#JHMChat Transcript
Healthcare social media transcript of the #JHMChat hashtag.
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See #JHMChat Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Society of Hospital Medicine @SocietyHospMed #JHMChat w/ @JHospMedicine, @FutureDocs & @MinaSedrakMD is LIVE! After the chat, we'll post the link to the evaluation to claim your #CME. https://t.co/D13N7mISpt |
| Society of Hospital Medicine @SocietyHospMed Glad to have you aboard for #JHMChat - looking forward to the discussion! https://t.co/uHqJO3GP9R |
 | Journal of Hospital Medicine @JHospMedicine Greetings, I am @FutureDocs your moderator for tonight's #JHMChat. Please introduce yourself. T1 up in a moment... |
| Journal of Hospital Medicine @JHospMedicine Tonight's #JHMChat article- Why residents order unnecessary tests by @MinaSedrakMD See https://t.co/UvPfIXDTD4 |
 | Michelle Brooks, MD, SFHM @michellebr00ks Interested in what others are doing to help residents move away from daily labs. #JHMChat |
 | Tony Breu @tony_breu Here for another #JHMChat from VA Boston. |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Greetings, I am @FutureDocs your moderator for tonight's #JHMChat. Please introduce yourself. T1 up in a moment... |
 | Adam Rodman @AdamRodmanMD I'm @AdamRodmanMD, from BIDMC in Boston, excited for my first #JHMchat! |
| Journal of Hospital Medicine @JHospMedicine REMINDER: tonight's #JHMChat tweeters eligible #CME AMA PRA Category 1 Credit. thx @SHMLive Register! https://t.co/YiXZjipcGc |
 | Chris Petrilli, MD, SFHM @PetrilliMD #JHMchat Chris Petrilli, Hospitalist at Univ of Michigan, very excited for this chat @FutureDocs @SHMLive @JHospMedicine @TWDFNR |
| Journal of Hospital Medicine @JHospMedicine welcome guest author @MinaSedrakMD ! author of why residents self report ordering unnecessary tests #JHMChat https://t.co/ojCkYevLAu |
| Michelle Brooks, MD, SFHM @michellebr00ks Hi - @michellebr00ks - hospitalist and APD at VCU Health #JHMChat |
| Society of Hospital Medicine @SocietyHospMed Important info to claim your #CME after tonight's #JHMChat - eval open from 10 to mid EST! https://t.co/KArQKULyRJ |
| Journal of Hospital Medicine @JHospMedicine @PetrilliMD @FutureDocs @SHMLive @TWDFNR excited to host you next time #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: #JHMChat w/ @JHospMedicine, @FutureDocs & @MinaSedrakMD is LIVE! After the chat, we'll post the link to the evaluat… |
| Chris Petrilli, MD, SFHM @PetrilliMD RT @JHospMedicine: @PetrilliMD @FutureDocs @SHMLive @TWDFNR excited to host you next time #jhmchat |
| Society of Hospital Medicine @SocietyHospMed Don't forget to use the #JHMChat hashtag in each of your tweets if you're participating - otherwise, others won't see your comments! |
 | Amit Pahwa @Pahwa @pahwa from @Hopkins_GIM @Hopkins_DOM_HVC - trying to get residents to reduce blood draws in don’t bleed if you don’t need #JHMchat |
 | Harry (Hyung Jin) Cho, MD @HarryChoMD Harry Cho from Mount Sinai, NY. Looking for a break from the #Elections2016 #JHMChat |
| Journal of Hospital Medicine @JHospMedicine T1: In @MinaSedrakMD et al, 90% residents report "practice habit" for ordering unnecessary tests. How can we break habit? #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: Don't forget to use the #JHMChat hashtag in each of your tweets if you're participating - otherwise, others won't see your com… |
| Journal of Hospital Medicine @JHospMedicine @HyungChoMD @pahwa great to see you on #JHMChat pre #ElectionDay edition |
 | Things We Do For No Reason @TWDFNR RT @JHospMedicine: @PetrilliMD @FutureDocs @SHMLive @TWDFNR excited to host you next time #jhmchat |
 | Faycal Tahiri M.D @FaycalTahiriMD2 @JHospMedicine @FutureDocs # Hi I am Faysal Tahiri an internal medicine physician in NY |
| Adam Rodman @AdamRodmanMD @HyungChoMD I want to know the candidates' views on daily labs :) #jhmchat |
| Tony Breu @tony_breu Starting with the toughest one! #JHMChat https://t.co/w6iYKWiqZI |
 | Rebecca Jaffe, MD @RJmdphilly Hi! Rebecca Jaffe from Philly, looking forward to this #jhmchat ! |
| Michelle Brooks, MD, SFHM @michellebr00ks The survey was interesting - maybe exposing trainees to both the cost of the labs and the savings that can result #JHMchat |
| Harry (Hyung Jin) Cho, MD @HarryChoMD #jhmchat @AdamRodmanMD pretty sure @realDonaldTrump wants to phlebotomize our HC system |
| Amit Pahwa @Pahwa @JHospMedicine @HyungChoMD Gots to represent @Hopkins_DOM_HVC #JHMchat |
| Journal of Hospital Medicine @JHospMedicine @FaycalTahiriMD2 @FutureDocs welcome! be sure to use #JHMChat in your tweets so we see them! |
| Things We Do For No Reason @TWDFNR #JHMChat Lenny Feldman joining in! |
| Adam Rodman @AdamRodmanMD T1: I like the conclusion that it starts with us setting a good example. But then we have to change our habits, which si hard #jhmchat |
| Amit Pahwa @Pahwa T1 - Habit is hard to break. Got to show people's it's okay not to do something. #JHMChat |
 | Vinny Arora MD MAPP @FutureDocs @tony_breu @JHospMedicine @MinaSedrakMD I figured let's get into it #jhmchat life is short on twitter;) |
| Journal of Hospital Medicine @JHospMedicine RT @AdamRodmanMD: T1: I like the conclusion that it starts with us setting a good example. But then we have to change our habits, which si… |
| Michelle Brooks, MD, SFHM @michellebr00ks The fear of not having the lab result if asked as a motivation to order daily labs - that was intriguing to me. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @AdamRodmanMD agree - residents change practice habit if mentors change practice habit. Kicks the ? up the lane #JHMChat |
| Amit Pahwa @Pahwa and @TWDFNR represening @Hopkins_DOM_HVC #jhmchat |
| Chris Petrilli, MD, SFHM @PetrilliMD While education is important, as with other CW implementation successes EHR solutions are prob key-Lets think of 3 #MySonLovesSeuss #jhmchat |
| Journal of Hospital Medicine @JHospMedicine @AdamRodmanMD welcome to your first #JHMchat! |
| Tony Breu @tony_breu @FutureDocs @JHospMedicine @MinaSedrakMD So then here is the question: does culture change top-down or bottom-up? |
| Adam Rodman @AdamRodmanMD @RJmdphilly exactly -- when i was a resident it annoyed me to be challenged about labs, but it's made me a better doctor #jhmchat |
| Adam Rodman @AdamRodmanMD RT @JHospMedicine: @AdamRodmanMD welcome to your first #JHMchat! |
| Tony Breu @tony_breu #JHMChat https://t.co/r1Z2Qe3SjA |
| Journal of Hospital Medicine @JHospMedicine Just a reminder to index #jhmchat https://t.co/G06Ziftlfh |
| Chris Petrilli, MD, SFHM @PetrilliMD Just showing the cost of labs has shown to be effective short-term but need meaningful decision support to have lasting effect #jhmchat |
