The document is a transcript of a tweetchat under the hashtag #hpm, where participants discuss various topics related to hospice and palliative care, including the language used around death and dying. Key issues include the struggle to communicate effectively about end-of-life care and the need for a cultural revolution in attitudes towards death. Participants shared articles, personal thoughts, and planned future discussions, highlighting the importance of openness in discussing death.

1. TweetChat - #hpm http://tweetchat.com/room/hpm
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a_singledrop RT @MeredithGould: We have so much trouble telling the truth about life,
how can we expect openness & honesty about death? #hpm -9:28 PM Jul 28th, 2010
pHealth RT @hcsmSV: RT @DrDavidBallard: Q&A: Mayo Clinic’s New Center for Social
Media (@WSJ Health Blog) http://bit.ly/d4O3Tz
#health #healthcare #hcsm #hpm -9:26 PM Jul 28th, 2010
hcsmSV RT @Y_A_H_A: "What Do You Do Today To Get Ready For Tomorrow?"
@AIDSgov talks about Young Adults http://ow.ly/2hSHY #hpm -9:20 PM Jul 28th, 2010
hcsmSV RT @klxmedia: RT @mashsocialmedia: How Social Media Can Make Us More
Productive http://ow.ly/2i0r0 #hpm -9:18 PM Jul 28th, 2010
erinwarde RT @MeredithGould: We have so much trouble telling the truth about life, how
can we expect openness & honesty about death? #hpm -9:18 PM Jul 28th, 2010
hcsmSV RT @renee_berry: Healthcare and Social Media: Bringing the Focus Back to the
Patient http://bit.ly/b4O6H0 via @a_signledrop #hpm -9:18 PM Jul 28th, 2010
revdoc Goodnight, all! Chat with you next week #hpm -9:14 PM Jul 28th, 2010
healthtap RT @hcsmSV: RT @DrDavidBallard: Q&A: Mayo Clinic’s New Center for Social
Media (@WSJ Health Blog) http://bit.ly/d4O3Tz #health #healthcare #hcsm #hpm
-9:14 PM Jul 28th, 2010
revdoc @renee_berry Perfect shirt for Christian! #hpm -9:12 PM Jul 28th, 2010
crgonzalez @MeredithGould LOL (perfect Old Spice riff) #hpm -9:09 PM Jul 28th, 2010
renee_berry RT @sharingstrength: RT @ctsinclair: Same time next week for #HPM
tweetchat. Wednesday 9 Eastern, 6 Pacific. Any offers to host?' #hpm -9:09 PM Jul 28th, 2010
MeredithGould @renee_berry And I guess clutching at your throat and staggering
wouldn't be professional, eh? #hpm -9:08 PM Jul 28th, 2010
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2. TweetChat - #hpm http://tweetchat.com/room/hpm
MeredithGould @ctsinclair Go for it. "Look at that dead body, now look at mine"...
#hpm -9:08 PM Jul 28th, 2010
renee_berry @MeredithGould right?! yes expired, I visibly cringed every time I heard it.
tried to find professional ways of verbalizing my concerns #hpm -9:07 PM Jul 28th, 2010
revdoc @crgonzalez What a long strange trip it's been... #hpm -9:06 PM Jul 28th, 2010
sharingstrength Thank you everyone for contributing to my #hpm continuing ed. I'm on
holidays and won't be joining you for a couple of weeks. -9:06 PM Jul 28th, 2010
MeredithGould We have so much trouble telling the truth about life, how can we expect
openness & honesty about death? #hpm -9:06 PM Jul 28th, 2010
renee_berry @ctsinclair @revdoc @MeridithGould Or put this T on http://ow.ly
/2i5b4 #hpm -9:06 PM Jul 28th, 2010
crgonzalez @MeredithGould "Dead" could work, but you need some Grateful Dead band
members to endorse it ala "I'm a Dead Head" #hpm -9:05 PM Jul 28th, 2010
revdoc RT @MeredithGould: @renee_berry "Expired"...like milk? Agree. Dead is dead.
Not passed, not expired. #hpm -9:05 PM Jul 28th, 2010
sharingstrength True enough. But @ctsinclair started it. RT @MeredithGould:
@sharingstrength "Viral" like that's not a scary word! #hpm -9:04 PM Jul 28th, 2010
MeredithGould @renee_berry "Expired"...like milk? #hpm -9:04 PM Jul 28th, 2010
MeredithGould @renee_berry I'm fond of "dead" but don't generally get a lot of support
for that word. #hpm -9:03 PM Jul 28th, 2010
revdoc Maybe the Old Spice guy would do it! Christian, keep your shirt on. #hpm -9:03 PM Jul
28th, 2010
sharingstrength RT @ctsinclair: Same time next week for #HPM tweetchat. Wednesday
9 Eastern, 6 Pacific. Any offers to host?' #hpm -9:03 PM Jul 28th, 2010
tymeyer @SheyontheBay Thanks all, enjoyed the chat! #hpm -9:03 PM Jul 28th, 2010
MeredithGould @ctsinclair Get spray painted. #hpm -9:03 PM Jul 28th, 2010
renee_berry @MeredithGould how about using the word 'expired?' ...terrible I know but
I've heard it far too often! #hpm -9:03 PM Jul 28th, 2010
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3. TweetChat - #hpm http://tweetchat.com/room/hpm
ctsinclair Good night all! #hpm -9:03 PM Jul 28th, 2010
ctsinclair Of course we would need to hire an actor with better abs than mine! #hpm -9:03
PM Jul 28th, 2010
sharingstrength Enjoy! RT @SheyontheBay: Good luck to @tymeyer and wife!! Mazel
tov! #hpm -9:02 PM Jul 28th, 2010
MeredithGould @sharingstrength "Viral" like that's not a scary word! #hpm -9:02 PM Jul
28th, 2010
ctsinclair I so want to do an @OldSpice parody for hospice and palliative care #hpm -9:02
PM Jul 28th, 2010
ctsinclair RT @SheyontheBay: Good luck to @tymeyer and wife!! Mazel tov! 'Yes please
let us know!' #hpm -9:01 PM Jul 28th, 2010
sharingstrength RT @ctsinclair: @crgonzalez Groovy care - Love it! #hpm //you'd
have a better chance at going viral :-)) -9:01 PM Jul 28th, 2010
ctsinclair RT @hollyby: @ctsinclair Same time next week for #HPM tweetchat?
