#JHMChat Transcript

Healthcare social media transcript of the #JHMChat hashtag.
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J Hospital Medicine @JHospMedicine
Greetings, I am @WrayCharles your moderator for tonight's joint #JHMChat #Nephjc chat! Please introduce yourself
Society of Hospital Medicine @SHMLive
#JHMChat on cost of #AKI starts NOW! Join the chat w/ @JHospMedicine @WrayCharles @kidney_boy, then claim #CME: https://t.co/IUNse3MqeX https://t.co/ayqyhazCCl
Nikhil Shah @dr_nikhilshah
RT @SHMLive: #JHMChat on cost of #AKI starts NOW! Join the chat w/ @JHospMedicine @WrayCharles @kidney_boy, then claim #CME:…
Nephrology Jrnl Club @NephJC
I am Joel Topf, not your moderator for tonight's #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
Swapnil Hiremath, nephrologist from @OttawaRenal #NephJC cofounder No CoI #JHMchat https://t.co/hPTTCzb3nS
Matt Sparks @Nephro_Sparks
Matt Sparks, Nephrologist APD @DukeKidney no COI #JHMChat
Swapnil Hiremath, MD, MPH @hswapnil
Hope to see author @Samuel_A_Silver - lot of questions lined up 🤔 #JHMchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
Hello - I'm Michelle Brooks, academic hospitalist at VCU Health in Richmond, VA. Tonight's #JHMchat is being fueled by tamiflu and mucinex
Tony Breu @tony_breu
@JHospMedicine @WrayCharles Tony Breu, here from VA Boston #jhmchat
Jay Koyner @jaykoyner
jay koyner - nephrologist from uchicago - COI - i do AKI research #jhmchat
Nephrology Jrnl Club @NephJC
hey Matt, hey Swap, thanks for joining #jhmchat
Nikhil Shah @dr_nikhilshah
Nikhil Shah, Nephrologist and Home Dialysis fellow, Edmonton, Canada. Inaugural #NSMC intern #nephjc. No COI. #jhmchat
Michelle Rheault @rheault_m
RT @SHMLive: #JHMChat on cost of #AKI starts NOW! Join the chat w/ @JHospMedicine @WrayCharles @kidney_boy, then claim #CME:…
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Edgar Lerma, Chicago-based Nephrologist #JHMChat https://t.co/YIt3J4Gxkl
Silvi Shah, MD, MS @silvishah
Silvi Shah transplant nephrologist Cincinnati no Coi #JHMChat
Nephrology Jrnl Club @NephJC
Jay! AKI researcher and content expert. I bet he's spent a few million on AKI therapy #jhmchat
Scherly Leon, MD @SLeonMD
Scherly Leon, nephrologist in NYC. Inaugural #NSMC intern #nephjc No COI #jhmchat
Gates Colbert, MD @DoctorGates
Dallas based Nephrologist. Texas A&M Faculty. NSMC Class of 2017. #AKI #jhmchat
Gary Singer @garysingermd
Gary Singer small town nephrologist #JHMChat
Ben Humphreys @humphreyslab
Ben Humphreys, physician-scientist and passionate about AKI #nephjc #JHMchat
Nephrology Jrnl Club @NephJC
Hello Silvi, Edgar and Nikhil. The whole crew is here! #jhmchat
Arvind Canchi 🇮🇳 @arvindcanchi
Arvind Canchi, Nephrologist, Good Morning from Bangalore, #JHMchat
Samuel Silver @samuel_a_silver
Sam Silver, nephrologist, research fellow, lead author on tonight's paper #jhmchat
Pravir @proximal_baxi
Pravir Baxi, Chicago-based Nephrologist, Rush University Medical Center #jhmchat
Nephrology Jrnl Club @NephJC
Welcome Gates Colbert, brand new #NSMC Intern! #jhmchat
Michelle Rheault @rheault_m
@SHMLive #JHMChat Hi! Michelle Rheault Ped Neph University of MN. Don't forget the little beans. COI in bio.