| Adam Rodman @AdamRodmanMD @PetrilliMD remove daily labs from admission sets :) #jhmchat |
| Society of Hospital Medicine @SocietyHospMed Join our #JHMChat now through 10pm EST as we discuss why #residents order unnecessary labs & how we can change it! #meded #choosingwisely |
| Journal of Hospital Medicine @JHospMedicine RT @Pahwa: T1 - Habit is hard to break. Got to show people's it's okay not to do something. #JHMChat |
 | Daniel Wolfson @WolfsonD #JHMchat Excited to hear experts on reasons for residents overuse. Perhaps ? is what are the reasons for overuse of all doc #choosingwisely |
| Michelle Brooks, MD, SFHM @michellebr00ks T1 - I hate to call residents out on rounds if unnecessary labs are ordered, but sounded like the residents wanted that feedback #jhmchat |
| Chris Petrilli, MD, SFHM @PetrilliMD As attending, I've deleted Morning labs - and only told the resdients AFTER rounds...showing that nothing changed.... #jhmchat |
| Things We Do For No Reason @TWDFNR #JHMChat @Pahwa and @TWDFNR are creating a dashboard to give residents feedback on ordering habits in comparison to colleagues. |
| Rebecca Jaffe, MD @RJmdphilly @tony_breu @FutureDocs @JHospMedicine @MinaSedrakMD both? Or each side thinks the other? #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Fear is a powerful motivator? @MinaSedrakMD #jhmchat https://t.co/n9Yf2XbeVU |
| Faycal Tahiri M.D @FaycalTahiriMD2 #JHMChat # I agree sometimes the right thing to do is to do nothing! # |
| Adam Rodman @AdamRodmanMD @PetrilliMD saving that one for later. or reviewing on one patient daily which labs changed management? #jhmchat |
 | Mina S. Sedrak @minasedrakmd T1: Recognizing that habit begins early on in the residency training is very important #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @RJmdphilly: @AdamRodmanMD agree - residents change practice habit if mentors change practice habit. Kicks the ? up the lane #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @AdamRodmanMD @PetrilliMD they did that when I was a resident. Oh the work arounds! Almost make me nostalgic. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @PetrilliMD: While education is important, as with other CW implementation successes EHR solutions are prob key-Lets think of 3 #MySonLo… |
| Society of Hospital Medicine @SocietyHospMed RT @WolfsonD: #JHMchat Excited to hear experts on reasons for residents overuse. Perhaps ? is what are the reasons for overuse of all doc #… |
| Amit Pahwa @Pahwa @tony_breu it requires change on both ends #jhmchat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Fear is a powerful motivator? @MinaSedrakMD #jhmchat https://t.co/n9Yf2XbeVU |
| Adam Rodman @AdamRodmanMD T1: always a challenge to not challenge resident autonomy but it def fails. Ex: team ordered porphyria work up for endometriosis #jhmchat |
| Harry (Hyung Jin) Cho, MD @HarryChoMD #JHMChat we have to change culture: role modeling and changing the conversation |
| Journal of Hospital Medicine @JHospMedicine RT @MinaSedrakMD: T1: Recognizing that habit begins early on in the residency training is very important #jhmchat |
| Adam Rodman @AdamRodmanMD @RJmdphilly @PetrilliMD ah, in epic, ordering the lab, changing frequency to daily, and duration "99 days". residents are tricky! #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @HyungChoMD: #JHMChat we have to change culture: role modeling and changing the conversation |
| Mina S. Sedrak @minasedrakmd T1: I remember the very first day I was an intern... my resident said... "dont forget to order labs everyday. hit copy, forward." #jhmchat |
| Tony Breu @tony_breu Even the term “AM labs” suggests it is an expectation. #JHMChat |
| Daniel Wolfson @WolfsonD #jhmchat Need $ to patients & total costs at poc with options - PBMs need to provide info to aggregators. Need skills of doc @CostsofCare |
| Adam Rodman @AdamRodmanMD @tony_breu good point. there's nothing routine about a needle jab every am #jhmchat |
| Journal of Hospital Medicine @JHospMedicine Keep the conversation going on T2, T3 up in a moment #JHMChat |
| Amit Pahwa @Pahwa @MinaSedrakMD and did you? #jhmchat |
| Adam Rodman @AdamRodmanMD T1: I work in Africa six months of the year, responsible for drawing my own labs (and walking them to the lab). Volume very diff #jhmchat |
| Mina S. Sedrak @minasedrakmd [REDACTED USER] I wonder how many residents would order daily labs if they had to draw it themselves each day... #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @MinaSedrakMD: [REDACTED USER] I wonder how many residents would order daily labs if they had to draw it themselves each day... #jhmchat |
| Things We Do For No Reason @TWDFNR #JHMChat I found this week on service that our TWDFNR series was a nice resource to be able to give the residents. @TWDFNR |
| Harry (Hyung Jin) Cho, MD @HarryChoMD #JHMChat Do you mean like this order? #workarounds https://t.co/3Cfy0rAiAT |
 | Nancy H. Stewart, DO, MS (she/her) @nvhstewart Excited to join the #JHMChat tonight cc @JHospMedicine |
| Tony Breu @tony_breu T1: What’s missing in lab ordering culture is reason/rationale. Needed for imagine/consults. Not labs. #JHMChat |
| Amit Pahwa @Pahwa Look at this group on #jhmchat. If we can just change one person and that person changes another things will get better #notapyramidscheme |
| Michelle Brooks, MD, SFHM @michellebr00ks Didn't Vanderbilt use number of needlesticks/patient/day as a metric? Might be interesting to track for residents #jhmchat |
| Society of Hospital Medicine @SocietyHospMed RT @Pahwa: Look at this group on #jhmchat. If we can just change one person and that person changes another things will get better #notapyr… |
| Adam Rodman @AdamRodmanMD @tony_breu CBC: infxn Chem7: lytes #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @HyungChoMD: #JHMChat Do you mean like this order? #workarounds https://t.co/3Cfy0rAiAT |
| Mina S. Sedrak @minasedrakmd @tony_breu agree... residents are no longer thinking "do I need labs on this patient today?" AM labs are "standard of care" #jhmchat |
| Amit Pahwa @Pahwa @MinaSedrakMD [REDACTED USER] None - see when nurse pages intern lab cannot be drawn. If they need it they go do it if not cancelled #jhmchat |
| Harry (Hyung Jin) Cho, MD @HarryChoMD RT @tony_breu: Even the term “AM labs” suggests it is an expectation. #JHMChat |
| Adam Rodman @AdamRodmanMD @michellebr00ks Kaiser does that where they tally radiation exposure. Would be awesome/terrifying for sticks. #jhmchat |
| Harry (Hyung Jin) Cho, MD @HarryChoMD RT @MinaSedrakMD: T1: I remember the very first day I was an intern... my resident said... "dont forget to order labs everyday. hit copy, f… |