Wednesday 9 Eastern, 6 Pacific? 'YUP! Any offers to host?' #hpm -9:01 PM Jul 28th, 2010
SheyontheBay Good luck to @tymeyer and wife!! Mazel tov! #hpm -9:01 PM Jul 28th, 2010
MeredithGould RT @ctsinclair: @MeredithGould We need a cultural revolution in
attitudes towards death and by extension life//Let's do it! #hpm -9:01 PM Jul 28th, 2010
revdoc @SheyontheBay OOOoooo. I like it! #hpm -9:01 PM Jul 28th, 2010
MeredithGould @renee_berry I know and I obviously agree. "Passed" just doesn't quite
capture the corporeal reality. #hpm -9:00 PM Jul 28th, 2010
ctsinclair @JDRFQUEEN We are almost done! Hang in there! #hpm -9:00 PM Jul 28th, 2010
sharingstrength @MeredithGould True. Not being able to use the word dying makes
SEO of #hpm websites nearly impossible too. -9:00 PM Jul 28th, 2010
revdoc @ctsinclair Miss the LIVE show? Crazy talk! #hpm -9:00 PM Jul 28th, 2010
renee_berry RT @SheyontheBay: @revdoc I'm still thinkin' mandatory EOL education
for license renewal!! Like infection control and child abuse here in NY! #hpm -9:00 PM Jul 28th,
2010
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4. TweetChat - #hpm http://tweetchat.com/room/hpm
hollyby @ctsinclair Same time next week for #HPM tweetchat? Wednesday 9 Eastern, 6
Pacific? #hpm -9:00 PM Jul 28th, 2010
ctsinclair @MeredithGould We need a cultural revolution in attitudes towards death and
by extension life #hpm -9:00 PM Jul 28th, 2010
JDRFQUEEN need to filter out my #hpm from my #dsma you have no idea how weird my
twitter stream looks right now! -9:00 PM Jul 28th, 2010
SheyontheBay @revdoc I'm still thinkin' mandatory EOL education for license renewal!!
Like infection control and child abuse here in NY! #hpm -9:00 PM Jul 28th, 2010
revdoc @ctsinclair Yep--last week I nearly blew a neuron! #hpm -9:00 PM Jul 28th, 2010
renee_berry @MeredithGould I think word like dying are not what people want to hear
but it is what they need to hear. #hpm -8:59 PM Jul 28th, 2010
ctsinclair @crgonzalez Groovy care - Love it! #hpm -8:59 PM Jul 28th, 2010
revdoc @SheyontheBay Most docs won't think about this until someone has been in hosp
many, many, many times and crashed beyond repair #hpm -8:59 PM Jul 28th, 2010
sharingstrength RT @ctsinclair: [Twitter Tip] when referring to the Gawande article
include @NewYorker maybe they will take notice? #hpm -8:59 PM Jul 28th, 2010
ctsinclair @revdoc DVR? Tweet during commercials? This was a bit of a slower pace
tonight, which probably helped! #hpm -8:59 PM Jul 28th, 2010
tymeyer RT @SheyontheBay: @revdoc Yes, during their FINAL hospital admission...dont
most have mult. hosp admits during the disease trajectory? #hpm -8:58 PM Jul 28th, 2010
MeredithGould @revdoc LOL. And I was in the throes of resolving an identity theft
situation that has been going on for days!! #hpm -8:58 PM Jul 28th, 2010
crgonzalez Quality of Life Care? (too sterile) Groovy Care? (just kidding) Temporal Care?
(too new age) ...where's the Madison Avenue ad geniuses? #hpm -8:58 PM Jul 28th, 2010
MeredithGould Is there any easy but accurate language to substitute for "hospice"? How
could there be when we can't even use words like "dying." #hpm -8:58 PM Jul 28th, 2010
revdoc This would be SO much easier if I were not trying to watch So You Think You Can
Dance at the same time! #hpm -8:58 PM Jul 28th, 2010
hollyby RT @revdoc: We need to show the stats on how pts live longer, have < $, >
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5. TweetChat - #hpm http://tweetchat.com/room/hpm
satisfaction, less PTSD for families. '< CG morbidity too!' #hpm -8:58 PM Jul 28th, 2010
ctsinclair OK another great Tweetchat! Wrapping up, please leave us with your last
thoughts for the night! #hpm -8:57 PM Jul 28th, 2010
SheyontheBay @revdoc Yes, during their FINAL hospital admission...don't most have
multiple hospital admissions during the disease trajectory? #hpm -8:57 PM Jul 28th, 2010
sharingstrength RT @ctsinclair: Would love for something viral like @GirlEffect for
hospice and palliative medicine. http://www.girleffect.org/ #hpm -8:57 PM Jul 28th, 2010
ctsinclair [Twitter Tip] when referring to the Gawande article include @NewYorker maybe
they will take notice? #hpm -8:57 PM Jul 28th, 2010
sharingstrength I see, but this wouldn't be used with the patient/family right? RT
@ctsinclair: @Sheyonthebay ...we use 'come on to hospice services' #hpm -8:56 PM Jul 28th,
2010
SheyontheBay Apples and oranges: referring docs and pts/families. Consider the WIFM
factor: what's in it for me? #hpm -8:56 PM Jul 28th, 2010
inhousehospice RT @hollyby: We need to help people know that people can live longer
on hospice than without it. Nice that Gawande mentioned it too. #hpm -8:56 PM Jul 28th, 2010
ctsinclair RT @SheyontheBay: first person to introduce MUST be trained/hpm savvy. 'A
dream for sure. Some make our job way easier, some harder.' #hpm -8:56 PM Jul 28th, 2010
revdoc @SheyontheBay Still often too late. We see a lot of hospital to inpt hospice #hpm
-8:56 PM Jul 28th, 2010
ctsinclair RT @revdoc: We need to show cardio, pulm, onc the stats on how pts live
longer, have lower $, more satisfaction, less PTSD for families #hpm -8:55 PM Jul 28th, 2010
hollyby @SheyontheBay We need to help people know that people can live longer on
hospice than without it. Nice that Gawande mentioned it too. #hpm -8:55 PM Jul 28th, 2010
SheyontheBay first person to introduce MUST be trained/hpm savvy. Mandatory palliative
consults in hospital to start? #hpm -8:55 PM Jul 28th, 2010
revdoc We need to show cardio, pulm, onc the stats on how pts live longer, have lower
costs, more satisfaction, less PTSD for families #hpm -8:55 PM Jul 28th, 2010
ctsinclair @sharingstrength @Sheyonthebay - Locally we use 'come on to hospice
services' may extend from 'coming on the Medicare Benefit' #hpm -8:54 PM Jul 28th, 2010
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6. TweetChat - #hpm http://tweetchat.com/room/hpm
tymeyer @sharingstrength Right, I use support for patients/families who aren't
necessarily aware of prior use of "supportive" in onc circles #hpm -8:54 PM Jul 28th, 2010
SheyontheBay @ctsinclair Yup, once we get past the word. Some shut down as soon as
the word is mentioned. As in, "thehospice nurse is here..." First #hpm -8:54 PM Jul 28th, 2010
ctsinclair RT @revdoc: Emphasis on upstream palliative care so we are not so scary when
people come near end of life--we continue what we do best #hpm -8:53 PM Jul 28th, 2010
renee_berry RT @revdoc: Emphasis on upstream palliative care so that we are not so
scary when people come to the end of life--we just continue what we do best #hpm -8:53 PM
Jul 28th, 2010
sharingstrength @SheyontheBay Is this phrase commonly used to "come on hospice"?
