ly/eY2Vsp ePatientDave Mon 13 Dec 2010 15:26:19#sGshealth till now 323 twts by 54 contributors kgapo Mon 13 Dec 2010 15:29:05RT @ePatientDave: Greek patients gaming the system: 2-3 month delay to see oncologist(!) so pts go to ED w/fictional complaint #sgshealth BioPharmaRob Mon 13 Dec 2010 15:30:19#sgshealth How to persuade the minister to support shared decision making = sell short term gains involve patients get media on side. glynelwyn Mon 13 Dec 2010 15:31:25Thx @ePatientDave 4 #sgshealth Salzburg Global Seminar on informed medical decision making. Tweets & info links: http://bit.ly/eY2Vsp LynetteMPH Mon 13 Dec 2010 15:31:35Presenting result of our case study - "Minister of Health" @ table listens to advisors pitch #sgshealth http://yfrog.com/h3bkadj ePatientDave Mon 13 Dec 2010 15:36:36#sgshealth #opnHealth #hcsmeu 3rd group presenting Richard Wexler addressing "Minister" kgapo Mon 13 Dec 2010 15:37:46#sgshealth #opnHealth #hcsmeu out turn with Peggy Ford and Steven Laitner to address "Minister" kgapo Mon 13 Dec 2010 15:40:01How can governments address supplier induced unwarranted variation?Groupwork scenario:involve all stakeholders and educate? #sgshealth LaylaMcCay Mon 13 Dec 2010 15:40:53#sgshealth Persuading the minister? Wheres the patient orientated outcomes? Patients reify QOL over other outcomes & r risk averse. glynelwyn Mon 13 Dec 2010 15:41:12@LaylaMcCay #sgshealth I think this was unanimous agreement in all groups kgapo Mon 13 Dec 2010 15:41:56@glynelwyn #sgshealth patients not sure when procedure is good for them this is how pt educ was suggested bfr any decision making kgapo Mon 13 Dec 2010 15:44:09Focus on providing holistic care:primarysecondary and tertiary;educate that tertiary care doesnt always equal best care #sgshealth LaylaMcCay Mon 13 Dec 2010 15:44:28RT @LaylaMcCay: Focus on providing holistic care:primarysecondary and tertiary;educate that tertiary care doesnt always equal best care #sgshealth kgapo Mon 13 Dec 2010 15:45:22@LaylaMcCay #sgshealth and that when 3ry is refused this shld be EBM kgapo Mon 13 Dec 2010 15:46:24PR is important tool in reducing unwarranted excess use of healthcare. Need to engage with media to educate public. #sgshealth LaylaMcCay Mon 13 Dec 2010 15:47:54Major barrier in implementing shared decision making is perception that its rationing by stealth #sgshealth LaylaMcCay Mon 13 Dec 2010 15:49:27@LaylaMcCay #sgshealth not so sure mass media have been also used to manipulate or mislead public kgapo Mon 13 Dec 2010 15:52:09#sgshealth Doing battle with anecdotes - be ready with the counter-anecdote. Model the good decision and give it to the media. glynelwyn Mon 13 Dec 2010 15:52:10Journalists need a narrative. A single person anecdote can sell shared decision making (or doom it!) #sgshealth LaylaMcCay Mon 13 Dec 2010 15:52:14@LaylaMcCay #sgshealth not a single more individual stories kgapo Mon 13 Dec 2010 15:53:06The single person anecdote is like a tactical human bomb. How do we make sure to use that power effectively? #sgshealth mollytoba Mon 13 Dec 2010 15:54:01RT @ePatientDave: Analysis of prostate surgery (TUR) outcomes showed it *didnt* improve survival did improve quality of life #sgshealth rkumar Mon 13 Dec 2010 17:03:43@drdrew Patients...The Greatest Untapped Resource in Healthcare? SharedDecisionMaking conf 12-17Dec Salzberg http://bit.ly/eXV9qc #sgshealth doctorblogs Mon 13 Dec 2010 17:42:48@Mtnmd Patients...The Greatest Untapped Resource in Healthcare? SharedDecisionMaking conf 12-17Dec Salzberg http://bit.ly/eXV9qc #sgshealth doctorblogs Mon 13 Dec 2010 17:43:24Okay folks - #sgshealth is done for the day. (Forgot to tell yall an hour ago!) Dinner. ePatientDave Mon 13 Dec 2010 17:49:28@bamberjg @ehealthgr @patientopinion @Scottishpolicy @doctorblogs @Kiwfranc @edrneelesh thank your for RTs #sgshealth #sgs477 kgapo Mon 13 Dec 2010 18:55:49RT @kgapo: Angela Coulter The Autonomous Patient: Ending Paternalism in Medical Care http://amzn.to/hGv #sgsHealth #opnHealth #hcsmeu ehealthgr Mon 13 Dec 2010 19:03:10@LaylaMcCay @wissit @QiCProgramme @MatthewBrowning @andrewspong @ePatientDave @mollytoba @drtonyah @drtonyah #sgshealth #sgshealth kgapo Mon 13 Dec 2010 20:43:51RT @ePatientDave: @KGApo: in Greece practice variation is NOT denied/debated - its just taken as "this stuff happens" #sgshealth kgapo Mon 13 Dec 2010 22:05:15RT @ePatientDave: @KGApo: Greece 1 of first nations to legislate patient rights (1992). Can select hospital & specialist they want #sgshealth kgapo Mon 13 Dec 2010 22:05:25RT @mollytoba: @kgapo doctors in Greece limited in # of test and treatments - neg effect of recent "austerity" measures or an existing prob? #sgshealth kgapo Mon 13 Dec 2010 22:06:21RT @mollytoba: Phillipines: Catholic church attempting to intervene to block reproductive health billl to limit choice #sgshealth jamespope Mon 13 Dec 2010 22:12:00RT @ePatientDave: Greek patients gaming the system: 2-3 month delay to see oncologist(!) so pts go to ED w/fictional complaint #sgshealth fredtrotter Tue 14 Dec 2010 01:22:36Day 3 of #sgshealth Salzburg Global Seminar on informed medical decision making. Tweetstream with links to info: http://bit.ly/eY2Vsp ePatientDave Tue 14 Dec 2010 08:07:29First session today: @GarySchwitzer of @HealthNewsRevu on impact of media & internet on consumer/patients #sgshealth ePatientDave Tue 14 Dec 2010 08:10:41Day 3 at the Salzburg Global Seminar kicks off with:influence of mass media&the internet on public perception of medical care #sgshealth LaylaMcCay Tue 14 Dec 2010 08:10:52@GarySchwitzer introducing Australian colleague Ray Moynihan who "invented" the Health News Review idea #sgshealth ePatientDave Tue 14 Dec 2010 08:11:33Moynihan: why cover how media covers health? Medias a key info source not just for pts but media & HC professionals #sgshealth ePatientDave Tue 14 Dec 2010 08:12:17Media is key source of health info for patients health professionals and policymakers but are hugely flawed #sgshealth LaylaMcCay Tue 14 Dec 2010 08:12:31Moynihan: there are fundamental flaws in the mechanisms of media info flow resulting in *false* inaccurate wrong stories #sgshealth ePatientDave Tue 14 Dec 2010 08:12:47He realized in the 90s there were many forces feeding info to media - drug cos machine vendors etc #sgshealth ePatientDave Tue 14 Dec 2010 08:13:41RT @LaylaMcCay: Media is key source of health info for patients health professionals and policymakers but are hugely flawed #sgshealth FIMDM Tue 14 Dec 2010 08:14:36#sgshealth roy moynihan - health reporting is driven by Press Release by promotion not by evidence - adverts not data glynelwyn Tue 14 Dec 2010 08:14:38RT @ePatientDave: First session today: @GarySchwitzer of @HealthNewsRevu on impact of media & internet on consumer/patients #sgshealth calliopeconsult Tue 14 Dec 2010 08:14:38RT @LaylaMcCay: Day 3 at the Salzburg Global Seminar kicks off with:influence of mass media&the internet on public perception of medical care #sgshealth mollytoba Tue 14 Dec 2010 08:15:09Advertising and promotion often dressed up as news and journalism: big problem in health #sgshealth LaylaMcCay Tue 14 Dec 2010 08:15:11Moynihan & a team @ Harvard created a methodical study of media coverage; 5 more since. Evidence. #sgshealth ePatientDave Tue 14 Dec 2010 08:15:21#sgshealth #opnHealth #hcsmeu Roy Moynihan on unhealthy medical reporting kgapo Tue 14 Dec 2010 08:15:40NEJM 2000 reported results. 200 news stories. How were benefits covered? Risks/harms? Conficts of interests covered? #sgshealth ePatientDave Tue 14 Dec 2010 08:15:54 Page  6
  • 7. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username Created#sgshealth moynihan NEJM 2000 = 200 media stories - comparing benefits and harms - were conflicts reported? benefits exaggerated by 80% glynelwyn Tue 14 Dec 2010 08:16:1780% of stories that quoted statistics exaggerated the benefits. Used relative risk not absolute figures. #sgshealth ePatientDave Tue 14 Dec 2010 08:16:2480% of stories that quoted statistics exaggerated the benefits. Used relative risk not absolute figures. #sgshealth -via @ePatientDave bacigalupe Tue 14 Dec 2010 08:16:53RT @LaylaMcCay: Advertising and promotion often dressed up as news and journalism: big problem in health #sgshealth kgapo Tue 14 Dec 2010 08:16:57RT @glynelwyn: #sgshealth moynihan NEJM 2000 = 200 media stories - comparing benefits and harms - were conflicts reported? benefits exaggerated by 80% mollytoba Tue 14 Dec 2010 08:17:02Example: if drug reduced risk of hip fracture 2% to 1% its reported as "50% drop in risk." Numerically true but misleading. #sgshealth ePatientDave Tue 14 Dec 2010 08:17:0653% of stories didnt mention harms/risks at ALL. #sgshealth ePatientDave Tue 14 Dec 2010 08:17:33#sgshealth moynihan NEJM most stories used relative frames and exaggerated the benefits - important side effects hardly mentioned glynelwyn Tue 14 Dec 2010 08:17:5740% of "experts" quoted didnt mention conflicts of interest e.g. the expert works for the drug co. #sgshealth ePatientDave Tue 14 Dec 2010 08:17:58RT @ePatientDave: Example: if drug reduced risk of hip fracture 2% to 1% its reported as "50% drop in risk." Numerically true but misleading. #sgshealth calliopeconsult Tue 14 Dec 2010 08:18:03NEJM 2000:assessed health news stories re benefitsrisks and COI.80% of news stories quoting stats overinflated effect #sgshealth LaylaMcCay Tue 14 Dec 2010 08:18:22RT @ePatientDave: 40% of "experts" quoted didnt mention conflicts of interest e.g. the expert works for the drug co. #sgshealth calliopeconsult Tue 14 Dec 2010 08:18:28(I have a bone to pick about statins evidence - well get to that.) #sgshealth ePatientDave Tue 14 Dec 2010 08:18:33#sgshealth moynihan NEJM most stories used relative frames & exaggerated benefits -important side effects hardly mentioned -via @glynelwyn bacigalupe Tue 14 Dec 2010 08:19:04Canadian Med Jour 2003: Canadian coverage of drugs. 19% covered only surrogate evidence 63% no risks. #sgshealth ePatientDave Tue 14 Dec 2010 08:19:21Several studies found less than half of new stories make mention of harm from treatments covered in news #sgshealth LaylaMcCay Tue 14 Dec 2010 08:19:30RT @bacigalupe: #sgshealth moynihan NEJM most stories used relative frames & exaggerated benefits -important side effects hardly mentioned -via @glynelwyn kgapo Tue 14 Dec 2010 08:19:33PLoS Medicine 2006 coverage of Restless Leg Syndrome (condition not a drug) #sgshealth ePatientDave Tue 14 Dec 2010 08:19:47One "expert" said 10% of ppl might have RLS -- absurd. 70% of stories parroted this; 71% omitted serious side effect. #sgshealth ePatientDave Tue 14 Dec 2010 08:20:37News report relative risk rather than absolute eg change of risk 2% to 1% is reported as 50% reduction #sgshealth LaylaMcCay Tue 14 Dec 2010 08:20:41#sgshealth moyhihan Cassels article - 68% of studies no mention of harms - inaccurate prevalence estimates get into urban myths glynelwyn Tue 14 Dec 2010 08:20:58RT @LaylaMcCay: Several studies found less than half of new stories make mention of harm from treatments covered in news #sgshealth kgapo Tue 14 Dec 2010 08:21:02RT @glynelwyn: #sgshealth moyhihan Cassels article - 68% of studies no mention of harms - inaccurate prevalence estimates get into urban myths ePatientDave Tue 14 Dec 2010 08:21:09JAMA looked at online news 2004-2008 specificallly whether funding of studies was reported. #sgshealth ePatientDave Tue 14 Dec 2010 08:21:55#sgshealth #opnHealth #hcsmeu apalling omission of mentioning AE and risks in med stories in mass media kgapo Tue 14 Dec 2010 08:22:0642% of news stories failed to report this basic information #sgshealth ePatientDave Tue 14 Dec 2010 08:22:10#sgshealth Hochman JAMA 2008 - online news review - 42% of stories failed to report the funding of the study... glynelwyn Tue 14 Dec 2010 08:22:11JAMA 2008:looked at online news over 4years:was funding of stories reported? 42% failed to report. #sgshealth LaylaMcCay Tue 14 Dec 2010 08:22:152010 Archives of Internal Medicine on how media covers cancer: 436 articles #sgshealth ePatientDave Tue 14 Dec 2010 08:22:35Ray Moynihan on analyses of health news in US Canada Norway and Australia. Failure to report harms conflicts side effects #sgshealth FIMDM Tue 14 Dec 2010 08:22:5557% discussed aggressive treatment exclusively not conservative treatments. <1% focused on palliative. #sgshealth ePatientDave Tue 14 Dec 2010 08:23:00#sgshealth #opnHealth #hcsmeu 2010 study of Archives of Internal Med 57% focused on agressive care kgapo Tue 14 Dec 2010 08:23:08Study of news articles re cancer: 57% of stories focused on aggressive treatment;<1% palliative care #sgshealth LaylaMcCay Tue 14 Dec 2010 08:23:19Editorial on that article: "Hype is the norm." #sgshealth ePatientDave Tue 14 Dec 2010 08:23:22(My question - the impact of this - how is an engaged patient supposed to become well informed??) #sgshealth ePatientDave Tue 14 Dec 2010 08:23:43#sgshealth #opnHealth #hcsmeu in cancer the "hype" is the norm kgapo Tue 14 Dec 2010 08:23:57Moynihan: medias not just misleading us on treatments; also on conditions. #sgshealth ePatientDave Tue 14 Dec 2010 08:24:10Too many media stories on health hype benefits downplay harms and hide conflicts of interests #sgshealth LaylaMcCay Tue 14 Dec 2010 08:24:12#sgshealth moynihan says that in terms of health reporting hype is the norm - media misleads us about the harms vs benefits glynelwyn Tue 14 Dec 2010 08:24:14Ray Moynihan: when it comes to media coverage of cancer hype is the norm. #sgshealth mollytoba Tue 14 Dec 2010 08:25:51RT @glynelwyn: #sgshealth moynihan says that in terms of health reporting hype is the norm - media misleads us about the harms vs benefits kgapo Tue 14 Dec 2010 08:25:52Showing excerpt of "documentary" on "Motivational Deficiency Disorder" :-) -- "patients" lying on beach couch #sgshealth ePatientDave Tue 14 Dec 2010 08:26:05(MDD was introduced to the world in April 1st) #sgshealth ePatientDave Tue 14 Dec 2010 08:26:24#sgshealth #opnHealth #hcsmeu selling sickness or inventing sickness to sell drugs? kgapo Tue 14 Dec 2010 08:26:55Next a clip from a real promo piece - "hypoactive sexual desire disorder" in women. (Seriously.) #sgshealth ePatientDave Tue 14 Dec 2010 08:27:47The drug company was directly paying the celebrity on the (non-commercial) TV program #sgshealth ePatientDave Tue 14 Dec 2010 08:28:40Media:critical role in disease-mongering eg hypoactive sexual desire disorder(directly funded by drug company-new libido drug) #sgshealth LaylaMcCay Tue 14 Dec 2010 08:29:00Supposed 10% prevalence of "disease" grew to 30% in later programs. This is *not* isolated example he says #sgshealth ePatientDave Tue 14 Dec 2010 08:29:20#sgshealth moynihan - scary creation of disease - selling sickness marketing funded by pharma e.g. hypo sexuality. Follow the money. glynelwyn Tue 14 Dec 2010 08:29:29#sgshealth #opnHealth #hcsmeu rule of journalism follow the money kgapo Tue 14 Dec 2010 08:29:37Moynihan: "follow the money" is common journo rule but too often ignored in healthcare #sgshealth ePatientDave Tue 14 Dec 2010 08:29:39Moynihan presents humorous video on "motivational deficiency disorder" to highlight problem of disease mongering in media. #sgshealth FIMDM Tue 14 Dec 2010 08:29:40RT @FIMDM: Moynihan presents humorous video on "motivational deficiency disorder" to highlight problem of disease mongering in media. #sgshealth kgapo Tue 14 Dec 2010 08:29:55Moynihan: journos commonly cite space limitations; he says a *good* journo fights w/editor for space when needed #sgshealth ePatientDave Tue 14 Dec 2010 08:30:21#sgshealth A decent journalist will follow the money and uncover the agendas - conflicts of interest and side effects - why not in health? glynelwyn Tue 14 Dec 2010 08:30:36RT @glynelwyn: #sgshealth A decent journalist will follow the money and uncover the agendas - conflicts of interest and side effects - why not in health? ePatientDave Tue 14 Dec 2010 08:30:44Why are media inaccurate?Time?Space?Not an excuse.Promotional pressures from all stakeholders and cultural problem:news=new #sgshealth LaylaMcCay Tue 14 Dec 2010 08:31:20#sgshealth #opnHealth #hcsmeu more a cultural issue what is news kgapo Tue 14 Dec 2010 08:31:24Discuss: Why does this happen? Moynihan: News favors the new - the latest the best. This skews what we see. #sgshealth ePatientDave Tue 14 Dec 2010 08:31:30What do we do about this? Educational strategies; need to change the culture of med reporting. #sgshealth ePatientDave Tue 14 Dec 2010 08:32:10Media inaccuracies. Whats the solution? Education and culture change re news expectations #sgshealth LaylaMcCay Tue 14 Dec 2010 08:32:49#sgshealth #opnHealth #hcsmeu journalists have to learn how to cover health but more important to address cultural attitudes kgapo Tue 14 Dec 2010 08:32:54@GarySchwitzer up now: Grading health news is important because of potential impact on decision making #sgshealth ePatientDave Tue 14 Dec 2010 08:33:17Link to moynihan video "motivational deficiency disorder" http://www.youtube.com/watch?feature=youtube_gdata_player&v=RoppJOtRLe4 #sgshealth FIMDM Tue 14 Dec 2010 08:33:52 Page  7
  • 8. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedSchwitzer: were also seeing some of the *best* HC coverage - deep investigations. Between peaks tho we have valleys of drek. #sgshealth ePatientDave Tue 14 Dec 2010 08:34:09RT @FIMDM: Link to moynihan video "motivational deficiency disorder" http://www.youtube.com/watch?feature=youtube_gdata_player&v=RoppJOtRLe4 #sgshealth ePatientDave Tue 14 Dec 2010 08:34:17#sgshealth #opnHealth #hcsmeu grading hc news is important bcs of potential impact on decision making Garry kgapo Tue 14 Dec 2010 08:34:20#sgshealth Schwitzer Grading healthcare news guru. See HealthNewsReview.org The impact on decision making. glynelwyn Tue 14 Dec 2010 08:34:31Gary Schwitzer from healthnewsreview.org :grading health news is important as impact on decision making #sgshealth LaylaMcCay Tue 14 Dec 2010 08:34:33Schwitzer: Steady diet of news from med journals - this disregards the publication bias for *positive* findings #sgshealth ePatientDave Tue 14 Dec 2010 08:35:58Steady diet of health news reflects a rose coloured positive finding impression that doesnt reflect reality #sgshealth LaylaMcCay Tue 14 Dec 2010 08:36:10(That is unfavorable outcomes just dont show up in journals) #sgshealth ePatientDave Tue 14 Dec 2010 08:36:22Media pressure from patient advocacy groups too often funded by treatment vendors #sgshealth ePatientDave Tue 14 Dec 2010 08:36:43#sgshealth #opnHealth #hcsmeu concerns abt cumulative effect of health messages G. Schwitzer kgapo Tue 14 Dec 2010 08:36:48RT @LaylaMcCay "Media:critical role in disease-mongering eg hypoactive sexual desire disorder(funded by drug co;new drug)" #sgshealth doctorblogs Tue 14 Dec 2010 08:37:14RT @ePatientDave: "Media pressure from patient advocacy groups too often funded by treatment vendors" #sgshealth doctorblogs Tue 14 Dec 2010 08:38:15more than oftn! RT @ePatientDave: Media pressure from pt advocacy groups 2 oftn funded by treatment vendors #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 08:38:23Van in Buffalo NY inviting men in for PSA test; take the test get free pro hockey tickets #sgshealth ePatientDave Tue 14 Dec 2010 08:39:03RT @LaylaMcCay: Steady diet of health news reflects a rose coloured positive finding impression that doesnt reflect reality #sgshealth kgapo Tue 14 Dec 2010 08:39:04Wonder drug miracle drug claims play on patient fears and inappropriately inflate/misrepresent reality #sgshealth LaylaMcCay Tue 14 Dec 2010 08:39:25RT @glynelwyn "A decent journalist will follow the money&uncover agendas- conflicts of interest&side effects- why not in health?" #sgshealth doctorblogs Tue 14 Dec 2010 08:40:03Schwitzer citing Health News Review sites now opening in several countries #sgshealth ePatientDave Tue 14 Dec 2010 08:41:10One recent week: 2 stories that used drug co execs as main source one predicting breakthru with no evidence #sgshealth ePatientDave Tue 14 Dec 2010 08:41:37RT @mollytoba "Ray Moynihan: when it comes to media coverage of #cancer #hype is the norm" @raymoynihan #sgshealth doctorblogs Tue 14 Dec 2010 08:41:39@ePatientDave: Discuss: Moynihan: News favors - the latest skews what we see. #sgshealth ^why? healthcare is a business cascadia Tue 14 Dec 2010 08:41:54One said a treatment may work after it was tested on 9 pieces of tissue outside of body #sgshealth ePatientDave Tue 14 Dec 2010 08:42:14RT @LaylaMcCay "Too many media stories on #health hype benefits downplay harms & hide conflicts of interest" #sgshealth doctorblogs Tue 14 Dec 2010 08:42:26@HealthNewsRevu only evaluates coverage of new treatments etc #sgshealth ePatientDave Tue 14 Dec 2010 08:42:51Media tend to claim something is a breakthrough new treatment with only mouse or in vitro evidence #sgshealth LaylaMcCay Tue 14 Dec 2010 08:42:54RT @LaylaMcCay: Media tend to claim something is a breakthrough new treatment with only mouse or in vitro evidence #sgshealth mollytoba Tue 14 Dec 2010 08:43:36#sgshealth Schwitzer - covering new technology or tests - claims of efficacy are just incredible - e.g. proton cancer treatment centre... glynelwyn Tue 14 Dec 2010 08:44:06RT @LaylaMcCay: Too many media stories on health hype benefits downplay harms and hide conflicts of interests #sgshealth dr_fiona Tue 14 Dec 2010 08:44:16RT @doctorblogs: RT @ePatientDave: "Media pressure from patient advocacy groups too often funded by treatment vendors" #sgshealth crimsoncrip Tue 14 Dec 2010 08:44:41#sgshealth #opnHealth #hcsmeu example of pushing tech is the proton beam therapy kgapo Tue 14 Dec 2010 08:45:09Schwitzer now covering proton beam therapy - extremely expensive little indication of need. #sgshealth ePatientDave Tue 14 Dec 2010 08:45:21#sgshealth proton beam therapy is controversial - but only one journalist questioned the efficacy claims made immense start up costs. glynelwyn Tue 14 Dec 2010 08:46:02RT @glynelwyn: #sgshealth A decent journalist will follow the money and uncover the agendas - conflicts of interest and side effects - why not in health? FIMDM Tue 14 Dec 2010 08:46:05@PaulFLevy post a month ago about this issue. http://bit.ly/aH1ttM #sgshealth ePatientDave Tue 14 Dec 2010 08:46:08http://bit.ly/hW1WPH RT @glynelwyn - #sgshealth roy moynihan - health reporting is driven by Press Release by ... http://bit.ly/hW1WPH noahproductions Tue 14 Dec 2010 08:46:34Industry assoc head showed up pompous; wouldnt discuss in public comments (incl my questions) #sgshealth ePatientDave Tue 14 Dec 2010 08:46:35#sgshealth #opnHealth #hcsmeu proton therapy pushed wt asking key Qs abt installationcost cost to patient clinical data abt efficiency kgapo Tue 14 Dec 2010 08:46:59Schwitzer: Journalism is abdicating its role on this issue. Exception: solid @NYTimes story. #sgshealth ePatientDave Tue 14 Dec 2010 08:47:13RT @doctorblogs: RT @ePatientDave: "Media pressure from