| Tony Breu @tony_breu @AdamRodmanMD And the daily phos? #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks @Pahwa reminds me of @iamjohnoliver this week! #JHMChat |
| Adam Rodman @AdamRodmanMD @tony_breu "phos"?? haha, i'm not that creative #jhmchat |
| Journal of Hospital Medicine @JHospMedicine T2: Over 80% residents report lack of cost transparency. Is it as simple as $ transparency to improve? #JHMChat |
| Amit Pahwa @Pahwa RT @TWDFNR: #JHMChat I found this week on service that our TWDFNR series was a nice resource to be able to give the residents. @TWDFNR |
| Journal of Hospital Medicine @JHospMedicine @HyungChoMD now that sounds like dr Seuss #jhmchat |
| Amit Pahwa @Pahwa I think a few of us on this #jhmchat wrote a few - @tony_breu @PetrilliMD https://t.co/CZRXlddpYw |
| Michelle Brooks, MD, SFHM @michellebr00ks T2 - transparency is probably the first step, but our VA lists cost, and it doesn't stop the residents #JHMChat |
| Harry (Hyung Jin) Cho, MD @HarryChoMD #JHMChat as @realDonaldTrump would say, “the system is rigged!” #trumpism |
| Tony Breu @tony_breu Potential for short-term decrease. Not sure it’s a durable solution. #JHMChat https://t.co/ku4LoBRHhz |
| Amit Pahwa @Pahwa @JHospMedicine T2 - one piece of puzzle as @TWDFNR showed but still need physician to be comfortable #jhmchat |
| Society of Hospital Medicine @SocietyHospMed #JHMChat is in full swing! Discussing why #residents order unnecessary labs & how we can change. #meded #choosingwisely. Join til 10p ET! https://t.co/gwc7Pgtm7j |
| Vinny Arora MD MAPP @FutureDocs Live on #jhmchat - how can we improve resident lab ordering #Meded #choosingwisely https://t.co/P6eIUExXvC |
| Tony Breu @tony_breu RT @Pahwa: I think a few of us on this #jhmchat wrote a few - @tony_breu @PetrilliMD https://t.co/CZRXlddpYw |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart Changing practice should start with role modeling which can go up or down the chain. Continuous convo regarding #hvhc #JHMChat #meded |
| Vinny Arora MD MAPP @FutureDocs RT @TWDFNR: #JHMChat I found this week on service that our TWDFNR series was a nice resource to be able to give the residents. @TWDFNR |
| Adam Rodman @AdamRodmanMD T2 -- agreed, I like VA ordering menu. At my residency (OHSU) both VA and Epic system, wonder if there's any data comparing labs #jhmchat |
| Amit Pahwa @Pahwa @michellebr00ks @iamjohnoliver Haha - just watched it! |
| Rebecca Jaffe, MD @RJmdphilly T2 thought that was interesting finding. Most really $$ labs not ordered daily. Really low yield rpt labs are cheaper. #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: Live on #jhmchat - how can we improve resident lab ordering #Meded #choosingwisely https://t.co/P6eIUExXvC |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: #JHMChat is in full swing! Discussing why #residents order unnecessary labs & how we can change. #meded… |
| Journal of Hospital Medicine @JHospMedicine @tony_breu curious why not ? #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: Potential for short-term decrease. Not sure it’s a durable solution. #JHMChat https://t.co/ku4LoBRHhz |
| Rebecca Jaffe, MD @RJmdphilly @Pahwa @tony_breu @PetrilliMD @TWDFNR we wrote on amylase for pancreatitis speaking of low yield labs! #JHMChat |
| Chris Petrilli, MD, SFHM @PetrilliMD RT @FutureDocs: Live on #jhmchat - how can we improve resident lab ordering #Meded #choosingwisely https://t.co/P6eIUExXvC |
| Chris Petrilli, MD, SFHM @PetrilliMD RT @SHMLive: #JHMChat is in full swing! Discussing why #residents order unnecessary labs & how we can change. #meded… |
| Adam Rodman @AdamRodmanMD #notalab but I'd go for cost posted next to "routine telemetry" ... #jhmchat |
| Tony Breu @tony_breu Might work for send-out labs which are typically more costly. #JHMChat https://t.co/HoE851SEJu |
| Amit Pahwa @Pahwa @nvhs0401 Yes - good data to show Hospital Intensity index correlates with role modeling https://t.co/jSeSfRRnfr @ChrisMoriates #jhmchat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @FutureDocs: Live on #jhmchat - how can we improve resident lab ordering #Meded #choosingwisely https://t.co/P6eIUExXvC |
| Rebecca Jaffe, MD @RJmdphilly #JHMChat that's what I would expect. If u want something and u aren't paying I'm guessing u order anyway. Find a way to make us pay? |
| Journal of Hospital Medicine @JHospMedicine RT @Pahwa: @JHospMedicine T2 - one piece of puzzle as @TWDFNR showed but still need physician to be comfortable #jhmchat |
 | Chris Moriates, MD @ChrisMoriates @AdamRodmanMD @michellebr00ks we tracked patient sticks for the Think Twice, Stick Once program @ucsf #JHMChat https://t.co/DFFhc7dXCZ |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: T2 - transparency is probably the first step, but our VA lists cost, and it doesn't stop the residents #JHMChat |
| Chris Moriates, MD @ChrisMoriates RT @Pahwa: @nvhs0401 Yes - good data to show Hospital Intensity index correlates with role modeling https://t.co/jSeSfRRnfr @ChrisMoriates… |
| Tony Breu @tony_breu After the stick shock has worn off, culture overwhelms. #JHMChat https://t.co/VuG8ee3VcM |
 | SCAAP @SC_AAP @michellebr00ks does displaying cost at least decrease ordering? |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: After the stick shock has worn off, culture overwhelms. #JHMChat https://t.co/VuG8ee3VcM |
| Chris Petrilli, MD, SFHM @PetrilliMD The actual "cost" isnt that $10-15 for a CBC it's the downstream anemia workup, colonoscopy/EGD w/ assoc possible complications... #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @tony_breu: After the stick shock has worn off, culture overwhelms. #JHMChat https://t.co/VuG8ee3VcM |
| Chris Moriates, MD @ChrisMoriates RT @TWDFNR: #JHMChat I found this week on service that our TWDFNR series was a nice resource to be able to give the residents. @TWDFNR |
| Tony Breu @tony_breu *sticker #JHMChat https://t.co/nxhrGan9Sx |
| Daniel Wolfson @WolfsonD #JHMchat @ASCP_Chicago is taking an active role in #choosewisely Professionals wanting to do good medicine - no incentive to do more |
| Adam Rodman @AdamRodmanMD @tony_breu I really think that's it. It's culture, which is far harder to change #jhmchat |
| Mina S. Sedrak @minasedrakmd T2: The overwhelming free responses to the question "what is the solution" to excessive testing was 'show me the money!' #jhmchat |
| Vinny Arora MD MAPP @FutureDocs @RJmdphilly #jhmchat interesting thought to have skin in the game |
 | Robert Hopkins @ARAdultImmDoc RT @TWDFNR: #JHMChat I found this week on service that our TWDFNR series was a nice resource to be able to give the residents. @TWDFNR |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart Posting costs of labs/tests may aid in trainee understanding of costs #hvhc #jhmchat cc @JHospMedicine @SHMLive https://t.co/MAhArWNQuc |