Swapnil Hiremath, MD, MPH @hswapnil
Awesome, author in house! RT @Samuel_A_Silver: Sam Silver, nephrologist, research fellow, lead author on tonight's paper #jhmchat
Amit Kumar Pahwa @pahwa
Amit Pahwa representing @Hopkins_GIM @HopkinsMedicine @Hopkins_DOM_HVC @hvpaa current subinternship director, HVC course 4 med stud #jhmchat
Nephrology Jrnl Club @NephJC
@Samuel_A_Silver Lead author in the house! #jhmchat
Matt Sparks @Nephro_Sparks
@NephRodby #jhmchat tonight
Malvinder Parmar @wittykidney
A nephtwitron with interests beyond nephrology. No COI. #jhmchat https://t.co/CTi2vGqjjX
Helen Currier @hxcurrier
RT @NephJC: Some thoughts on Table 2 for tonight's #JHMChat https://t.co/H7M0seBkeG
Hector Madariaga, MD @hecmagsmd
Hector Madariaga. Nephrologist from Patriots Nation. #jhmchat
Rebecca Jaffe @RJmdphilly
Rebecca Jaffe academic hospitalist in balmy PA. Not nephrologist and pardon any misplaced tweets re Sen Toomey #JHMChat
J Hospital Medicine @JHospMedicine
FYI. 4 topics tonight! Don't forget to tag your tweets with #JHMChat. T1 up in a moment…
Nephrology Jrnl Club @NephJC
An embarrassment of riches! Hello Michelle, Pravir, Amit and Malvinder! #jhmchat
Kenar Jhaveri @kdjhaveri
RT @hswapnil: Awesome, author in house! RT @Samuel_A_Silver: Sam Silver, nephrologist, research fellow, lead author on tonight's paper #jh
Vinny Arora MD MAPP @FutureDocs
Hi Vinny Arora hospitalist from u chicago here on #jhmchat - excited to be a participant!
Bea Concepcion @kidneybea_n
Bea Concepcion, transplant nephrologist in Nashville, no COI #jhmchat
High Value Alliance @hvpaa
RT @Pahwa: Amit Pahwa representing @Hopkins_GIM @HopkinsMedicine @Hopkins_DOM_HVC @hvpaa current subinternship director, HVC course 4 med s…
J Hospital Medicine @JHospMedicine
Great turnout tonight! Let's get started... #jhmchat
Raymond Hsu @drraymondhsu
Hi #JHMChat! Raymond Hsu nephrologist and researcher in SF, CA here #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @Samuel_A_Silver: Sam Silver, nephrologist, research fellow, lead author on tonight's paper #jhmchat
Joel Topf, MD FACP @kidney_boy
@Pahwa remember to add #JHMChat so everyone can see your comment. Too funny. Love the fast and loose rules of e-journalism
Nikhil Shah @dr_nikhilshah
Thanks Joel! #jhmchat
Shannon K. Martin @shannonmartinmd
Hi all, Shannon Martin, academic hospitalist from UChicago, looking forward to the latest #jhmchat!
Swapnil Hiremath, MD, MPH @hswapnil
Bea and Gates: newest #NSMC interns in the chat. Awesome #jhmchat
Nathaniel Reisinger @nephrothaniel
Nathaniel Reisinger. Nephrology fellow in Philadelphia and newly minted NSMC Intern. Pleased to be here. #jhmchat
J Hospital Medicine @JHospMedicine
Want to welcome @kidneyboy and @Samuel_A_Silver as author of "Cost of AKI in Hosp Pt" as our special guests tonight #jhmchat
Nephrology Jrnl Club @NephJC
Bing! RT @nephrothaniel: Nathaniel Reisinger. Nephrology fellow in Philadelphia and newly minted NSMC Intern. Pleased to be here. #jhmchat
Matt Sparks @Nephro_Sparks
@ShannonMartinMD Hi Shannon. should be a nice chat #JHMChat
Jay Koyner @jaykoyner
@NephJC - im from @uchicago where we are very aware of #costofcare #jhmchat ask @futuredoc we have saved a few million #jhmchat
J Hospital Medicine @JHospMedicine
T1: The marker for AKI was high spec/low sens. Are we comfortable with this? How does this affect conclusions of paper? #JHMChat
Matt Sparks @Nephro_Sparks
RT @hswapnil: Bea and Gates: newest #NSMC interns in the chat. Awesome #jhmchat
Nikhil Shah @dr_nikhilshah
Nephrologists and NSMC rocking this chat! Welcome to all #NSMC interns. #jhmchat
Amit Kumar Pahwa @pahwa
@JHospMedicine only because you are moderating @WrayCharles #jhmchat
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: FYI. 4 topics tonight! Don't forget to tag your tweets with #JHMChat. T1 up in a moment…
Nephrology Jrnl Club @NephJC
Not to be pedantic, but it's @Kidney_boy MT @JHospMedicine: Want to welcome @kidneyboy and @Samuel_A_Silver lead author #jhmchat
J Hospital Medicine @JHospMedicine
RT @hswapnil: Bea and Gates: newest #NSMC interns in the chat. Awesome #jhmchat
Matt Sparks @Nephro_Sparks
@FutureDocs Hi Vinny. Have been looking forward to this one #JHMChat
Society of Hospital Medicine @SHMLive
T1 is LIVE! Join us now discussing cost of #AKI! #JHMChat https://t.co/DlJ9dm2VBY
Swapnil Hiremath, MD, MPH @hswapnil
T1: very specific = included more severe AKI. Cost of mild AKI might be different (mostly lower) can't generalize #jhmchat
Scherly Leon, MD @SLeonMD
RT @SHMLive: T1 is LIVE! Join us now discussing cost of #AKI! #JHMChat https://t.co/DlJ9dm2VBY
Nephrology Jrnl Club @NephJC
@jaykoyner @NephJC @UChicago @Futuredoc I remember those ICUs. We spent money like drunken sailors! #jhmchat
Matt Sparks @Nephro_Sparks
@jaykoyner Hi Jay #jhmchat
J Hospital Medicine @JHospMedicine
Glad you could join us, Nathaniel! https://t.co/Tian6QNaGJ
Tony Breu @tony_breu
@hswapnil But total cost to healthcare system is likely underestimated (even if per patient is overestimated). #jhmchat
Vinny Arora MD MAPP @FutureDocs
@Nephro_Sparks thx for coming #jhmchat and great to see #nephjc community @kidney_boy too !