As in go on a treatment? interesting. #hpm -8:53 PM Jul 28th, 2010
ctsinclair Would love for something viral like @GirlEffect for hospice and palliative
medicine. http://www.girleffect.org/ #hpm -8:53 PM Jul 28th, 2010
revdoc Emphasis on upstream palliative care so that we are not so scary when people
come to the end of life--we just continue what we do best #hpm -8:52 PM Jul 28th, 2010
sharingstrength @tymeyer I suspect your use of supportive would only be confusing to
those who have encountered it used for symptom management prior to #hpm -8:52 PM Jul 28th,
2010
ctsinclair @SheyontheBay ...to say, let's try to give the full benefit of hospice and get the
most time we can with the help. #hpm -8:51 PM Jul 28th, 2010
SheyontheBay @hollyby As long as the perception is "They came on hospice and were
dead within a week" we need time for a new paradigm #hpm -8:50 PM Jul 28th, 2010
ctsinclair @SheyontheBay I flip the hospice = death within days/weeks meme to say, it is
actually true, b/c of cultural avoidance. then I go on... #hpm -8:50 PM Jul 28th, 2010
tymeyer @hollyby That has been our conversation and reason we haven't changed names
yet #hpm -8:50 PM Jul 28th, 2010
sharingstrength RT @ctsinclair: It is very possible whatever we change the name to is
likely to be stigmatized. #hpm / i dare say likely. -8:50 PM Jul 28th, 2010
renee_berry RT @hollyby: I wonder if we all abandoned the names "hospice" or
"palliative" how quickly "supportive care" would become the new feared words. #hpm -8:50
PM Jul 28th, 2010
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7. TweetChat - #hpm http://tweetchat.com/room/hpm
inhousehospice @SheyontheBay It's the truth! So many families believes hospice=last
days.. That's why it's become the "h-word".. #hpm -8:49 PM Jul 28th, 2010
sharingstrength @ctsinclair @tymeyer interesting how you use opposite words to
acheive same goal: comfort to patient and family #hpm -8:49 PM Jul 28th, 2010
ctsinclair @hollyby: And people might even use air quotes around the word 'support' for
sarcasm/doubt #hpm -8:49 PM Jul 28th, 2010
SheyontheBay @ctsinclair But people have been ingrained to associate"hospice" with
death - within days/weeks! Even had docs saying it to me #hpm -8:49 PM Jul 28th, 2010
revdoc RT @SheyontheBay: We need a good word, invoking the science of medicine with
the goals of living well. Agreed! #hpm -8:48 PM Jul 28th, 2010
inhousehospice RT @ctsinclair: It is very possible whatever we change the name to is
likely to be stigmatized. "very true." #hpm -8:48 PM Jul 28th, 2010
hollyby I wonder if we all abandoned the names "hospice" or "palliative" how quickly
"supportive care" would become the new feared words. #hpm -8:48 PM Jul 28th, 2010
SheyontheBay @ctsinclair Me too. We need a good word, invoking the science of
medicine with the goals of living well. Brainstorm? #hpm -8:47 PM Jul 28th, 2010
ctsinclair It is very possible whatever we change the name to is likely to be stigmatized.
#hpm -8:47 PM Jul 28th, 2010
renee_berry RT @hollyby Branding is important. Both run the risk= "do nothing" or only
hospice instead of upstream concurrent care Education is key #hpm -8:47 PM Jul 28th, 2010
revdoc Spoonful of sugar strategy? I just don't want to "trick" people into something by
calling a rose by any other name #hpm -8:47 PM Jul 28th, 2010
tymeyer RT True but helps with desciption for me @sharingstrength: T3: But supportive
care is not necessarily the equivalent of palliative care #hpm -8:47 PM Jul 28th, 2010
ctsinclair I actually use the mystery surrounding 'palliative' to allow me to tailor my
definition to what the patients immediate needs are. #hpm -8:46 PM Jul 28th, 2010
sharingstrength RT @crgonzalez: @ctsinclair reading your article, stunned by how
many ppl claimed term palliative care caused them distress! #hpm /me too -8:46 PM Jul 28th,
2010
hollyby T3: Branding is important. Both run the risk = "do nothing" or only hospice instead
of upstream concurrent care. Education is key. #hpm -8:46 PM Jul 28th, 2010
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8. TweetChat - #hpm http://tweetchat.com/room/hpm
ctsinclair Oncologists typically use the word 'supportive' care, and peers see increase in
consults when name changed to 'supportive' #hpm -8:45 PM Jul 28th, 2010
crgonzalez @ctsinclair Wow. In reading your article I'm stunned by how many
respondents claimed the term palliative care caused them distress! #hpm -8:45 PM Jul 28th, 2010
tymeyer Supportive in that we will help discuss issues as they arrive, help you be more
comfortable and will keep fam up to date #hpm -8:45 PM Jul 28th, 2010
ctsinclair @SheyontheBay I am proud of 'hospice' and 'palliative' but if a barrier to getting
more good care to ppl, I (think) I can get over it #hpm -8:44 PM Jul 28th, 2010
sharingstrength RT @ctsinclair: For more background reading on Supportive Care v
Palliative Care see @Pallimed 2009 post http://bit.ly/idXIc #hpm -8:44 PM Jul 28th, 2010
sharingstrength T3: But supportive care is not necessarily the equivalent of palliative
care. #hpm -8:44 PM Jul 28th, 2010
SheyontheBay I'm proud of "hospice" but the word itself is an incredible obstacle #hpm
-8:43 PM Jul 28th, 2010
ctsinclair RT @tymeyer: Actually use "supportive care" when describing "palliative care" "I
do as well.' #hpm -8:43 PM Jul 28th, 2010
sharingstrength Like this topic. RT @ctsinclair: Topic #3: Palliative Care/Medicine vs.