| Mina S. Sedrak @minasedrakmd T2: residents believe that displaying costs in the EMR at the time of ordering will change their behavior #jhmchat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @Pahwa: @nvhs0401 Yes - good data to show Hospital Intensity index correlates with role modeling https://t.co/jSeSfRRnfr @ChrisMoriates… |
| Amit Pahwa @Pahwa @AdamRodmanMD data show surgical residents who went on global health rotations ordered less when came back https://t.co/MsjqCVMDVr #jhmchat |
| Mina S. Sedrak @minasedrakmd T2: but what they say will change their behavior and what actually happens may be quiet different #jhmchat |
| Tony Breu @tony_breu It’s an intuitive solution. But the interns/residents/attendings are the payer. #JHMChat https://t.co/Oqwcg5dLUn |
| Journal of Hospital Medicine @JHospMedicine @MinaSedrakMD curious if that was surprising to you? #jhmchat |
| Adam Rodman @AdamRodmanMD @Pahwa that was my personal experience... but that's a great idea for a study in internal medicine residents! #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks Had an attending that gave us $$$$$ - overtime we ordered an expensive test, he would take one away. I lost by day 4 or 5 of 28. #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @MinaSedrakMD: T2: residents believe that displaying costs in the EMR at the time of ordering will change their behavior #jhmchat |
| Tony Breu @tony_breu I could see this for MRI and other high(er) cost items. #JHMChat https://t.co/6mdZXG1Dq4 |
| Adam Rodman @AdamRodmanMD RT @Pahwa: @AdamRodmanMD data show surgical residents who went on global health rotations ordered less when came back https://t.co/MsjqCVM… |
| Vinny Arora MD MAPP @FutureDocs Yes the author speaks the truth #jhmchat https://t.co/IEe1avS5Cm |
| Amit Pahwa @Pahwa @AdamRodmanMD @tony_breu true but as @ChrisMoriates said @SHMLive #HM16 recycling bins are now everywhere but weren't few yrs ago #JHMChat |
| Chris Petrilli, MD, SFHM @PetrilliMD @FutureDocs @RJmdphilly That's what worked JAMA. 2016;316(10):1061-1072. Though I'm STILL trying to figure out the methods section :) |
| Michelle Brooks, MD, SFHM @michellebr00ks T2 - a cost-benefit analysis with funds going back to residents for future QI work somehow would be interesting #jhmchat |
| Vinny Arora MD MAPP @FutureDocs @Pahwa @AdamRodmanMD wow that's the best rationale if seen for funding #globalhealth rotations #JHMChat |
| Adam Rodman @AdamRodmanMD @michellebr00ks or even take the "soul cycle" approach -- list different residents' spending on a leaderboard? #mostlykidding #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @FutureDocs it's like paying on credit #JHMChat |
| Amit Pahwa @Pahwa @tony_breu funny you said that - @TWDFNR showed radiology ordering didn't change at least inpatient https://t.co/Clls8jTyjh #JHMChat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart If this is so, why isn't it posted everywhere and on each #EMR ?#meded #jhmchat @SHMLive @JHospMedicine https://t.co/kFkEhBYADG |
| Journal of Hospital Medicine @JHospMedicine What our author @MinaSedrakMD was surprised by #JHMchat https://t.co/357gJzyX5u |
| Rebecca Jaffe, MD @RJmdphilly @MinaSedrakMD and do you buy it? They already KNOW it costs $. Why is the # such a surprise/motivator? #JHMChat |
| Chris Petrilli, MD, SFHM @PetrilliMD @michellebr00ks #JHMChat JAMA. 2016;316(10):1061-1072. (funds to physicians) |
| Tony Breu @tony_breu It’s rare to want to display chargemaster costs. #JHMChat https://t.co/YuEQXInE5e |
 | Chris Moreland @cjmoreland @michellebr00ks Agreed. And can be done in a way that seems supportive. |
| Mina S. Sedrak @minasedrakmd Nope I dont buy it ... agree with @RJmdphilly @jjaeger3 #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @MinaSedrakMD I agree. I don't think seeing the cost will change - I think uncertainty is the enemy. And "fear" of attending. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: What our author @MinaSedrakMD was surprised by #JHMchat https://t.co/357gJzyX5u |
| Things We Do For No Reason @TWDFNR @RJmdphilly @MinaSedrakMD feels like funny $. No explicit connection. #JHMchat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @JHospMedicine: What our author @MinaSedrakMD was surprised by #JHMchat https://t.co/357gJzyX5u |
| Vinny Arora MD MAPP @FutureDocs On that note...hang tight #jhmchat https://t.co/usvj3kfQnH |
| Tony Breu @tony_breu @Pahwa @RJmdphilly @PetrilliMD @TWDFNR Lenny strikes again! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine T3 One third residents reported attendings role modeling restraint would help. How can we teach faculty to do this? #JHMChat |
| Chris Petrilli, MD, SFHM @PetrilliMD #JHMchat @Pahwa @RJmdphilly @tony_breu @TWDFNR It's alright...w/ only 140 characters it's tough...no wonder nobody wants to acquire twitter |
| Mina S. Sedrak @minasedrakmd "Fear" of attending is a big driver of true behavior @RJmdphilly #JHMChat |
 | OHSU IM Residency @OHSUIMRes Better late than never! Joining #JHMChat from Portland, Oregon! |
| Adam Rodman @AdamRodmanMD Step 1 -- we do a better job! #jhmchat |
| Adam Rodman @AdamRodmanMD @OHSUIMRes why hello there, OHSU alum representing from Boston! #jhmchat |
| Things We Do For No Reason @TWDFNR #JHMchat BID labs at least for pts diuresing. What are practice patterns at your place? |
| Harry (Hyung Jin) Cho, MD @HarryChoMD #JHMChat fear of repercussion is a driver. need to change conversation >> positive reinforcement for not checking daily labs |
| Vinny Arora MD MAPP @FutureDocs Seems like although residents said transparency would help, concern old habits die hard prevails #jhmchat @MinaSedrakMD |
| Daniel Wolfson @WolfsonD RT @JHospMedicine: T3 One third residents reported attendings role modeling restraint would help. How can we teach faculty to do this? #JHM… |
| Mina S. Sedrak @minasedrakmd RT @FutureDocs: Seems like although residents said transparency would help, concern old habits die hard prevails #jhmchat @MinaSedrakMD |
| Mina S. Sedrak @minasedrakmd RT @HyungChoMD: #JHMChat fear of repercussion is a driver. need to change conversation >> positive reinforcement for not checking daily labs |
| Adam Rodman @AdamRodmanMD @TWDFNR really? BID for diuresis? is there evidence that twice daily lyte replacement improves outcome (truly curious)? #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks @PetrilliMD September? You're much more up to date than I am. #JHMChat |
| Tony Breu @tony_breu Of course, doesn’t mean we shouldn’t do it! #JHMChat https://t.co/NndQBdg6xk |