patient advocacy groups too often funded by treatment vendors" #sgshealth BenatIpsosMORI Tue 14 Dec 2010 08:47:16Proton beam therapy:hugely expensiveand lack of evidence of benefits and harmsbut media driving uptake #sgshealth LaylaMcCay Tue 14 Dec 2010 08:47:29RT @noahproductions: http://bit.ly/hW1WPH RT @glynelwyn - #sgshealth roy moynihan - health reporting is driven by Press Release by ... http://bit.ly/hW1WPH kgapo Tue 14 Dec 2010 08:47:46RT @ePatientDave: @PaulFLevy post a month ago about this issue. http://bit.ly/aH1ttM #sgshealth kgapo Tue 14 Dec 2010 08:47:56RT @glynelwyn: #sgshealth A decent journalist will follow the money and uncover the agendas - conflicts of interest and side effects - why not in health? kgapo Tue 14 Dec 2010 08:48:08#sgshealth Schwitzer: Journalism abdicating its responsibility in doing check and balance check on claims of global consumer marketing glynelwyn Tue 14 Dec 2010 08:48:19@JaneSymons1 @doctorblogs Understood that many groups need pharma support. Point here is just that it biases news. #sgshealth ePatientDave Tue 14 Dec 2010 08:48:21RT @doctorblogs: RT @ePatientDave: "Media pressure from patient advocacy groups too often funded by treatment vendors" #sgshealth Puffles2010 Tue 14 Dec 2010 08:49:15#sgshealth #opnHealth #hcsmeu Cyberknife and DaVinci hype stripped out kgapo Tue 14 Dec 2010 08:50:16US HHS and Agency for Healthcare Research & Quality concluded proton beam is being used w/o evidence! #sgshealth ePatientDave Tue 14 Dec 2010 08:50:57Media love fancy new equipment.What might benefit a tiny minority are promoted to the majority:demand costlyunproven technology #sgshealth LaylaMcCay Tue 14 Dec 2010 08:51:38Schwitzer on last years uproar about mammography recommendations from US Preventive Svcs Task Force - #sgshealth ePatientDave Tue 14 Dec 2010 08:51:45#sgshealth Schwitzer harm = media hype of new whips worried well into a frenzy demanding costly care sure does more harm than good. glynelwyn Tue 14 Dec 2010 08:52:01#sgshealth #opnHealth #hcsmeu news coverage & poor discussion of screening tests shld be most concerning as in the case of mammography kgapo Tue 14 Dec 2010 08:52:13Schwitzer lists 10 claims commonly quoted without critical analysis. #sgshealth ePatientDave Tue 14 Dec 2010 08:52:34RT @glynelwyn: #sgshealth Schwitzer harm = media hype of new whips worried well into a frenzy demanding costly care sure does more harm than good. kgapo Tue 14 Dec 2010 08:53:13USPSTF actually wrote "should be an individual one" incl patients values. Special interests stormed the media. #sgshealth ePatientDave Tue 14 Dec 2010 08:53:15Shared decision making recommendations (eg mammography age 40-49) can be lost by wrath over perceived rationing fuelled by media #sgshealth LaylaMcCay Tue 14 Dec 2010 08:54:14Amer Cancer Society and many others with financial stake overwhelmed media coverage with false claims #sgshealth ePatientDave Tue 14 Dec 2010 08:54:21In reality among the USPSTF members there are *zero* radiologists / people in the business. #sgshealth ePatientDave Tue 14 Dec 2010 08:54:51Gary Schwitzer: USPSTF recs on mammography was a shared decision-making golden moment lost on general public bc of news coverage #sgshealth mollytoba Tue 14 Dec 2010 08:56:16Schwitzer: vast coverage of prostate screening rarely conveys risk e.g. of false positives which are a major issue. #sgshealth ePatientDave Tue 14 Dec 2010 08:56:33Journalism complicit in causing harm through promoting excessive or inappropriate interventions #sgshealth LaylaMcCay Tue 14 Dec 2010 08:56:59#sgshealth #opnHealth #hcsmeu NBCC: Myth #2: Mammograms can only help and not harm you http://bit.ly/hluV9h kgapo Tue 14 Dec 2010 08:57:34#sgshealth Schwitzer Journalism is complicit guilty of creating harm - e.g.uncritical promotion of evidence-free screening programmes glynelwyn Tue 14 Dec 2010 08:57:37A week in coverage of screening on lung cancer screening: NPR story was terrific; one awful (ABC) #sgshealth ePatientDave Tue 14 Dec 2010 08:57:43 Page  8
  • 9. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username Created@JaneSymons1 @doctorblogs @ePatientDave perhaps pharma could put $ into blind trust for advocacy groups to draw from? #sgshealth cascadia Tue 14 Dec 2010 08:57:58@ArtL7 See this page - explanation & info links http://bit.ly/eY2Vsp #sgshealth ePatientDave Tue 14 Dec 2010 08:58:15@Cascadia #sgshealth can u pls explain what u mean? kgapo Tue 14 Dec 2010 08:58:39HealthDay wire covered pancreatic cancer screening after study of just 7 peoples tissue #sgshealth ePatientDave Tue 14 Dec 2010 08:59:00RT @LaylaMcCay: Journalism complicit in causing harm through promoting excessive or inappropriate interventions #sgshealth kgapo Tue 14 Dec 2010 08:59:45Failure to establish preliminary nature of research results is a dangerous journalism issue #sgshealth LaylaMcCay Tue 14 Dec 2010 08:59:58Its too easy for the media to whip the worried well public into a frenzy #sgshealth LaylaMcCay Tue 14 Dec 2010 09:01:05"All screening tests cause harm" to various extents; "some may do good." #sgshealth ePatientDave Tue 14 Dec 2010 09:01:24#sgshealth #opnHealth #hcsmeu all screening tests cause harm some may do good kgapo Tue 14 Dec 2010 09:01:55Interesting suggestion for screening description: all screening tests cause harm;some may do good. What do you think? #sgshealth LaylaMcCay Tue 14 Dec 2010 09:02:05RT @LaylaMcCay: Failure to establish preliminary nature of research results is a dangerous journalism issue #sgshealth kgapo Tue 14 Dec 2010 09:02:29RT @LaylaMcCay: Its too easy for the media to whip the worried well public into a frenzy #sgshealth kgapo Tue 14 Dec 2010 09:02:36People have deep-seated beliefs that more is better and newer is better (Health Affairs 2010) #sgshealth LaylaMcCay Tue 14 Dec 2010 09:02:52Health Affairs article: consumers are skeptical about evidence-based care. <=This to me is our #1 challenge #sgshealth ePatientDave Tue 14 Dec 2010 09:03:34#sgshealth Schwitzer We have screening madness in the USA - it is crusading one-sided advocacy. Try quantifying the harms vs benefits. glynelwyn Tue 14 Dec 2010 09:03:43@LaylaMcCay FYI - In Asia shared-decision making not popular; patient wants MD to make best call #sgshealth #paternalism drsteventucker Tue 14 Dec 2010 09:03:59#sgshealth #opnHealth #hcsmeu health news shld answer Qs kgapo Tue 14 Dec 2010 09:04:06@ePatientDave What is #sgshealth ? I stumbled in dont want to just lurk. drsteventucker Tue 14 Dec 2010 09:04:43#sgshealth #opnHealth #hcsmeu out of 1300 stories 72%failed to report on cost kgapo Tue 14 Dec 2010 09:04:56After 5 years of @HealthNewsRevu: 72% dont discuss cot 68% dont quantify benefit; 66% dont quantify harm #sgshealth ePatientDave Tue 14 Dec 2010 09:05:07#sgshealth Schwitzer See Covering Medical Research Gary Schwitzer - a guide to journalists covering health. glynelwyn Tue 14 Dec 2010 09:05:47@drsteventucker See links to info on Salzburg Global Seminar here http://wthashtag.com/Sgshealth #sgshealth ePatientDave Tue 14 Dec 2010 09:05:49RT @glynelwyn: #sgshealth Schwitzer See Covering Medical Research Gary Schwitzer - a guide to journalists covering health. kgapo Tue 14 Dec 2010 09:06:17shared decision-making video program for 600000 members of Seattle based @grouphealth http://is.gd/iIFcL #sgshealth cascadia Tue 14 Dec 2010 09:06:45@ePatientDave Thanks! Interesting. I had to learn to balance paternalism and move away from shared-decision making in Asia #sgshealth drsteventucker Tue 14 Dec 2010 09:07:56@ePatientDave In Asia shared-decision making is perceived by patients as incompetence. eg "Why r u asking me u r the doctor!" #sgshealth drsteventucker Tue 14 Dec 2010 09:08:38RT @drsteventucker: @ePatientDave In Asia shared-decision making is perceived by patients as incompetence. eg "Why r u asking me u r the doctor!" #sgshealth ePatientDave Tue 14 Dec 2010 09:08:48RT @drsteventucker: @ePatientDave In Asia shared-decision making is perceived by patients as incompetence. eg "Why r u asking me u r the doctor!" #sgshealth manteln Tue 14 Dec 2010 09:09:27RT In Asia shared-decision making is perceived by patients as incompetence. eg "Why r u asking me u r the doctor!" #sgshealth Yolandax76 Tue 14 Dec 2010 09:09:31@drsteventucker Yes some pts in US feel the same. #sgshealth Sometimes docs job is to advise and sometimes to decide eh? #sgshealth ePatientDave Tue 14 Dec 2010 09:09:55@garyschwitzer media gives "kid in candy store" view of healthcare everything is terrific nothing is risky costs dont matter #sgshealth mollytoba Tue 14 Dec 2010 09:09:59@ePatientDave All true. And the key is sharing honest transparent opinions (or biases) #sgshealth drsteventucker Tue 14 Dec 2010 09:11:14Why should clinicians engage with the media? Because of the potential to convey the right message and reduce harm #sgshealth LaylaMcCay Tue 14 Dec 2010 09:11:19RT @drsteventucker: @ePatientDave All true. And the key is sharing honest transparent opinions (or biases) #sgshealth ePatientDave Tue 14 Dec 2010 09:11:28Why clinicians should engage with media:critical educational pathway to educate public AND journalists #sgshealth LaylaMcCay Tue 14 Dec 2010 09:12:18@mollytoba @garyschwitzer except if story is how completely evil organized medicine/science is! [only black or white sells] #sgshealth drsteventucker Tue 14 Dec 2010 09:12:49RT @glynelwyn: #sgshealth Schwitzer See Covering Medical Research Gary Schwitzer - a guide to journalists covering health. LaylaMcCay Tue 14 Dec 2010 09:13:09RT @cascadia: shared decision-making video program for 600000 members of Seattle based @grouphealth http://is.gd/iIFcL #sgshealth kgapo Tue 14 Dec 2010 09:13:43Terrific! RT @Cascadia shared decision-making video program for 600000 members of Seattle based @grouphealth http://is.gd/iIFcL #sgshealth FIMDM Tue 14 Dec 2010 09:13:43#sgshealth Heather Tesoriero producer at CBS News chairs the debate - can we trust the media? Seems not: journalism has lost its ethics. glynelwyn Tue 14 Dec 2010 09:14:17@LaylaMcCay Still engagement is risky. Reporter can easily become expert/inquisitor on a subject. #sgshealth drsteventucker Tue 14 Dec 2010 09:14:20#sgshealth is Salzburg Global Seminar 2010: Informing & Involving Patients in Medical Decision Making http://is.gd/iIGmQ cascadia Tue 14 Dec 2010 09:14:21RT @mollytoba: @garyschwitzer media gives "kid in candy store" view of healthcare everything is terrific nothing is risky costs dont matter #sgshealth kgapo Tue 14 Dec 2010 09:14:27RT @LaylaMcCay: Why clinicians should engage with media:critical educational pathway to educate public AND journalists #sgshealth kgapo Tue 14 Dec 2010 09:14:52RT @drsteventucker: @mollytoba @garyschwitzer except if story is how completely evil organized medicine/science is! [only black or white sells] #sgshealth kgapo Tue 14 Dec 2010 09:15:19RT @glynelwyn: #sgshealth Heather Tesoriero producer at CBS News chairs the debate - can we trust the media? Seems not: journalism has lost its ethics. kgapo Tue 14 Dec 2010 09:15:39RT @glynelwyn Producer at CBS News chairs the debate - can we trust the media? Seems not: journalism has lost its ethics #sgshealth drsteventucker Tue 14 Dec 2010 09:16:00RT @cascadia: #sgshealth is Salzburg Global Seminar 2010: Informing & Involving Patients in Medical Decision Making http://is.gd/iIGmQ andrewspong Tue 14 Dec 2010 09:16:31http://j.mp/gCPe1X ‚ôª @drsteventucker @ePatientDave All true. And the key is sharing honest transparent opinions (or biases) #sgshealth healthgist Tue 14 Dec 2010 09:16:32RT @doctorblogs: RT @LaylaMcCay "Too many media stories on #health hype benefits downplay harms & hide conflicts of interest" #sgshealth David_Dobbs Tue 14 Dec 2010 09:16:41Is media misreporting specific to health? Partly yes:health stories are usually framed as positive stories #sgshealth LaylaMcCay Tue 14 Dec 2010 09:17:36RT @LaylaMcCay: Is media misreporting specific to health? Partly yes:health stories are usually framed as positive stories #sgshealth kgapo Tue 14 Dec 2010 09:19:13Medical journals can help educate journalistsbut hard as journals compete for journalists attention (positive findings) #sgshealth LaylaMcCay Tue 14 Dec 2010 09:20:39We shouldnt allow absolute and relative risk to be used in the same article. Misleadingand journals could lead revolution #sgshealth LaylaMcCay Tue 14 Dec 2010 09:21:58RT @LaylaMcCay: Medical journals can help educate journalistsbut hard as journals compete for journalists attention (positive findings) #sgshealth kgapo Tue 14 Dec 2010 09:22:18I have a question I hope to get to answer - are there courses science/health writers can take? #sgshealth ePatientDave Tue 14 Dec 2010 09:23:51MIT Graduate Program in Science Writing: http://web.mit.edu/sciwrite/ #sgshealth <=make this available online?? ePatientDave Tue 14 Dec 2010 09:24:35#sgshealth #opnHealth #hcsmeu RT @LaylaMcCay shouldnt allow absolute & Rlative risk 2 B used in same article. Mi‚Ķ http://twishort.com/ab5oi kgapo Tue 14 Dec 2010 09:26:11Journalists cant give doctors a preview copy but you can ask them for factchecks #sgshealth LaylaMcCay Tue 14 Dec 2010 09:26:31#sgshealth #opnHealth #hcsmeu RT shouldnt allow absolute & Rlative risk 2 B used in same article. Mi‚Ķ http://twishort.com/ab5oi Krantzs84 Tue 14 Dec 2010 09:26:50RT @kgapo: #sgshealth #opnHealth #hcsmeu NBCC: Myth #2: Mammograms can only help and not harm you http://bit.ly/hluV9h ehealthgr Tue 14 Dec 2010 09:27:13Arg cant get a word in edgewise..... does no good to just gripe about this need what we can DO #sgshealth ePatientDave Tue 14 Dec 2010 09:27:19RT @ePatientDave: HealthDay wire covered pancreatic cancer screening after study of just 7 peoples tissue ¬´== RIDICULOUS!!! #sgshealth Annie_Stith Tue 14 Dec 2010 09:28:27RT @ePatientDave: MIT Graduate Program in Science Writing: http://web.mit.edu/sciwrite/ #sgshealth <=make this available online?? ehealthgr Tue 14 Dec 2010 09:28:36 Page  9
  • 10. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedA new form of communication with media:contact journalists who repeatedly write inaccurately and arrange to meet and talk to them #sgshealth LaylaMcCay Tue 14 Dec 2010 09:30:43#sgshealth #opnHealth #hcsmeu uknown unintended harm done by journalists kgapo Tue 14 Dec 2010 09:31:33RT @LaylaMcCay: A new form of communication with media:contact journalists who repeatedly write inaccurately and arrange to meet and talk to them #sgshealth kgapo Tue 14 Dec 2010 09:31:40@ePatientDave: "All screening tests cause harm" to various extents; "some may do good." ¬´== [stress from waiting is bad enough] #sgshealth" Annie_Stith Tue 14 Dec 2010 09:32:33RT @LaylaMcCay: Media:critical role in disease-mongering eg hypoactive sexual desire disorder(directly funded by drug company-new libido drug) #sgshealth JoBrodie Tue 14 Dec 2010 09:33:04Drug companies etc flood journalist inboxes with news;drs can also proactively contact media and develop personal relationships #sgshealth LaylaMcCay Tue 14 Dec 2010 09:35:38The plural of anecdote is not data #sgshealth LaylaMcCay Tue 14 Dec 2010 09:36:37Moynihan: dont underestimate the power of personal relationships with journalists they are people too. #sgshealth mollytoba Tue 14 Dec 2010 09:36:45RT @LaylaMcCay: The plural of anecdote is not data #sgshealth drsteventucker Tue 14 Dec 2010 09:37:04RT @ePatientDave: Arg cant get a word in edgewise..... does no good to just gripe about this need what we can DO #sgshealth <-- #focus andrewspong Tue 14 Dec 2010 09:37:36RT @LaylaMcCay: Media:critical role in disease-mongering eg hypoactive sexual desire disorder(directly funded by drug company-new libido drug) #sgshealth christineottery Tue 14 Dec 2010 09:38:06RT @mollytoba: Moynihan: dont underestimate the power of personal relationships with journalists they are people too. #sgshealth kgapo Tue 14 Dec 2010 09:38:24RT @LaylaMcCay: The plural of anecdote is not data #sgshealth Scqueila Tue 14 Dec 2010 09:38:45Schwitzer now listing other media training resources - Ill try to harvest them & post them later #sgshealth ePatientDave Tue 14 Dec 2010 09:39:57RT @ePatientDave: I have a question I hope to get to ask: are there courses science/health writers can take? #sgshealth <-- @David_Dobbs? andrewspong Tue 14 Dec 2010 09:40:03Top doctors tend to gravitate to centres with fancy equipment. Incentive for hospitals to inappropriately invest #sgshealth LaylaMcCay Tue 14 Dec 2010 09:40:39@fidouglas Salzburg Global Seminar on informing and involving patients in decisions about their medical care #sgshealth LaylaMcCay Tue 14 Dec 2010 09:42:35RT @LaylaMcCay: The plural of anecdote is not data #sgshealth fidouglas Tue 14 Dec 2010 09:44:14Breaks over. Were now in groups to analyze a news story using @HealthNewsRevu criteria. #sgshealth ePatientDave Tue 14 Dec 2010 10:08:58Heres the story were evaluating http://bit.ly/agi7vU and the review criteria http://bit.ly/fgX3TH #sgshealth ePatientDave Tue 14 Dec 2010 10:24:31#sgshealth œÉœÖŒ∂ŒÆœÑŒ∑œÉŒ∑ Œ≥ŒπŒ± ŒµœÄŒØŒ¥œÅŒ±œÉŒ∑ ŒúŒúŒï+ŒπŒΩœÑŒµœÅŒΩŒµœÑ œÉœÑŒ∑ŒΩ Œ±ŒΩœÑŒØŒªŒ∑œàŒ∑ Œ≥ŒπŒ± œÑŒ∑ŒΩ œÖŒ≥ŒµŒØŒ± ŒµŒæŒ±ŒπœÅŒµœÑŒπŒ∫ŒÆ http://youtu.be/2D2BB kgapo Tue 14 Dec 2010 10:25:38I wish I was here #sgshealth is Salzbrg Glbl Sem2010: Informing & Involving Patients in Medical Decision Making http://is.gd/iIGmQ wiltonbound Tue 14 Dec 2010 10:28:28#sgsHealth #opnHealth Œ¨œÉŒ∫Œ∑œÉŒ∑: Œ¨ŒΩ Œ¨œÅŒ∏œÅŒø œÑŒøœÖ Bloomberg Œ≥ŒπŒ± ŒΩŒ≠Œø œÑŒ≠œÉœÑ Œ≥ŒπŒ± œÄœÅŒøœÉœÑŒ¨œÑŒ∑ Œ±ŒΩœÑŒ≠œáŒµŒπ Œ∫œÅŒπœÑŒπŒ∫œå Œ≠ŒªŒµŒ≥œáŒø 10œÉŒ∑ŒºŒµŒØœâŒ kgapo Tue 14 Dec 2010 10:40:17RT @ePatientDave: Breaks over. Were now in groups to analyze a news story using @HealthNewsRevu criteria. #sgshealth kgapo Tue 14 Dec 2010 10:43:50œÑŒø Œ¨œÅŒ∏œÅŒø œÄŒøœÖ Œ∫œÅŒπŒΩŒøœÖŒºŒµ http://bit.ly/agi7vU Œ∫Œ±Œπ œÑŒ± Œ∫œÅŒπœÑŒÆœÅŒπŒ± ŒøœÅŒ∏ŒÆœÇ œÄœÅŒ±Œ∫œÑŒπŒ∫ŒÆœÇ œÅŒµœÄŒøœÅœÑŒ¨Œ∂ œÖŒ≥ŒµŒØŒ±œÇ http://bit.ly/fgX3TH #sgshealth #op kgapo Tue 14 Dec 2010 10:45:52Interesting:exercise on rating health news stories on appropriateness. Rigorous #sgshealth LaylaMcCay Tue 14 Dec 2010 10:47:04#sgshealth #opnHealth #hcsmeu Ben Moulton suggests an 11th criterium: follow the money kgapo Tue 14 Dec 2010 10:48:02Criteria:Availabilitycostdiseasemongeringevidence qualityharmstrue noveltybenefitslifted from news releaseCOIalternative #sgshealth LaylaMcCay Tue 14 Dec 2010 10:52:22Hm.. Interesting:exercise on rating health news stories on appropriateness. Rigorous #sgshealth :)) CarlMMerrill Tue 14 Dec 2010 10:54:35#sgshealth Using HealthNewsReview criteria to check the quality of health reporting - fantastic test of report validity. Mandate it? glynelwyn Tue 14 Dec 2010 10:57:07Dont report sensitivity without specificity. Easy to set thresholds to 100%sensitivity. Sounds goodbut... #sgshealth LaylaMcCay Tue 14 Dec 2010 10:57:14RT @LaylaMcCay: Dont report sensitivity without specificity. Easy to set thresholds to 100%sensitivity. Sounds goodbut... #sgshealth kgapo Tue 14 Dec 2010 10:57:50YES! RT @glynelwyn #sgshealth Using HlthNewsRview criteria 2 check quality of hlth rporting fantastic test of rpo‚Ķ http://twishort.com/ab5oq kgapo Tue 14 Dec 2010 11:00:33#opnHealth #sgsHealth Œ±ŒΩŒ¨Œ≥Œ∫Œ∑ œÖŒπŒøŒ∏Œ≠œÑŒ∑œÉŒ∑œÇ Œ∫œÅŒπœÑŒ∑œÅŒØœâŒΩ œÅŒµœÄŒøœÅœÑŒ¨Œ∂ œÖŒ≥ŒµŒØŒ±œÇ Œ±œÄœå œÅŒµœÄœåœÅœÑŒµœÅœÇ MME/sites http://bit.ly/fgX3TH kgapo Tue 14 Dec 2010 11:07:05#sgshealth HealthNewsReview It only takes one good questioning journalist to turn a story - so why not make this a crowd sourcing effort? glynelwyn Tue 14 Dec 2010 11:11:36RT @kgapo: œÑŒø Œ¨œÅŒ∏œÅŒø œÄŒøœÖ Œ∫œÅŒπŒΩŒøœÖŒºŒµ http://bit.ly/agi7vU Œ∫Œ±Œπ œÑŒ± Œ∫œÅŒπœÑŒÆœÅŒπŒ± ŒøœÅŒ∏ŒÆœÇ œÄœÅŒ±Œ∫œÑŒπŒ∫ŒÆœÇ œÅŒµœÄŒøœÅœÑŒ¨Œ∂ œÖŒ≥ŒµŒØŒ±œÇ http://bit.ly/fgX3TH #s ehealthgr Tue 14 Dec 2010 11:11:50RT @kgapo: #opnHealth #sgsHealth Œ±ŒΩŒ¨Œ≥Œ∫Œ∑ œÖŒπŒøŒ∏Œ≠œÑŒ∑œÉŒ∑œÇ Œ∫œÅŒπœÑŒ∑œÅŒØœâŒΩ œÅŒµœÄŒøœÅœÑŒ¨Œ∂ œÖŒ≥ŒµŒØŒ±œÇ Œ±œÄœå œÅŒµœÄœåœÅœÑŒµœÅœÇ MME/sites http://bit.ly/fgX3TH ancanta Tue 14 Dec 2010 11:11:56RT @kgapo: #opnHealth #sgsHealth Œ±ŒΩŒ¨Œ≥Œ∫Œ∑ œÖŒπŒøŒ∏Œ≠œÑŒ∑œÉŒ∑œÇ Œ∫œÅŒπœÑŒ∑œÅŒØœâŒΩ œÅŒµœÄŒøœÅœÑŒ¨Œ∂ œÖŒ≥ŒµŒØŒ±œÇ Œ±œÄœå œÅŒµœÄœåœÅœÑŒµœÅœÇ MME/sites http://bit.ly/fgX3TH ehealthgr Tue 14 Dec 2010 11:11:58Little health content governance possible for audiovisual media -should they have to make their transcripts available for review? #sgshealth LaylaMcCay Tue 14 Dec 2010 11:12:52g schwitzer: large gap in consumer uptake comprehension of issues of health news stories #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 11:13:37Its rare for a journalist to write the headline of their own story (print) or intro (AV) #sgshealth LaylaMcCay Tue 14 Dec 2010 11:14:32Reminder for US awakening: #sgshealth day 3 is underway - tweets & info link: http://wthashtag.com/Sgshealth ePatientDave Tue 14 Dec 2010 11:15:03RT @LaylaMcCay: Little health content governance possible for audiovisual media -should they have to make their transcripts available for review? #sgshealth kgapo Tue 14 Dec 2010 11:16:02Internet takes health stories out of their original context&makes them available to all:journalists need to act on implications #sgshealth LaylaMcCay Tue 14 Dec 2010 11:17:54very good remark tht article in Q is more interesting to investors than to pts/clincians #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 11:18:38@ePatientDave askd abt tools 4 pt adv. 2 learn 2 understand whts hidden in news stories #sgshealth #opnHealth ch‚Ķ http://twishort.com/ab5ou kgapo Tue 14 Dec 2010 11:23:13Should we use social media to improve open source critical appraisal of health news articles? #sgshealth LaylaMcCay Tue 14 Dec 2010 11:23:33crowdsourcing? RT @LaylaMcCay: Should we use social media to improve open source critical appraisal of health news articles? #sgshealth kgapo Tue 14 Dec 2010 11:24:58@LaylaMcCay: What if @HealthNewsRevu allowed blog comments on their reviews? #sgshealth ePatientDave Tue 14 Dec 2010 11:25:11Should there be a public ranking of quality of health news companies to drive improvement? #sgshealth LaylaMcCay Tue 14 Dec 2010 11:27:05@garyschwitzer toolkit for journalists health news reporting http://www.healthnewsreview.org/tips-for-understanding-studies.php #sgshealth FIMDM Tue 14 Dec 2010 11:29:44@LaylaMcCay #sgshealth why not? rankings are the order of the day in many sectors kgapo Tue 14 Dec 2010 11:29:55LOL - @GarySchwitzer got into health journalism in 1970s because nobody else @ the TV station wanted the beat! #sgshealth ePatientDave Tue 14 Dec 2010 11:30:24@ePatientDave Its a logical next step. Lay reviewers are an untapped resource and can be mobilised. #sgshealth LaylaMcCay Tue 14 Dec 2010 11:30:39Hey @FIMDM @GarySchwitzer - why not offer Certified Health Journalist training & badge? #sgshealth ePatientDave Tue 14 Dec 2010 11:31:30@FIMDM suggests the @garyschwitzer toolkit 4 journalists health news reporting http://bit.ly/eyz14D #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 11:31:50@kgapo would need to mobilise bigger reviewer resource probably via social media... Wikinewsreview? #sgshealth LaylaMcCay Tue 14 Dec 2010 11:32:32@LaylaMcCay #sgshealth interesting lets discuss it over lunch kgapo Tue 14 Dec 2010 11:33:17@LaylaMcCay And crowdsourcing is very modern - and it scales up as people learn. Participatory democracy! #sgshealth ePatientDave Tue 14 Dec 2010 11:33:51RT @cascadia: #sgshealth is Salzburg Global Seminar 2010: Informing & Involving Patients in Medical Decision Making http://is.gd/iIGmQ zenofbass Tue 14 Dec 2010 12:02:25Woot: I get to moderate next #sgshealth panel Patient Perspective w/awesome panelists Susan Edgman-Levitan and Angela Coulter! ePatientDave Tue 14 Dec 2010 13:02:14@ePatientDave w/ Angela Coulter Dir global initiatives Foundation 4 Informed Medical Decision Making http://is.gd/iJgh0 #sgshealth cascadia Tue 14 Dec 2010 13:07:39@kgapo @ePatientDave @LaylaMcCay @FIMDM @glynelwyn TY for your continuing great coverage of #sgshealth andrewspong Tue 14 Dec 2010 13:09:36Greatest Untapped Resource in Healthcare? Informing & Involving Patients in Medical Care Decisions http://is.gd/iIGmQ #sgshealth cascadia Tue 14 Dec 2010 13:10:37 Page  10