Supportive Care? Does the name really make a difference? #hpm -8:43 PM Jul 28th, 2010
revdoc "Supportive care" to me sounds more like our field is not grounded in good
medicine/science? Sounds like a "soft" care? #hpm -8:43 PM Jul 28th, 2010
ctsinclair For more background reading on Supportive Care v Palliative Care see
@Pallimed 2009 post http://bit.ly/idXIc #hpm -8:42 PM Jul 28th, 2010
sharingstrength Mentors are vital in peer support forums RT @ctsinclair: RT
@crgonzalez: Having a buddy system makes #hpm approachable. #hpm -8:42 PM Jul 28th,
2010
tymeyer Actually use "supportive care" when describing "palliative care" #hpm -8:42 PM Jul
28th, 2010
crgonzalez T3: This is where health literacy kicks in. A lot people don't know the meaning
of the word palliative #hpm -8:41 PM Jul 28th, 2010
ctsinclair @crgonzalez Insurance companies have used Case managers with more
palliative care knowledge to check in on pts w/ chronic dz #hpm -8:41 PM Jul 28th, 2010
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9. TweetChat - #hpm http://tweetchat.com/room/hpm
sharingstrength Thanks everyone for the input on topic 2 #hpm -8:41 PM Jul 28th, 2010
sharingstrength RT @hollyby: use in bereavement, especially of teen and tweens. It
would be a good combo of tech and peer group. #hpm -8:40 PM Jul 28th, 2010
crgonzalez @ctsinclair Exactly. #hpm -8:40 PM Jul 28th, 2010
ctsinclair Topic #3: Palliative Care/Medicine vs. Supportive Care? Does the name really
make a difference? #hpm -8:40 PM Jul 28th, 2010
renee_berry RT @revdoc: Look at some of the tribute pages on FB--it is not just the kids
posting in bereavement. I agree #hpm -8:39 PM Jul 28th, 2010
ctsinclair RT @crgonzalez: Having a buddy system makes #hpm approachable. 'like
breast CA navigators?' #hpm -8:39 PM Jul 28th, 2010
tymeyer RT I like that. @hollyby: Could be interesting to use in bereavement, especially
of teen and tweens. #hpm -8:39 PM Jul 28th, 2010
SheyontheBay http://dev.mycarecommunity.com/ - sustained by large insurance
company #hpm -8:39 PM Jul 28th, 2010
ctsinclair Getting ready to move to Topic #3..... #hpm -8:38 PM Jul 28th, 2010
revdoc Look at some of the tribute pages on FB--it is not just the kids posting in
bereavement. (I have posted on pages of deceased friends) #hpm -8:38 PM Jul 28th, 2010
crgonzalez @ctsinclair Having a buddy system makes hospice and palliative care
approachable. I'd like a "Palliative Pal" from HC pros to get info #hpm -8:38 PM Jul 28th, 2010
hollyby Could be interesting to use in bereavement, especially of teen and tweens. It would
be a good combo of tech and peer group. #hpm -8:37 PM Jul 28th, 2010
revdoc @ctsinclair Agreed. There is a lot of crap on the web #hpm -8:37 PM Jul 28th, 2010
ctsinclair What about putting out good material on various SM platforms with ability to
comment/share and you get a virtual/open community? #hpm -8:37 PM Jul 28th, 2010
ctsinclair RT @revdoc: Would we run the risk of creating another "junk information"
anecdotal forum? 'Would need heavy moderation = time = $' #hpm -8:36 PM Jul 28th, 2010
renee_berry RT @hollyby RT @crgonzalez I like what CaringBridge does allowing
patients &family to connect loved ones with their own SM hub Agreed! #hpm -8:36 PM Jul 28th,
2010
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10. TweetChat - #hpm http://tweetchat.com/room/hpm
sharingstrength RT @ctsinclair: forming online comm. in #hpm requires trusting others
w/ potentially intense issues, tough to build trust in short time #hpm -8:36 PM Jul 28th, 2010
revdoc Would we run the risk of creating another "junk information" anecdotal forum?