 | Elliot Tapper @ebtapper How about a flag screen w/ppv or npo? If low clin value, big impact. Worked for ceruloplasmin https://t.co/EoDb9OWbxx #JHMChat @SHMLive |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart Good question- in the litigious society we practice in, changing attending practice likely quite challenging #jhmchat #meded #hvhc https://t.co/rrG5X7vrQI |
| Chris Petrilli, MD, SFHM @PetrilliMD @TWDFNR #jhmchat BID labs are my biggest pet peeve on service right now...maybe the first day to look for MASSIVE losses, then just supp... |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @HyungChoMD: #JHMChat fear of repercussion is a driver. need to change conversation >> positive reinforcement for not checking daily labs |
| Things We Do For No Reason @TWDFNR @TWDFNR #JHMChat the hidden curriculum is extremely powerful |
 | The Ghostwriting Physician 👻⌨️ @doctorakelso21 Agree, future intern here 🤞 @RJmdphilly @MinaSedrakMD Uncertainty, unknown about possible disease progression, typical scenarios #jhmchat |
| Tony Breu @tony_breu Does any use checklists on rounds? If so, does it include discussion of labs for following day? #JHMChat https://t.co/WTWzrZiRGr |
| Vinny Arora MD MAPP @FutureDocs Some #jhmchat wisdom https://t.co/heYHRr7hb0 |
 | John B. Bulger @johnbbulger @RJmdphilly @FutureDocs Someone else's credit... #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks T3: faculty development is key. We can change - had a die-hard "labbie" change her practice within the past year. #choosingwisely #JHMChat https://t.co/uJtfip5JqK |
| Amit Pahwa @Pahwa @AdamRodmanMD @TWDFNR No -accf guidelines heart failure explicitly states once a day sufficient - i do order more frequently K < 3 #JHMChat |
| Chris Moreland @cjmoreland How about asking faculty to discuss lab ordering practices w/ one another in front of learners? Town hall style? On rounds? #JHMChat https://t.co/fFl0fxBTKC |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: T3: faculty development is key. We can change - had a die-hard "labbie" change her practice within the past year.… |
| Journal of Hospital Medicine @JHospMedicine @michellebr00ks be curious about intensity of fac dev #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @cjmoreland: How about asking faculty to discuss lab ordering practices w/ one another in front of learners? Town hall style? On… |
| Mina S. Sedrak @minasedrakmd @TWDFNR yes. hidden curriculum and unspoken expectations. attending are in a power position to influence resident behavior #jhmchat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @FutureDocs: Some #jhmchat wisdom https://t.co/heYHRr7hb0 |
| Tony Breu @tony_breu Even then, many order entire chem panel, not just K. #JHMChat https://t.co/UT0rgdSnzu |
| Amit Pahwa @Pahwa @tony_breu I will sometimes say what labs DON'T we need tomorrow, but when service busy alas laziness sets in #JHMchat |
| Society of Hospital Medicine @SocietyHospMed RT @FutureDocs: Some #jhmchat wisdom https://t.co/heYHRr7hb0 |
| Rebecca Jaffe, MD @RJmdphilly Treat the team as a patient. Round on it every day - problem list: safety, efficiency, utilization #JHMChat |
| Adam Rodman @AdamRodmanMD @MinaSedrakMD how do you address this with your residents on rounds? #jhmchat |
| The Ghostwriting Physician 👻⌨️ @doctorakelso21 not ordering labs "for teaching purposes" #jhmchat |
| Chris Petrilli, MD, SFHM @PetrilliMD People always talk about legal worries...but iatrongenic anemia + assoc mortality is real Arch Intern Med. 2011;171(18):1646-1653 #jhmchat |
| Vinny Arora MD MAPP @FutureDocs @tony_breu @JHospMedicine #JHMChat I use one that @WrayCharles taught me re overuse- FLIP -Foley labs Indicatioms for tele & prophy |
| Rebecca Jaffe, MD @RJmdphilly @MinaSedrakMD @TWDFNR always wonder about the "fear of being yelled at" - does that happen? Or is it hypersensitivity to feedback? #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @RJmdphilly: Treat the team as a patient. Round on it every day - problem list: safety, efficiency, utilization #JHMChat |
| OHSU IM Residency @OHSUIMRes @JHospMedicine asking "what labs do we need today/tomorrow" should be on daily topics list, just like DVT prophet, DC planning #JHMChat |
| John B. Bulger @johnbbulger @JHospMedicine #JHMChat Reward value not volume |
| Journal of Hospital Medicine @JHospMedicine RT @johnbbulger: @JHospMedicine #JHMChat Reward value not volume |
| Tony Breu @tony_breu @Pahwa Agree 100%. I’m trying to use checklist currently. Intertia and other “priorities" set in. And I care about this stuff! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @OHSUIMRes: @JHospMedicine asking "what labs do we need today/tomorrow" should be on daily topics list, just like DVT prophet, DC planni… |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @FutureDocs: @tony_breu @JHospMedicine #JHMChat I use one that @WrayCharles taught me re overuse- FLIP -Foley labs Indicatioms for tele… |
| Journal of Hospital Medicine @JHospMedicine RT @HyungChoMD: #JHMChat fear of repercussion is a driver. need to change conversation >> positive reinforcement for not checking daily labs |
| OHSU IM Residency @OHSUIMRes @michellebr00ks #JHMChat attendings could use Socratic Method rather than pimping: "what info were you hoping to gain by ordering that lab?" |
| Mina S. Sedrak @minasedrakmd @AdamRodmanMD 1. share expectations 2. incorporate teaching points that discourage low-value care 3. make high-value care decisions #JHMChat |
| Chris Petrilli, MD, SFHM @PetrilliMD @PetrilliMD #JHMChat sorry JHM :) J Hosp Med. 2013 Sep;8(9):506-12 iatrogenic anemia mortality (the better citation!) |
| Michelle Brooks, MD, SFHM @michellebr00ks @JHospMedicine I think it was mainly going to Hospital Medicine 2014 that changed her practice. #choosingwisely #JHMChat |
| Chris Moreland @cjmoreland RT @PetrilliMD: People always talk about legal worries...but iatrongenic anemia + assoc mortality is real Arch Intern Med. 2011;171(18):164… |
| Harry (Hyung Jin) Cho, MD @HarryChoMD #JHMchat Sorry, I can’t stop the #trumpism #Memes - “Make hospital mornings great again! - stop daily labs!” https://t.co/fdmJ3PwVHS |
| Journal of Hospital Medicine @JHospMedicine T4 Lots of talk on discomfort with diagnostic uncertainty- #3 reason for unnecessary test orders. Solutions for residents? #JHMChat |
| Amit Pahwa @Pahwa @johnbbulger about to ask @HopkinsMedicine MS1 tomorrow how Medicare can reward value! |
| Journal of Hospital Medicine @JHospMedicine RT @MinaSedrakMD: @AdamRodmanMD 1. share expectations 2. incorporate teaching points that discourage low-value care 3. make high-value care… |