  • 11. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedRT @ePatientDave: Woot: I get to moderate next #sgshealth panel Patient Perspective w/awesome panelists Susan Edgman and Angela Coulter! pjmachado Tue 14 Dec 2010 13:20:09break at #sgshealth: overflowing with great ideas! Excited to share @ home. ;) NursePaguio Tue 14 Dec 2010 13:21:15This afternoon: what patients know and want #sgshealth LaylaMcCay Tue 14 Dec 2010 13:34:26Participatory medicine: movement where networked patients shift from being mere passengers to responsible drivers of their health #sgshealth LaylaMcCay Tue 14 Dec 2010 13:39:15#sgshealth @ePatientDave speaks about the Society Participatory Medicine. See http://e-patients.net/ glynelwyn Tue 14 Dec 2010 13:41:09patients doctors academics researchers inivted to join http://bit.ly/i3Nlfl #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 13:41:23India originally had patient centred medicine;they lost it after colonisation by Britain and adoption of western health practices #sgshealth LaylaMcCay Tue 14 Dec 2010 13:42:09@ePatientDave introducing session on patients perspectives what patients know and want #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 13:42:43RT @NursePaguio: break at #sgshealth: overflowing with great ideas! Excited to share @ home. ;) kgapo Tue 14 Dec 2010 13:43:15RT @FIMDM: @garyschwitzer toolkit 4 journalists health news reporting http://bit.ly/8NBhPg #sgshealth #hcmktg mkmackey Tue 14 Dec 2010 13:45:10In Kenya clinicians dislike being questioned and patients believe doctors know it all;starting to encourage patient involvement #sgshealth LaylaMcCay Tue 14 Dec 2010 13:46:07fellows from Africa and Asia share their experience abt SDM (shared decision making) in their countries #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 13:48:16True in almost every field RT @LaylaMcCay The plural of anecdote is not data #sgshealth JohnstonDon Tue 14 Dec 2010 13:48:27In Ugandadoctors are starting to seek patients views;patients are reluctant to askand time is limited #sgshealth LaylaMcCay Tue 14 Dec 2010 13:48:42@ePatientDave Congratulations! #sgshealth sarahmorgan Tue 14 Dec 2010 13:48:48In Hong Kong patients feel they have a right to know about their carebut let doctors decide on that care #sgshealth LaylaMcCay Tue 14 Dec 2010 13:52:18A previous Salzburg Global Seminar coined the catchphrase nothing about me without me #sgshealth LaylaMcCay Tue 14 Dec 2010 13:53:51RT @kgapo: patients doctors academics researchers inivted to join http://bit.ly/i3Nlfl #sgshealth #opnHealth #hcsmeu ehealthgr Tue 14 Dec 2010 13:54:57Interesting that UK government in England basing new reforms on idea developed at Salzburg Global Seminar #sgshealth LaylaMcCay Tue 14 Dec 2010 13:55:58Angela Coulter: theme of previous #sgshealth conference "nothing about me without me" has resurfaced in NHS white paper on health reform. FIMDM Tue 14 Dec 2010 13:58:38Sharing decision means acknowledging doctor&patient have expertise in different areas-need to combine expertise for good decision #sgshealth LaylaMcCay Tue 14 Dec 2010 13:59:20wish that UK gov talked 2 GR colleagues RT @LaylaMcCay UK gov basing new rforms on idea dveloped here at SGS #sgshealth #opnHealth kgapo Tue 14 Dec 2010 14:00:34RT @FIMDM: Angela Coulter: theme of previous #sgshealth conference "nothing about me without me" has resurfaced in NHS white paper on health reform. kgapo Tue 14 Dec 2010 14:00:59RT @LaylaMcCay: Sharing decision means acknowledging doctor&patient have expertise in different areas-need to combine expertise for good decision #sgshealth kgapo Tue 14 Dec 2010 14:01:06NHS annual surveys show 2002-9: almost half of those surveyed wanted more involvement in treatment decisions #sgshealth LaylaMcCay Tue 14 Dec 2010 14:02:28Commonwealth Fund survey 2008: in UK only 51% said their dr always gives info about treatment choices #sgshealth LaylaMcCay Tue 14 Dec 2010 14:03:40NL fares best in docs always give info abt gtreatment choices & elicites preference #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 14:04:18Providers usually recommend the treatment theyre trained to provide #sgshealth LaylaMcCay Tue 14 Dec 2010 14:04:32Angela Coulter low health literacy low engagement #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 14:05:12To start engaging in shared decisionspatients need: knowledge skills and confidence #sgshealth LaylaMcCay Tue 14 Dec 2010 14:05:49build hlth literacy?encourage pt activation?promote critcal awarness?support self-managment? #sgshealth #opnHealth #hcsmeu #healthlit kgapo Tue 14 Dec 2010 14:08:00RT @LaylaMcCay: To start engaging in shared decisionspatients need: knowledge skills and confidence #sgshealth kgapo Tue 14 Dec 2010 14:08:27The current healthcare system views patients as either inventory or imbeciles H Picker 1988 #sgshealth LaylaMcCay Tue 14 Dec 2010 14:11:41Susan Edgman-Levitan a vision 4 nxt generation of patient engagement #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 14:11:43@marrelaki suggest by all means to attend future #sgshealth kgapo Tue 14 Dec 2010 14:12:51Patient-centred care should be the umbrella for all quality indicators rather than a category: discuss #sgshealth LaylaMcCay Tue 14 Dec 2010 14:13:25RT @mkmackey: RT @FIMDM: @garyschwitzer toolkit 4 journalists health news reporting http://bit.ly/8NBhPg #sgshealth #hcmktg askclarion Tue 14 Dec 2010 14:14:18y is it important 2 measure the patient Xprience @engagementstrat session 2 attend wld lk hear ur comments #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 14:14:49http://yfrog.com/h2hinij definition of patient centered care from IOM #sgshealth ePatientDave Tue 14 Dec 2010 14:15:53measuring pt care expernces identifies quality issues #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 14:16:25shift health care from biomedicine to infomedicine #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 14:17:02Salzburg seminar 1998:shift healthcare from biomedicine to infomedicine and use IT to give patients clinical info #sgshealth LaylaMcCay Tue 14 Dec 2010 14:18:30Internet revolution has democratised medicine:previously hard to access technical books;now available online to all #sgshealth LaylaMcCay Tue 14 Dec 2010 14:19:49Susan defines patient centered care/IOM #sgshealth #opnHealth #hcsmeu ICT to enable patients to access to clinical info kgapo Tue 14 Dec 2010 14:19:55Honest criticism is hard to takeparticularly from a relative friend colleague or stranger - Jones #sgshealth LaylaMcCay Tue 14 Dec 2010 14:21:20RT @LaylaMcCay: Honest criticism is hard to takeparticularly from a relative friend colleague or stranger - Jones #sgshealth #opnHealth kgapo Tue 14 Dec 2010 14:21:59Even highly educated patients arent always being aware that a decision has been made #sgshealth LaylaMcCay Tue 14 Dec 2010 14:25:35in US emphasis on pts tools 4 pts 2 get educatd in various forms 4 diverse populations-CAHPS tools in web #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 14:25:36RT @LaylaMcCay: Even highly educated patients arent always being aware that a decision has been made #sgshealth kgapo Tue 14 Dec 2010 14:25:49Edgman-Levitan: in initial survey qs "did doc inform you re options" -> 98% yes - clearly the q wasnt getting accurate answers #sgshealth ePatientDave Tue 14 Dec 2010 14:27:04@kgapo It sounds really interesting! Ill follow it on twitter. Enjoy the conf and your stay! Well catch up when you get back! #sgshealth marrelaki Tue 14 Dec 2010 14:27:27@marrelaki #sgshealth wld be worth for Ath team to follow kgapo Tue 14 Dec 2010 14:28:31Literacy is not just a reading issue; its a medical language issue #sgshealth LaylaMcCay Tue 14 Dec 2010 14:29:30today health literacy is not enough shld be accompanied w digital literacy #sgshealth #opnHealth #hcsmeu #healthlit kgapo Tue 14 Dec 2010 14:30:50@vtriantopoulos @kgogi message from Kathi: RT @kgapo: @marrelaki #sgshealth wld be worth for Ath team to follow marrelaki Tue 14 Dec 2010 14:30:53How do we shift our orientation from what is the matter with you to what matters to you #sgshealth LaylaMcCay Tue 14 Dec 2010 14:32:58@triantopoulos @kgogi message from Kathi: RT @kgapo: @marrelaki #sgshealth wld be worth for Ath team to follow marrelaki Tue 14 Dec 2010 14:33:20Those who say it cannot be done should not interrupt the person doing it - Chinese proverb #sgshealth LaylaMcCay Tue 14 Dec 2010 14:34:07we have to go from what is the matter with you? docs ask to what matters to you? #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 14:34:19RT @ePatientDave: Reminder for US awakening: #sgshealth day 3 is underway - tweets & info link: http://wthashtag.com/Sgshealth tinkerrr Tue 14 Dec 2010 14:35:04those who say it cannot bedone should not interrupt the person doing it-Chinese proverb #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 14:35:39If doctors are not taught business skills they find it hard to know how to treat patients as empowered customers #sgshealth LaylaMcCay Tue 14 Dec 2010 14:36:08so let us patient advocates docs nurses academics and policy makers who want to go on with SDM do it #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 14:37:07RT @LaylaMcCay: If doctors are not taught business skills they find it hard to know how to treat patients as empowered customers #sgshealth kgapo Tue 14 Dec 2010 14:37:22 Page  11
  • 12. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username Created#sgshealth Coulter Lets re-define patients to be co-producers of health. Bravo says: then re-define professionals to be facilitators glynelwyn Tue 14 Dec 2010 14:38:56Should we redefine health professional to be someone who facilitates care rather than someone who provides care #sgshealth LaylaMcCay Tue 14 Dec 2010 14:39:12Idea: health practitioner as someone who facilitates care not providing care. Same or different as a Health Coach? #sgshealth mollytoba Tue 14 Dec 2010 14:39:43RT @ePatientDave: http://yfrog.com/h2hinij definition of patient centered care from IOM #sgshealth midwifeamy Tue 14 Dec 2010 14:40:05Difficult to be partners where Dr holds lots of info about patient that patient doesnt have access to #sgshealth LaylaMcCay Tue 14 Dec 2010 14:41:37#sgshealth #opnHealth #hcsmeu communication skills not taught in Greek med schools neither legslation on Code of Med Deontology/pt rights kgapo Tue 14 Dec 2010 14:41:37RT @LaylaMcCay: Difficult to be partners where Dr holds lots of info about patient that patient doesnt have access to #sgshealth MarkOneinFour Tue 14 Dec 2010 14:42:39RT @LaylaMcCay: Should we redefine health professional to be someone who facilitates care rather than someone who provides care #sgshealth MarkOneinFour Tue 14 Dec 2010 14:42:49RT @LaylaMcCay: If doctors are not taught business skills they find it hard to know how to treat patients as empowered customers #sgshealth MarkOneinFour Tue 14 Dec 2010 14:42:56patients need confidence in their own experience not challenging docs but bring up their experience #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 14:43:07RT @LaylaMcCay: How do we shift our orientation from what is the matter with you to what matters to you #sgshealth MarkOneinFour Tue 14 Dec 2010 14:43:10@mollytoba #sgshealth doctors definitely hold the technical aspect of medicine but they shld facilitate patient understanding of it kgapo Tue 14 Dec 2010 14:45:05Redefine biomedicine > infomedicine > infohealth: create a different sort of multidisciplinary holistic healthcare #sgshealth LaylaMcCay Tue 14 Dec 2010 14:45:44You wouldnt get a bank manager holding a statement you cant seetelling you to spend less - why do we accept this in health? #sgshealth LaylaMcCay Tue 14 Dec 2010 14:47:50EœÖœÅœâœÄŒ±ŒØŒøŒπ Œ±œÉŒ∏ŒµŒΩŒµŒØœÇ+œÄŒøŒªŒØœÑŒµœÇ œÄœÅŒ≠œÄŒµŒπ ŒΩŒ± œÉœÑŒ∑œÅŒØŒæŒøœÖŒΩ Œ¥œÖŒΩŒ±ŒºŒπŒ∫Œ¨ œÑŒø kgapo Œ¥Œ∑ŒºœåœÉŒπŒø14 Dec 2010 14:50:03 Tue œáŒ±œÅŒ±Œ∫œÑŒÆœÅŒ± œÑŒ∑œÇ œÖŒ≥ŒµŒWe teach the mathematics of certainty but not of uncertainty #sgshealth LaylaMcCay Tue 14 Dec 2010 14:51:35RT @LaylaMcCay: How do we shift our orientation from what is the matter with you to what matters to you #sgshealth NucleusMedMedia Tue 14 Dec 2010 14:51:37RT @doctorblogs: RT @LaylaMcCay "Too many media stories on #health hype benefits downplay harms & hide conflicts of interest" #sgshealth mamaier262 Tue 14 Dec 2010 14:51:59well said! RT @LaylaMcCay We teach the mathematics of certainty but not of uncertainty #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 14:53:33Referring to patients as clients encourages health professionals to focus on customer service and partnership #sgshealth LaylaMcCay Tue 14 Dec 2010 14:54:10Lexicon of "patient" vs "client" sets very different tone in how people are viewed and treated. #sgshealth mollytoba Tue 14 Dec 2010 14:54:19@mollytoba #sgshealth vry strong feelings against client/consumer terms used in the the US & patient preferred in Europe #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 14:55:54Lack of continuity of care may erode partnership and shared decision making relationship. #sgshealth LaylaMcCay Tue 14 Dec 2010 14:56:44Wow - what a session on the patient perspective. 90 minutes and we could have gone much longer. #sgshealth ePatientDave Tue 14 Dec 2010 15:03:11Big questions: how can we have shared informed decisions if patients dont share the information? #sgshealth ePatientDave Tue 14 Dec 2010 15:03:50How can we shift the *patient* culture to be more proactive/engaged? (People here from Asia Africa India) #sgshealth ePatientDave Tue 14 Dec 2010 15:04:18And of course how can we shift the physician/provider culture to be more participatory? #sgshealth ePatientDave Tue 14 Dec 2010 15:05:06@tinkerrr Hey Tinker! Great to see you here! (virtually) #sgshealth ePatientDave Tue 14 Dec 2010 15:05:27RT @LaylaMcCay: You wouldnt get a bank manager holding a statement you cant seetelling you to spend less - why do we accept this in health? #sgshealth ePatientDave Tue 14 Dec 2010 15:06:24@LaylaMcCay And yet we do accept that. #sgshealth ePatientDave Tue 14 Dec 2010 15:06:38#sgshealth Reminder: the goal of all this work is to have patients get the RIGHT CARE based on evidence & THEIR WANTS. ePatientDave Tue 14 Dec 2010 15:07:13RT @ePatientDave: Big questions: how can we have shared informed decisions if patients dont share the information? #sgshealth cascadia Tue 14 Dec 2010 15:07:54When we fail to accomplish that our work has fallen short people dont have the best life they could costs^^. #sgshealth ePatientDave Tue 14 Dec 2010 15:07:56Thats the real human impact for instance of poor health news reporting (@GarySchwitzer) #sgshealth ePatientDave Tue 14 Dec 2010 15:08:46The nature of the physician-patient dialogue during the routine office visit is stacked against the patient http://wp.me/pGXmn-fW #sgshealth Healthmessaging Tue 14 Dec 2010 15:10:27@ePatientDave #sgshealth #opnHealth #hcsmeu best example of pts sharing med info is the acor cancer pts listserv. kgapo Tue 14 Dec 2010 15:10:40RT @CECSarahG: @LaylaMcCay You also dont have bankers asking you to choose a plan that couldnt provide details of coverage. #sgshealth ePatientDave Tue 14 Dec 2010 15:10:51RT @kgapo: @ePatientDave #sgshealth #opnHealth #hcsmeu best example of pts sharing med info is the acor cancer pts listserv. ePatientDave Tue 14 Dec 2010 15:11:04RT @ePatientDave Big questions: how can we have shared informed decisions if patients dont share the information? #sgshealth WhereToFindCare Tue 14 Dec 2010 15:13:40Admire warm support of acor.org IBC group-Wld love to have Gilles Frydman (@gfry) in faculty #sgshealth #opnHealth #hcsmeu kgapo Tue 14 Dec 2010 15:15:22RT @LaylaMcCay: You wouldnt get a bank manager holding a statement you cant seetelling you to spend less - why do we accept this in health? #sgshealth motorcycle_guy Tue 14 Dec 2010 15:18:43#sgshealth Coulter Lets redefine patients to be co-producers of health. Bravo: then redefine prfssionals to be facilitators -ht @glynelwyn bacigalupe Tue 14 Dec 2010 15:29:11RT @bacigalupe: #sgshealth Coulter Lets redefine patients to be co-producers of health. Bravo: then redefine prfssionals to be facilitators -ht @glynelwyn ePatientDave Tue 14 Dec 2010 15:31:59RT @bacigalupe: #sgshealth Coulter Lets redefine patients to be co-producers of health. Bravo: then redefine prfssionals to be facilitators -ht @glynelwyn sjdmd Tue 14 Dec 2010 15:33:18Its dangerous to assume you know whats important to your patients #sgshealth LaylaMcCay Tue 14 Dec 2010 15:39:13#sgshealth Beinfield shows video of men talking about active surveillance when they have prostate ... activated patients take it on! glynelwyn Tue 14 Dec 2010 15:43:27RT @LaylaMcCay: The plural of anecdote is not data #sgshealth fverter Tue 14 Dec 2010 15:44:13Watching a great @FIMDM video now (not on YouTube!) of prostate pt who chose "active surveillance" #sgshealth. Now: discuss. ePatientDave Tue 14 Dec 2010 15:45:02Yay! RT @FIMDM: @ePatientDave were working on our YouTube library. More to come soon! #sgshealth ePatientDave Tue 14 Dec 2010 15:46:51@DrDannySands Im quoting you again at #sgshealth (Salzburg Global Seminar). Will you never get out of my mind??? :) ePatientDave Tue 14 Dec 2010 15:49:19RT @WhereToFindCare: RT @ePatientDave Big questions: how can we have shared informed decisions if patients dont share the information? #sgshealth jrcatarina Tue 14 Dec 2010 16:00:26RT @LaylaMcCay: Redefine biomedicine > infomedicine > infohealth: create a different sort of multidisciplinary holistic healthcare #sgshealth jrcatarina Tue 14 Dec 2010 16:03:05RT @LaylaMcCay: Those who say it cannot be done should not interrupt the person doing it - Chinese proverb #sgshealth jrcatarina Tue 14 Dec 2010 16:04:01RT @FIMDM: Angela Coulter: theme of previous #sgshealth conference "nothing about me without me" has resurfaced in NHS white paper on health reform. jrcatarina Tue 14 Dec 2010 16:09:47Deep discussion about obstacles to shared decision making at the patient end. Fear lack of info culture too many to tweet. #sgshealth ePatientDave Tue 14 Dec 2010 16:23:52For awakening west coast: #sgshealth day 3 is underway - tweets & info link: http://bit.ly/eY2Vsp ePatientDave Tue 14 Dec 2010 16:25:51@ePatientDave I just set this up too http://lanyrd.com/2010/sgshealth/ Are you speaking? #sgshealth amcunningham Tue 14 Dec 2010 16:41:54RT @LaylaMcCay: Media is key source of health info for patients health professionals and policymakers but are hugely flawed #sgshealth DocComLtd Tue 14 Dec 2010 16:46:59@amcunningham Cool! Im not listed as faculty but I did moderate a session - go for it! #sgshealth ePatientDave Tue 14 Dec 2010 16:49:21Now on break before dinner. #sgshealth (Well some people are...) ePatientDave Tue 14 Dec 2010 16:58:35RT @LaylaMcCay: How do we shift our orientation from what is the matter with you to what matters to you #sgshealth AnnieBrocklesby Tue 14 Dec 2010 17:23:37RT @ePatientDave: Deep discussion about obstacles to shared decision making at the patient end. Fear lack of info culture too many to tweet. #sgshealth Sara_Elias Tue 14 Dec 2010 17:38:45http://yfrog.com/h2axjcj Evening snowfall at dinnertime in Salzburg #sgshealth ePatientDave Tue 14 Dec 2010 17:56:15RT @LaylaMcCay: Its dangerous to assume you know whats important to your patients #sgshealth monalisa1n Tue 14 Dec 2010 17:58:59 Page  12