#hpm -8:36 PM Jul 28th, 2010
hollyby RT @crgonzalez: I like what CaringBridge does in allowing patients & family to
connect loved ones with their own SM hub. 'Agreed!' #hpm -8:35 PM Jul 28th, 2010
ctsinclair Have imagined it would be nice to see a hospice have online forums, where
family members could use each other for support. Examples? #hpm -8:35 PM Jul 28th, 2010
renee_berry @revdoc bring palliative care into popular culture #hpm -8:35 PM Jul 28th, 2010
sharingstrength Yes RT @crgonzalez: I like what CaringBridge does in allowing patients
& family to connect loved ones with their own SM hub. #hpm -8:34 PM Jul 28th, 2010
revdoc @crgonzalez Love Caring Bridge #hpm -8:34 PM Jul 28th, 2010
sharingstrength RT @ctsinclair: need to reach out to family members who are looking
for help. Kind of augmenting the 24/7 on-call nurse availability #hpm -8:34 PM Jul 28th, 2010
ctsinclair Although many a patient has told me it is easier to talk abt some of the most
difficult things to a stranger compared to familiar face #hpm -8:34 PM Jul 28th, 2010
hollyby Online or otherwise communities of people receiving #HPM services will come
down to marketing it correctly and providing useful info #hpm -8:34 PM Jul 28th, 2010
revdoc "Palliative care" ed would be more palatable to wider community--but could
increase knowledge that there "is something we can do" #hpm -8:34 PM Jul 28th, 2010
SheyontheBay Focus on: 'It's about how you live' not the dreaded H-word #hpm -8:33 PM Jul
28th, 2010
sharingstrength @ctsinclair HTN meds? #hpm -8:33 PM Jul 28th, 2010
ctsinclair And forming an online community in #hpm requires trusting others with
potentially intense issues, tough to build trust in short time #hpm -8:33 PM Jul 28th, 2010
crgonzalez @sharingstrength I like what CaringBridge does in allowing patients & family
to connect loved ones with their own SM hub. #hpm -8:33 PM Jul 28th, 2010
sharingstrength And sustaining. RT @MeredithGould: @sharingstrength So the
question is how to building communities among those folks? #hpm -8:33 PM Jul 28th, 2010
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11. TweetChat - #hpm http://tweetchat.com/room/hpm
hollyby Many people don't want to focus on the #HPM experience, b/c often it is still about
fighting XYZ disease & trying to feel normal #hpm -8:32 PM Jul 28th, 2010
sharingstrength I would like to discuss the particular challenges of sustaining an online
peer support community in #hpm -8:32 PM Jul 28th, 2010
ctsinclair RT @revdoc: How your heart works vs how you die carry diff levels of emotional
overlay-careful with tone w/o face to go w/ explan #hpm -8:32 PM Jul 28th, 2010
SheyontheBay reach out to tech-savvy 30/40yr olds,may be searching 4 info 4 their
parents needs. #hpm -8:32 PM Jul 28th, 2010
revdoc Trying 2 explain mechanics of dying could come across very cold if we just put up
"technical" stuff or gooshy if we stray too emotional #hpm -8:32 PM Jul 28th, 2010
sharingstrength The challenges of getting ppl to participate online are common not matter
what disease type or state (managing or palliative) #hpm -8:31 PM Jul 28th, 2010
ctsinclair I think we need to be reaching out to family members who are looking for help.
Kind of augmenting the 24/7 on-call nurse availability #hpm -8:31 PM Jul 28th, 2010
revdoc How your heart works vs how you die carry different levels of emotional
overlay--need to be careful with tone w/o face to go w/ explan #hpm -8:31 PM Jul 28th, 2010
ctsinclair @sharingstrength Well when talking about using SM to educate patients about
HTN meds, it is about a chronic dz management #hpm -8:30 PM Jul 28th, 2010
renee_berry RT @ctsinclair @revdoc I think the age barrier to tech is a surrogate4
openess 2new experiences/curiosity which varies w/any age cohort #hpm -8:30 PM Jul 28th, 2010
ctsinclair RT @MeredithGould: So the question is how to building communities among
pt/family? 'Maybe a good role for volunteers?' #hpm -8:29 PM Jul 28th, 2010
sharingstrength For sure. RT @MeredithGould: @sharingstrength Maybe the "peers"
are the caregivers/family members? #hpm -8:29 PM Jul 28th, 2010
revdoc Yep--Skype may be next on Mom's list with grandchildren off to college #hpm -8:29
PM Jul 28th, 2010
sharingstrength Can u explain the differences? RT @ctsinclair: When I hear other
specialties talk about pt education & sm, doesn't seem to fit for #hpm -8:29 PM Jul 28th, 2010
crgonzalez RT @MeredithGould @revdoc Boomers & older are generally introduced to
and become engaged by social media b/c of grandkids. #hpm -8:29 PM Jul 28th, 2010
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12. TweetChat - #hpm http://tweetchat.com/room/hpm
ctsinclair @revdoc I think the 'age barrier to tech' is a surrogate for 'openess to new
experiences/curiosity' which varies w/ any age cohort #hpm -8:29 PM Jul 28th, 2010
MeredithGould @sharingstrength So the question is how to building communities
among those folks? #hpm -8:28 PM Jul 28th, 2010
MeredithGould @revdoc And we're discovering that boomers & older are generally
introduced to and become engaged by social media b/c of grandkids. #hpm -8:28 PM Jul 28th,
2010
ctsinclair Searching for info about #hpm versus entering into communities and
participating are two very different ways to use the web #hpm -8:28 PM Jul 28th, 2010
sharingstrength @SheyontheBay my query was focused on the patient/family audience
#hpm -8:27 PM Jul 28th, 2010
revdoc We could do pain and other sx mgmt ed virtually #hpm -8:27 PM Jul 28th, 2010
sharingstrength RT @SheyontheBay: challenges: two-fold target market: providers and
patients/families - different needs, different usage #hpm -8:27 PM Jul 28th, 2010
revdoc Of course, that is a gross generalization because I know folks of all ages who do or
do not embrace tech #hpm -8:26 PM Jul 28th, 2010
hollyby T2: Getting those that are internet savvy to the online community, difficult subject
matter, exhausted pts and families even if willing #hpm -8:26 PM Jul 28th, 2010
sharingstrength RT @ctsinclair: I think biggest barrier to online communities is short
timespan people receive hospice or palliative care services #hpm -8:26 PM Jul 28th, 2010
MeredithGould @sharingstrength Maybe the "peers" are the caregivers/family
members? #hpm -8:26 PM Jul 28th, 2010
renee_berry RT @MeredithGould: Barrier: denial and resistance to end-of-life planning in