| Adam Rodman @AdamRodmanMD @MinaSedrakMD i think that's why your article is so interesting -- the residents KNOW they're making low-value care decisions #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @PetrilliMD: @PetrilliMD #JHMChat sorry JHM :) J Hosp Med. 2013 Sep;8(9):506-12 iatrogenic anemia mortality (the better citation!) |
| Amit Pahwa @Pahwa I love this term "labbie"! #JHMChat https://t.co/mxtpmq82Tq |
| Adam Rodman @AdamRodmanMD @JHospMedicine T4: be comfortable with it yourself :) #selfimprovement #jhmchat |
| Journal of Hospital Medicine @JHospMedicine Nice save:) #jhmchat https://t.co/qqgNN6z0ST |
| Society of Hospital Medicine @SocietyHospMed Moving right along on tonight's #JHMChat! Join in if you haven't already - there's still time! https://t.co/cQOhd8ndWS |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @FutureDocs: @tony_breu @JHospMedicine #JHMChat I use one that @WrayCharles taught me re overuse- FLIP -Foley labs Indicatioms for tele… |
| Things We Do For No Reason @TWDFNR @michellebr00ks @JHospMedicine #JHMChat will have high value care track at HM17! |
| The Ghostwriting Physician 👻⌨️ @doctorakelso21 @JHospMedicine more about predictive values of lab tests & lessons in how to find, use, interpret-had IM attending that did this! #jhmchat |
| Tony Breu @tony_breu And say it out loud. Often. #JHMChat https://t.co/IlIKCR8wcg |
| Rebecca Jaffe, MD @RJmdphilly T4 systems fix - make it easier to get labs later in the day if needed, after discussion w team #JHMChat |
| OHSU IM Residency @OHSUIMRes @JHospMedicine #JHMChat create safe space to be honest about uncertainty with attendings! |
| Vinny Arora MD MAPP @FutureDocs . @HyungChoMD restraint trumps overuse #JHMChat #Election2016 @MinaSedrakMD |
| Vinny Arora MD MAPP @FutureDocs RT @TWDFNR: @michellebr00ks @JHospMedicine #JHMChat will have high value care track at HM17! |
| Mina S. Sedrak @minasedrakmd "build a wall around AM labs order set" @FutureDocs @HyungChoMD #JHMChat |
| Amit Pahwa @Pahwa @TWDFNR & @tony_breu doing the #TWDFNR talks #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @TWDFNR: @michellebr00ks @JHospMedicine #JHMChat will have high value care track at HM17! |
| Chris Petrilli, MD, SFHM @PetrilliMD RT @JHospMedicine: Nice save:) #jhmchat https://t.co/qqgNN6z0ST |
| Adam Rodman @AdamRodmanMD @doctorakelso21 @JHospMedicine I always do iron deficiency lab characteristics with my residents. i see a lot more "ferritin only" #jhmchat |
| John B. Bulger @johnbbulger T4 @JHospMedicine Uneccesary labs add to dx uncertainty more than they solve it. #JHMChat Ask, what am I going to do with the result? |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: Moving right along on tonight's #JHMChat! Join in if you haven't already - there's still time! https://t.co/cQOhd8ndWS |
| Journal of Hospital Medicine @JHospMedicine RT @johnbbulger: T4 @JHospMedicine Uneccesary labs add to dx uncertainty more than they solve it. #JHMChat Ask, what am I going to do with… |
| Adam Rodman @AdamRodmanMD @johnbbulger @JHospMedicine the dreaded "d-dimer for no reason" #jhmchat |
| Harry (Hyung Jin) Cho, MD @HarryChoMD #JHMChat Involve the real players in the game - RNs, phlebotomists, AND patients #cocreation |
| Harry (Hyung Jin) Cho, MD @HarryChoMD RT @MinaSedrakMD: "build a wall around AM labs order set" @FutureDocs @HyungChoMD #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Great idea for #JHMChat https://t.co/AeNaJDimtJ |
| Journal of Hospital Medicine @JHospMedicine RT @doctorakelso21: @JHospMedicine more about predictive values of lab tests & lessons in how to find, use, interpret-had IM attending that… |
| John B. Bulger @johnbbulger T2: Don't order today what you can consider tomorrow. #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks T4: maybe teach restraint with low hanging fruit 1st (amylase in pancreatitis, CK in chest pain, ammonia in hepatic encephalopathy) #jhmchat |
| Journal of Hospital Medicine @JHospMedicine Amazing @SHMLive was the intervention! #JHMChat https://t.co/G23YthIFUq |
| Journal of Hospital Medicine @JHospMedicine RT @HyungChoMD: #JHMChat Involve the real players in the game - RNs, phlebotomists, AND patients #cocreation |
| Journal of Hospital Medicine @JHospMedicine RT @MinaSedrakMD: "build a wall around AM labs order set" @FutureDocs @HyungChoMD #JHMChat |
 | KcPedDr @ktranda8 RT @SHMLive: We're getting ready to talk about why #residents order unnecessary labs w/ @MinaSedrakMD on #JHMChat! Join us at 9… |
| Vinny Arora MD MAPP @FutureDocs RT @MinaSedrakMD: "build a wall around AM labs order set" @FutureDocs @HyungChoMD #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @AdamRodmanMD proBNP to eval volume status. Knife/heart #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @FutureDocs: . @HyungChoMD restraint trumps overuse #JHMChat #Election2016 @MinaSedrakMD |
| Mina S. Sedrak @minasedrakmd most residents KNEW they were ordering "unnecessary labs" but what does "unnecessary" really mean? #jhmchat |
| Mina S. Sedrak @minasedrakmd would what one resident thinks is "unnecessary" be the same if you were an intern or a resident #jhmchat |
| Daniel Wolfson @WolfsonD #jhmchat @TalmadgeKing @UCSFMedicine Quote: Why do you need that test rather than why didn't you do that test #choosewisely https://t.co/pPRqfkE0wQ |
| Rebecca Jaffe, MD @RJmdphilly @ShannonMartinMD @JHospMedicine ah but that would require time for teaching #jhmchat #greenQOD |
| Tony Breu @tony_breu [REDACTED USER] @OHSUIMRes @JHospMedicine This is great recommendation. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Amazing @SHMLive was the intervention! #JHMChat https://t.co/G23YthIFUq |
| Amit Pahwa @Pahwa I think we all have to be like JD and Kelso in this episode - https://t.co/wG0L0OiSqL #jhmchat |
| Journal of Hospital Medicine @JHospMedicine Great question from our first author @MinaSedrakMD for #JHMChat participants https://t.co/oSOxtRTDsG |
| Mina S. Sedrak @minasedrakmd would a test deemed "unnecessary" by resident be also considered unnecessary by attendings or even patients... #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @MinaSedrakMD: most residents KNEW they were ordering "unnecessary labs" but what does "unnecessary" really mean? #jhmchat |
| Adam Rodman @AdamRodmanMD @MinaSedrakMD right ... need to be understanding also that residents are learners. sometimes a wonky test is just that #jhmchat |
| Things We Do For No Reason @TWDFNR @michellebr00ks #JHMChat all @TWDFNR topics! |
| Amit Pahwa @Pahwa @HyungChoMD we did for our @Hopkins_DOM_HVC "don't bleed if you don't need" initiative. very eye opening to all of us #Jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @MinaSedrakMD: would a test deemed "unnecessary" by resident be also considered unnecessary by attendings or even patients... #jhmchat |