Swapnil Hiremath, MD, MPH @hswapnil
@NephJC @kidney_boy @JHospMedicine (off topic: Story of Margaret Atwood and Joel: https://t.co/FONrEaJviU) #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @jaykoyner: @NephJC - im from @uchicago where we are very aware of #costofcare #jhmchat ask @futuredoc we have saved a few million #jh
Swapnil Hiremath, MD, MPH @hswapnil
Hmm Maybe MT @tony_breu: But total cost to healthcare system is likely underestimated (even if per patient is overestimated). #jhmchat
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Kidney Attack from @JAMA_current by @kellumja @BellomoRinaldo @croncoIRRIV #Nephpearls #JHMChat https://t.co/KOh8RIphMb https://t.co/yUyyOlm7g0
Nephrology Jrnl Club @NephJC
T1: except when Chertow looked using Cr, a more sensitive marker he got higher adj cost: $4,886 for Cr up by 0.3 mg/dl #jhmchat
Jay Koyner @jaykoyner
@NephJC @Futuredocs - those were different times - now we spend money on VADs and ECMO and spare the renal u/s and urine eos #jhmchat
J Hospital Medicine @JHospMedicine
RT @tony_breu: @hswapnil But total cost to healthcare system is likely underestimated (even if per patient is overestimated). #jhmchat
Malvinder Parmar @wittykidney
@SHMLive not sure, these were billing codes used on data from 2012, there is high likelihood of errors in such codes #JHMChat
Matt Sparks @Nephro_Sparks
RT @jaykoyner: those were different times - now we spend money on VADs and ECMO and spare the renal u/s and urine eos #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @jaykoyner: @NephJC @Futuredocs - those were different times - now we spend money on VADs and ECMO and spare the renal u/s and urine eo…
Edgar V. Lerma 🇵🇭 @edgarvlermamd
The AKI Effect #Nephpearls #JHMChat https://t.co/w7UIF1Ap27 https://t.co/g0bfCE3h4m
Franklin Loachamin @franloachamin
RT @JHospMedicine: A GIF Is Worth 3000 Words: New #VisualAbstract for #JHMChat: THIS MONDAY 9p ET! @WrayCharles @kidney_boy #nephjc
Jay Koyner @jaykoyner
@Nephro_Sparks hey matt - hope all is well and you are ready to get your AKI on - #jhmchat
Tony Breu @tony_breu
@hswapnil The ICD-9 used allowed for higher paying DRGs (as it allows for CC/MCC) which increases charges to Medicare #jhmchat
Malvinder Parmar @wittykidney
@JHospMedicine @WrayCharles @kidney_boy adjusted costs & LoS > unadjusted, opposite of fig 2. Is this correct? #JHMChat #NephJC
Kenar Jhaveri @kdjhaveri
RT @jaykoyner: @NephJC @Futuredocs - those were different times - now we spend money on VADs and ECMO and spare the renal u/s and urine eo…
Swapnil Hiremath, MD, MPH @hswapnil
RT @tony_breu: @hswapnil The ICD-9 used allowed for higher paying DRGs (as it allows for CC/MCC) which increases charges to Medicare #jhmch
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @edgarvlermamd: The AKI Effect #Nephpearls #JHMChat https://t.co/w7UIF1Ap27 https://t.co/g0bfCE3h4m
Gary Singer @garysingermd
RT @edgarvlermamd: The AKI Effect #Nephpearls #JHMChat https://t.co/w7UIF1Ap27 https://t.co/g0bfCE3h4m
Nephrology Jrnl Club @NephJC
@wittykidney @JHospMedicine @WrayCharles @kidney_boy No. Adjusted costs and LOS were both shorter I thought #jhmchat
Vinny Arora MD MAPP @FutureDocs
@jaykoyner @NephJC Perhaps it's the kidney intensivists? #jhmchat
J Hospital Medicine @JHospMedicine
Great point! Begs the question as to why different definitions of AKI used on this study vs. Chertows 2005 study #jhmchat https://t.co/EPrxXWAlYs
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Want to welcome @kidneyboy and @Samuel_A_Silver as author of "Cost of AKI in Hosp Pt" as our special guests tonight #jhm
Society of Hospital Medicine @SHMLive
RT @NephJC: T1: except when Chertow looked using Cr, a more sensitive marker he got higher adj cost: $4,886 for Cr up by 0.3 mg/dl #jhmchat