advance. #hpm -8:26 PM Jul 28th, 2010
ctsinclair When I hear other specialties (Cards/Oncology/Renal) talk about patient
education and social media, it doesn't seem to fit for hospice #hpm -8:26 PM Jul 28th, 2010
renee_berry @ctsinclair isn't part of that because people are not aware of palliative
services till the very end? #hpm -8:26 PM Jul 28th, 2010
revdoc Certain pop. cohorts are not familiar with tech: my mother isn't on FB or Twitter-
barely have her emailing. My daus won't use Twitter #hpm -8:26 PM Jul 28th, 2010
12 of 20 7/28/2010 10:04 PM

13. TweetChat - #hpm http://tweetchat.com/room/hpm
MeredithGould Barrier: denial and resistance to end-of-life planning in advance. #hpm
-8:26 PM Jul 28th, 2010
sharingstrength maintaining an online #hpm community of peer support must be
challenging given that the members are dying and internally focussed. -8:25 PM Jul 28th, 2010
SheyontheBay challenges: two-fold target market: providers and patients/families -
different needs, different usage #hpm -8:25 PM Jul 28th, 2010
ctsinclair I think the biggest barrier to online communities is the short timespan people
receive hospice or palliative care services #hpm -8:24 PM Jul 28th, 2010
renee_berry RT @revdoc: Fear on the part of administrations, worries about HIPPA, not
tech savvy enough to feel comfortable with this new-fangled stuff #hpm -8:23 PM Jul 28th, 2010
ctsinclair @hollyby I think the story makes the article. I was talking with someone on
LinkedIn Forum about how to take parts to put in brochure #hpm -8:23 PM Jul 28th, 2010
MeredithGould Faced by...? @sharingstrength Please clarify. #hpm -8:23 PM Jul 28th, 2010
revdoc Fear on the part of administrations, worries about HIPPA, not tech savvy enough to
feel comfortable with this new-fangled stuff #hpm -8:23 PM Jul 28th, 2010
ctsinclair @renee_berry Gawande was Topic #1, now moving onto Topic #2 #hpm -8:22
PM Jul 28th, 2010
MeredithGould RT @ctsinclair: Topic #2: What challenges are faced in supporting online
communities in hospice or palliative care? #hpm -8:22 PM Jul 28th, 2010
hollyby Maybe but people love a good story @ctsinclair: I think a abbreviated version of
this article would be better for mass distribution. #hpm -8:22 PM Jul 28th, 2010
ctsinclair @sharingstrength can clarify any points on how I worded the questions. I
believe she is asking more about patient/family online com, #hpm -8:22 PM Jul 28th, 2010
renee_berry @ctsinclair is this our T1? #hpm -8:21 PM Jul 28th, 2010
ctsinclair Topic #2: What challenges are faced in supporting online communities in hospice
or palliative care? #hpm -8:21 PM Jul 28th, 2010
ctsinclair Moving to topic #2, a questions from @sharingstrength #hpm -8:21 PM Jul 28th,
2010
revdoc That photo was creepy, but the guy's other works are cool #hpm -8:21 PM Jul 28th, 2010
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14. TweetChat - #hpm http://tweetchat.com/room/hpm
inhousehospice @tymeyer I agree! It's a great resource for people who don't understand
what #hospice or #palliative care is/can do. #hpm -8:20 PM Jul 28th, 2010
ctsinclair RT @revdoc: American attention span not suited for items that wont fit on
Twitter? 'It is getting there; smaller packets of info #hpm -8:20 PM Jul 28th, 2010
SheyontheBay RT @ctsinclair: If we have 4000 hospices with avg staff of 50 = 200000
people to help spread this article, are we doing this well? #hpm -8:20 PM Jul 28th, 2010
ctsinclair The photo for the article is from @MrToledano photo-editorial about the last
days with his father with #Alz http://bit.ly/cOwEfj #hpm -8:20 PM Jul 28th, 2010
tymeyer RT Sure @ctsinclair: I think a abbreviated version of this article would be better
for mass distribution #hpm -8:19 PM Jul 28th, 2010
revdoc American attention span not suited for items that won't fit on Twitter? #hpm -8:19 PM
Jul 28th, 2010
ctsinclair Hey did use the word 'narcotic' instead of 'opioid' but I can let that slide. #hpm
-8:18 PM Jul 28th, 2010
ctsinclair I think a abbreviated version of this article would be better for mass distribution
#hpm -8:18 PM Jul 28th, 2010
tymeyer I thought it was a great view from an "outsider" to #hpm. Should really help give
others a better idea of what we do. #hpm -8:18 PM Jul 28th, 2010
sharingstrength Me too. RT @MeredithGould: @ctsinclair Whew, I wondered! #hpm
-8:17 PM Jul 28th, 2010
ctsinclair If we have 4000 hospices with avg staff of 50 = 200000 people to help spread
this article, are we doing this well? #hpm -8:16 PM Jul 28th, 2010
revdoc RT @revdoc: Wrong article--here's the right link http://bit.ly/d6pbwg #hpm
-8:16 PM Jul 28th, 2010
hollyby I told my IDG today as well. It is a great start to a conversation, and hopefully will
have more people reading it after @nprfreshair #hpm -8:16 PM Jul 28th, 2010
ctsinclair I passed out the article to my palliative home health team, explained why it was
important to read. #hpm -8:15 PM Jul 28th, 2010
MeredithGould RT @ctsinclair:Wrong link for earlier Gawande article, here is the
hospice/palliative one: http://bit.ly/d6pbwg #hpm -8:15 PM Jul 28th, 2010
14 of 20 7/28/2010 10:04 PM

15. TweetChat - #hpm http://tweetchat.com/room/hpm
crgonzalez Were there examples on overused medical care that resonated with anyone
who read the article? #hpm -8:15 PM Jul 28th, 2010
MeredithGould @ctsinclair Whew, I wondered! #hpm -8:15 PM Jul 28th, 2010
MeredithGould Off topic observation: Thnx to Tweetdeck I'm noticing active healthcare
industry chats going on right now (e.g., #socpharma) #hpm -8:15 PM Jul 28th, 2010
ctsinclair Ack! Wrong link for earlier Gawande article, here is the hospice/palliative one:
http://bit.ly/d6pbwg The other is about cutting costs! #hpm -8:14 PM Jul 28th, 2010
inhousehospice T1: YES! Loved it-found via @Kathy_Brandt on Twitter, RT'ed it and
sent it via e-mail. Posted on our FB page, too! #hpm -8:14 PM Jul 28th, 2010
ctsinclair Do you think a high percentage of #hpm staff know about this article? How
could we use it to help our field? #hpm -8:13 PM Jul 28th, 2010
revdoc For all my friends: EXCELLENT article about what I do for a living! http://bit.ly
/dvZUAW #hpm -8:12 PM Jul 28th, 2010
ctsinclair I heard about it from @doclake on Twitter who RT from @mchwistek and
posted on @Pallimed and my FB page #hpm -8:12 PM Jul 28th, 2010
hollyby T1: I did read the article, loved it. Heard about it from @doclake on Twitter.