| OHSU IM Residency @OHSUIMRes One of the most informative facts re burden of labs--patients get charged for each phlebotomy! Bundle labs if can #JHMChat |
| Harry (Hyung Jin) Cho, MD @HarryChoMD @Pahwa @Hopkins_DOM_HVC love the title #JHMChat |
| The Ghostwriting Physician 👻⌨️ @doctorakelso21 @JHospMedicine I also think better knowledge/ease with what could be followed up outpt - discuss with pcp / better d/c comunication #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks @Pahwa I think we would be BFF - favorite episode of Scrubs and @iamjohnoliver. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Yes like a syllabus for teaching restraint #JHMChat https://t.co/8vf8ZC7ljI |
| Adam Rodman @AdamRodmanMD @OHSUIMRes "Know what labs can wait" #almostallofthem #jhmchat |
| Amit Pahwa @Pahwa @MinaSedrakMD sounds like a follow up study! #JHMchat |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: T4: maybe teach restraint with low hanging fruit 1st (amylase in pancreatitis, CK in chest pain, ammonia in hepatic enc… |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @Pahwa: @HyungChoMD we did for our @Hopkins_DOM_HVC "don't bleed if you don't need" initiative. very eye opening to all of us #Jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @Pahwa: @HyungChoMD we did for our @Hopkins_DOM_HVC "don't bleed if you don't need" initiative. very eye opening to all of us #Jhmchat |
| Tony Breu @tony_breu No, but that’s ok. We ask our learners to “make a commitment” regarding diagnoses. We can ask for the same regarding testing #JHMChat https://t.co/7aZNSiPEML |
| OHSU IM Residency @OHSUIMRes #JHMChat does anyone's facility have "lab add on" option, i.e. Tube already at lab, avoid repeat phlebotomy. We do. |
| Adam Rodman @AdamRodmanMD [REDACTED USER] @michellebr00ks FOBT as inpatient! #jhmchat |
| OHSU IM Residency @OHSUIMRes RT @AdamRodmanMD: @OHSUIMRes "Know what labs can wait" #almostallofthem #jhmchat |
| Adam Rodman @AdamRodmanMD @OHSUIMRes we do too. always encourage that, if only to minimize discomfort. #jhmchat |
| Adam Rodman @AdamRodmanMD Just like police officers get tazed so they know what it feels like, maybe residents should get stuck when they start? #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks Labbies are going to want the labs. INR of 1 for 4 days straight, not on warfarin? #nbd #amINR #unnecessarylabs #JHMChat |
| OHSU IM Residency @OHSUIMRes #JHMChat take time to research "lab manual", what goes in green top, lavender top, know "operating characteristics" of each lab |
| Journal of Hospital Medicine @JHospMedicine RT @OHSUIMRes: #JHMChat take time to research "lab manual", what goes in green top, lavender top, know "operating characteristics" of each… |
| Rebecca Jaffe, MD @RJmdphilly @OHSUIMRes again, make it easier to get there test later if needed. Then don't have to decide the night before #JHMChat |
 | Sinai Hospitalist @mshshospitalist @Pahwa We have NO LABS by @drtsega - "Necessity Of Labs Assessed BedSide” w nurses & docs discussing w patients together #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Time has flown! 5 min left for #JHMChat - please share closing thoughts on ways we can prevent residents from ordering unnecessary labs |
| OHSU IM Residency @OHSUIMRes #JHMChat also get handle on what's done in-house v send out, also sense of turn-around time. If checking cause curious, necessary to wait?? |
| OHSU IM Residency @OHSUIMRes RT @HyungChoMD: #JHMChat fear of repercussion is a driver. need to change conversation >> positive reinforcement for not checking daily labs |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Time has flown! 5 min left for #JHMChat - please share closing thoughts on ways we can prevent residents from ordering u… |
 | Omi @Omi_082 RT @MinaSedrakMD: would a test deemed "unnecessary" by resident be also considered unnecessary by attendings or even patients... #jhmchat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Time has flown! 5 min left for #JHMChat - please share closing thoughts on ways we can prevent residents from ordering u… |
| Amit Pahwa @Pahwa @mshshospitalist @drtsega you guys love the acronyms!! #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @mshshospitalist @Pahwa @drtsega we have "no labs in am" order so nightfloat doesn't have to re-decide when called #JHMChat |
| OHSU IM Residency @OHSUIMRes @michellebr00ks #JHMChat love this idea! Also CPK and CKMB in addition to troponin, PTT in addition to INR |
| Journal of Hospital Medicine @JHospMedicine RT @MinaSedrakMD: would a test deemed "unnecessary" by resident be also considered unnecessary by attendings or even patients... #jhmchat |
| Mina S. Sedrak @minasedrakmd @RJmdphilly @mshshospitalist @Pahwa @drtsega that's brilliant #JHMChat |
| John B. Bulger @johnbbulger @OHSUIMRes Yes #JHMChat @GeisingerHealth |
| OHSU IM Residency @OHSUIMRes [REDACTED USER] #JHMChat had patient advocate for themselves! "I already got stuck today, is that really necessary???" |
| Michelle Brooks, MD, SFHM @michellebr00ks Closing thoughts - provide costs, role model cost-conscious care, track some data, positive reinforcement for restraint #JHMChat |
| Adam Rodman @AdamRodmanMD @RJmdphilly @mshshospitalist @Pahwa @drtsega really like that idea #jhmchat |
| Amit Pahwa @Pahwa @AdamRodmanMD @TWDFNR possibly intern orientation activity? Osler cheech on you! #JHMChat |
| Omi @Omi_082 RT @MinaSedrakMD: most residents KNEW they were ordering "unnecessary labs" but what does "unnecessary" really mean? #jhmchat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart Lab "add on" not as easy as it sounds- often lab requires "different color tube" so still need to redraw. Must think before order. #JHMChat |
| Adam Rodman @AdamRodmanMD Closing thought #1: It's starts with us, role modeling. CT#2: this was AWESOME, can't wait til next #JHMChat!!!! |
| Rebecca Jaffe, MD @RJmdphilly @MinaSedrakMD @mshshospitalist @Pahwa @drtsega not my idea @JHospMedicine interested in a study ;) #JHMChat |
| Vinny Arora MD MAPP @FutureDocs Love integrating restraint into handoff- 2 of my favorite things :) #jhmchat https://t.co/uv9Y1Sd1KB |
 | Gretchen Diemer @gretchendiemer @HyungChoMD critical thinking about what question it answers! #JHMChat |
| Harry (Hyung Jin) Cho, MD @HarryChoMD #JHMChat gotta love all the enthusiasm 4 reducing unnecessary labs set forth by @johnbbulger & #ChoosingWisely |