  • 13. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedRT @glynelwyn: #sgshealth A decent journalist will follow the money and uncover the agendas - conflicts of interest and side effects - why not in health? monalisa1n Tue 14 Dec 2010 17:59:41RT @glynelwyn: #sgshealth moynihan - scary creation of disease - selling sickness marketing funded by pharma e.g. hypo sexuality. Follow the money. monalisa1n Tue 14 Dec 2010 17:59:49RT @ePatientDave http://yfrog.com/h2axjcj Evening snowfall at dinnertime in Salzburg #sgshealth <thanks! more pics!plz :) soulflsepulcher Tue 14 Dec 2010 18:01:16RT @LaylaMcCay: Difficult to be partners where Dr holds lots of info about patient that patient doesnt have access to #sgshealth roiben Tue 14 Dec 2010 18:50:09Perfect weather for some Gluhwein! RT @ePatientDave: http://yfrog.com/h2axjcj Evening snowfall at dinnertime in Salzburg #sgshealth Colin_Hung Tue 14 Dec 2010 19:00:52RT @LaylaMcCay: Its dangerous to assume you know whats important to your patients #sgshealth emmabelanger Tue 14 Dec 2010 20:18:53RT @cochranecollab @andrewspong More info on #Cochrane work on integrating pt preferences in #EBM http://cot.ag/dZFuZj #sgshealth #opnHealth kgapo Tue 14 Dec 2010 21:12:39@ePatientDave @amcunningham #sgshealth we can testify you did! ha ha! kgapo Tue 14 Dec 2010 21:16:40@DocComLtd @LaylaMcCay #sgshealth not only media internet tends to become the main source as well as patient networks see acor.org kgapo Tue 14 Dec 2010 21:18:08No truth to the rumors that the music in the digital jukebox had anything to do with Gerd Gigerenzer kicking my butt at pingpong. #sgshealth ePatientDave Tue 14 Dec 2010 21:18:19@amcunningham #sgshealth announce your page tomorrow morning at 9.00am so that participants can see it kgapo Tue 14 Dec 2010 21:21:29#sgshealth Page of resources used at Salzburg Global SDM Seminar http://bit.ly/gVLyvk glynelwyn Wed Dec 15 05:04:52 2010Unpopular idea w/journos RT @ePatientDave: @FIMDM @GarySchwitzer - why not offer Certified Health Journalist training & badge? #sgshealth garyschwitzer Wed Dec 15 06:26:37 2010Later well be discussing if shared decision making should be enshrined in legislation.I say no;many say yes.Arguments please! #sgshealth LaylaMcCay Wed Dec 15 06:36:52 2010Day 3 at the Salzburg symposium. Whats your top topic for fireside chats. mines still full patient access to medical records #sgshealth tessajlrichards Wed Dec 15 08:08:22 2010@garyschwitzer @FIMDM I reject that as a reason not to offer it like MITs grad program. :-) You know some do want it! #sgshealth ePatientDave Wed Dec 15 08:10:10 2010Day 4 of #sgshealth Salzburg Global Seminar on informed medical decision making. Tweetstream with links to info: http://bit.ly/eY2Vsp ePatientDave Wed Dec 15 08:10:37 2010Today at Salzburg:communication of risk in shared decision making #sgshealth LaylaMcCay Wed Dec 15 08:12:09 2010First speaker Anne Stiggelbout Netherlands http://bit.ly/dRokOR (Prof of Medical Decision Making) #sgshealth ePatientDave Wed Dec 15 08:13:19 2010Veatch doctor-patient models: priestly collegial contractual engineering #sgshealth LaylaMcCay Wed Dec 15 08:13:52 2010Doctor-patient models - Veatch 72: Priestly -> Collegial/contractual -> engineering(!) #sgshealth ePatientDave Wed Dec 15 08:14:00 2010RT @ePatientDave: How can we have shared informed decisions if patients dont share the information? #sgshealth #openness QuimeTapu Wed Dec 15 08:14:23 2010Emanuel doctor-patient models:paternalistic deliberative interprative informative #sgshealth LaylaMcCay Wed Dec 15 08:15:13 2010Emanuael & Emanuel JAMA 1992: paternalistic deliberative interpretive (counseling) informative (consumerist) #sgshealth ePatientDave Wed Dec 15 08:15:29 2010Doctors role in E&E 92: Paternalistic=guardian; there are still situations where we want this e.g. emergency - dont discard #sgshealth ePatientDave Wed Dec 15 08:16:12 2010Deliberative = friend/teacher (this is what we discussed yesterday) #sgshealth ePatientDave Wed Dec 15 08:17:04 2010Paternalistic =guardiandeliberative=friend/teacher interpretative=counsellor/advisorinformative=competent technical expert #sgshealth LaylaMcCay Wed Dec 15 08:17:07 2010Doctors obligation (E&E): Paternalistic: promote pts well being regardless of what pt wants #sgshealth ePatientDave Wed Dec 15 08:17:32 2010RT @glynelwyn: #sgshealth Page of resources used at Salzburg Global SDM Seminar http://bit.ly/gVLyvk mollytoba Wed Dec 15 08:17:35 2010Obligation in deliberative: inform; persuade of admirable values; implement pts choice #sgshealth ePatientDave Wed Dec 15 08:17:55 2010(Rats couldnt get the rest - will need to get slides) #sgshealth ePatientDave Wed Dec 15 08:18:17 2010Pt values: Pternalist: objctiv shared; deliberatv: open to revisn; interp: inchoate /conflicting; informative: defined known #sgshealth ePatientDave Wed Dec 15 08:19:24 2010Conception of pts autonomy (E&E): Patern:assenting to objective values; Delib:self-devel (pt or client??); #sgshealth ePatientDave Wed Dec 15 08:20:09 2010interpretive: self-understanding re medical care; informative: choice & control over med care #sgshealth ePatientDave Wed Dec 15 08:20:40 2010@JoPM @S4PM #WhyPM Participatory Medicine people: We MUST write about Emanuel&Emanual 1992 JAMA article (see #sgshealth 3 a.m. 12/15) ePatientDave Wed Dec 15 08:22:11 2010Class member adds: Veatch also proposed a "doc-pt match" model in the 1970s. #sgshealth <=I love this idea! ePatientDave Wed Dec 15 08:24:07 2010Veatch model: matching of doctor and patients so they have shared values- surely a tad tricky! #sgshealth LaylaMcCay Wed Dec 15 08:24:23 2010@LaylaMcCay Not tricky at all given reasonable time to discuss eh? #sgshealth ePatientDave Wed Dec 15 08:24:56 2010Edgman-Levitan: Kaiser tried to do that w/a dating-style questionnaire; failed bc ppls needs change by circumstance(!) #sgshealth ePatientDave Wed Dec 15 08:25:42 2010Attempt to match doctor and patient via online dating type process was unsuccessful #sgshealth LaylaMcCay Wed Dec 15 08:25:47 2010Stiggelbout continues recapping Wennberg: In "effective medicine" (genl agreemt) consultation is on doing it #sgshealth ePatientDave Wed Dec 15 08:26:55 2010In "pref sensitive" medicine the consultation aims at eliciting patients pref. (How often does your doc do this?) #sgshealth ePatientDave Wed Dec 15 08:27:30 2010RT @glynelwyn: #sgshealth Schwitzer See Covering Medical Research Gary Schwitzer - a guide to journalists covering health. CureT1Diabetes Wed Dec 15 08:27:39 2010RT @glynelwyn: #sgshealth moynihan says that in terms of health reporting hype is the norm - media misleads us about the harms vs benefits CureT1Diabetes Wed Dec 15 08:28:53 2010Doc expected to assess pts pref; but slide shows major diff between pt pref and radiotherapists prediction #sgshealth ePatientDave Wed Dec 15 08:29:13 2010@ePatientDave Youd have to screen tons of doctors!Cant in villages.And few people accurately share your values on everything! #sgshealth LaylaMcCay Wed Dec 15 08:29:51 2010Information prefs: pts want to know more than docs think; pts often dont know options / dont experience choice #sgshealth ePatientDave Wed Dec 15 08:29:52 2010@LaylaMcCay I didnt think of it as exhaustive shopping just browsing (web?) then meeting #sgshealth ePatientDave Wed Dec 15 08:30:50 2010Clinicians are poor at predicting patient preferences. #sgshealth LaylaMcCay Wed Dec 15 08:31:38 2010What is shared decision making? Both pt & clinician: are involved; exchange info; state prefs; agree w/answer #sgshealth ePatientDave Wed Dec 15 08:32:02 2010@ePatientDave As a doctor unsure Id be comfortable recording v personal values online... Could have concerning consequences #sgshealth LaylaMcCay Wed Dec 15 08:32:58 2010@LaylaMcCay Im just saying that my doc (@DrDannySands) & I are extremely good fit re style; we were "matched" by mutual contact #sgshealth ePatientDave Wed Dec 15 08:33:12 2010@LaylaMcCay Well I certainly wouldnt force anyone to do that! Same as online dating in that regard. #sgshealth ePatientDave Wed Dec 15 08:33:42 2010SDM is not just the final decision; its about awareness and understanding of the options #sgshealth LaylaMcCay Wed Dec 15 08:33:49 2010@LaylaMcCay You cant honor choice by forcing people i.e. ignoring their preferences :-) #sgshealth ePatientDave Wed Dec 15 08:34:25 2010Next: Glyn Elwyn U of Cardiff http://bit.ly/evimKa #sgshealth "Klasinas untapped resource" ePatientDave Wed Dec 15 08:36:06 2010Elwyn: in philosophy "things" matter - things have "agency" <=huh? Need to make this clearer #sgshealth ePatientDave Wed Dec 15 08:37:12 20102day ws late & had missed part of fantastic pres of Anne Stiggelbout #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 08:37:21 2010@amcunningham Interesting convo on shared decision making youll want to review under #sgshealth this morning from c.8.30 andrewspong Wed Dec 15 08:37:52 2010#sgsHealth #opnHealth #hcsmeu now Glyn Elwyn on Klasinas untapped resource kgapo Wed Dec 15 08:38:07 2010RT @LaylaMcCay: SDM is not just the final decision; its about awareness and understanding of the options #sgshealth monalisa1n Wed Dec 15 08:38:13 2010One definition of "agency": being in action or exerting power #sgshealth ePatientDave Wed Dec 15 08:39:06 2010Decision support tools change the dynamic empowering patients in the consultation #sgshealth LaylaMcCay Wed Dec 15 08:39:25 2010Klasina - patient lives alone daughter abroad active life breast cancer. Surgery choice? shocked confused #sgshealth ePatientDave Wed Dec 15 08:40:28 2010 Page  13
  • 14. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username Created@garyschwitzer #sgshealth how will training assure employment nowadays? kgapo Wed Dec 15 08:40:49 2010Theres some debate about margins of tumor; 6 radiotherapy; becomes tired; breast shrinks/painful #sgshealth ePatientDave Wed Dec 15 08:41:53 2010#sgsHealth #opnHealth #hcsmeu oh a web resource I didint know bresdex #breastcancer kgapo Wed Dec 15 08:43:12 2010RT @ePatientDave: What is shared decision making? Both pt & clinician: are involved; exchange info; state prefs; agree w/answer #sgshealth lizasisler Wed Dec 15 08:43:36 2010She googles and finds an option grid with additional information. #sgshealth ePatientDave Wed Dec 15 08:43:48 2010In hindsight her prefs were unexpressed - unknown to others. #sgshealth ePatientDave Wed Dec 15 08:45:09 2010Klasina suffered the pain & distress of undiagnosed preferences #sgshealth ePatientDave Wed Dec 15 08:45:40 2010History: first use of "shared decision making" was Presidents Commission in 1982 #sgshealth ePatientDave Wed Dec 15 08:46:05 2010Interesting decision tools at Bresdex - comparative tables and preference weighting calculator seem very helpful in breast cancer #sgshealth LaylaMcCay Wed Dec 15 08:46:08 2010@glynelwyn demonstrates the use of http://www.bresdex.com/ breast cancer decision tool in a hypothetical patient. #sgshealth FIMDM Wed Dec 15 08:46:09 2010#sgsHealth #opnHealth #hcsmeu bresdex decision tool kgapo Wed Dec 15 08:46:21 2010SDM: choice talkoption talk deliberation preference talk and decisions #sgshealth LaylaMcCay Wed Dec 15 08:47:45 2010course SDM: choice talk-option talk-deliberation- preference talk-decisions #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 08:48:15 2010SDM: need tools to use both inside and outside consultation to support deliberation #sgshealth LaylaMcCay Wed Dec 15 08:49:08 2010SDM: "help people deliberate independently or in collaboration with others" #sgshealth ePatientDave Wed Dec 15 08:49:58 2010important others in life of patient need to to follow same process #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 08:50:00 2010RT @ePatientDave: SDM: "help people deliberate independently or in collaboration with others" #sgshealth monalisa1n Wed Dec 15 08:50:51 2010Captivating Salzburg talk by @glynelwyn of Cardiff on undiagnosed uninformed patient preferences. #sgshealth garyschwitzer Wed Dec 15 08:51:08 2010Everyone here (but me(!)) seems to know the Cochrane Reviews of decision processes http://www.cochrane.org/cochrane-reviews #sgshealth ePatientDave Wed Dec 15 08:51:48 2010Elwyn presents list of ~15 questions to measure how informed patients felt. #sgshealth ePatientDave Wed Dec 15 08:53:00 2010what to measure in relation to SDM: ahead delibration knowledge preferences decision process intention #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 08:53:15 2010Observed benefits of informed prefs: quality; inequity; medical error of doing things to wrong pt; litigation; more. #sgshealth ePatientDave Wed Dec 15 08:53:44 2010RT @garyschwitzer Captivating Salzburg talk by @glynelwyn of Cardiff on undiagnosed uninformed pt preferences #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 08:54:36 2010Thanks Glyn for your pres. wish that I and my oncologists had this iknowledge back in 1990 and 2001 #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 08:56:38 2010@FIMDM founder Al Mulley: the doc-pt relationship models map closely to leadership models. #sgshealth ePatientDave Wed Dec 15 08:56:53 2010If you ask leaders to rate their styles then ask their subords answers usually differ. Similar: docs often say "I already do it" #sgshealth ePatientDave Wed Dec 15 08:57:56 2010@kgapo @ePatientDave Has any announcement been made as to whether #sgshealth presentations will be shared on the web? andrewspong Wed Dec 15 08:58:38 2010Patients face a sense of conflict when facing decisions -Al Muley #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 08:58:48 2010Mulley: question of attention pt wants to give. Some want to decide some keep asking. #sgshealth ePatientDave Wed Dec 15 08:58:51 2010@andrewspong #sgshealth no generally only to SGS fellows kgapo Wed Dec 15 08:59:36 2010A @FIMDM decision aid produced ^^ pt knowledge *and ^^ uncertainty*. #sgshealth ePatientDave Wed Dec 15 08:59:53 2010RT @ePatientDave: A @FIMDM decision aid produced ^^ pt knowledge *and ^^ uncertainty* #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 09:00:43 2010SDM started with normative model of decision making;emotional component quickly had to be added #sgshealth LaylaMcCay Wed Dec 15 09:01:07 2010RT @LaylaMcCay: SDM started with normative model of decision making;emotional component quickly had to be added #sgshealth monalisa1n Wed Dec 15 09:01:55 2010Pt abandonment? How much cn we Xpect pts 2 accept burden of decision responsibility regret & accountability? #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 09:03:10 2010Some discussion of needing ability to shift "leadership" styles from situation to situation #sgshealth ePatientDave Wed Dec 15 09:03:26 2010Boy this aspect of shared decision making (how to best elicit & honor patient prefs) is much deeper than Ive seen #sgshealth ePatientDave Wed Dec 15 09:04:03 2010Personally Im at stage where its mind-expanding to know Wennbergs "effective med" vs "pref-sensitive" vs "supply-sensitive" #sgshealth ePatientDave Wed Dec 15 09:05:17 2010RT @LaylaMcCay SDM started w/ normative model of decision making;emotionl component quickly had 2 B added #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 09:05:23 2010@tobyhillman No;rather all have their own place even paternalism eg in emergency #sgshealth LaylaMcCay Wed Dec 15 09:05:46 2010Measures? What proof will we need? Clinical pathway design? Where shld decision support sit the pathway? #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 09:06:50 2010@kgapo @ePatientDave No sharing? Thats disappointing to hear and very much at odds with the subject matter. #sgshealth please reconsider andrewspong Wed Dec 15 09:07:26 2010Discussion: UK docs w/big immigrant populn said "We cant use yr English decision aid" BUT pts said yes my daughter spks Eng #sgshealth ePatientDave Wed Dec 15 09:08:03 2010now discussing commenting on set of Qs I posted just bfor #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 09:08:46 2010@andrewspong @kgapo I cant speak for @FIMDM but they publish a ton of stuff #sgshealth ePatientDave Wed Dec 15 09:09:06 2010Elwyn: "the hidden curriculum overpowers the taught curriculum" #sgshealth ePatientDave Wed Dec 15 09:09:57 2010medicine strongly based on role model #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 09:10:08 2010Difficult:how to present options as all viable choices rather than stressing a doctor preferred choice thus biasing? #sgshealth LaylaMcCay Wed Dec 15 09:12:45 2010@andrewspong #sgshealth read the instructions last night fellows not allowed to distr. session materials kgapo Wed Dec 15 09:13:43 2010@ePatientDave @andrewspong question is abt #sgshealth materials kgapo Wed Dec 15 09:15:04 2010RT @ePatientDave: Elwyn: "the hidden curriculum overpowers the taught curriculum" #sgshealth kgapo Wed Dec 15 09:16:10 2010Should doctors be required to give patients decision aids for certain decisions? #sgshealth LaylaMcCay Wed Dec 15 09:16:15 2010heuristic decision making explained #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 09:17:02 2010If more than one decision aid producerhow to choose the right aid?Risk of biased aids (eg by pharma/government targets) #sgshealth LaylaMcCay Wed Dec 15 09:19:02 2010@ePatientDave @andrewspong @kgapo All presentations will be available under "Session Media" on the session website #sgshealth FIMDM Wed Dec 15 09:19:02 2010@ePatientDave @andrewspong @kgapo All presentations will be available under "Session Media" #sgshealth FIMDM Wed Dec 15 09:19:31 2010RT @FIMDM: @ePatientDave @andrewspong @kgapo All presentations will be available under "Session Media" on the session website #sgshealth LaylaMcCay Wed Dec 15 09:19:31 2010Woohoo! RT @FIMDM: @ePatientDave @andrewspong @kgapo All presentations will be available under "Session Media" #sgshealth ePatientDave Wed Dec 15 09:19:53 2010Theres a role for unconscious thought in decisionmaking ie go and sleep on it #sgshealth LaylaMcCay Wed Dec 15 09:21:37 2010Question from Chile: thinking how we adapt this to all our different realities. And what happens when HCPs become patients? #sgshealth. ePatientDave Wed Dec 15 09:22:16 2010@LaylaMcCay #sgshealth thought Elwyn said decision aids are for all-did I miss something? kgapo Wed Dec 15 09:23:32 2010Incorporate SDM throughout life so doesnt come as a new skill/shock when suddenly presented on diagnosis.Social change needed #sgshealth LaylaMcCay Wed Dec 15 09:24:33 2010@FIMDM #sgshealth also to non fellows? kgapo Wed Dec 15 09:24:45 2010Wennberg steps in: This theoretical / behavioral discussion is separate from reality of supply-sensitive utilization #sgshealth <==YES ePatientDave Wed Dec 15 09:25:45 2010 Page  14
  • 15. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username Created@andrewspong @kgapo @ePatientDave some pdfs r online http://ow.ly/3pro4 #sgshealth #hcsmeu if there are presentations wd b gr8 to share!! wissit Wed Dec 15 09:25:57 2010Wennberg: Can we rescue end of life care from the clutches of capacity? #sgshealth FIMDM Wed Dec 15 09:26:14 2010Whos to stop marketing people developing decision aids with a bias? @kgapo #sgshealth LaylaMcCay Wed Dec 15 09:26:44 2010@LaylaMcCay YEAAH! thats what I have done before important decision making on health issues #sgshealth kgapo Wed Dec 15 09:26:58 2010RT @FIMDM: @ePatientDave @andrewspong @kgapo All presos will be available under "Session Media" on the session website #sgshealth <-- TY :D andrewspong Wed Dec 15 09:28:43 2010http://j.mp/gCPe1X ‚ôª @glynelwyn #sgshealth Page of resources used at Salzburg Global SDM Seminar http://bit.ly/gVLyvk healthgist Wed Dec 15 09:28:44 2010Mini-explosion (IMO) thought: all our discussion of decision aids only impacts pref-sensitive utilization #sgshealth ePatientDave Wed Dec 15 09:30:09 2010RT @FIMDM: Wennberg: Can we rescue end of life care from the clutches of capacity? #sgshealth LaylaMcCay Wed Dec 15 09:30:21 2010Mulley: But if we empower/inform re choice & prefs itll pull some away from supply-sensitive utilization #sgshealth ePatientDave Wed Dec 15 09:31:02 2010Wennberg: It will save an occasional person from it but guaranteed another unwilling volunteer will be pulled in(!) #sgshealth ePatientDave Wed Dec 15 09:31:48 2010:-) RT @FIMDM: @ePatientDave @andrewspong @kgapo All presos will be available under "Session Media" on the session website #sgshealth wissit Wed Dec 15 09:32:50 2010How to manage preference sensitive decisionmaking where there are supply restrictions? #sgshealth LaylaMcCay Wed Dec 15 09:33:25 2010#sgsHealth #opnHealth #hcsmeu Prof Wennberg on the problems posed by supply sensitive med utilisation and SDM kgapo Wed Dec 15 09:33:30 2010RT @FIMDM: Wennberg: Can we rescue end of life care from the clutches of capacity? #sgshealth kgapo Wed Dec 15 09:34:17 2010(Recap for people who werent here Monday: Wennberg (Dartmouth) data shows enormous amount of hospital utilization.... #sgshealth ePatientDave Wed Dec 15 09:34:22 2010...is proportional to *capacity* (beds machines) not medical need. Amazing data; docs dont realize it. ... #sgshealth ePatientDave Wed Dec 15 09:35:03 2010... this is what he calls "supply-sensitive" utilization. The harm: treatmts being done to ppl who dont actually need it.) #sgshealth ePatientDave Wed Dec 15 09:35:51 2010Controversy around using shared decision-making to address health system problems (i.e. overuse perverse incentives variation). #sgshealth FIMDM Wed Dec 15 09:37:00 2010Stiggelbout says theres a move to add shared decision making (SDM) into med curriculum (I want to know more!) #sgshealth ePatientDave Wed Dec 15 09:37:36 2010@FIMDM I dont see controversy on that - I only meant that SDM/pt empowermt doesnt address unconscious utilization #sgshealth ePatientDave Wed Dec 15 09:39:06 2010SDM is publicised as a cost effective measure; should it instead be framed as an ethical issue or patient safety issue? #sgshealth LaylaMcCay Wed Dec 15 09:39:16 2010Shared decision making is in GMCs Good Medical Practice document-we need to be doing this well #sgshealth LaylaMcCay Wed Dec 15 09:40:31 2010SDM stardard component of medical education in UK #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 09:40:36 2010Wennberg: can we agree on statement of the ethical imperative of shared decision making? Would be a great contribution. #sgshealth FIMDM Wed Dec 15 09:40:39 2010@GlenElwyn: revise Descartes - I believe ergo I do; or even I see (others do) therefore I do (e.g. mirror neurons) #sgshealth ePatientDave Wed Dec 15 09:41:27 2010Break time! #sgshealth ePatientDave Wed Dec 15 09:47:29 2010Back from break. Declaration: as good as most conferences are for me this one is INFINITELY more stimulating. Whoosh. #sgshealth ePatientDave Wed Dec 15 10:19:03 2010Next up: Gerd Gigerenzer of Max Planck Inst. of Human Development Berlin. #sgshealth ePatientDave Wed Dec 15 10:20:56 2010My 2008 post on Gigerenzers excellent article on statistical illiteracy - including doctors! http://bit.ly/hdQkgD #sgshealth ePatientDave Wed Dec 15 10:21:30 2010Gerd Gigerenzer talks on risk communication and informed consent #sgshealth LaylaMcCay Wed Dec 15 10:22:44 2010RT @ePatientDave: Next up: Gerd Gigerenzer of Max Planck Inst. of Human Development Berlin. #sgshealth FIMDM Wed Dec 15 10:22:55 2010Gigerenzer on Risk Communication & Informed Consent. #sgshealth ePatientDave Wed Dec 15 10:23:13 2010New book due Feb 2011: "Launching the Century of the Patient" MIT Press http://bit.ly/hZapAY #sgshealth ePatientDave Wed Dec 15 10:23:38 2010Conditions for informed consent: 1) Transparent & complete risk communicn (benefits harms) #sgshealth ePatientDave Wed Dec 15 10:24:34 2010RT @ePatientDave: Conditions for informed consent: 1) Transparent & complete risk communicn (benefits harms) #sgshealth PracticalWisdom Wed Dec 15 10:25:15 2010Informed consent is impossible for most doctors and patients because most doctors and patients are not informed #sgshealth LaylaMcCay Wed Dec 15 10:25:31 2010Informed consent is impossible today because most docs & pts are not informed. They THINK they are (! - see post I just linked) #sgshealth ePatientDave Wed Dec 15 10:25:37 2010Gigerenzer: 5 "sins" that prevent Informed Consent 1)Biased reporting in medical journals 2)Biased reporting in health pamphlets #sgshealth FIMDM Wed Dec 15 10:26:09 20105 sins that prevent informed consent: biased reporting in med journals; biased reporting in health pamphlets; #sgshealth ePatientDave Wed Dec 15 10:26:13 2010biase reporting in media; conflicts of interest & defensive medicine; docs not understanding health statistics #sgshealth ePatientDave Wed Dec 15 10:26:43 2010RT @LaylaMcCay: Informed consent is impossible for most doctors and patients because most doctors and patients are not informed #sgshealth kgapo Wed Dec 15 10:26:56 20103)Biased reporting in the media 4)Conflicts of interest & defensive medicine 5)Doctors lack of understanding health statistics #sgshealth FIMDM Wed Dec 15 10:27:03 2010misiniformed pts research in 9 EU countries on wht does public know abt benfitsof mammography/psa screening #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 10:29:02 2010RT @ePatientDave: New book due Feb 2011: "Launching the Century of the Patient" MIT Press http://bit.ly/hZapAY #sgshealth FIMDM Wed Dec 15 10:29:07 2010Gerd Gigerenzer - risk comm guru - includes biased news reptg. as 1 of 5 sins preventing informed consent. #sgshealth garyschwitzer Wed Dec 15 10:30:01 2010Why not informed:Biased reporting in med journalspamphletsmedia;COI;defensive medicinelack of dr understanding of stats #sgshealth LaylaMcCay Wed Dec 15 10:30:25 2010fact box summarizes risks & benefits. In US reform law (good); NOT in law: who writes them where published? #sgshealth ePatientDave Wed Dec 15 10:30:31 2010RT @ePatientDave: New book due Feb 2011: "Launching the Century of the Patient" MIT Press http://bit.ly/hZapAY #sgshealth kgapo Wed Dec 15 10:30:35 2010Gigerenzer with sample fact box: mammography #sgshealth http://yfrog.com/h0cl2ryj ePatientDave Wed Dec 15 10:36:01 2010PSA (prostate screening) fact box shows ZERO lives saved from screening except in 1 study; most media reports cite that 1! #sgshealth ePatientDave Wed Dec 15 10:39:33 2010Both mammography & prostate screening benefits VASTLY overestimated by public. VASTLY. (This is IMPORTANT to know.) #sgshealth ePatientDave Wed Dec 15 10:41:01 2010Actual data says screening saves 0-1 life per thousand who get screened; public perception is off 100x! #sgshealth ePatientDave Wed Dec 15 10:42:18 2010GErmans French Dutch rely on health publications 4 info German also heavily on internet #sgsHealth #opnHealth #‚Ķ http://twishort.com/ab5ug kgapo Wed Dec 15 10:44:36 2010@andrewspong yes my colleague @glynelwyn was leading discussion! #sgshealth amcunningham Wed Dec 15 10:47:13 2010#sgshealth Gigerenzer 5 sins = bias in journals pamphlets media conflicts of interest defensive med and prof. statistical illiteracy glynelwyn Wed Dec 15 10:48:32 2010Re biased reporting in journals: "trick #1" Mismatched Framing - #sgshealth ePatientDave Wed Dec 15 10:49:21 2010RT @garyschwitzer: Captivating Salzburg talk by @glynelwyn of Cardiff on undiagnosed uninformed patient preferences. #sgshealth amcunningham Wed Dec 15 10:49:35 2010Gigerenzer: shared medical decisions can be shared ignorance if both MD & patient are uninformed on risk/benefit data. #sgshealth garyschwitzer Wed Dec 15 10:49:55 2010Report benefits in relative risks (BIG eg "reduces cancer 40%") harms in absolute numbers ("1 in 1000") #sgshealth ePatientDave Wed Dec 15 10:50:08 20101 in 1000 gives you no ability to compare to "40%" #sgshealth ePatientDave Wed Dec 15 10:50:32 2010@amcunningham #sgshealth a stunning pres. much acclaimed! kgapo Wed Dec 15 10:50:47 2010RT @glynelwyn: #sgshealth Gigerenzer 5 sins = bias in journals pamphlets media conflicts of interest defensive med and prof. statis ... kgapo Wed Dec 15 10:50:59 2010Wow: BMJ JAMA and Lancet (!) 2004-2006 used mismatched framing in 1 of 3 articles! #sgshealth ePatientDave Wed Dec 15 10:51:21 2010BMJLancet and JAMA 2004-6: Mismatched framing (benefits reported as relative risk;harms as absolute risk) in 1 out of 3 articles #sgshealth LaylaMcCay Wed Dec 15 10:51:41 2010 Page  15