Nephrology Jrnl Club @NephJC
I don't understand this. Can someone explain? MT @tony_breu: ICD-9 used allowed for higher paying DRGs... #jhmchat
Pablo Garcia @pablogarciamd
#jhmchat Pablo Garcia. NSMC class of 2017. New Brunswick, NJ no CoI
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Association between AKI severity and survival, mortality, length of stay, increase in care, readmission #JHMChat https://t.co/Q2CprT8r0k https://t.co/Rdt6omBHi7
Matt Sparks @Nephro_Sparks
RT @PabloGarciaMD: #jhmchat Pablo Garcia. NSMC class of 2017. New Brunswick, NJ no CoI
Nephrology Jrnl Club @NephJC
Hey Pablo! RT @PabloGarciaMD: #jhmchat Pablo Garcia. NSMC class of 2017. New Brunswick, NJ no CoI
Jay Koyner @jaykoyner
@FutureDocs @NephJC oh thats me vinny ICU neph - plenty of $$$ on CRRT but have tried to cut back on UNneccessary tests #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
@NephJC @wittykidney @JHospMedicine @WrayCharles @kidney_boy yup, adjusted << unadjusted #JHMchat (not sure, hope to learn more tonight_) https://t.co/Fw0crKOGX9
Malvinder Parmar @wittykidney
@NephJC @JHospMedicine @WrayCharles @kidney_boy but the visual abstract tells otherwise, that's what I wanted to point out #JHMChat
Samuel Silver @samuel_a_silver
adjusted models all produced lower estimates than unadjusted models #jhmchat https://t.co/QYFUDLVrEs
Arvind Canchi 🇮🇳 @arvindcanchi
#jhmchat https://t.co/ZxozSnI1gF
J Hospital Medicine @JHospMedicine
For those of you just joining us, we're discussing @Samuel_A_Silver's article on AKI & Costs #JHMChat with the #NephJC crowd https://t.co/9RhopxZ81k
Tony Breu @tony_breu
@NephJC Adding “Acute kidney failure” to a primary diagnosis increases the Medicare payment for the primary diagnosis). #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
@Samuel_A_Silver how was that? (maybe its a different topic coming up, let's not jump the gun!) #jhmchat
J Hospital Medicine @JHospMedicine
For those of you just joining us, we're discussing @Samuel_A_Silver's article on AKI & Costs #JHMChat with the... https://t.co/iiFYoIRIPo
James Luther @drjmluther
RT @hswapnil: @NephJC @kidney_boy @JHospMedicine (off topic: Story of Margaret Atwood and Joel: https://t.co/FONrEaJviU) #jhmchat
Matt Sparks @Nephro_Sparks
RT @JHospMedicine: For those of you just joining us, we're discussing @Samuel_A_Silver's article on AKI & Costs #JHMChat with the…
Vinny Arora MD MAPP @FutureDocs
@jaykoyner @NephJC lol I know ;) just kidding #jhmchat
Gates Colbert, MD @DoctorGates
#AKI unfortunately is too often ignored in the hospital. Most don't pay attention until the LAB Creatinine is RED, has a ! or H. #jhmchat
Kenar Jhaveri @kdjhaveri
@edgarvlermamd have u used the nephrocheck in practice? #jhmchat
Society of Hospital Medicine @SHMLive
It's not to late to join the #JHMChat conversation! https://t.co/c1QiDJ8y8B
Swapnil Hiremath, MD, MPH @hswapnil
BTW, welcome also to Pablo and Nate, two more #NSMC interns! #jhmchat
Tulun Sokit @tulunsokit
RT @JHospMedicine: A GIF Is Worth 3000 Words: New #VisualAbstract for #JHMChat: THIS MONDAY 9p ET! @WrayCharles @kidney_boy #nephjc
Joel Topf, MD FACP @kidney_boy
RT @tony_breu: @NephJC Adding “Acute kidney failure” to a primary diagnosis increases the Medicare payment for the primary diagnosis). #jhm
Swapnil Hiremath, MD, MPH @hswapnil
RT @JHospMedicine: T1: The marker for AKI was high spec/low sens. Are we comfortable with this? How does this affect conclusions of paper?…
Amit Kumar Pahwa @pahwa
@tony_breu @NephJC love the healthcare payment chat here #jhmchat
Society of Hospital Medicine @SHMLive
Be sure to tag #JHMChat in all of your tweets so they can be indexed and seen by other participants!