| John B. Bulger @johnbbulger @Pahwa @HyungChoMD @Hopkins_DOM_HVC DRacula: Bleeding them into the lab. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @AdamRodmanMD: Closing thought #1: It's starts with us, role modeling. CT#2: this was AWESOME, can't wait til next #JHMChat!!!! |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: Closing thoughts - provide costs, role model cost-conscious care, track some data, positive reinforcement for restraint… |
| Journal of Hospital Medicine @JHospMedicine RT @OHSUIMRes: [REDACTED USER] #JHMChat had patient advocate for themselves! "I already got stuck today, is that really necessary???" |
| OHSU IM Residency @OHSUIMRes RT @RJmdphilly: @mshshospitalist @Pahwa @drtsega we have "no labs in am" order so nightfloat doesn't have to re-decide when called #JHMChat |
| Journal of Hospital Medicine @JHospMedicine REMINDER: tonight's #JHMChat tweeters eligible #CME AMA PRA Category 1 Credit. go to @SHMLive to Register! https://t.co/YiXZjipcGc |
| Tony Breu @tony_breu Thank you @FutureDocs and @MinaSedrakMD for a great #JHMChat. Can’t wait for the next one. |
| OHSU IM Residency @OHSUIMRes #JHMChat take what do if positive/negative/equivocal approach to any lab you might order. Do I really need it? Will it change management? |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @michellebr00ks: Closing thoughts - provide costs, role model cost-conscious care, track some data, positive reinforcement for restraint… |
| Chris Petrilli, MD, SFHM @PetrilliMD After 20+ yrs of competition in school - residents thrive in it...report cards/rankings of utilization labs/tele (indexed by DRG) #jhmchat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: REMINDER: tonight's #JHMChat tweeters eligible #CME AMA PRA Category 1 Credit. go to @SHMLive to Register! https://t.co… |
| Society of Hospital Medicine @SocietyHospMed Bookmark the following link to claim your #CME after #JHMChat - the eval is open from 10 to midnight EST: https://t.co/mPGES9iJBf |
| Adam Rodman @AdamRodmanMD @PetrilliMD SoulCycle Approach! (or Enterprise Car Rental) #jhmchat |
| Journal of Hospital Medicine @JHospMedicine Special thx to partners @SHMLive @CostsofCare @ABIMFoundation & guest author @MinaSedrakMD for bringing #JHMChat eve of #ElectionDay |
| Mina S. Sedrak @minasedrakmd Recognize that the clinical deicisions we make on rounds have a big impact on trainees; soi we should strive to make HVC ones #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly Take homes 1) suspect $s won't speak as loud as reported 2) attending buy in vital 3) systems and culture fixes needed #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Tune in 4 next #JHMChat Mon Jan 9th 2017 9p ET on things we do for no reason: thrombophilia worksups w/ @PetrilliMD #choosingwisely |
| Society of Hospital Medicine @SocietyHospMed @JHospMedicine @CostsofCare @ABIMFoundation @MinaSedrakMD thanks to all for another engaging, thought-provoking #JHMChat! |
| Daniel Wolfson @WolfsonD RT @JHospMedicine: Special thx to partners @SHMLive @CostsofCare @ABIMFoundation & guest author @MinaSedrakMD for bringing #JHMChat eve of… |
| Amit Pahwa @Pahwa @SHMLive just did it #jhmchat |
| OHSU IM Residency @OHSUIMRes RT @AdamRodmanMD: Closing thought #1: It's starts with us, role modeling. CT#2: this was AWESOME, can't wait til next #JHMChat!!!! |
| OHSU IM Residency @OHSUIMRes RT @MinaSedrakMD: would a test deemed "unnecessary" by resident be also considered unnecessary by attendings or even patients... #jhmchat |
| Mina S. Sedrak @minasedrakmd @JHospMedicine @SHMLive @CostsofCare @ABIMFoundation great discussions. very happy to be apart of tonight's #jhmchat |
| Tony Breu @tony_breu @JHospMedicine @PetrilliMD No better way to ring in the new year than with a #JHMChat |
| Vinny Arora MD MAPP @FutureDocs Me too;) Thanks for your participation! #jhmchat https://t.co/QyiOEZnjzv |
| Adam Rodman @AdamRodmanMD #bestCMEever #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @MinaSedrakMD: @JHospMedicine @SHMLive @CostsofCare @ABIMFoundation great discussions. very happy to be apart of tonight's #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: Bookmark the following link to claim your #CME after #JHMChat - the eval is open from 10 to midnight EST: https://t.co/mPGES9i… |
| Mina S. Sedrak @minasedrakmd @tony_breu @FutureDocs thank you for inviting me. This was great! #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @MinaSedrakMD: @JHospMedicine @SHMLive @CostsofCare @ABIMFoundation great discussions. very happy to be apart of tonight's #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Tune in 4 next #JHMChat Mon Jan 9th 2017 9p ET on things we do for no reason: thrombophilia worksups w/ @PetrilliMD #cho… |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: Bookmark the following link to claim your #CME after #JHMChat - the eval is open from 10 to midnight EST: https://t.co/mPGES9i… |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart Yes, thank you @FutureDocs and @MinaSedrakMD ! Enjoyed this #jhmchat and looking forward to the next one! cc @JHospMedicine @SHMLive https://t.co/6n0s6jUczC |
| Amit Pahwa @Pahwa @MinaSedrakMD @JHospMedicine thanks for doing great research and publishing it! #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @MinaSedrakMD: @JHospMedicine @SHMLive @CostsofCare @ABIMFoundation great discussions. very happy to be apart of tonight's #jhmchat |
| Mina S. Sedrak @minasedrakmd RT @RJmdphilly: Take homes 1) suspect $s won't speak as loud as reported 2) attending buy in vital 3) systems and culture fixes needed #JHM… |
| Society of Hospital Medicine @SocietyHospMed Thx to @JHospMedicine, @FutureDocs, @MinaSedrakMD & partners @ABIMFoundation & @CostsofCare for another fantastic #JHMChat! |
| Chris Petrilli, MD, SFHM @PetrilliMD When deciding between the college football playoff championship & #JHMChat #choosewisely @JHospMedicine @FutureDocs @TWDFNR @CoachJim4UM https://t.co/EizlZ3tG1n |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: Thx to @JHospMedicine, @FutureDocs, @MinaSedrakMD & partners @ABIMFoundation & @CostsofCare for another fantastic #JHMChat! |
| Chris Petrilli, MD, SFHM @PetrilliMD @AdamRodmanMD #jhmchat ... they'll pick u up! |
| OHSU IM Residency @OHSUIMRes @WolfsonD @JHospMedicine @TalmadgeKing @UCSFMedicine @johnbbulger #JHMChat exactly! |
| Society of Hospital Medicine @SocietyHospMed Take the eval to claim your #CME for #JHMChat between now & midnight EST: https://t.co/mPGES9iJBf |
 | kaboell @boellkeith RT @JHospMedicine: T2: Over 80% residents report lack of cost transparency. Is it as simple as $ transparency to improve? #JHMChat |
| OHSU IM Residency @OHSUIMRes @AdamRodmanMD but that is the joy of twitter chats--you can still read and interact with the "transcript"! #JHMChat |
#JHMChat content from Twitter.