Shared it with my FB friends via update. #hpm -8:11 PM Jul 28th, 2010
MeredithGould RT @ctsinclair: Gawande article for those who had not heard about it yet:
http://bit.ly/dvZUAW (Long article so dont start now!) #hpm -8:11 PM Jul 28th, 2010
nickdawson RT @ctsinclair: #hpm tweetchat Tonight @ 9pm EST. Talking all things
hospice and palliative medicine http://bit.ly/dcA3ic
#hpm -8:10 PM Jul 28th, 2010
ctsinclair Here is the Gawande article for those who had not heard about it yet:
http://bit.ly/dvZUAW (Long article so don't start now!) #hpm -8:10 PM Jul 28th, 2010
renee_berry I invited Terry Gross & @nprfreshair since they're talking about hospice on
their program tomorrow (very long shot, but I tried!) :) #hpm -8:10 PM Jul 28th, 2010
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16. TweetChat - #hpm http://tweetchat.com/room/hpm
revdoc EXCELLENT article! I get The New Yorker electronically on my Kindle--have told
everyone I know about it! (email, verbally) #hpm -8:09 PM Jul 28th, 2010
SheyontheBay Printed the Gawande article for work; sent link to article to my frinds on the
'nets #hpm -8:09 PM Jul 28th, 2010
rawarrior RT @MeredithGould: @ctsinclair I'm going to pretend I invited @crgonzalez!
#hpm //haha! -8:09 PM Jul 28th, 2010
tymeyer Posted Gawande article to facebook... #hpm -8:09 PM Jul 28th, 2010
MeredithGould @ctsinclair I'm going to pretend I invited @crgonzalez! #hpm -8:08 PM Jul
28th, 2010
tymeyer We'll find out soon enough. Will let everyone know.. #hpm -8:08 PM Jul 28th, 2010
ctsinclair Topic #1: Did you read the Gawande article in @NewYorker this week? How did
you hear about it? Who did you share it with? And how? #hpm -8:08 PM Jul 28th, 2010
revdoc I retweeted about the chat... #hpm -8:07 PM Jul 28th, 2010
ctsinclair @tymeyer Oh boy (or girl)! You might be distracted! #hpm -8:07 PM Jul 28th, 2010
renee_berry hi, renee from the sf bay area in CA with @klxmedia passionate about
access to #hpm -8:07 PM Jul 28th, 2010
ctsinclair Did everyone remember their homework from last week? Who did you bring to
(or at least tell about) #hpm? #hpm -8:07 PM Jul 28th, 2010
tymeyer Howdy Ya'll. I'm Ty. HPM doc on Gulf Coast of Tx. I'll be involved tonight as long
as my wife doesn't go into labor. #hpm -8:07 PM Jul 28th, 2010
crgonzalez Carmen Gonzalez, clinical trial strategist, social media advocate; curious about
palliative care #hpm -8:06 PM Jul 28th, 2010
SheyontheBay BarbaraShey- hospice nurse, NY #hpm -8:06 PM Jul 28th, 2010
ctsinclair @equijada @DIaneEMeier hope you can join us tonight for Tweetchat #hpm
-8:06 PM Jul 28th, 2010
MeredithGould <-- sociologist, writer interested in promoting clear communications &
health literacy. Special interest: health-faith connection(s) #hpm -8:05 PM Jul 28th, 2010
ctsinclair Christian Sinclair blogger for @Pallimed, assoc med dir @KCHospice, board
16 of 20 7/28/2010 10:04 PM

17. TweetChat - #hpm http://tweetchat.com/room/hpm
member for @AAHPM (All tweets are my own!) #hpm -8:05 PM Jul 28th, 2010
hollyby Hello! Holly Yang here, #hpm doc from San Diego. Looking forward to chatting.
#hpm -8:04 PM Jul 28th, 2010
revdoc Just kidding. I'm Pam--Christian's partner at KC Hospice and an ordained minister
#hpm -8:04 PM Jul 28th, 2010
sharingstrength Colleen here. Plain language health writer & community manager.
Interested in learning the "language" of #hpm. -8:03 PM Jul 28th, 2010
ctsinclair @revdoc DM = direct message. As for you , you know how to get in touch with
me! #hpm -8:03 PM Jul 28th, 2010
revdoc Diabetes? #hpm -8:02 PM Jul 28th, 2010
inhousehospice Hi, again! It's Ashley, PR/Mktg Assistant @ In-House Hospice & Palliative
Care in MI & OH. Excited to be here! #hpm -8:02 PM Jul 28th, 2010
ctsinclair This week's Tweetchat is hosted by me, but will be looking for people to host the
upcoming weeks. No need to hog the mic! just DM #hpm -8:02 PM Jul 28th, 2010
sharingstrength Please lurk and participate!! RT @crgonzalez: @MeredithGould Is the
#HPM chat invitation only, or can I lurk? -8:02 PM Jul 28th, 2010
MeredithGould @crgonzalez Absolutely not "invitation only." It's an open chat and all are
welcome, esp. you! #hpm -8:01 PM Jul 28th, 2010
ctsinclair @crgonzalez Don't just lurk, come on in the water is nice! #hpm -8:01 PM Jul 28th,
2010
ctsinclair Hey it is 6/7/8/9 pm and time to start #HPM Tweetchat. Let's start as usual with
some introductions! #hpm -8:01 PM Jul 28th, 2010
sharingstrength Hi all I'll be participating in the #HPM chat for the next hour. You can
expect to see tweets about hospice & palliative medicine! #hpm -8:01 PM Jul 28th, 2010
equijada RT @renee_berry: Would love to hear @BradHStuart interviewed on
@NPRfreshair about his innovative AIM program, incredible results 4patients & families
#hpm -8:01 PM Jul 28th, 2010
crgonzalez @MeredithGould Is the #HPM chat invitation only, or can I lurk? -8:01 PM Jul 28th,
2010
ctsinclair RT @MeredithGould: Friends: Ill be in the #HPM chat for the next hour so
17 of 20 7/28/2010 10:04 PM

18. TweetChat - #hpm http://tweetchat.com/room/hpm
expect tweets about hospice & palliative medicine! 'me too!' #hpm -8:00 PM Jul 28th, 2010
MeredithGould Friends: I'll be participating in the #HPM chat for the next hour so don't be
surprised by tweets about hospice & palliative medicine! #hpm -7:59 PM Jul 28th, 2010
ctsinclair @revdoc Hey #hpm -7:58 PM Jul 28th, 2010
MeredithGould RT @revdoc: RT @ctsinclair: #hpm tweetchat Tonight @ 9pm EST.