Kenar Jhaveri @kdjhaveri
RT @edgarvlermamd: Kidney Attack from @JAMA_current by @kellumja @BellomoRinaldo @croncoIRRIV #Nephpearls #JHMChat
Helen Currier @hxcurrier
RT @JHospMedicine: For those of you just joining us, we're discussing @Samuel_A_Silver's article on AKI & Costs #JHMChat with the…
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @tony_breu: @NephJC Adding “Acute kidney failure” to a primary diagnosis increases the Medicare payment for the primary diagnosis). #jhm
Nephrology Jrnl Club @NephJC
@tony_breu do you think this biases the results? Do you think there is over coding because of this? #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @DoctorGates: #AKI unfortunately is too often ignored in the hospital. Most don't pay attention until the LAB Creatinine is RED, has a…
Vinny Arora MD MAPP @FutureDocs
@tony_breu @NephJC oh those coding queries for "renal failure" #jhmchat
J Hospital Medicine @JHospMedicine
Great point, Gates! The unfortunate side effect of practicing categorical medicine in a continuous world #jhmchat https://t.co/iDkrZ6dyt4
Michelle Rheault @rheault_m
RT @DoctorGates: #AKI unfortunately is too often ignored in the hospital. Most don't pay attention until the LAB Creatinine is RED, has a…
Matt Sparks @Nephro_Sparks
@NephJC @tony_breu can't fake the AKI with HD @kidney_boy #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
@DoctorGates indeed, so less sensitive, more specific. #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @DoctorGates: #AKI unfortunately is too often ignored in the hospital. Most don't pay attention until the LAB Creatinine is RED, has a…
Scherly Leon, MD @SLeonMD
RT @JHospMedicine: For those of you just joining us, we're discussing @Samuel_A_Silver's article on AKI & Costs #JHMChat with the…
Gary Singer @garysingermd
@DoctorGates late renal consult = increased cost and LOS #jhmchat
Amit Kumar Pahwa @pahwa
@NephJC @tony_breu there is not overcodin which is illegal but more people being specific to get the dollars #JHMchat
J Hospital Medicine @JHospMedicine
3 more topics to go! We'll be announcing T2 shortly #JHMChat
Tony Breu @tony_breu
@NephJC Not necessarily overcoding. It may be accurate, but it’s also going to up the reimbursement when “AKI from ATN” is listed #jhmchat
Samuel Silver @samuel_a_silver
sorry @hswapnil first journal chat...maybe got a little excited! #jhmchat
Roger Rodby @NephRodby
Roger Rodby, Chicago Rush, back from Chat room limbo #jhmchat
Jay Koyner @jaykoyner
RT @GarySingerMD: @DoctorGates late renal consult = increased cost and LOS #jhmchat
miguel villagra @drvillagra
Love this interactive journal club #JHMChat
Matt Sparks @Nephro_Sparks
@DoctorGates but recall @methodsmanmd 's AKI alert paper. No help #JHMChat
Edgar V. Lerma 🇵🇭 @edgarvlermamd
AKI: Is early detection cost-effective⁉ #JHMChat #Nephpearls https://t.co/k0oIH2dHRC https://t.co/CHqSXdmAOO
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@FutureDocs - and now the stages of AKI! #JHMchat
Nephrology Jrnl Club @NephJC
@Nephro_Sparks @NephJC @tony_breu The AKI-D dx was highly sensitive and Specific. The AKI was sold as specific not sensitive. #jhmchat
Malvinder Parmar @wittykidney
@NephJC @tony_breu hospitals often over code and recommend MDs to do so #JHMchat
Raymond Hsu @drraymondhsu
T1 authors excluded upfront thoe concurrent ESRD codes, likely strengthening "true" AKI & AKI-D cases #jhmchat
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Improving AKI outcomes from @JAMA_current by @kellumja @BellomoRinaldo @croncoIRRIV #Nephpearls #JHMChat https://t.co/KOh8RIphMb https://t.co/Vb3Ds9SSch
Edgar V. Lerma 🇵🇭 @edgarvlermamd
AKI Biomarkers vs the Urinalysis: Have We Found the Kidney Troponin? #Nephpearls #JHMChat https://t.co/zwwy5rLCtO via @AJKDonline
Swapnil Hiremath, MD, MPH @hswapnil
Good point! @DrRaymondHsu: T1 authors excluded upfront thoe concurrent ESRD codes, likely strengthening "true" AKI & AKI-D cases #jhmchat