  • 16. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedRT @garyschwitzer Gigerenzer SDM cn B shared ignorance if both MD & patient R uninformed on risk/benefit data #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 10:52:13 2010#sgshealth Gigerenzer Concept mismatch framing. i.e. report benefits in relative risk 20% report harms in absolute frequency 1:1000. glynelwyn Wed Dec 15 10:52:32 2010Trick #2: In *50%* of the articles neither risks nor harms were reported with absolute numbers. #sgshealth ePatientDave Wed Dec 15 10:52:37 2010RT @ePatientDave: Wow: BMJ JAMA and Lancet (!) 2004-2006 used mismatched framing in 1 of 3 articles! #sgshealth kgapo Wed Dec 15 10:52:44 2010RT @glynelwyn: #sgshealth Gigerenzer Concept mismatch framing. i.e. report benefits in relative risk 20% report harms in absolute freq ... kgapo Wed Dec 15 10:53:03 2010(This is incredibly important people - we argue for patients to see what docs see but THAT is often screwed up!) #sgshealth ePatientDave Wed Dec 15 10:53:19 2010BMJJAMA and Lancet:no absolute risks or other transparent frequency data reported in 1 out of 2 articles #sgshealth LaylaMcCay Wed Dec 15 10:53:24 2010RT @glynelwyn: #sgshealth Gigerenzer Concept mismatch framing. i.e. report benefits in relative risk 20% report harms in absolute freq ... FIMDM Wed Dec 15 10:53:58 2010RT @LaylaMcCay: Shared decision making is in GMCs Good Medical Practice document-we need to be doing this well #sgshealth amcunningham Wed Dec 15 10:54:06 2010biased reporting tricks: mismatched framing and report neither benefits nor harms in a transparent way #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 10:54:07 2010Relative risk misleads most people; absolute risk is transparent. Press likes relative risk:sounds more impressive! #sgshealth LaylaMcCay Wed Dec 15 10:54:59 2010Gigerenzer citing birth control story from 2008 article http://bit.ly/hdQkgD #sgshealth ePatientDave Wed Dec 15 10:55:20 2010Reality: journals depend on ads & reprints - and readers. Editors are responsible for transparent/honest policies - #sgshealth ePatientDave Wed Dec 15 10:56:43 2010Gigerenzer: ask your institutions to give journals 2 years to change their policy to transparent data or cancel. #sgshealth ePatientDave Wed Dec 15 10:57:21 2010Countries who cant afford it have no access to the Cochrane Library:a problem #sgshealth LaylaMcCay Wed Dec 15 10:59:13 2010Med journal trick #3: emphasize benefits dont report harms; trick #4: report 5 yr survival rates not mortality. #sgshealth ePatientDave Wed Dec 15 11:00:03 2010#sgshealth Gigerenzer Bias tricks. Mismatch framing. Untransparent data on pros/cons. benefits > harm. Report 5y survival not mortality. glynelwyn Wed Dec 15 11:00:07 2010Gigerenzer: journals allow mismatched framing - benefits in relative terms (sounds big) harms in absolute terms (sounds small) #sgshealth garyschwitzer Wed Dec 15 11:00:34 2010e.g. Website says "Study shows 90% of BCs detected early survive 5 yrs" - compared to what?? Irresponsible reporting. #sgshealth ePatientDave Wed Dec 15 11:01:12 2010Gigerenzer: reporting absolute risk/benefit data is a moral issue for journalism. #sgshealth garyschwitzer Wed Dec 15 11:01:51 2010RT @garyschwitzer: Gigerenzer: reporting absolute risk/benefit data is a moral issue for journalism #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 11:02:31 2010The majority of people overestimate the magnitude of benefits of interventions and underestimate harms #sgshealth LaylaMcCay Wed Dec 15 11:03:31 2010RT @garyschwitzer: Gigerenzer: reporting absolute risk/benefit data is a moral issue for journalism. #sgshealth LaylaMcCay Wed Dec 15 11:04:16 2010tendency of patients & population 2 ignore AE/harms & anchor on/stress benefits even if not evidence based #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 11:06:58 2010RT @ePatientDave: Trick #2: In *50%* of the articles neither risks nor harms were reported with absolute numbers. #sgshealth CureT1Diabetes Wed Dec 15 11:09:26 2010Deutsche Krebshilfe improved its brochure on mammography after repeated criticism from Gigerenzer on how information is presented #sgshealth mollytoba Wed Dec 15 11:09:37 2010Next problem: Conflicts of interest & defensive medicine #sgshealth ePatientDave Wed Dec 15 11:10:02 2010Studies: 93% of 824 US docs in high risk fields report practicing defensive medicine (duh) #sgshealth ePatientDave Wed Dec 15 11:10:30 2010Switzerland: rate of hysterectomy 16% but only 10% among female docs & docs wives. (!!) #sgshealth ePatientDave Wed Dec 15 11:11:05 201041% & 43% of Swiss GPs & internists report practicing defensive medicine. #sgshealth ePatientDave Wed Dec 15 11:11:51 2010Gigerenzer: Studdert 2005 93% of US doctors with high risk of litigation report practicing "defensive" medicine. #sgshealth FIMDM Wed Dec 15 11:12:06 201093% of 824 US doctors reported practicing defensive medicine thus overinvestigation and overtreatment;41-ish % Swiss #sgshealth LaylaMcCay Wed Dec 15 11:12:21 2010conflicts of interest and defensive medicine #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 11:13:07 2010Politics is another conflict of interest. e.g. Rudi Giulianis campaign stmt about prostate. (in http://bit.ly/hdQkgD) #sgshealth ePatientDave Wed Dec 15 11:13:20 2010Again: *5 year survival* tells you NOTHING about ultimate # of deaths. This politician compared them; incompetent or crooked. #sgshealth ePatientDave Wed Dec 15 11:14:34 2010RT @LaylaMcCay 93% of 824 US docs rported practicing dfensive med=ovrinvestigation+ovrtreatment 41-ish % Swiss #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 11:15:22 2010And regardless of "incompetent or crooked" off-base public perception results so "empowered pts" would choose wrong #sgshealth ePatientDave Wed Dec 15 11:15:32 2010@ePatientDave well yes ultimately everyone will die.... #sgshealth amcunningham Wed Dec 15 11:16:04 2010@amcunningham Ill post photos at lunch of Gigerenzers slides. Brilliant & accurate. #sgshealth ePatientDave Wed Dec 15 11:17:27 2010Screening falsely inflates 5 year survival - very misleading #sgshealth LaylaMcCay Wed Dec 15 11:17:34 2010RT @LaylaMcCay: Screening falsely inflates 5 year survival - very misleading #sgshealth kgapo Wed Dec 15 11:17:48 2010Now showing an MD Anderson ad that does EXACTLY the same: touts greater 5 year survival vs no change in actual mortality #sgshealth ePatientDave Wed Dec 15 11:19:38 2010confusion abt progress against cancer unwarrantd entusiasm for med center #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 11:21:05 2010#sgshealth Reporting 5 y survival rates in screening is totally misleading in screening programmes because of lead time bias. glynelwyn Wed Dec 15 11:21:20 2010Wow MD Anderson under scrutiny for misleading info to patients on prostate! #sgsHealth #opnHealth #hcsmeu kgapo Wed Dec 15 11:21:20 2010Next big cause: Physicians statistical illiteracy (NOT taught in med schools) #sgshealth ePatientDave Wed Dec 15 11:22:22 2010RT @glynelwyn #sgshealth Reporting 5y survival rates in screening=totally misleading in screening programmes beca‚Ķ http://twishort.com/ab5ul kgapo Wed Dec 15 11:22:44 2010RT @glynelwyn #sgshealth Reporting 5y survival rates in screening=totally misleading in screening programmes beca‚Ķ http://twishort.com/ab5um kgapo Wed Dec 15 11:22:46 201065 German docs: When same info was presented as survival 79% said screenings effective; as mortality rates 5% did. #sgshealth ePatientDave Wed Dec 15 11:23:09 2010Zero of the 65 knew that this misinterpretation could lead to overdiagnosis. #sgshealth ePatientDave Wed Dec 15 11:23:44 2010Next issue: do physicians understand relative risk reduction? 150 German GYN in a training session #sgshealth ePatientDave Wed Dec 15 11:24:28 2010Asked the GYNs "screening reduces BC mortality 25%. If 1000 participate how many are saved?" 1/3 were off by 25x or more. #sgshealth ePatientDave Wed Dec 15 11:25:28 2010Drs interpret screening test efficacy from stats.Survival rates 79% said effective;mortality rates5% judged it as effective! #sgshealth LaylaMcCay Wed Dec 15 11:26:47 2010What can we do about physician statistical illiteracy? CME (continuing med education) #sgshealth ePatientDave Wed Dec 15 11:27:06 2010do doctors 5yr undrstand rlative risk rductions? wht cn we do abt docs risk illiteracy? continue med edu #sgshealth #opnHealth #hcsmeu kgapo Wed Dec 15 11:27:18 2010Over 90% of men and women in the EU overestimate the benefit of cancer screening. #sgshealth LaylaMcCay Wed Dec 15 11:30:24 2010RT @amcunningham: @andrewspong yes my colleague @glynelwyn was leading discussion! #sgshealth <-- Saw that just after I sent the tweet :D andrewspong Wed Dec 15 11:30:30 2010Conclusion: Informed consent is not possible(!) if docs & pts are MISinformed! #sgshealth <=so important to understand. ePatientDave Wed Dec 15 11:30:30 2010informed consent is not posible if physicians and patients are misinformed #sgshealth #opnHealth #hcsmeu kgapo Wed Dec 15 11:30:31 2010Some proven solutions: fact boxes public threat to reputation CME in risk literacy #sgshealth LaylaMcCay Wed Dec 15 11:31:32 2010Gigerenzer finishes. SO important. SO essential. We talk about evidence based medicine; we must ALL understand evidence. #sgshealth ePatientDave Wed Dec 15 11:31:36 2010Gigerenzer: Solutions that hes seen work: Fact Boxes; public threat to reputation(!) CME. #sgshealth ePatientDave Wed Dec 15 11:32:20 2010RT @garyschwitzer: Gigerenzer: reporting absolute risk/benefit data is a moral issue for journalism. #sgshealth archellegeorgio Wed Dec 15 11:32:24 2010Gigerenzer: CME in risk literacy as a way to improve informed consent process. #sgshealth FIMDM Wed Dec 15 11:32:39 2010 Page  16
  • 17. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedRT @LaylaMcCay: Some proven solutions: fact boxes public threat to reputation CME in risk literacy #sgshealth #opnHealth #hcsmeu kgapo Wed Dec 15 11:33:04 2010Lunch coming up. Guess what people: #sgshealth has the afternoon OFF to visit Salzburg (or some of us work...) ePatientDave Wed Dec 15 11:33:09 2010RT @LaylaMcCay: Over 90% of men and women in the EU overestimate the benefit of cancer screening. #sgshealth amcunningham Wed Dec 15 11:33:25 2010The desire to increase screening rates introduces systematic bias: COI #sgshealth LaylaMcCay Wed Dec 15 11:33:42 2010Get this: tomorrow at lunch were going to do a Twitter training - lots of ppl here interested! #sgshealth ePatientDave Wed Dec 15 11:33:58 2010RT @LaylaMcCay: The desire to increase screening rates introduces systematic bias: COI #sgshealth ePatientDave Wed Dec 15 11:34:08 2010Gigerenzer & Gray book March 2011 MIT Press: Better Doctors Better Pts Better Decisions. #sgshealth ePatientDave Wed Dec 15 11:35:17 2010@richardblogger well I hope as a gp that my patients would say the same... But seems not all patients think the same. Following #sgshealth? amcunningham Wed Dec 15 11:35:39 2010@whydotpharma Silja youve got a competitor in speedtweeting: @LaylaMcKay cant match her speed!! #sgshealth kgapo Wed Dec 15 11:35:53 2010RT @FIMDM: Gigerenzer: CME in risk literacy as a way to improve informed consent process #sgshealth #opnHealth #hcsmeu kgapo Wed Dec 15 11:36:31 2010RT @ePatientDave: Get this: tomorrow at lunch were going to do a Twitter training - lots of ppl here interested! #sgshealth amcunningham Wed Dec 15 11:36:32 2010@ePatientDave @amcunningham Call it "social utility education" and Im sold. :p #sgshealth markhawker Wed Dec 15 11:37:11 2010RT @LaylaMcCay: The desire to increase screening rates introduces systematic bias: COI #sgshealth kgapo Wed Dec 15 11:37:15 2010RT @ePatientDave: Gigerenzer & Gray book March 2011 MIT Press: Better Doctors Better Pts Better Decisions. #sgshealth amcunningham Wed Dec 15 11:37:33 2010@markhawker Er I dont understand that expression sir! Whats it mean? #sgshealth ePatientDave Wed Dec 15 11:37:39 2010@ePatientDave #sgshealth can join you as co-trainer! kgapo Wed Dec 15 11:37:50 2010How can we collect the #sgshealth tweets and turn them into an ebook? (rather than just PDF). Some great convo insight stats here andrewspong Wed Dec 15 11:39:03 2010@ePatientDave Sorry education pedant. If you train them then what happens when it goes? Never mind. Have fun! #sgshealth markhawker Wed Dec 15 11:39:27 2010@andrewspong Its in the WTHashtag feed dude. #sgshealth View Transcript. ePatientDave Wed Dec 15 11:39:30 2010If youre over 55 otherwise healthy and not taking aspirin read this and then talk to your doctor (pdf) http://j.mp/h4GziA #sgshealth amcunningham Wed Dec 15 11:39:33 2010@markhawker Oh that! I completely agree. Have been agitating the same during breaks here: "What will we DO with this?" #sgshealth ePatientDave Wed Dec 15 11:40:02 2010@andrewspong #sgshealth I thin we should collect the blog posts that will be written and make a story kgapo Wed Dec 15 11:40:18 2010@markhawker For your point important to recall context - Wennbergs analysis of "effective" vs "pref-sensit" vs "supply sens" #sgshealth ePatientDave Wed Dec 15 11:41:21 2010Gigerenzer highlights the conflict between public health and individual decision making. #sgshealth mollytoba Wed Dec 15 11:42:04 2010Fascinating to see how twitter is opening up a major health conference. Many thanks to @epatientdave @laylamccay @egapo #sgshealth amcunningham Wed Dec 15 11:43:33 2010RT @raovac: stats IS taught in med school but critical thinking & logic & explicit goal setting w patient not so much #sgshealth ePatientDave Wed Dec 15 11:43:34 2010@raovac Thanks - gigerenzer refined it finally to *risk communication*. Does that fit yr thoughts better? #sgshealth ePatientDave Wed Dec 15 11:44:00 2010RT @amcunningham: Fascinating to see how twitter is opening up a major health conference. Thx @epatientdave @laylamccay @kgapo #sgshealth ePatientDave Wed Dec 15 11:44:21 2010@amcunningham So per Mark Hawkers social utility question: what can we do with this to change anything? #sgshealth ePatientDave Wed Dec 15 11:44:42 2010@ePatientDave I think thats right. Im at home. Where are you and gigerenzer and #sgshealth??? raovac Wed Dec 15 11:45:43 2010RT @andrewspong: How can we collect the #sgshealth tweets and turn them into an ebook? (rather than just PDF). Some great convo insight ... marta_cisa Wed Dec 15 11:46:06 2010@raovac #sgshealth Tweetstream and event info links: http://wthashtag.com/Sgshealth (On lunch now; done for the day) ePatientDave Wed Dec 15 11:46:58 2010@ePatientDave I think your presence and dissemination is quite a big start. I hope the #sgshealth videos are embeddable when they appear. amcunningham Wed Dec 15 11:48:34 2010Note: at 5:30 CET (5 hours from now) were having informal "fireside chats" by various Fellows. Dont know if well tweet. #sgshealth ePatientDave Wed Dec 15 11:48:36 2010@ePatientDave what would you like to see come out of this? #sgshealth amcunningham Wed Dec 15 11:50:20 2010Again all #SGShealth is Salzburg Global Seminar on informed decision making. My post: http://bit.ly/gTwnUE. Tweets: http://bit.ly/eY2Vsp ePatientDave Wed Dec 15 11:50:36 2010@amcunningham @TessaJLRichards of BMJ just asked the same. Me I want better decisions better care - but whats step 1? #sgshealth ePatientDave Wed Dec 15 11:51:57 2010@ePatientDave so no audio??? What a pity:( #sgshealth amcunningham Wed Dec 15 11:51:57 2010RT @mollytoba: Gigerenzer highlights the conflict between public health and individual decision making. #sgshealth #opnhealth kgapo Wed Dec 15 11:52:00 2010Next Salzburg Seminar on health is in fall http://bit.ly/hIju8D. But its not by @FIMDM which is where my soul is right now. #sgshealth ePatientDave Wed Dec 15 11:53:56 2010@amcunningham what was the name of the conference #sgshealth HelenPullen Wed Dec 15 12:15:50 2010RT @ePatientDave: Report benefits in relative risks (BIG eg "reduces cancer 40%") harms in absolute numbers ("1 in 1000") #sgshealth westr Wed Dec 15 12:28:02 2010@ePatientDave Can you provide a Summary blog? #sgshealth westr Wed Dec 15 12:30:51 2010RT @glynelwyn: #sgshealth Gigerenzer Concept mismatch framing. i.e. report benefits in relative risk 20% report harms in absolute freq ... westr Wed Dec 15 12:32:15 2010Blind leading the blind! RT @ePatientDave: (We argue for patients to see what docs see but THAT is often screwed up!) #sgshealth #pm101 westr Wed Dec 15 12:33:49 2010@CochraneLibrary How does Cochrane establish who gets free access? GDP? Was surprised to hear at #sgshealth that Germany have no access. LaylaMcCay Wed Dec 15 12:35:40 2010@dr_fiona Very sorry to have missed it. Summary? The Salzburg Global Seminar is also proving to be very inspiring #sgshealth LaylaMcCay Wed Dec 15 12:54:20 2010RT @ePatientDave: New book due Feb 2011: "Launching the Century of the Patient" MIT Press http://bit.ly/hZapAY #sgshealth zenofbass Wed Dec 15 13:01:53 2010RT @garyschwitzer: Gerd Gigerenzer - risk comm guru - includes biased news reptg. as 1 of 5 sins preventing informed consent. #sgshealth jonbrodyharris Wed Dec 15 13:20:41 2010#transparency #COI RT @garyschwitzer: Gigerenzer: reporting absolute risk/benefit data is a moral issue for medical journalism. #sgshealth drtonyah Wed Dec 15 13:26:05 2010Important yes but moral? RT @garyschwitzer: Gigerenzer: reporting absolute risk/benefit data is a moral issue for journalism. #sgshealth scotthensley Wed Dec 15 13:27:08 2010RT @ePatientDave: Conclusion: Informed consent is not possible(!) if docs & pts are MISinformed! #sgshealth <=so important to understand. drtonyah Wed Dec 15 13:28:52 2010RT @andrewspong: RT @ePatientDave: New book due Feb 2011: "Launching the Century of the Patient" MIT Press http://bit.ly/hZapAY #sgshealth MatthewBrowning Wed Dec 15 13:55:59 2010RT @amcunningham: If youre over 55 healthy @ not taking aspirin read this and then talk to your doctor (pdf) http://j.mp/h4GziA #sgshealth MatthewBrowning Wed Dec 15 13:57:51 2010RT @garyschwitzer: Gerd Gigerenzer - risk comm guru - includes biased news reptg. as 1 of 5 sins preventing informed consent. #sgshealth kgapo Wed Dec 15 14:21:55 2010@scotthensley #sgshealth majority of class wll agree that reporting absolute risk/benefit data is a moral issue 4 journalism-wll ask tonite kgapo Wed Dec 15 14:26:51 2010@kgapo @scotthensley I understand but moral=subjective. More important to me: reporting a wrong conclusion is simply a failure. #sgshealth ePatientDave Wed Dec 15 14:45:13 2010@kgapo @scotthensley My view: why bother reporting if what u report gives people wrong info? #sgshealth ePatientDave Wed Dec 15 14:46:15 2010Ph.D. Fawler: The Data R Clear Most Patients wnt 2 B Involvd in Their Medcl Decisions http://bit.ly/hMpVL0 #sgshealth #opnHealth #hcsmeu kgapo Wed Dec 15 15:07:36 20106Th Intl Shard Dcision Makng conf Bridgng gap btwn Rsearch+practice: pt pull or clinician push?19-22/6/2011 http://bit.ly/g95GPm #sgsHealth kgapo Wed Dec 15 15:51:50 2010abbreviations used: SDM shared decision making hosp hospitals pt patient docs doctors EBM evidence based medicine #sgsHealth #opnHealth kgapo Wed Dec 15 15:53:17 2010@scotthensley too deep for tweets dude. :) Aux bloggage! #sgshealth ePatientDave Wed Dec 15 15:53:49 2010@scotthensley Example: "triple the risk" is true but IMO unimportant if its 1 in a billion -> 3 in a billion #sgshealth ePatientDave Wed Dec 15 16:13:08 2010Correct reporting of EBP studies VERY important but w/o taking the human-ness of the patient when used numbers r just numbers.#SGSHEALTH NursePaguio Wed Dec 15 16:14:21 2010 Page  17