Talking all things hospice and palliative medicine #hpm -7:54 PM Jul 28th, 2010
revdoc RT @ctsinclair: #hpm tweetchat Tonight @ 9pm EST. Talking all things hospice
and palliative medicine #hpm -7:49 PM Jul 28th, 2010
koehlerjo RT @ctsinclair: #hpm tweetchat 2nite @ 9pm EST. Talking all things hospice &
palliative medicine http://bit.ly/dcA3ic
#hcsm #rnchat #hpm -7:48 PM Jul 28th, 2010
revdoc Hey #hpm -7:46 PM Jul 28th, 2010
ctsinclair #hpm tweetchat Tonight @ 9pm EST. Talking all things hospice and palliative
medicine http://bit.ly/dcA3ic #hcsm #rnchat #hpm -7:45 PM Jul 28th, 2010
DianeEMeier RT @renee_berry: Program Aims to Integrate Palliative Care&ICU
@MedicalNewsNet http://bit.ly/bxtwIX @CAPCpalliative awesome as usual #hpm
-7:43 PM Jul 28th, 2010
CompAndChoices RT @renee_berry: Terry Gross http://ow.ly/2hWyO is hosting Atul
Gawande http://ow.ly/2hWDJ on @NPRfreshair tomorrow #hospice #palliative
#hpm SO EXCITED! -7:36 PM Jul 28th, 2010
CompAndChoices RT @sharingstrength: RT @ctsinclair: #hpm tweetchat Tonight @
9pm EST. Talking all things hospice and palliative medicine http://bit.ly/dcA3ic #hcsm
#rnchat -7:35 PM Jul 28th, 2010
innovchange RT @sharingstrength: RT @ctsinclair: #hpm tweetchat Tonight @ 9pm
EST. Talking all things hospice and palliative medicine http://bit.ly/dcA3ic #hcsm
#rnchat -7:16 PM Jul 28th, 2010
sharingstrength RT @ctsinclair: #hpm tweetchat Tonight @ 9pm EST. Talking all things
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19. TweetChat - #hpm http://tweetchat.com/room/hpm
hospice and palliative medicine http://bit.ly/dcA3ic #hcsm #rnchat -7:13 PM Jul 28th, 2010
SheyontheBay how 'bout mandatory EOL training part of CEU updates for renewing
licenses? includes mandatory palliative consult in disease algorithm #hpm -7:13 PM Jul 28th, 2010
emacartney RT @KentBottles: RT @kevinmd Palliative care shows the importance of
language http://ow.ly/2h4PE #hpm -6:26 PM Jul 28th, 2010
klxmedia RT @mashsocialmedia: How Social Media Can Make Us More Productive
http://ow.ly/2i0r0 #hpm -5:01 PM Jul 28th, 2010
renee_berry Program Aims to Integrate Palliative Care&ICU via @MedicalNewsNet &
@MaryEllenNY http://bit.ly/bxtwIX @CAPCpalliative awesome as usual #hpm -5:00 PM
Jul 28th, 2010
ctsinclair RT @MedAnthRocks: Med anthropologist Kaufman's And a Time to Die: How
American Hospitals Shape the End of Life is a must read. #hpm 'true' -4:24 PM Jul 28th, 2010
doclake Gawande "We train and retrain for surgical skills. We probably need to do so for
these discussions with terminally ill patients" #hpm -4:23 PM Jul 28th, 2010
renee_berry Would love to hear @BradHStuart interviewed on @NPRfreshair about his
innovative AIM program, incredible results 4patients & families #hpm -4:22 PM Jul 28th, 2010
mkmackey RT @FierceHealth: Atul Gawande article in #TheNewYorker could helps
raise demand for #hospice care. http://ht.ly/2hZgx #healthcare #hpm -4:09 PM Jul 28th,
2010
ctsinclair RT @doclake: I'll be up for the ADD inducing #hpm twitchat tonight after slow
@NewYorker thing http://bit.ly/dcA3ic 'totally diff speed' -4:07 PM Jul 28th, 2010
inhousehospice @renee_berry Don't forget #hpm tweetchat Tnight @ 8p CT Talking all
things #hospice &palliative medicine "We'll be there, too!" -4:01 PM Jul 28th, 2010
renee_berry RT @ctsinclair Don't forget #hpm tweetchat Tnight @ 8p CT Talking all
things #hospice &palliative medicine http://bit.ly/dcA3ic @nprfreshair -3:59 PM Jul 28th,
2010
ctsinclair Don't forget #hpm tweetchat Tonight @ 8pm Cent. Talking all things hospice
and palliative medicine http://bit.ly/dcA3ic #hcsm #rnchat -3:49 PM Jul 28th, 2010
renee_berry @Pallimed @Geripalblog thoughts? RT @DeathwDignity How far have we
come in end-of-life pain management in12 years? http://bit.ly/dzaZL7 #hpm -2:40 PM Jul
28th, 2010
renee_berry #hpm What do you think? RT @DeathwDignity How far have we come in
19 of 20 7/28/2010 10:04 PM

20. TweetChat - #hpm http://tweetchat.com/room/hpm
end-of-life pain management in 12 years? http://bit.ly/dzaZL7 #hospice -2:39 PM Jul 28th,
2010
doclake RT @renee_berry: Terry Gross http://ow.ly/2hWyO hosting Atul Gawande
http://ow.ly/2hWDJ on @NPRfreshair tomorrow #hospice #palliative #hpm -2:37 PM
Jul 28th, 2010
20 of 20 7/28/2010 10:04 PM