Loc Queen 💋 @drcockymd
RT @DoctorGates: #AKI unfortunately is too often ignored in the hospital. Most don't pay attention until the LAB Creatinine is RED, has a…
Scherly Leon, MD @SLeonMD
RT @edgarvlermamd: AKI Biomarkers vs the Urinalysis: Have We Found the Kidney Troponin? #Nephpearls #JHMChat https://t.co/zwwy5rLCtO via @…
Joel Topf, MD FACP @kidney_boy
RT @JHospMedicine: Great point, Gates! The unfortunate side effect of practicing categorical medicine in a continuous world #jhmchat https:…
Loc Queen 💋 @drcockymd
RT @JHospMedicine: A GIF Is Worth 3000 Words: New #VisualAbstract for #JHMChat: THIS MONDAY 9p ET! @WrayCharles @kidney_boy #nephjc
J Hospital Medicine @JHospMedicine
RT @DrRaymondHsu: T1 authors excluded upfront thoe concurrent ESRD codes, likely strengthening "true" AKI & AKI-D cases #jhmchat
Jay Koyner @jaykoyner
@arvindcanchi @Nephro_Sparks - that doesnt stop folks from sending it (non-neph) #jhmchat - and lab wont remove it from orders
Daniel Wolfson @WolfsonD
#JHMChat Glad to join this session. @SHMLive @ABIMFoundation #choosingwisely
Vinny Arora MD MAPP @FutureDocs
Coding query PTSD #jhmchat https://t.co/b977wG7Ne7
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Potential role for novel biomarkers in AKI #Nephpearls #JHMChat https://t.co/k0oIH2dHRC https://t.co/3yR9aT5PjQ
Roger Rodby @NephRodby
LOS increased 3 days, cost only $7900? you can't get a tylenol for for $3900, what am I missing? #jhmchat
Rebecca Jaffe @RJmdphilly
I'll like anything from @methodsmanmd :) https://t.co/ia8QYh31u1
Raymond Hsu @drraymondhsu
In our prior study found ~30% AKI-D had ESRD code also, though some may be true AKI-D --> ESRD. not possible to tease out with data #jhmchat
J Hospital Medicine @JHospMedicine
Glad to have you, Daniel! Great conversation going right now! https://t.co/tB9gst05hE
Malvinder Parmar @wittykidney
@DrRaymondHsu but pts with AKI had higher % of CKD and other comorbidities that will result in AKI #JHMchat
Aelaf Worku @DrAelaf
Agreed. The effort by clinicians to trend against baseline renal failure function is too inconsistent https://t.co/9T0I1d3Gvc
Samuel Silver @samuel_a_silver
good validation studies on AKI codes to support their use #jhmchat https://t.co/9ZE3wp12Lr
J Hospital Medicine @JHospMedicine
T2: Urban Teaching hospitals are noted 2 be more expensive than other locales. Thoughts? Real finding or confounding? #JHMChat #jhmchat
Kenar Jhaveri @kdjhaveri
@DoctorGates #jhmchat totally agree. sometimes we get too late and crt had doubled from 0.4 to 0.8 and then 1.2 ( still not RED)
Anna Burgner MD MEHP @anna_burgner
Hey! This is Anna Burgner, Vanderbilt Nephrologist with No COI. Sorry I'm late! #jhmchat
Tony Breu @tony_breu
@NephRodby Payment based on DRG (for Medicare), not fee for service. #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @JHospMedicine: T2: Urban Teaching hospitals are noted 2 be more expensive than other locales. Thoughts? Real finding or confounding? #J
Matt Sparks @Nephro_Sparks
RT @RJmdphilly: I'll like anything from @methodsmanmd :) https://t.co/ia8QYh31u1
Kenar Jhaveri @kdjhaveri
RT @edgarvlermamd: Potential role for novel biomarkers in AKI #Nephpearls #JHMChat https://t.co/k0oIH2dHRC https://t.co/3yR9aT5PjQ
Nephrology Jrnl Club @NephJC
@NephRodby that's nothing compared to the $800 saving from having a GI Bleed🤔 #jhmchat
Matt Sparks @Nephro_Sparks
explain that please! RT @NephJC: @NephRodby that's nothing compared to the $800 saving from having a GI Bleed🤔 #jhmchat
Kenar Jhaveri @kdjhaveri
@NephJC @NephRodby What is the cost of "calling a nephrologist" ;) #jhmchat
Vinny Arora MD MAPP @FutureDocs
We did cover that in a previous #jhmchat with @Pahwa ! #choosingwisely https://t.co/Z50KbzXTCk
Michelle Brooks, MD, FACP, FHM @michellebr00ks
seriously - and it's about $1/ml of NS, so those 3 L of IVF you got are going to run you about $3000. #JHMChat https://t.co/frCawNTIhZ