  • 18. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedRT @kgapo: Ph.D. Fawler: The Data R Clear Most Patients wnt 2 B Involvd in Their Medcl Decisions http://bit.ly/hMpVL0 #sgshealth #opnHea ... ehealthgr Wed Dec 15 16:41:53 2010Shared decision making is not something magical; its just a normal human conversation #sgshealth LaylaMcCay Wed Dec 15 16:53:02 2010Healthcare is not the valued commodity; what people value is health #sgshealth LaylaMcCay Wed Dec 15 16:57:21 2010Should we proactively encourage people to bring a friend/relative to aid info recall? #sgshealth LaylaMcCay Wed Dec 15 17:16:11 2010In a health crisis patients are pressed to make rapid decisions with state of mind not conducive to logical deliberation #sgshealth LaylaMcCay Wed Dec 15 17:20:28 2010Getting to shared decision making means the authoritative culture of medicine is changed #sgshealth LaylaMcCay Wed Dec 15 17:23:20 2010Getting to shared decision making means changing the authoritative culture of medicine #sgshealth LaylaMcCay Wed Dec 15 17:24:43 2010Outstanding article! ‚Äú@ePatientDave: Gigerenzer citing birth control story from 2008 article http://bit.ly/hdQkgD #sgshealth‚Äù ieslick Wed Dec 15 17:24:53 2010Urgency of action may be fabricated by physicians who dont want to engage in shared decision-making. #sgshealth garyschwitzer Wed Dec 15 17:25:30 2010RT @garyschwitzer: Urgency of action may be fabricated by physicians who dont want to engage in shared decision-making. #sgshealth showjumper42 Wed Dec 15 17:26:51 2010major barrier to seeking help for mental illness in Uganda: lack of knowledge of what mental illness is and how it manifests #sgshealth LaylaMcCay Wed Dec 15 17:37:53 2010Suggested mental illness cures in Uganda:bite flesh of live goatbring a dead persons tooth... SDM in action:goat or tooth?Hmmm #sgshealth LaylaMcCay Wed Dec 15 17:41:54 2010RT @LaylaMcCay: Healthcare is not the valued commodity; what people value is health #sgshealth jrcatarina Wed Dec 15 18:28:37 2010‚Äú@LaylaMcCay: Some proven solutions: CME in risk literacy #sgshealth‚Äù CME in risk literacy <<YESSSS wrexhamrob Wed Dec 15 19:44:04 2010@garyschwitzer #sgshealth in critical conditions like cancer its doctors who put urgency burden on patients #opnHealth kgapo Wed Dec 15 20:04:04 2010RT @garyschwitzer: Urgency of action may be fabricated by physicians who dont want to engage in shared decision-making. #sgshealth kgapo Wed Dec 15 20:04:14 2010RT @ePatientDave: New book due Feb 2011: "Launching the Century of the Patient" MIT Press http://bit.ly/hZapAY #sgshealth ehealthgr Wed Dec 15 21:04:12 2010RT @kgapo: abbreviations used: SDM shared decision making hosp hospitals pt patient docs doctors EBM evidence based medicine #sgsHealth ... ehealthgr Wed Dec 15 21:13:00 2010@wissit @andrewspong @LaylaMcCay @ePatientDave #sgshealth Tx for RTs! kgapo Thu Dec 16 07:32:00 2010Day 5 at Salzburg - time for some shared decision making practical examples! #sgshealth LaylaMcCay Thu Dec 16 08:09:18 2010E-patients:equippedengagedempowered and enabled www.epatients.net #sgshealth LaylaMcCay Thu Dec 16 08:14:05 2010Internet Age: more people can create value (in form of information) #sgshealth LaylaMcCay Thu Dec 16 08:16:42 2010Lethal lag time: 2-5 years - time between successful completion of research and journal paper published and read #sgshealth LaylaMcCay Thu Dec 16 08:21:41 2010People talk of the dangers of people getting health info from internet.No clear cases of death by Google;many iatrogenic deaths #sgshealth LaylaMcCay Thu Dec 16 08:23:30 2010RT @LaylaMcCay: Lethal lag time: 2-5 years - time between successful completion of research and journal paper published and read #sgshealth tobite Thu Dec 16 08:23:54 2010RT @LaylaMcCay: Lethal lag time: 2-5 years - time between successful completion of research and journal paper published and read #sgshealth kgapo Thu Dec 16 08:24:09 2010Participatory Medicine www.participatorymedicine.org www.jopm.org #sgshealth LaylaMcCay Thu Dec 16 08:26:45 2010@ePatientDave on the floor this morning explaining why patients are the most untapped resource in healthcare #sgsHealth #opnHealth #hchsmeu kgapo Thu Dec 16 08:27:11 2010@ePatientDave authorittative information may be found outside medical community #sgsHealth #opnHealth #hchsmeu kgapo Thu Dec 16 08:29:09 2010Just because somethings peer reviewed doesnt mean its right #sgshealth LaylaMcCay Thu Dec 16 08:29:16 20106th international Shared Decision Making COnference Maastricht Holland June 19-22 www.isdm2011.org #sgshealth ePatientDave Thu Dec 16 08:31:59 2010RT @ePatientDave: 6th international Shared Decision Making COnference Maastricht Holland June 19-22 www.isdm2011.org #sgshealth mollytoba Thu Dec 16 08:34:39 2010RT @ePatientDave: 6th international Shared Decision Making COnference Maastricht Holland June 19-22 www.isdm2011.org #sgshealth FIMDM Thu Dec 16 08:35:00 2010Mangione: "so Im not sure WHICH category I belong in :-)" Also a tool-maker (decision tools) #sgshealth ePatientDave Thu Dec 16 08:39:53 2010US adults 65+: 83% have one or more chronic conditions. #sgshealth ePatientDave Thu Dec 16 08:40:24 2010Pt activation defined as: able ot self-manage; engaging in worthy activities. #sgshealth ePatientDave Thu Dec 16 08:40:48 2010Carol Mangione now speaking on activating adults to improve chronic disease care. #sgshealth FIMDM Thu Dec 16 08:40:59 2010Has been shown to improve chronics outcomes but challenging to implement. #sgshealth ePatientDave Thu Dec 16 08:41:24 2010Patient activation:being able to self-manage symptoms and engage in decisions -> improves disease control #sgshealth LaylaMcCay Thu Dec 16 08:41:38 2010Mangione echos Doc Toms observation that especially for chronics self-care is the vast majority of care. #sgshealth ePatientDave Thu Dec 16 08:42:04 2010Cites an 83yo patient who reminds herself to eat well by putting pic of her diabetic son on her kitchen table #sgshealth ePatientDave Thu Dec 16 08:42:59 2010Study of using FIMDM tools to activate older people.n=116.5 FIMDM videos on managing chronic conditions. #sgshealth LaylaMcCay Thu Dec 16 08:45:44 2010In LA senior center zero pts attended self-viewings of FIMDM videos but many came in groups. Important to realize this. #sgshealth ePatientDave Thu Dec 16 08:46:18 20105 programs: coronary heart failure Type II diabetes low back pain advanced directives. #sgshealth ePatientDave Thu Dec 16 08:46:47 2010Hypothesis: ppl who attended 3+ screening would show higher levels of activation. One test center added $50 incentive. #sgshealth ePatientDave Thu Dec 16 08:47:29 2010Completed surveys @ baseline end of period (12 wks) 6 months later. Tested w/ Pt Activation Measure others. #sgshealth ePatientDave Thu Dec 16 08:48:13 2010Patient Activation Measure: http://www.insigniahealth.com/products/pam.html #sgshealth ePatientDave Thu Dec 16 08:48:50 2010Carol Mangione: "activated" v. "empowered" patients -explains Patient Acitvation Measure -PAM 13 item measure #sgsHealth #opnHealth #hchsmeu kgapo Thu Dec 16 08:49:30 2010Women came to more screenings. PAM scores & meds didnt predict how many viewings. #sgshealth ePatientDave Thu Dec 16 08:51:43 2010RT @LaylaMcCay Pt activation being able 2 slf-manage symptoms & engage in decisions=mproves disease control #sgshealth #opnHealth #hcsmeu kgapo Thu Dec 16 08:51:47 2010PAM scores significantly higher (p=.035) among 3+ viewings. Walking & exercise too (less so 6 months out) #sgshealth ePatientDave Thu Dec 16 08:52:55 2010RT @ePatientDave: Patient Activation Measure: http://www.insigniahealth.com/products/pam.html #sgshealth mollytoba Thu Dec 16 08:53:17 2010Older people who attended 3 or more FIMDM sctreenings were doing more exercise and higher QoL scores;effect sustained at 6months #sgshealth LaylaMcCay Thu Dec 16 08:53:19 2010FIMDM tools to activate older people for managing chronic conditions #sgshealth #opnHealth #hcsmeu kgapo Thu Dec 16 08:54:49 2010Beyond the PAM and other measures also got anecdotal self-statements. Lots of reported behavior changes. #sgshealth ePatientDave Thu Dec 16 08:56:09 2010Conclusion: DVDs are extremely inexpensive way to achieve pt engagement in these seniors. #sgshealth ePatientDave Thu Dec 16 08:56:58 2010Im just thrilled to hear this good work happening. Sponsored by FIMDM Palo Alto Medical Foundation UCLA Dept of Med #sgshealth ePatientDave Thu Dec 16 08:58:48 2010RT @ePatientDave: Patient Activation Measure: http://bit.ly/h8rczK #sgshealth #hcsmeu #opnHealth PAM used w +65yr olds with chronic cond kgapo Thu Dec 16 08:58:52 2010BUT: second study shows its not easy to activate highest risk populations. #sgshealth ePatientDave Thu Dec 16 08:59:55 2010@ePatientDave but is known exactly how risk populations could be activated? #sgshealth hout Thu Dec 16 09:03:07 2010@marrelaki C. Mangione improving diabetes care self-management thru behaviouralsupport interventions #sgsHealth #opnHealth #hcsmeu kgapo Thu Dec 16 09:03:58 2010@hout We havent gotten that far yet #sgshealth ePatientDave Thu Dec 16 09:05:56 2010Mangione reporting on intervention at Venice (Calif) Family Clinic - 70% poor etc. #sgshealth ePatientDave Thu Dec 16 09:07:03 2010@ePatientDave I was afraid so ;-) Is research being initiated then at the least? #sgshealth hout Thu Dec 16 09:08:21 2010 Page  18
  • 19. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username Created@marrelaki nclusion/xclusion critria 4 including ppl in diabetes selfcare improvment prgrm 4 highrisk ppl #sgshealth #opnHealth #hcsmeu kgapo Thu Dec 16 09:08:49 2010@hout Yessir thats the work shes reporting on. #sgshealth ePatientDave Thu Dec 16 09:09:00 2010Mangione details & quotes from participants about life suggest to me that pt activation is hard @ bottom of Maslows heirarchy #sgshealth ePatientDave Thu Dec 16 09:11:39 2010@marrelaki tel coaching intrvention improved slightly the self-management of underserved diabetes pts #sgshealth #opnHealth #hcsmeu kgapo Thu Dec 16 09:13:41 2010#sgshealth Mangione and Froschs work on activating seniors - group work is important http://www.ncbi.nlm.nih.gov/pubmed/20662953 glynelwyn Thu Dec 16 09:15:31 2010Activating patients seems to need them to be quite high in Maslows hierarchy of needs. Is managing your health well a luxury? #sgshealth LaylaMcCay Thu Dec 16 09:15:43 2010activation difficult when patients face survival problems eg jobless uninsured w/t shelter ppl #sgshealth #hcsmeu #opnHealth kgapo Thu Dec 16 09:15:53 2010RT @glynelwyn: #sgshealth Mangione and Froschs work on activating seniors - group work is important http://www.ncbi.nlm.nih.gov/pubmed/ ... kgapo Thu Dec 16 09:16:13 2010(Note: in the LA study the $50 incentive made almost no difference in outcomes.) #sgshealth ePatientDave Thu Dec 16 09:16:30 2010@LaylaMcCay Why "quite high" on Maslow? The Latinos quote was just about getting by from day to day yes? #sgshealth ePatientDave Thu Dec 16 09:18:40 2010RT @glynelwyn: #sgshealth Mangione and Froschs work on activating seniors - group work is important http://www.ncbi.nlm.nih.gov/pubmed/ ... FIMDM Thu Dec 16 09:19:54 2010RT @ePatientDave: Q&A from @KGApo leads to discussion that health is social. #sgshealth <-- @healthissocial :) andrewspong Thu Dec 16 09:22:55 2010Mangione: really important - socialization and group learning critical in creating behavior change #sgshealth mollytoba Thu Dec 16 09:23:41 2010??? What the heck is going on outside the window @ #sgshealth?? ePatientDave Thu Dec 16 09:24:21 2010........omg the sun came out.:) #sgshealth ePatientDave Thu Dec 16 09:24:28 2010YES HEALTH IS SOCIAL! RT @andrewspong @ePatientDave Q&A fm @KGApo leads 2 dscussion hlth is socl #sgshealth<-- @healthissocial :) #opnhealth kgapo Thu Dec 16 09:26:04 2010@ePatientDave #sgshealth beautiful I can see the mountains outside! will have coffee in the veranda kgapo Thu Dec 16 09:26:52 2010@ePatientDave 5 levels need to achieve survival needs safety needs and psychological needs Id guess to engage well? #sgshealth LaylaMcCay Thu Dec 16 09:36:13 2010@LaylaMcCay Right getting through day to day trumps having a *better* life. I experienced this while nearly dying. #sgshealth ePatientDave Thu Dec 16 09:37:02 2010RT @mollytoba: Mangione: really important - socialization and group learning critical in creating behavior change #sgshealth #opnHealth kgapo Thu Dec 16 09:37:21 2010RT @kgapo: @ePatientDave on the floor this morning explaining why patients are the most untapped resource in healthcare #sgsHealth #opnH ... Scottishpolicy Thu Dec 16 09:38:53 2010Mangione: often a poorer patients "action plan" will be "get a different doctor" #sgshealth (did I hear that right?) ePatientDave Thu Dec 16 09:39:19 2010RT @glynelwyn: #sgshealth Mangione and Froschs work on activating seniors - group work is important http://www.ncbi.nlm.nih.gov/pubmed/ ... garyschwitzer Thu Dec 16 09:39:27 2010RT @mollytoba: Mangione: really important - socialization and group learning critical in creating behavior change #sgshealth LaylaMcCay Thu Dec 16 09:40:01 2010RT @glynelwyn: #sgshealth Mangione-Frosch work on activating seniors - group work is important http://bit.ly/dYMj33 garyschwitzer Thu Dec 16 09:42:21 2010http://j.mp/gCPe1X ‚ôª @ePatientDave US adults 65+: 83% have one or more chronic conditions. #sgshealth healthgist Thu Dec 16 09:42:21 2010According to @epatientdave poor people have higher uptake of electronic patient records online?due to less healthcare stability? #sgshealth LaylaMcCay Thu Dec 16 09:49:50 2010@LaylaMcCay Heres the @John_Chilmark post on the Baltimore diabetes/PHR project http://bit.ly/cqMd45 #sgshealth ePatientDave Thu Dec 16 09:50:37 2010RT @ePatientDave: @LaylaMcCay Heres the @John_Chilmark post on the Baltimore diabetes/PHR project http://bit.ly/cqMd45 #sgshealth LaylaMcCay Thu Dec 16 09:51:31 2010@marrelaki RT@ePatientDave @LaylaMcCay Heres the @John_Chilmark post on the Baltimore diabetes/PHR project http://bit.ly/cqMd45 #sgshealth kgapo Thu Dec 16 09:51:34 2010Shared decision making and activating patients: we need more high quality research to prove it makes a difference #sgshealth LaylaMcCay Thu Dec 16 09:54:27 2010Role of group work not just in chronic conditions but preference-sensitive conditions needs more research #sgshealth mollytoba Thu Dec 16 09:58:10 2010RT @LaylaMcCay Shard dcision making & activatng pts: need more high qlty rsearch 2 prove it makes a dfference #sgshealth #hcsmeu #opnHeaalth kgapo Thu Dec 16 09:59:29 2010RT @mollytoba: Mangione: really important - socialization and group learning critical in creating behavior change #sgshealth tobyhillman Thu Dec 16 10:11:40 2010Sunny day;shame free afternoon was yesterday with hike over hill to Salzburg in the snow (less good getting lost on way back!) #sgshealth LaylaMcCay Thu Dec 16 10:28:19 2010Clay will talk about what Wennberg calls "preference sensitive care" - evidence supports >1 reasonable treatment option #sgshealth ePatientDave Thu Dec 16 10:37:20 2010In preference sensitive care choice of treatment should be based on patients priority: pain relief? side effects? etc #sgshealth ePatientDave Thu Dec 16 10:37:55 2010(Note: this continues our move from concept to "making it happen") #sgshealth ePatientDave Thu Dec 16 10:38:40 2010How to implement shared decision making. About to hear about the Dartmouth experience from director #sgshealth LaylaMcCay Thu Dec 16 10:38:56 2010Kate Clay RN informing & involving patients in decision abt their medical care Making it happen #sgshealth #opnhealth #hcsmeu kgapo Thu Dec 16 10:39:37 2010RT @ePatientDave: US adults 65+: 83% have one or more chronic conditions. #sgshealth pharmaphorum Thu Dec 16 10:39:46 2010Kate Clay is director for Center for Shared Decision Making @ Dartmouth-Hitchcock http://bit.ly/eBVwHh #sgshealth ePatientDave Thu Dec 16 10:40:10 2010Great Tweetstream from @ePatientDave at #sgshealth today pharmaphorum Thu Dec 16 10:41:13 2010Case study on use of online patient portal in diabetes management among urban poor in US. Via @epatientdave http://bit.ly/cqMd45 #sgshealth QiCProgramme Thu Dec 16 10:42:05 2010If you build it they will come doesnt seem to apply to shared decision making: proactive outreach needed #sgshealth LaylaMcCay Thu Dec 16 10:42:51 2010@LaylaMcCay #sgshealth very true! the Cancer Patient Rights Advocacy Program had similar fate #opnhealth kgapo Thu Dec 16 10:47:51 2010Important to instill belief in Doctors and medical students that decisions ARE preference-sensitive #sgshealth LaylaMcCay Thu Dec 16 10:48:49 2010Interesting example of whether something is preference-sensitive: breast feeding. ... #sgshealth ePatientDave Thu Dec 16 10:48:53 2010Clay: "How do you tell woman she MUST do that with her body if she doesnt want?" (My thought: do we empower the pt or not?) #sgshealth ePatientDave Thu Dec 16 10:50:12 2010Dartmouth CSDM (Center for Shared Decision Making) emails "decision aid" to patient for at-home review #sgshealth ePatientDave Thu Dec 16 10:51:39 2010RT @raovac: @ePatientDave great link to Dartmouth site. .... #sgshealth ePatientDave Thu Dec 16 10:52:51 2010Huh? Got a simple link? RT @raovac: ...My new mission: apply Cognitive Engineering and Situation Awareness theory in medicine #sgshealth ePatientDave Thu Dec 16 10:53:18 2010Dartmouth:if youre diagnosedyoure mailed a decision aid before appointment-you arrive at clinic already understanding options #sgshealth LaylaMcCay Thu Dec 16 10:53:20 2010If not appropriate to pre-mail decision aidrefer to shared decision making service directly after appointment #sgshealth LaylaMcCay Thu Dec 16 10:54:26 2010#sgshealth Clay describes pre-visit / post-visit methods giving people access to decision support @ Dartmouth : 11 y of hard work glynelwyn Thu Dec 16 10:54:36 2010RT @glynelwyn: #sgshealth Clay describes pre-visit / post-visit methods giving people access to decision support @ Dartmouth : 11 y ... kgapo Thu Dec 16 10:55:45 2010RT @LaylaMcCay: Important to instill belief in Doctors and medical students that decisions ARE preference-sensitive #sgshealth amcunningham Thu Dec 16 10:56:48 2010Decision aids prescribed at primary care ensures only patients ready for it decide to be referred for secondary care input #sgshealth LaylaMcCay Thu Dec 16 10:57:12 2010Xcellent prgrm 4 shared dcision making prgrm 4 breast cancer newly diagnosed by Kate Clay #breastcancer #hcsmeu #opnhealth #sgshealth kgapo Thu Dec 16 10:58:21 2010yes! RT @LaylaMcCay: Important to instill belief in Doctors and medical students that decisions ARE PREFERENCE-sensitive #sgshealth kgapo Thu Dec 16 10:59:35 2010RT @ePatientDave: US adults 65+: 83% have one or more chronic conditions. #sgshealth gvanantwerp Thu Dec 16 10:59:44 2010Many ways of building shared decision making into system so its automatic and systematic #sgshealth LaylaMcCay Thu Dec 16 11:00:10 2010@LaylaMcCay #sgshealth nice guidance -women in uk should have info on menorrhagia rx options b4 OP appt but doesnt state who should do amcunningham Thu Dec 16 11:01:30 2010Good morning America - 1 hour until lunch here at #sgshealth. Tweet stream & info links: http://wthashtag.com/sgshealth ePatientDave Thu Dec 16 11:01:53 2010 Page  19
  • 20. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username Created@LaylaMcCay #sgshealth end result is that most often it doesnt happen in primary or secondary care amcunningham Thu Dec 16 11:02:10 2010Clay is describing detailed workflow in use for orthopedics at Dartmouth-Hitchcock CSDM. #sgshealth ePatientDave Thu Dec 16 11:03:20 2010Jim Weinstein director of CSDM at Dartmout: I am not a clinical champion I just want my patients to be informed. #sgshealth mollytoba Thu Dec 16 11:03:45 2010Wennberg adds: theyre keeping a registry to track long-term results both clinical & patient-reported satisfaction. #sgshealth ePatientDave Thu Dec 16 11:04:03 2010RT @mollytoba: Jim Weinstein director of CSDM at Dartmout: I am not a clinical champion I just want my patients to be informed. #sgshealth ePatientDave Thu Dec 16 11:05:09 2010WOW! Dartmouth CSDM toolkits are available free on the web! http://bit.ly/ed44Br Incl how to start a CSDM! #sgshealth ePatientDave Thu Dec 16 11:06:20 2010#sgshealth Kate Clays web page at the Shared Decision Making Centre - http://bit.ly/eBVwHh glynelwyn Thu Dec 16 11:07:16 2010Also has links to Ottawa Hospitals decision aids too http://decisionaid.ohri.ca/decaids.html. #sgshealth ePatientDave Thu Dec 16 11:07:25 2010Clay: "Were the only hosp with a decision making center w/dedicated staff. Ppl say Why dont I have this @ my hosp??" #sgshealth ePatientDave Thu Dec 16 11:08:13 2010RT @ePatientDave: WOW! Dartmouth CSDM toolkits are available free on the web! http://bit.ly/ed44Br Incl how to start a CSDM! #sgshealth LaylaMcCay Thu Dec 16 11:08:23 2010RT @ePatientDave: WOW! Dartmouth CSDM toolkits are available free on the web! http://bit.ly/ed44Br Incl how to start a CSDM! #sgshealth biggreenchris Thu Dec 16 11:08:24 2010Im so excited about this: had no idea some people are actually DOING this "in production" not just experiments #sgshealth ePatientDave Thu Dec 16 11:08:56 2010RT @ePatientDave: Also has links to Ottawa Hospitals decision aids too http://decisionaid.ohri.ca/decaids.html. #sgshealth LaylaMcCay Thu Dec 16 11:09:10 2010my comment C Mangione pres: offline pt edu pilot prgrm spirals into Mplmentation in svral cities & online v. http://bit.ly/i72WVl #sgshealth kgapo Thu Dec 16 11:09:31 2010Q: What results? A: Examples: fewer ppl get PSA testing; more choose colonoscopy. #sgshealth ePatientDave Thu Dec 16 11:09:54 2010RT @ePatientDave: Also has links 2 Ottawa Hospitals decision aids 2 http://decisionaidhttp://bit.ly/ff0IXT #sgshealth #opnhealth kgapo Thu Dec 16 11:10:21 2010RT @mollytoba: Mangione: rlly important - socialization & group learning critical in creating behavior change #sgshealth #openhealth kgapo Thu Dec 16 11:11:02 2010RT @ePatientDave: Also has links to Ottawa Hospitals decision aids too http://decisionaid.ohri.ca/decaids.html. #sgshealth nahumg Thu Dec 16 11:11:20 2010RT @ePatientDave: Q: What results? A: Examples: fewer ppl get PSA testing; more choose colonoscopy. #sgshealth nahumg Thu Dec 16 11:11:53 2010RT @amcunningham: @LaylaMcCay #sgshealth nice guidance -women in uk should have info on menorrhagia rx options b4 OP appt but doesnt s ... LaylaMcCay Thu Dec 16 11:12:10 2010Interesting: social media decision tools eg ishould app on Facebook #sgshealth LaylaMcCay Thu Dec 16 11:13:53 2010Recommentations for implementation: 1. have a clinical champion; 2. Define a goal (why doing this?); #sgshealth ePatientDave Thu Dec 16 11:15:18 2010Ottawa Hospital has an "iShould" decision aid *in Facebook*! http://www.facebook.com/apps/application.php?id=20788068773 #sgshealth ePatientDave Thu Dec 16 11:16:04 2010gr8 work Kate! actual implementtion of dcsion makng tools in real hosp. w/ real pts: im alrdy an evangelist! #sgshealth #opnhealth #hcsmeu kgapo Thu Dec 16 11:16:50 2010If youre introducing SDMfind out local needscustomiseand integrate into the system #sgshealth LaylaMcCay Thu Dec 16 11:16:52 2010(recommendations contd) 3. Customize (dont try to "be Dartmouth" - do what YOU need); #sgshealth ePatientDave Thu Dec 16 11:16:53 20104. Automate/systematic (e.g. pull info out of clinical record FOR the pt); 5. Ask your patients *early* in the process #sgshealth ePatientDave Thu Dec 16 11:17:23 20106. Create a *culture* of SDM / patient engagement ("an ethical imperative"); #sgshealth ePatientDave Thu Dec 16 11:17:56 2010#sgshealth Kate Clays top 10 recommendations for implementating shared decision making http://twitpic.com/3gecqk mollytoba Thu Dec 16 11:17:58 2010clinical champion in SDMtools can be a nurse: also under utilised resource in hc #sgshealth #opnhealth #hcsmeu kgapo Thu Dec 16 11:18:14 20107. Its a Conversation -"Attend to both sides pt & clinician"; 8. measure measure measure (prove youre improving) #sgshealth ePatientDave Thu Dec 16 11:19:20 20109. Feed back. They PUBLISH how many decision aids docs "prescribe". Also gather what pts say about experience. #sgshealth ePatientDave Thu Dec 16 11:20:24 2010Docs will say "My pts dont want this stuff." Need to be able to say "Oh yes they do - LOOK." #sgshealth ePatientDave Thu Dec 16 11:20:46 2010Feedback and benchmarking will drive up shared decisionmaking. Stop people saying my patients dont need/want this #sgshealth LaylaMcCay Thu Dec 16 11:20:55 201010. Feed *forward* - dont let the data sit in your database! #sgshealth ePatientDave Thu Dec 16 11:21:32 20101."I dont have time for this" - wrong; doesnt take away time changes quality of time #sgshealth ePatientDave Thu Dec 16 11:22:29 20102. "I already do this" - no you dont not like this #sgshealth ePatientDave Thu Dec 16 11:22:45 2010SDM doesnt take more time;youre already having the conversation-why not make it a more interactive one? #sgshealth LaylaMcCay Thu Dec 16 11:22:55 20103. "This decision aid is outdated or is wrong" - Its ok for doc to customize/add to the vid #sgshealth ePatientDave Thu Dec 16 11:23:26 20104. "I dont get paid to do this" - yes big problem. We need to fix this insurance companies! #sgshealth ePatientDave Thu Dec 16 11:23:46 2010Œ∫Œ¨ŒΩŒµŒπ Œ∫Œ¨œÄŒøŒπŒøœÇ live tweeting Œ±œÄœå œÑŒø œÉœÖŒΩŒ≠Œ¥œÅŒπŒø œÑŒ∑œÇ ŒïŒ£ŒîŒ•?? #opnhealth Œ±ŒΩ ŒΩŒ±ŒØ Œ¨œÇ œÉœÖœÉœÑŒÆœÉŒµŒπ œÉŒµ œåŒªŒøœÖœÇ œÑŒø #sgshealth ŒµŒØŒΩŒ±Œπ‚Ķ htt kgapo Thu Dec 16 11:24:07 2010RT @ePatientDave: 6th international Shared Decision Making COnference Maastricht Holland June 19-22 www.isdm2011.org #sgshealth vmontori Thu Dec 16 11:24:34 20105. My patients want me to tell them what to do. 6. This isnt pref-sensitive - Ill tell pt (be careful where u say that) #sgshealth ePatientDave Thu Dec 16 11:24:35 2010Final: "I dont know how to do this" - need to train #sgshealth ePatientDave Thu Dec 16 11:25:21 2010tweeted earlier today abt conf in Athens of ESDY it is the Graduate School of Public Health #sgshealth kgapo Thu Dec 16 11:25:21 2010RT @kgapo: RT @mollytoba: Mangione: rlly important - socialization & group learning critical in creating behavior change #sgshealth #ope ... cdebie Thu Dec 16 11:25:27 2010RT @kgapo: Œ∫Œ¨ŒΩŒµŒπ Œ∫Œ¨œÄŒøŒπŒøœÇ live tweeting Œ±œÄœå œÑŒø œÉœÖŒΩŒ≠Œ¥œÅŒπŒø œÑŒ∑œÇ ŒïŒ£ŒîŒ•?? #opnhealth Œ±ŒΩ ŒΩŒ±ŒØ Œ¨œÇ œÉœÖœÉœÑŒÆœÉŒµŒπDec 16 11:25:57 2010 ehealthgr Thu œÉŒµ œåŒªŒøœÖœÇ œÑŒø #sgshealth ŒµŒØŒΩŒNow @FIMDM pres Mike Barry: Dartmouth-Hitchcock is one of several demonstration sites FIMDM funds. #sgshealth ePatientDave Thu Dec 16 11:26:01 2010RT @LaylaMcCay: Interesting: social media decision tools eg ishould app on Facebook #sgshealth #opnhealth #hcsmeu kgapo Thu Dec 16 11:26:38 2010RT @ePatientDave Ottawa Hospital has an "iShould" decision aid in FB! http://on.fb.me/eydYEq #sgshealth #hcsmeu #opnhealth kgapo Thu Dec 16 11:27:46 2010Doctors worry that using SDM will lead to patients making wrong choices;culture change needed to move conceptual barrier #sgshealth LaylaMcCay Thu Dec 16 11:28:04 2010Mike Barry talking about visit to @GroupHealth. 2 urologists shared a practice but disagreed about incidence of a complication #sgshealth ePatientDave Thu Dec 16 11:29:31 2010Lesson: even good docs tend not to look at analytics #sgshealth ePatientDave Thu Dec 16 11:30:08 2010Physicians worry about prescribing videos if havent watched them (but lack time) #sgshealth LaylaMcCay Thu Dec 16 11:30:17 2010Physicians dont like the thought of being shown up by well-informed patients: barrier to SDM implementation #sgshealth LaylaMcCay Thu Dec 16 11:31:10 2010Barry cites e-patient white paper note that e-patients can indeed have newer info than in decision aid. #sgshealth ePatientDave Thu Dec 16 11:31:21 2010Mike Barry: docs nervous about prescribing decision aids they havent seen but not about drugs they havent taken. #sgshealth mollytoba Thu Dec 16 11:31:40 2010ooo: Dartmouths Richard Wexler notes docs commonly value themselves based on what they know so NOT knowing is social obstacle #sgshealth ePatientDave Thu Dec 16 11:32:35 2010RT @mollytoba: Mike Barry: docs nervous about prescribing decision aids they havent seen but not about drugs they havent taken. #sgshealth ePatientDave Thu Dec 16 11:33:14 2010RT @glynelwyn: #sgshealth Kate Clays web page at Dartmouth Shared Decision Making Centre - http://bit.ly/eBVwHh garyschwitzer Thu Dec 16 11:33:44 2010http://j.mp/dIPDoa ‚ôª @glynelwyn #sgshealth Kate Clays web page at the Shared Decision Making Centre - http://bit.ly/eBVwHh healthgist Thu Dec 16 11:33:44 2010(Wexlers point is first view Ive seen of that problem that adds empathy doesnt just suggest arrogance. Thanks.) #sgshealth ePatientDave Thu Dec 16 11:34:25 2010Richard Wexler: strategy to tell docs that decision aids can save time in visits by compressing the information sharing #sgshealth mollytoba Thu Dec 16 11:35:16 2010Barry: looking for a future where were paid for better decision quality #sgshealth ePatientDave Thu Dec 16 11:35:38 2010 Page  20
  • 21. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedClay: "its magical" when a patient realizes "There IS a way to make this decision" #sgshealth ePatientDave Thu Dec 16 11:36:45 2010RT @LaylaMcCay: Its not just pts who need gd tools 4 decisions;hlth prof/nals need thm 2: aids confident conv #sgshealth #opnhealth #hcsmeu kgapo Thu Dec 16 11:36:47 2010YES! Poorer families dont have DVD players but DO have Xbox etc; *kids show the parents how* and *learn about the disease too*! #sgshealth ePatientDave Thu Dec 16 11:40:26 2010@Nick_Glezakos RT @ePatientDave @raovac EHR designers need to plan app frm ground up around shard decision model-not adapt later #sgshealth kgapo Thu Dec 16 11:41:03 2010RT @ePatientDave: Docs will say "My pts dont want this stuff." Need to be able to say "Oh yes they do - LOOK." #sgshealth #opnhealth kgapo Thu Dec 16 11:42:43 2010#sgshealth Care planning approach patient navigators shared decisoin making - different words - same idea ! http://bit.ly/gxRw4t glynelwyn Thu Dec 16 11:44:44 2010RT @ePatientDave: Barry: looking for a future where were paid for better decision quality #sgshealth edyson Thu Dec 16 11:48:28 2010RT @LaylaMcCay Fdback/benchmarkng drive up shard decisionmaking. stp ppl saying my patients dont need/want ths #sgshealth #opnhealth kgapo Thu Dec 16 11:49:09 2010Is the question of whether SDM saves money for health services trumped by ethical imperative? #sgshealth LaylaMcCay Thu Dec 16 11:49:44 2010RT @LaylaMcCay: Is the question of whether SDM saves money for health services trumped by ethical imperative? #sgshealth FIMDM Thu Dec 16 11:51:01 2010RT @LaylaMcCay: SDM doesnt take more time;youre already having the conversation-why not make it a more interactive one? #sgshealth kgapo Thu Dec 16 11:57:18 2010RT @ePatientDave: WOW! Dartmouth CSDM toolkits are available free on the web! http://bit.ly/ed44Br Incl how to start a CSDM! #sgshealth cmeadvocate Thu Dec 16 11:59:09 2010Ingrained belief thatscreening is always good-means Dr perceived to fail if doesnt persuade patient to be screened #sgshealth LaylaMcCay Thu Dec 16 11:59:26 2010Slide: History of shared decision making at Dartmouth-Hitchcock 1973-2009 #sgshealth http://yfrog.com/h2jf8wj ePatientDave Thu Dec 16 12:00:56 2010Malpractice as lever for uptake of SDM? Look out for @FIMDM mock trial results in PSA testing decision. In press. #sgshealth mollytoba Thu Dec 16 12:03:00 2010RT @ePatientDave: 10. Feed *forward* - dont let the data sit in your database! #sgshealth biggreenchris Thu Dec 16 12:03:10 2010RT @garyschwitzer RT @glynelwyn #sgshealth Kate Clays web page at Dartmouth Shared Decision Making Centre http://bit.ly/eBVwHh #opnhealth kgapo Thu Dec 16 12:03:22 2010RT @mollytoba Rich.Wexler strategy 2 tell docs decision aids cn save visit time by compressing info sharing #sgshealth #opnhealth #hcsmeu kgapo Thu Dec 16 12:05:54 2010RT @ePatientDave: Clay: "its magical" when a patient realizes "There IS a way to make this decision" #sgshealth kgapo Thu Dec 16 12:06:14 2010RT @glynelwyn #sgshealth Care planning approach pt navigators SDmaking - difft words -same idea ! http://bit.ly/gxRw4t #opnhealth #hcsmeu kgapo Thu Dec 16 12:08:23 2010RT @ePatientDave: Slide: History of shared decision making at Dartmouth-Hitchcock 1973-2009 #sgshealth http://yfrog.com/h2jf8wj medicallessons Thu Dec 16 12:10:19 2010RT @mollytoba Malpractice as lever 4 uptake of SDM? @FIMDM mock trial results in PSA testing decision. In press. #sgshealth #opnhealth kgapo Thu Dec 16 12:10:21 2010RT @kgapo: RT @glynelwyn #sgshealth Care planning approach pt navigators SDmaking - difft words -same idea ! http://bit.ly/gxRw4t #opn ... nickglezakos Thu Dec 16 12:10:24 2010RT @kgapo: RT @LaylaMcCay Fdback/benchmarkng drive up shard decisionmaking. stp ppl saying my patients dont need/want ths #sgshealth # ... nickglezakos Thu Dec 16 12:16:10 2010RT @kgapo: RT @ePatientDave Ottawa Hospital has an "iShould" decision aid in FB! http://on.fb.me/eydYEq #sgshealth #hcsmeu #opnhealth nickglezakos Thu Dec 16 12:16:25 2010RT @kgapo: RT @LaylaMcCay: Interesting: social media decision tools eg ishould app on Facebook #sgshealth #opnhealth #hcsmeu nickglezakos Thu Dec 16 12:17:15 2010RT @kgapo: tweeted earlier today abt conf in Athens of ESDY it is the Graduate School of Public Health #sgshealth nickglezakos Thu Dec 16 12:17:21 2010Situation Awareness (SA) a decision is preceeded by 3 levels of SA: perception comprehension projection of future #sgshealth raovac Thu Dec 16 12:31:27 2010Decision errors can be linked to each level: fail to perceive fail to comprehend fail to project (see Mica Endsley) #sgshealth raovac Thu Dec 16 12:31:59 2010the word auf Deutch Fingerspitzengefuhl might be translated as Situation Awareness a military & aviation term #sgshealth raovac Thu Dec 16 12:34:24 2010Cognitive Engineering improving human performance (decisions) with system design; lets engineer shared decisions #sgshealth raovac Thu Dec 16 12:36:10 2010see Mitre Corps: A Survey of Cognitive Engineering Methods and Uses: http://mentalmodels.mitre.org/cog_eng/ #sgshealth raovac Thu Dec 16 12:36:56 2010Searching for health info is now the third most popular online activity across all generations: http://pewrsr.ch/fwRT9v #sgshealth raovac Thu Dec 16 12:44:03 2010RT @glynelwyn: #sgshealth Mangione and Froschs work on activating seniors - group work is important http://www.ncbi.nlm.nih.gov/pubmed/ ... zenofbass Thu Dec 16 12:47:58 2010RT @ePatientDave: WOW! Dartmouth CSDM toolkits are available free on the web! http://bit.ly/ed44Br Incl how to start a CSDM! #sgshealth BunnysGotMoxie Thu Dec 16 13:01:25 2010RT @kgapo: #sgshealth Kate Clays web page at Dartmouth Shared Decision Making Centre http://bit.ly/eBVwHh #opnhealth ehealthgr Thu Dec 16 13:08:13 2010‚Äú@LaylaMcCay: If I read 2 journal articles every night at the end of a year Id be 400 years behind - Lindberg #sgshealth‚Äù bacigalupe Thu Dec 16 13:42:12 2010‚Äú@LaylaMcCay Lethal lag time: 2-5 years - time between successful completion of research and journal paper published and read #sgshealth‚Äù bacigalupe Thu Dec 16 13:42:28 2010‚Äú@LaylaMcCay: Not whats the matter with you?; what matters to you? #sgshealth‚Äù #CFHA bacigalupe Thu Dec 16 13:44:15 2010@HealthIsSocial Take a look at the #sgshealth convo all this week (& tomorrow). Some great stuff. @ePatientDave @KGApo andrewspong Thu Dec 16 13:48:58 2010Looking forward to hearing how @ePatientDaves Twitter masterclass went at #sgshealth. Dave mentioned hed pimp #hcsmeu too. How kind :) andrewspong Thu Dec 16 13:50:04 2010Not much live tweeting now - were doing an interactive workshop using Kate Clays decision aids #sgshealth ePatientDave Thu Dec 16 13:53:24 2010@LaylaMcCay @ePatientDave @FIMDM @kgapo How to keep this highly productive discussion moving post #sgshealth & convert to action? andrewspong Thu Dec 16 13:54:34 2010Decisional Conflict: Uncertainty about which course to take when choice involves risk #sgshealth ePatientDave Thu Dec 16 13:57:29 2010@ePatientDaves excellent adventure w/ @FIMDM in Salzburg www.isdm2011.org Teaching Twitter http://yfrog.com/h4t3rwj #sgshealth SusanCarr Thu Dec 16 13:58:20 2010@andrewspong #sgshealth include content 1 topic at a time in the regular #hcsmeu online Friday meetings-not ths Frid bcs Ill B travelling kgapo Thu Dec 16 13:58:28 2010RT @glynelwyn: #sgshealth Q. Any evidence shared decision making reduces litigation rates.? Moulton mock trial might help here. In Press. HealthNewsRevu Thu Dec 16 13:59:24 2010As an Msc student in DSS and as a cancer patient I must admit that I find the topic very interesting. Keep up the good work. #sgshealth moloch82 Thu Dec 16 13:59:47 2010Key SDM communication skills for HCPs: Address their uncertainty; be clear about communicating risk (Gigerenzers methods); #sgshealth ePatientDave Thu Dec 16 13:59:49 2010provide context (vivid images like "5 seats out of our football stadium"; use pictures; etc. #sgshealth ePatientDave Thu Dec 16 14:00:45 2010key SDM comm skills: addrss uncertainty use clean risk comm addrss irrational fear #sgshealth #opnHealth #hcsmeu kgapo Thu Dec 16 14:01:22 2010We fear snakesnot cars;fear spectacularly unlikely disease;fear cancer more than heart disease.Decisions arent always rational #sgshealth LaylaMcCay Thu Dec 16 14:02:02 2010RT @glynelwyn: #sgshealth Q. Any evidence shared decision making reduces litigation rates.? Moulton mock trial might help here. In Press. garyschwitzer Thu Dec 16 14:02:25 2010Wow: Ottawa Decision Guide is available in Japanese too #sgshealth ePatientDave Thu Dec 16 14:02:27 2010Teaching Twitter: Heres how to do it. http://yfrog.com/h4t3rwj @ePatientDave at #sgshealth #hcsmca colleen_young Thu Dec 16 14:02:57 2010RT @ePatientDave: Wow: Ottawa Decision Guide is available in Japanese too #sgshealth #hcsmca colleen_young Thu Dec 16 14:03:18 2010#sgshealth See pages 16-20 for policy summary England re shared decision making. http://bit.ly/ggmPgw glynelwyn Thu Dec 16 14:06:07 2010@andrewspong @LaylaMcCay @ePatientDave @FIMDM #sgshealth #hcsmeu how to move ahead? why not discuss it tonight? #opnhealth kgapo Thu Dec 16 14:06:25 2010e.g. If pt really doesnt want2know if they have cancer thats okay on this form: THEY get to say. (Result: "dont get tested") #sgshealth ePatientDave Thu Dec 16 14:07:47 2010RT @Colleen_Young: Teaching twttr: hres how 2 do it. http://yfrog.com/h4t3rwj @ePatientDave at #sgshealth #hcsmca <-- luv it! :) kgapo Thu Dec 16 14:09:12 2010@colleen_young #sgshealth #hcsmca if there is time I will talk about how to use twitter to promote a cause #opnhealth kgapo Thu Dec 16 14:12:41 2010RT @LaylaMcCay: Its unethical for a doctor to answer what would you do or what would you do if it was your mother #sgshealth #opnhealth kgapo Thu Dec 16 14:13:31 2010@moloch82 #sgshealth wlcme 2 R convo.we wld lk 2 hear yr eXprience: did U hv an informd shard dcision makng sessi‚Ķ http://twishort.com/ab51b kgapo Thu Dec 16 14:16:29 2010live demo role playing of Personal Decision Guide with Kate Clay in role of coach and Carol in role of pt #sgshealth #opnhealth kgapo Thu Dec 16 14:21:01 2010 Page  21
  • 22. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedClay: some of the best sessions are ppl who HAVE decided & want to go over it. (Structured review is helpful) #sgshealth ePatientDave Thu Dec 16 14:22:26 2010@kgapo #sgshealth The public hospitals and doctors did not offer neither info nor decision support. After (cont) http://tl.gd/7hcfvb moloch82 Thu Dec 16 14:23:03 2010My fav tweet evah: RT @FIMDM: http://yfrog.com/h4t3rwj @epatientdave teaches jack wennberg al mulley others how to use twitter. #sgshealth ePatientDave Thu Dec 16 14:23:57 2010RT @ePatientDave fav tweet evah RT @FIMDM http://yfrog.com/h4t3rwj @epatientdave teaches jack wennberg al mulley how 2 use twttr #sgshealth healthblawg Thu Dec 16 14:25:46 2010Clay now leading patient thru questions: "What options r u aware of? For each tell me yr view of the risks & benefits" #sgshealth ePatientDave Thu Dec 16 14:26:01 2010(Curiosity as Kate Clay runs this demo interview: how expert must the interviewer be to draw out needed info?) #sgshealth ePatientDave Thu Dec 16 14:31:56 2010RT @moloch82: @kgapo #sgshealth The public hospitals and doctors did not offer neither info nor decision support. After (cont) http://tl ... kgapo Thu Dec 16 14:33:02 2010After drawing answers out of pt on all risks&benefits go thru w pt assigning 1-5 stars to importance the *patient* puts on eac #sgshealth ePatientDave Thu Dec 16 14:37:23 2010@MarksPhone did you have the opportunity to follow #sgshealth http://bit.ly/eg2MME seminar on the greatest untapped resource in hc? kgapo Thu Dec 16 14:38:58 2010RT @glynelwyn: #sgshealth Mangione and Froschs work on activating seniors - group work is important http://www.ncbi.nlm.nih.gov/pubmed/ ... geri_doc Thu Dec 16 14:41:44 2010Okay its role play time. tweet you later. #sgshealth ePatientDave Thu Dec 16 14:44:13 2010RT @ePatientDave: "Decisional Conflict": Uncertainty about which course to take when choice involves risk #sgshealth BioPharmaRob Thu Dec 16 15:01:15 2010Reach to Recovery Program support program for BrCa patients http://bit.ly/ehxiKR #sgshealth #opnhealth #hcsmeu kgapo Thu Dec 16 15:39:49 2010thanks for tweeting abt #sgshealth @LaylaMcCay @ePatientDave @FIMDM @kgapo and all the others! wissit Thu Dec 16 15:40:35 2010@kgapo For me its not just about human social relations: the entire proposition of h/care is social. Hard to expand in 140 ;) #sgshealth HealthIsSocial Thu Dec 16 15:45:33 2010@kathybarbour H Kathy suggest look at #sgshealth the gr8 Salzburg Global Seminar on the gr8test untappd rsource in hc http://bit.ly/i9bcf4 kgapo Thu Dec 16 15:56:52 2010Q: what to do in SDM decision aid mtg if pt has no knowledge yet? Clays A: we try not to let them past the scheduling secretary #sgshealth ePatientDave Thu Dec 16 15:59:27 2010Q: What about surrogate interviews? (Parent-child adult-elder?) A: Have 2b very careful its surrogate about what *pt* wd want #sgshealth ePatientDave Thu Dec 16 16:01:23 2010Q: What if theyre using bad logic e.g. "my cousin had cancer so I know I will"? Clay: Ill correct clearly wrong info/logic. #sgshealth ePatientDave Thu Dec 16 16:03:16 2010RT @kgapo: Reach to Recovery Program support program for BrCa patients http://bit.ly/ehxiKR #sgshealth #opnhealth #hcsmeu ehealthgr Thu Dec 16 16:09:26 2010Thx @garyschwitzer! RT: Important post by @murzee "Why medical testing is never a simple decision." http://tinyurl.com/33sqpx6 #sgshealth murzee Thu Dec 16 16:18:46 2010LOL - Mike Barrys dentist form said "What are yr dental goals?" He answered: "Not to be buried w anything too expensive" #sgshealth ePatientDave Thu Dec 16 16:30:54 2010WellIm heading home tomorrow so thats my last session;Ill retweet from others tomorrow! #sgshealth LaylaMcCay Thu Dec 16 16:42:18 2010@ePatientDave Thats true across fields and employees - not unique to health! #sgshealth dwitzel Thu Dec 16 18:10:19 2010RT @garyschwitzer: Important post by @murzee "Why medical testing is never a simple decision." http://tinyurl.com/33sqpx6 #sgshealth KentBottles Thu Dec 16 22:57:46 2010RT @garyschwitzer Important post by @murzee "Why medical testing is never a simple decision." http://tinyurl.com/33sqpx6 #sgshealth BarbaraFicarra Thu Dec 16 23:03:57 2010@chibbie #hcsmeu #sgshealth did not speak of nurse sm but sdm=shared decision making champion kgapo Fri Dec 17 06:10:01 2010Individualizd Support Improvs Pt-Physician Communication & Enhances Decision Making 4 BrCa Pts http://bit.ly/hjWwDA #sgshealth #opnhealth kgapo Fri Dec 17 06:41:01 2010welcome back to the club! RT @val1a: Consumer Genetic Privacy Manual http://bit.ly/fhF5FI #opnhealth #sgshealth kgapo Fri Dec 17 07:20:01 2010Okay Salzburg people: have had to leave early so am counting on you for tweet updates from todays sessions! #sgshealth LaylaMcCay Fri Dec 17 08:18:54 2010@LaylaMcCay #sgshealth gdmorning Layla we miss yr twts! will try my best! greetings from wrap session kgapo Fri Dec 17 08:47:39 2010#sgshealth final 2 hours starting. We end at noon CET. Just started with a goofy Monty Python childbirth clip. ePatientDave Fri Dec 17 08:51:52 2010Takeaways group 1: We could declare as a group the ethical imperative of shared decision making. An international declaration? #sgshealth ePatientDave Fri Dec 17 08:53:40 2010Training targets: patients professionals media. Tools for sharing info two-way. #sgshealth ePatientDave Fri Dec 17 08:54:03 20103rd item from group 1: need measurement to have rigor & show progress. Better measures for pt-reported outcomes. #sgshealth ePatientDave Fri Dec 17 08:54:39 2010John Lotherington prgrm Director rcapitulating sessions-#sgshealth #opnHealth #hcsmeu kgapo Fri Dec 17 08:55:06 2010Molly Beinfeld gives conclusion of group of Chinese room-ethical aspects-training+educ-media - media #sgshealth #opnhealth kgapo Fri Dec 17 08:56:12 2010Group 2: health communication (all sources): delivery of unbiased balanced information. #sgshealth ePatientDave Fri Dec 17 08:56:27 2010The best health professions come from informed pts & clinicians who are conscious of pt preferences. #sgshealth ePatientDave Fri Dec 17 08:56:54 2010Board room #sgshealth #opnHealth stress on unbiased communication abt SDM and other issues tackled at seminar kgapo Fri Dec 17 08:57:46 2010#sgshealth #opnHealth #hcsmeu John on role of morality in all this kgapo Fri Dec 17 08:59:42 2010Salzburg global seminar coming to a close. It has been an amazing week. Breakout groups summarizing recs. Will post them soon! #sgshealth FIMDM Fri Dec 17 09:05:45 2010@FIMDMs Ben Moulton: the entry point for this in healthcare will be the current point of Informed Consent. Broken; fix it. #sgshealth ePatientDave Fri Dec 17 09:07:22 2010Angela Coulter: would it work better as "informed choice"? Ben: 100 yr history. An unauthorized touching is battery. #sgshealth ePatientDave Fri Dec 17 09:08:11 2010#sgshealth #opnHealth #hcsmeu Ben & I rportd fm Seminar room SDM golden standard in hc kgapo Fri Dec 17 09:08:41 2010John asks whether thr shld B legal rquirement 2 prove thr hs bn a real SDM procedure & not only signing a form #sgshealth #opnhealth #hcsmeu kgapo Fri Dec 17 09:12:46 2010Beautiful Salzburg site of shared decision-making global seminar. #sgshealth http://twitpic.com/3gontt http://twitpic.com/3gonxd garyschwitzer Fri Dec 17 09:13:53 2010#sgshealth #opnhealth #hcsmeu discussed w/ Robert Johnston Board Dir. @IAPOtweets possblility 2 propose SDM 2 Board as theme 4 nxt congress kgapo Fri Dec 17 09:19:00 2010Best description of supply-sensitive care from Al Mulley: "a built bed is a filled bed." #sgshealth mollytoba Fri Dec 17 09:21:04 2010Angela: thats from the Word Health Orgs surgical checklist which has been shown to improve safety. #sgshealth ePatientDave Fri Dec 17 09:24:06 2010RT @mollytoba: Best description of supply-sensitive care from Al Mulley: "a built bed is a filled bed." #sgshealth kgapo Fri Dec 17 09:25:54 2010RT @mollytoba: Best description of supply-sensitive care from Al Mulley: "a built bed is a filled bed." #sgshealth ePatientDave Fri Dec 17 09:31:05 2010RT @FIMDM: Mike Barry: making the patient the center of care be it in Uganda or the US is universal. #sgshealth #opnhealth #hcsmeu kgapo Fri Dec 17 09:37:02 2010Persistent question: SDM as a legal mandate or an ethical imperative? #sgshealth mollytoba Fri Dec 17 09:40:06 2010Molly its not so much abt legl oblgtions of docs but how they implement it @mollytoba #sgshealth #opnhealth #hcsmeu kgapo Fri Dec 17 09:46:15 2010RT @mollytoba: Persistent question: SDM as a legal mandate or an ethical imperative? #sgshealth kgapo Fri Dec 17 09:46:28 2010Example: Wennberg data decades ago showed tonsillectomies are *commonly* overprescribed; some kill kids! Injustice! #sgshealth ePatientDave Fri Dec 17 09:53:13 2010Love. Robert Johnstone: we are a new army to humanize medicine. #sgshealth FIMDM Fri Dec 17 10:06:59 2010Wow they let us out an hour early - #sgshealth is a wrap! There will be bloggage. ePatientDave Fri Dec 17 10:16:26 2010RT @FIMDM: Love. Robert Johnstone: we are a new army to humanize medicine. #sgshealth ePatientDave Fri Dec 17 10:16:34 2010RT @FIMDM: Love. Robert Johnstone: we are a new army to humanize medicine. #sgshealth kgapo Fri Dec 17 10:19:34 2010RT @mollytoba: My headline from #sgshealth: health is social. How to harness the role of community for behavior change? kgapo Fri Dec 17 10:20:07 2010session adjourned! #sgshealth =1525 twts 157 contrbtors-213 tweets/day= highly productive class! kgapo Fri Dec 17 10:52:04 2010RT @healthgist: http://j.mp/gCPe1X ‚ôª @FIMDM Love. Robert Johnstone: we are a new army to humanize medicine. #sgshealth kgapo Fri Dec 17 10:52:10 2010 Page  22