Nephrology Jrnl Club @NephJC
Hey Anna, thanks for making it. The author is about to tell us how we can save money by causing GI bleeds and cardiac arrests #jhmchat
Malvinder Parmar @wittykidney
@JHospMedicine confounding with regards to hospital size, underlying comorbidities #JHMchat
Gary Singer @garysingermd
@DrRaymondHsu can you use @USRDS data set to tease out? #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @JHospMedicine: T2: Urban Teaching hospitals are noted 2 be more expensive than other locales. Thoughts? Real finding or confounding? #J
Matt Sparks @Nephro_Sparks
@kdjhaveri @DoctorGates again cue the @methodsmanmd paper. In the surgical wards actually needed more HD #jhmchat
Samuel Silver @samuel_a_silver
@nephrodby those were mean costs attributed to AKI; not total costs #jhmchat
Rebecca Jaffe @RJmdphilly
RT @JHospMedicine: T2: Urban Teaching hospitals are noted 2 be more expensive than other locales. Thoughts? Real finding or confounding? #J
Swapnil Hiremath, MD, MPH @hswapnil
@JHospMedicine Shocking. See supp T3. Suspect missing residual confounding (or teaching hosp waste money?) #JHMchat https://t.co/hLdX1k9G80
Gates Colbert, MD @DoctorGates
@DrRaymondHsu I feel like almost no one recodes the diagnosis if AKI -> dialysis or AKI -> CKD. #EMRHasselFactor #jhmchat
Scherly Leon, MD @SLeonMD
@michellebr00ks ridiculous! #jhmchat
Aelaf Worku @DrAelaf
Agreed. While case mix is a challenge in the former, they also get compensated with a Lin enhanced DRG for being a teaching Hosp #jhmchat https://t.co/VX3DhpfT3l
Raymond Hsu @drraymondhsu
@GarySingerMD @DrRaymondHsu yes if linkable, but this national data is has no identifier #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
I'm not surprised that GI bleeds are cheaper - no heparin prophylaxis, NPO, IV PPI - orders are easy as a hospitalist. #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
@Samuel_A_Silver @NephRodby so AKI pt with GI bleed = 860$ cheaper than without GI bleed? Why would that be?? #jhmchat
Malvinder Parmar @wittykidney
@NephJC arrests don't resuscitate will save money, GI bleed, not clear if let them bleed #JHMchat
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: T2: Urban Teaching hospitals are noted 2 be more expensive than other locales. Thoughts? Real finding or confounding? #J
Nephrology Jrnl Club @NephJC
@hswapnil @JHospMedicine Interns always order everything. Get in trouble for not getting a test, rarely for ordering unnecessaries #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @hswapnil: @JHospMedicine Shocking. See supp T3. Suspect missing residual confounding (or teaching hosp waste money?) #JHMchat https://t…
J Hospital Medicine @JHospMedicine
Teaching hospitals love their zebras and fancy work-ups...? https://t.co/dVLcx9MKw1
Matt Sparks @Nephro_Sparks
@michellebr00ks no scopy for GI bleedy? #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @wittykidney: @JHospMedicine confounding with regards to hospital size, underlying comorbidities #JHMchat
Nephrology Jrnl Club @NephJC
@michellebr00ks but there is the pesky EGD/C-scope. Not Free💰 #jhmchat
Raymond Hsu @drraymondhsu
@DoctorGates @DrRaymondHsu there is a lot of re-labelling of AKI-D to ESRD to facilitate discharge #jhmchat
Jay Koyner @jaykoyner
@hswapnil @Samuel_A_Silver @NephRodby i b/c the GI bleed explains the AKI and is readily managed vs other sources which R complex? #jhmchat
Amit Kumar Pahwa @pahwa
@NephJC @hswapnil You can change the culture - medical students notice too - https://t.co/NhK7BUT0vT #JHMChat
Irsk Anderson @ijanders1
@NephJC @michellebr00ks cost of blood products? #jhmchat
Samuel Silver @samuel_a_silver
agree with @hswapnil lots of residual confounding, but Fischer et al found same thing in their study re: $$$ academic hospital #jhmchat
Joel Topf, MD FACP @kidney_boy