  • 23. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username Created@health20Paris: #FF Recent Global Hashtags health & socialmedia #doctors20 #hcsmglobal #sgshealth :) vj_CR Fri Dec 17 11:49:36 2010Depressing... *1938*#tonsillectomy overuse: Glover Ind J Paeds http://bit.ly/gWKWoP "& it still happens" twtd @epatientdave at #sgshealth doctorblogs Fri Dec 17 13:45:03 2010RT @kgapo: session adjourned! #sgshealth =1525 twts 157 contrbtors-213 tweets/day= highly productive class! ehealthgr Fri Dec 17 14:00:47 2010Its no surprise but wow @KGApo is a force to be reckoned with. When she has something to say sit down & listen! #sgshealth ePatientDave Fri Dec 17 14:01:33 2010RT @ePatientDave: RT @bentoth: New NHS Atlas of variation http://bit.ly/dUU4Kg has much variation #sgshealth pjmachado Fri Dec 17 14:01:58 2010RT @kgapo: RT @mollytoba: My headline from #sgshealth: health is social. How to harness the role of community for behavior change? nickglezakos Fri Dec 17 15:08:03 2010RTing w #sgshealth tag: What Dartmouth can teach Oxford: UK Health Maps Show A Shared Problem Across The Pond http://n.pr/e6FkxI scotthensley Fri Dec 17 19:46:19 2010Chris Weaver from @FIMDM #sgshealth conf--Gr8 RT @ScottHensley: What Dartmouth can teach Oxford: Shared Prob Across Pond http://n.pr/e6FkxI ePatientDave Fri Dec 17 20:02:12 2010RT @rsm2800: @garyschwitzer For ur blog? 12/17 WaPo pg1 on FDA/Avastin "women turn to in last-ditch effort to save their lives." #sgshealth ePatientDave Sat Dec 18 07:40:17 2010RT @ePatientDave: Its no surprise but wow @KGApo is a force 2 B reckond w/. When she hs something 2 say sit dn & listen! #sgshealth kgapo Sat Dec 18 14:12:02 2010@ePatientDave #sgshealth wow! Dave thanks you make me blush!! hv u arrived home? arrived at 2.45am flight delayed 2hrs kgapo Sat Dec 18 14:14:03 2010RT @ePatientDave: Its no surprise but wow @KGApo is a force 2 B reckond w/. When she hs something 2 say sit dn & listen! #sgshealth ehealthgr Sat Dec 18 14:17:39 2010@iapotweets John ur paradigm is a live Xample of ur statment RT @FIDM luv. Robert Johnstone: we R a new army 2 humanize medcine #sgshealth kgapo Sat Dec 18 14:30:06 2010@health_literacy @FloridaLiteracy #healthlit discussd extensivly at #sgshealth as buildng block of informd shard decision making #opnhealth kgapo Sat Dec 18 16:05:27 2010Made it home by some miracle when 80% at Heathrow were canceled. Hope my friends from #sgshealth were just as lucky! mollytoba Sat Dec 18 16:16:41 2010US law Rquires fedral agencies use clear Gov.communication public cn understand & use http://bit.ly/f1l4bW #sgsHealth #opnHealth #opengovgr kgapo Sat Dec 18 16:27:41 2010@mollytoba Good for you! Mines on schedule. #sgshealth rocked @fimdm rocks. Wennberg too but dont tell him.:) ePatientDave Sat Dec 18 16:33:26 2010gr8 Rsources 4 preparng 4 med. visits Centr 4 Shard Decision Making-Dartmouth-Hitchcok Med Center http://bit.ly/elKAWN #opnhealth #sgsHealth kgapo Sat Dec 18 17:27:08 2010RT @epatientdave: Im thrilled to hear this good work happening. Sponsored by FIMDM Palo Alto Medical Foundation UCLA Med #sgshealth emacartney Sat Dec 18 22:20:15 2010@ePatientDave #sgshealth survey whether patients agree w/ FDA/Avastin runs on the internet am afraid @garyschwitzer will find it flawed kgapo Sun Dec 19 01:06:38 2010RT @ePatientDave: Chris Weaver from @FIMDM #sgshealth conf--Gr8 RT @ScottHensley: What Dartmouth can teach Oxford: Shared Prob Across Po ... mollytoba Sun Dec 19 01:59:57 2010Terrific piece on practice variation in the UK by #sgshealth fellow Chris Weaver. Must read! http://m.npr.org/story/132135209 FIMDM Sun Dec 19 02:06:42 2010RT @FIMDM: Terrific piece on practice variation in the UK by #sgshealth fellow Chris Weaver. Must read! http://m.npr.org/story/132135209 MarilynMann Sun Dec 19 02:17:12 2010RT @FIMDM: Terrific piece on practice variation in the UK by #sgshealth fellow Chris Weaver. Must read! http://m.npr.org/story/132135209 midwifeamy Sun Dec 19 03:21:28 2010@haikalis #opnhealth ..ŒºŒØŒªŒ∑œÉŒ± œÉœÑŒø #sgshealth Œ≥ŒπŒ± œÄœÅŒøŒ≤ŒªŒÆŒºŒ±œÑŒ±/œÄœÅŒøŒ∫ŒªŒÆœÉŒµŒπœÇ ŒïŒ£Œ•-Œ±œÄŒ¨ŒΩœÑŒ∑œÉŒ∑: hlthcare cuts must hv a goal 411:01:16 2010 services kgapo Sun Dec 19 better hlthcare#opnhealth #sgsHealth=live twts+œÉœÖŒΩŒµœá/ŒºŒµŒΩŒ∑ œÉœÖŒ∂ŒÆœÑŒ∑œÉŒ∑ fellows Salzburg Global Seminar- http://bit.ly/eg2MME Gr8est Untappd Rsource in HC? kgapo Sun Dec 19 11:15:50 2010#PatientView Check out discussions for the Salzburg Global Seminar on shared decision-making on #sgsHealth PatientView Sun Dec 19 11:44:44 2010A. Muley-K. Sepucha: A Perspective on the Patients Role in Treatment Decisions http://bit.ly/igbVFI #sgshealth #opnheallth kgapo Sun Dec 19 13:10:40 2010Pts & physicians need 2 engage w/ 1 another as a team but patient decides whts rt 4 him #opnHealth #sgsHealth http://bit.ly/frExFO kgapo Sun Dec 19 14:11:00 2010msg 2 medical students: being gd at talking 2 ppl of every generation->skill U wll need as a doc #opnhealth #sgshealth http://nyti.ms/eOnINr kgapo Sun Dec 19 14:24:41 2010I have about a dozen posts I want to write from #sgshealth. Glad I have 2 weeks off now. ePatientDave Sun Dec 19 16:57:22 2010RT @kgapo: #sgshealth œÉœÖŒ∂ŒÆœÑŒ∑œÉŒ∑ Œ≥ŒπŒ± ŒµœÄŒØŒ¥œÅŒ±œÉŒ∑ ŒúŒúŒï+ŒπŒΩœÑŒµœÅŒΩŒµœÑ œÉœÑŒ∑ŒΩ Œ±ŒΩœÑŒØŒªŒ∑œàŒ∑ Œ≥ŒπŒ± œÑŒ∑ŒΩ œÖŒ≥ŒµŒØŒ± ŒµŒæŒ±ŒπœÅŒµœÑŒπŒ∫ŒÆ http://you nickglezakos Sun Dec 19 18:04:39 2010RT @kgapo: #sgshealth œÉœÖŒ∂ŒÆœÑŒ∑œÉŒ∑ Œ≥ŒπŒ± ŒµœÄŒØŒ¥œÅŒ±œÉŒ∑ ŒúŒúŒï+ŒπŒΩœÑŒµœÅŒΩŒµœÑ œÉœÑŒ∑ŒΩ Œ±ŒΩœÑŒØŒªŒ∑œàŒ∑ Œ≥ŒπŒ± œÑŒ∑ŒΩ œÖŒ≥ŒµŒØŒ± ŒµŒæŒ±ŒπœÅŒµœÑŒπŒ∫ŒÆ http://you emmanuelch Sun Dec 19 19:57:27 2010@emmanuelch @alexanderberler #sgshealth Œ¥ŒπŒ±Œ≤Œ¨Œ∂ŒøŒΩœÑŒ±œÇ ŒΩŒ≠Œ± Œ≥ŒπŒ± œÑŒ∑ŒΩ œÖŒ≥ŒµŒØŒ± ŒµœÜŒ±œÅŒºœåœÉœÑŒµ œÑŒ± 10 Œ∫œÅŒπœÑŒÆœÅŒπŒ± œÑŒøœÖ @garyschwitzer http://bit.ly/h5MMMZ kgapo Sun Dec 19 20:47:09 2010RT @FIMDM Terrific piece on UK practice variation by #sgshealth fellow Chris Weaver http://m.npr.org/story/132135209 #opnHeallth #hcsmeu kgapo Sun Dec 19 21:37:52 2010RT @FIMDM Terrific piece on UK practice variation by #sgshealth Fellow Chris Weaver http://m.npr.org/story/132135209 #opnHeallth #hcsmeu ePatientDave Mon Dec 20 05:35:13 2010RT @ePatientDave: RT @FIMDM Terrific piece on UK practice variation by #sgshealth Fellow Chris Weaver http://m.npr.org/story/132135209 # ... rohal Mon Dec 20 10:23:18 2010First post from #sgshealth: ‚ÄúPractice variation‚Äù: an essential e-patient awareness topic (*essential!*) http://bit.ly/eBQJlu ePatientDave Mon Dec 20 18:03:31 2010RT @ePatientDave: First post from #sgshealth: ‚ÄúPractice variation‚Äù: an essential e-patient awareness topic (*essential!*) http://bit.ly ... KentBottles Mon Dec 20 18:04:56 2010RT @ePatientDave: First post from #sgshealth: ‚ÄúPractice variation‚Äù: an essential e-patient awareness topic (*essential!*) http://bit.ly ... midwifeamy Mon Dec 20 18:05:58 2010Prepared Patient Forum: Why Medical Testing Is Never a Simple Decision/@murzee http://t.co/x4CXECq #opnHealth #sgshealth #epatientgr kgapo Tue Dec 21 09:12:36 2010FDA Social Media Guidance http://ow.ly/3siFY #fdasm #hcsm #hcsmeu #opnhealth #sgshealth how this guidance may affect patients? kgapo Tue Dec 21 11:33:34 2010@LeeAase @ritters90 @USATODAY how to improve/accelerate health+digital literacy of seniors? #opnHealth #hcsmeu #sgshealth #healthLitMO kgapo Tue Dec 21 11:37:56 2010@HealthNewsRevu posts follow-up to #sgshealth: Gigerenzer video on moral issue of risk communication http://bit.ly/gOLEaT ePatientDave Tue Dec 21 17:19:20 2010New posts by me & @ePatientDave following Salzburg Global Seminar on informing/involving patients. http://bit.ly/gOLEaT #sgshealth garyschwitzer Tue Dec 21 17:29:47 2010Alles klar? RT @garyschwitzer: Folo to Salzburg Seminar: Gigerenzer on moral issue of risk communication. #sgshealth http://bit.ly/gOLEaT scotthensley Tue Dec 21 18:28:00 2010RT @kgapo: Prepared Patient Forum: Why Medical Testing Is Never a Simple Decision/@murzee http://t.co/x4CXECq #opnHealth #sgshealth ehealthgr Tue Dec 21 22:51:12 2010RT @kgapo: FDA Social Media Guidance http://ow.ly/3siFY #fdasm #hcsm #hcsmeu #opnhealth #sgshealth how this guidance may affect patients? healthpolicygrp Wed Dec 22 03:30:20 2010RT @ePatientDave: I *love* @PhilBaumanns "Health Is Social" blog. This grew out of brief #sgshealth tweet exchange: http://bit.ly/etpNaL mollytoba Wed Dec 22 14:06:53 2010About time! ex-Sen. Durenberger touts importance of @HealthNewsRevu! http://bit.ly/fdcXIk #sgshealth ePatientDave Wed Dec 22 20:52:47 2010@garyschwitzer #sgsHealth enlargment of markt potential or a breakthrough?Gardasil 4 prvention of anal cancer http://ow.ly/1azRpY #opnHealth kgapo Thu Dec 23 10:27:48 2010Patients in chargenot Drs:"Down w paternalismlong live shared decn making" @LaylaMcCay BMJ http://t.co/GFIgYyq #sgshealth doctorblogs Thu Dec 23 15:19:33 2010@LaylaMcCay #sgshealth #opnHealth cngrts Layla! no wonder! Super Layla! her twts frm session show her talent in rlly fast & talented writing kgapo Thu Dec 23 17:03:20 2010RT @doctorblogs: Patients in chargenot Drs:"Down w paternalismlong live shared decn making" @LaylaMcCay BMJ http://t.co/GFIgYyq #sgshealth FIMDM Thu Dec 23 17:36:46 2010@kgapo Thank you very much - thats very sweet. We were indeed Salzburg twitter fiends! #sgshealth LaylaMcCay Thu Dec 23 17:41:24 2010Tessa Richards commenting on Salzburg Global Seminar Health II: Patients as cost savers? http://t.co/zMLuLYH #openHealth #sgsHealth #hcsmeu kgapo Thu Dec 23 17:42:19 2010RT @doctorblogs: Patients in chargenot Drs:"Down w paternalismlong live shared decn making" @LaylaMcCay BMJ http://t.co/GFIgYyq #sgshealth DianeEMeier Thu Dec 23 18:03:06 2010Oo Im being followed by @KateClayDHMC the awesome Pt Decision Aid whiz from Dartmouth-Hitchcock! Wootage! #sgshealth ePatientDave Thu Dec 23 18:50:47 2010#sgshealth people see new @JoPM commentary on JAMA June article - effect of patient engagemt on decisions http://bit.ly/hS7U9y ePatientDave Thu Dec 23 19:04:57 2010RT @ePatientDave: #sgshealth people see new @JoPM commentary on JAMA June article - effect of patient engagemt on decisions http://bit.l ... Taneya Thu Dec 23 19:09:32 2010RT @epatientdave: #sgshealth people c new @JoPM commentary on JAMA June article - effect of pt engagemt on decisions http://bit.ly/hS7U9y MD_chat Thu Dec 23 19:30:02 2010#HEAC314 #HEAC364 BMJ blog: Doc Toms e-patients emerge in shared decision-making http://bit.ly/haEmyI #sgshealthRT@ePatientDave PamNelmesFoH Thu Dec 23 19:38:26 2010@LaylaMcCay #sgshealth haha!not just twttr friends U R a twttr/texting master! me just plain follower...cantt match U ur 5twts=1 mine kgapo Thu Dec 23 21:37:59 2010@ePatientDave Kate Clay cn convince even the hardst followrs of paternalstic med tht its 2 their interest 2 adopt SDM #sgsHealth #opnHealth kgapo Thu Dec 23 22:04:13 2010 Page  23
  • 24. Salzburg  Global  Seminar  on  Informed  Medical  Decision  Making,  Dec.  12-­‐17  2010Text Username CreatedRisk comm guru Gigerenzer argues that absolute risk communication is a moral issue http://bit.ly/eKc6zI #opnHealth #sgsHealth #hcsmeu kgapo Thu Dec 23 22:37:18 2010RT @doctorblogs: Patients in chargenot Drs:"Down w paternalismlong live shared decn making" @LaylaMcCay BMJ http://t.co/GFIgYyq #sgshealth PIER_Project Fri Dec 24 07:27:43 2010RT @doctorblogs: Patients in chargenot Drs:"Down w paternalismlong live shared decn making" @LaylaMcCay BMJ http://t.co/GFIgYyq #sgshealth dsgadv Fri Dec 24 14:05:45 2010#sgsHealth faculty member G. Gigerenzer on #hcsmeu Daily ‚ñ∏ todays top stories are contributed by @kgapo @foreonline http://t.co/Uw6rQYM kgapo Fri Dec 24 14:49:33 2010RT @ePatientDave Just got an email frm Amazon new book Family Violence wll be out Jan. 5 #weirdmatchup! #sgsHealth #opnHealth #hcsmeu kgapo Fri 24 Dec 2010 18:35:48RT @ePatientDave: I *love* @PhilBaumanns "Health Is Social" blog. This grew out of brief #sgshealth tweet exchange: http://bit.ly/etpNaL ScratchMM Sun Dec 26 05:50:40 2010The Difficult Science-Kent Bottles MD on mass media & health stories http://bit.ly/eCFeFv #opnHealth #sgsHealth #hcsmeu via @aliettejonkers kgapo Mon 27 Dec 2010 07:10:04"Markets & Public Values in Health Care" Erasmus Unv. Inst. of Hlth Policy & Management http://bit.ly/he8qqp #opnHealth #sgsHealth kgapo Mon 27 Dec 2010 10:34:48RT @kgapo: "Markets & Public Values in Health Care" Erasmus Unv. Inst. of Hlth Policy & Management http://bit.ly/he8qqp #opnHealth #sgsHealth karounos Mon 27 Dec 2010 11:00:50RT @ePatientDave: My fav tweet evah: RT @FIMDM: http://yfrog.com/h4t3rwj @epatientdave teaches jack wennberg al mulley others how to use twitter. #sgshealth mamaier262 Mon 27 Dec 2010 16:30:54RT @MayoClinic: Advancing patient-centered care through Shared Decision Making - http://youtu.be/a8KnOg83cdg #sgshealth ePatientDave Mon 27 Dec 2010 21:03:06RT @ePatientDave: RT @MayoClinic: Advancing patient-centered care through Shared Decision Making - http://youtu.be/a8KnOg83cdg #sgshealth teaminspire Mon 27 Dec 2010 21:04:25RT @ePatientDave: RT @MayoClinic: Advancing patient-centered care through Shared Decision Making - http://youtu.be/a8KnOg83cdg #sgshealth JustinHOPE Mon 27 Dec 2010 21:06:03@KateClayDHMC How would you compare yr decision aids w/ what @VMontori of #mayoclinic describes here? http://youtu.be/a8KnOg83cdg #sgshealth ePatientDave Mon 27 Dec 2010 21:25:50RT @ePatientDave: RT @MayoClinic: Advancing patient-centered care through Shared Decision Making - http://youtu.be/a8KnOg83cdg #sgshealth LuCaramel Mon 27 Dec 2010 21:30:00RT @ePatientDave: RT @MayoClinic: Advancing patient-centered care through Shared Decision Making - http://youtu.be/a8KnOg83cdg #sgshealth AuraViva Mon 27 Dec 2010 22:06:22RT @ePatientDave: @KateClayDHMC How would you compare yr decision aids w/ what @VMontori of #mayoclinic describes here? http://youtu.be/a8KnOg83cdg #sgshealth vmontori Mon 27 Dec 2010 22:58:27RT @ePatientDave: RT @MayoClinic: Advancing patient-centered care through Shared Decision Making - http://youtu.be/a8KnOg83cdg #sgshealth redeskako Mon 27 Dec 2010 23:30:43RT @ePatientDave: @KateClayDHMC How would you compare yr decision aids w/ what @VMontori of #mayoclinic describes here? http://youtu.be/a8KnOg83cdg #sgshealth roshanpaudel Tue 28 Dec 2010 00:52:35RT @ePatientDave: RT @MayoClinic: Advancing patient-centered care through Shared Decision Making - http://youtu.be/a8KnOg83cdg #sgshealth calamityLDN Tue 28 Dec 2010 11:56:21@ePatientDave Hi Dave wld also be interested to hear @KateClayDHMC comment #mayoclinic #sgshealth kgapo Tue 28 Dec 2010 13:33:44RT @ePatientDave: @KateClayDHMC How would you compare yr decision aids w/ what @VMontori of #mayoclinic describes here? http://youtu.be/a8KnOg83cdg #sgshealth kgapo Tue 28 Dec 2010 13:33:56#sgshealth: who has link to Dartmouths page? RT @vmontori: our Shared Decision Making Resource Page: http://bit.ly/aMPLpA thanks! ePatientDave Tue Dec 28 13:45:32 2010@ePatientDave #sgshealth is this u R looking for? the Center for Informed Choice at Dartmouth kgapo Tue 28 Dec 2010 17:53:07Barbara Ficarra/HuffPost Patient Care: y U the Patient R the Most Important Part of the Health Care Team http://huff.to/f2KQP9 #sgsHealth kgapo Wed 29 Dec 2010 17:46:02@BarbaraFiccara yr post summarises beautifully the essence of the Salzburg Global Seminar Health II http://bit.ly/aKEqPr #sgsHealth kgapo Wed 29 Dec 2010 19:54:23@faethon71 #opnHealth ..ŒºŒµ Œ¥œÖœå ŒªŒ≠ŒæŒµŒπœÇ: "Œ∑ ŒπŒ±œÑœÅŒπŒ∫ŒÆ œÉŒøœÖ œÄŒµœÅŒØŒ∏Œ±ŒªœàŒ∑ ŒµŒæŒ±œÅœÑŒ¨œÑŒ±Œπ Œ±œÄœå œÑŒø œÄŒøœç Œ∂ŒµŒπœÇ" http://bit.ly/fVajqq #sgsHealth kgapo Wed 29 Dec 2010 20:01:21Measuring the quality of long-term care-EuroHealth-London School of Economics http://bit.ly/fvbi1f #opnHealth #sgsHealth kgapo Wed 29 Dec 2010 20:07:02RT @okihiro_t_id @Callooh #plainlanguage tutorial 4 creating informed consent docs http://ow.ly/3vXRc #healthlit #hcsm #sgsHealth #opnHealth kgapo Thu 30 Dec 2010 08:33:05Set of resources 4 any1 prepping 4 a doc visit from x Health Online http://bit.ly/f9RGiX #healthlit #hcsm by @Callooh #opnHealth #sgsHealth kgapo Thu 30 Dec 2010 08:35:14RT @kgapo: @faethon71 #opnHealth ..ŒºŒµ Œ¥œÖœå ŒªŒ≠ŒæŒµŒπœÇ: "Œ∑ ŒπŒ±œÑœÅŒπŒ∫ŒÆ œÉŒøœÖ œÄŒµœÅŒØŒ∏Œ±ŒªœàŒ∑ ŒµŒæŒ±œÅœÑŒ¨œÑŒ±Œπ Œ±œÄœå œÑŒø œÄŒøœç Œ∂ŒµŒπœÇ" http://bit.ly/fVajqq #sgsH ehealthgr Thu 30 Dec 2010 16:07:49RT @kgapo: Measuring the quality of long-term care-EuroHealth-London School of Economics http://bit.ly/fvbi1f #opnHealth #sgsHealth ehealthgr Thu Dec 30 16:09:11 2010@jourPM New response http://bit.ly/hlEJsV to article on June JAMA article (effect of pt engagemt on decisions) #sgshealth ePatientDave Mon Jan 03 15:34:24 2011Prof. John Wennberg/Braveheart=weapons intellectual bravery & dogged sense of doing the rt thing #opnHealth #sgsHealth http://bit.ly/dMglMe kgapo Tue 04 Jan 2011 10:26:15Œ≥ŒπŒ±œÑŒØ Œ¥ŒµŒΩ Œ≠œáŒøœÖŒºŒµ Œ≠ŒΩŒ± ŒïŒªŒªŒ∑ŒΩŒ± Prof. John Wennberg ŒΩŒ± ŒªœçœÉŒµŒπ œÑŒøŒΩ Œ≥œåœÅŒ¥ŒπŒø Œ¥ŒµœÉŒºœå œÑŒ∑œÇ œÖŒ≥ŒµŒØŒ±œÇ? #opnHealth #sgsHealthkgapo Tue 04 Jan 2011 10:51:57RT @kgapo: Œ≥ŒπŒ±œÑŒØ Œ¥ŒµŒΩ Œ≠œáŒøœÖŒºŒµ Œ≠ŒΩŒ± ŒïŒªŒªŒ∑ŒΩŒ± Prof. John Wennberg ŒΩŒ± ŒªœçœÉŒµŒπ œÑŒøŒΩ Œ≥œåœÅŒ¥ŒπŒø Œ¥ŒµœÉŒºœå œÑŒ∑œÇ œÖŒ≥ŒµŒØŒ±œÇ? #opnHealth #sgsHealth ehealthgr Tue 04 Jan 2011 11:50:47RT @kgapo: Prof. John Wennberg/Braveheart=weapons intellectual bravery & dogged sense of doing the rt thing #opnHealth #sgsHealth http://bit.ly/dMglMe ehealthgr Tue 04 Jan 2011 11:52:35RT @kgapo: Prof. John Wennberg/Braveheart=weapons intellectual bravery & dogged sense of doing the rt thing #opnHealth #sgsHealth http://bit.ly/dMglMe dartmouthnow Tue 04 Jan 2011 13:57:08Tech. isnt evrything in hlthcare Still need 2 address culture education recruitment..politics http://bit.ly/gsF0LM #opnHealth #sgsHealth kgapo Tue 04 Jan 2011 15:52:39RT @kgapo: Prof. John Wennberg/Braveheart=weapons intellectual bravery & dogged sense of doing the rt thing #opnHealth #sgsHealth http://bit.ly/dMglMe ePatientDave Tue 04 Jan 2011 16:02:32RT @kgapo: Tech. isnt evrything in hlthcare Still need 2 address culture education recruitment..politics http://bit.ly/gsF0LM #opnHealth #sgsHealth ehealthgr Tue 04 Jan 2011 16:21:27fave twt @HealthIsSocial That‚Äôs wht ths (social) media R 4: 2 make differences tht matter http://bit.ly/gsF0LM #opnHealth #hcsmeu #sgsHealth kgapo Tue 04 Jan 2011 16:23:45RT @kgapo love it! Prof. John Wennberg as Braveheart! #sgsHealth http://bit.ly/dMglMe FIMDM Tue 04 Jan 2011 23:57:35But it didnt end well for Braveheart RT @FIMDM: RT @kgapo love it! Prof. John Wennberg as Braveheart! #sgsHealth http://bit.ly/dMglMe ivanoransky Tue 04 Jan 2011 23:58:27@ivanoransky #sgsHealth Braveheart and other stories may not end well but if they teach us something they are worth reading/listening to... kgapo Wed 05 Jan 2011 17:14:49RT @FIMDM: RT @kgapo love it! Prof. John Wennberg as Braveheart! #sgsHealth http://bit.ly/dMglMe kgapo Wed 05 Jan 2011 17:15:08@ivanoransky @FIMDM #sgsHealth thank you for comments & RTs kgapo Wed 05 Jan 2011 17:17:03Prof. J. Ioannidis: Statistically significant findings -http://bit.ly/gi26Rq #opnHealth #sgsHealth kgapo Thu 06 Jan 2011 07:19:01Prof. J.Ioannidis-Molecular EBM-Evolution & integration of information in the genomic era http://bit.ly/i0V0QG #opnHealth #sgsHealth kgapo Thu 06 Jan 2011 07:22:01RT @kgapo: Prof. J.Ioannidis-Molecular EBM-Evolution & integration of information in the genomic era http://bit.ly/i0V0QG #opnHealth #sgsHealth ehealthgr Thu 06 Jan 2011 09:31:04gr8 Rsource: The CAHPS Improvment Guide-Practical Strategies 4 Improving Patient Care Experience #opnHealth #sgsHealth http://bit.ly/hLERxD kgapo Fri Jan 07 11:37:41 2011RT @kgapo: gr8 Rsource: The CAHPS Improvment Guide-Practical Strategies 4 Improving Patient Care Experience #opnHealth #sgsHealth http://bit.ly/hLERxD alexanderberler Fri 07 Jan 2011 16:32:05RT @ehealthgr: Shared Decision Making¬†Tools http://ow.ly/3ALIm #opnhealth #sgsHealth #epatientGR kgapo Sun 09 Jan 2011 22:34:13"Oh thats God he thinks he is a doctor" http://bit.ly/fTcYOQ #hcsm via @Doctor_V @FutureDocs #opnHealth #sgsHealth kgapo Sun 09 Jan 2011 22:41:40Oh thats God he thinks he is a doctor http://bit.ly/fTcYOQ #hcsm via @Doctor_V @FutureDocs #opnHealth #sgsHealth kgapo Sun Jan 09 22:41:40 2011RT @kgapo: "Oh thats God he thinks he is a doctor" http://bit.ly/fTcYOQ #hcsm via @Doctor_V @FutureDocs #opnHealth #sgsHealth DreamTrapped Sun 09 Jan 2011 22:46:08RT @kgapo: "Oh thats God he thinks he is a doctor" http://bit.ly/fTcYOQ #hcsm via @Doctor_V @FutureDocs #opnHealth #sgsHealth DreamTrapped Sun Jan 09 22:46:08 2011RT @kgapo: "Oh thats God he thinks he is a doctor" http://bit.ly/fTcYOQ #hcsm via @Doctor_V @FutureDocs #opnHealth #sgsHealth DocForeman Sun 09 Jan 2011 23:52:30RT @kgapo: "Oh thats God he thinks he is a doctor" http://bit.ly/fTcYOQ #hcsm via @Doctor_V @FutureDocs #opnHealth #sgsHealth ehealthgr Mon 10 Jan 2011 03:49:44RT @ePatientDave: Shazow! RT @FIMDM: Slides videos photos more from Salzburg Global Seminar are up http://bit.ly/hBGa3L #sgshealth. midwifeamy Tue Jan 11 20:09:11 2011 Page  24

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