RT @Pahwa: @NephJC @hswapnil You can change the culture - medical students notice too - https://t.co/NhK7BUT0vT #JHMChat
Amit Kumar Pahwa @pahwa
@DrRaymondHsu @DoctorGates although medicare now pays for AKI-D!!!! #JHMChat
Matt Sparks @Nephro_Sparks
This is truth (but changing now) #JHMChat Coding Changes with Policy https://t.co/cfPvmDaXiX
J Hospital Medicine @JHospMedicine
#JHMChat had a discussion about this a few months back. Residents under lots of pressure to order tests https://t.co/cuXCX6MWSW
Michelle Brooks, MD, FACP, FHM @michellebr00ks
True! I'm blaming the tamiflu for all my mistakes tonight. #JHMChat Or are GI docs charging less for EGD/scope than nephrologists for HD? https://t.co/ljspKM788r
Society of Hospital Medicine @SHMLive
#JHMChat T2 is live, join us in discussing cost of #AKI https://t.co/RBrKecUKk0
Tulun Sokit @tulunsokit
@NephJC #JHMChat GI bleeds and MI reduce LOS possibly ?
J Hospital Medicine @JHospMedicine
RT @Samuel_A_Silver: agree with @hswapnil lots of residual confounding, but Fischer et al found same thing in their study re: $$$ academic…
Raymond Hsu @drraymondhsu
Yup, interesting to see if ESRD incidence decreases substantially this year #jhmchat
Malvinder Parmar @wittykidney
@michellebr00ks system won't save money, hospitals might - start PPI, send pt home, do scope on out-patient basis & get extra $ #JHMchat
Gates Colbert, MD @DoctorGates
@NephJC @hswapnil @JHospMedicine Correct. Residents can hide unnecessary NEG tests by conveniently not mentioning them in rounds #jhmchat
Irsk Anderson @ijanders1
Sorry. Irsk Anderson. @UChicagoMed Late to conversation. Kids with gastro! Ugh! #jhmchat https://t.co/UESFDAuwiq
Vinny Arora MD MAPP @FutureDocs
. @ValueVictoria will share research at @SHMLive on Inc costs in teaching hosp @ChrisMoriates @sumantranji #jhmchat (not Aki) https://t.co/QGQZMQUWaU
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: T2: Urban Teaching hospitals are noted 2 be more expensive than other locales. Thoughts? Real finding or confounding? #J
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @FutureDocs: . @ValueVictoria will share research at @SHMLive on Inc costs in teaching hosp @ChrisMoriates @sumantranji #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
Maybe patients who have CPR/GI bleed = more likely to die, so save money? Possible @samuel_A_silver ? or too cynical? #jhmchat
Rebecca Jaffe @RJmdphilly
@Nephro_Sparks @michellebr00ks AKI in GIB is $ saver cause GI less likely to scope #jhmchat
J Hospital Medicine @JHospMedicine
RT @FutureDocs: . @ValueVictoria will share research at @SHMLive on Inc costs in teaching hosp @ChrisMoriates @sumantranji #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @Samuel_A_Silver: agree with @hswapnil lots of residual confounding, but Fischer et al found same thing in their study re: $$$ academic…
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @wittykidney: @michellebr00ks system won't save money, hospitals might - start PPI, send pt home, do scope on out-patient basis & get e…
Matt Sparks @Nephro_Sparks
this happens RT @DoctorGates: Residents can hide unnecessary NEG tests by conveniently not mentioning them in rounds #jhmchat
Roger Rodby @NephRodby
Dialysis cheap, scope not? #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @RJmdphilly: @Nephro_Sparks @michellebr00ks AKI in GIB is $ saver cause GI less likely to scope #jhmchat
Amit Kumar Pahwa @pahwa
@FutureDocs @arvindcanchi - read about it here - https://t.co/d2nJq0ksHO #JHMChat
Nephrology Jrnl Club @NephJC
Why was COPD and CHF not included in Table 2. Very common hospital admissions. Surprised not to find them. #jhmchat
Scherly Leon, MD @SLeonMD
@kdjhaveri @DoctorGates no #alternativefacts detected. #jhmchat
Irsk Anderson @ijanders1
@hswapnil @Samuel_A_Silver likely very true even if morbid :) #jhmchat
J Hospital Medicine @JHospMedicine
Glad to have you, Irsk! #jhmchat https://t.co/0eJFNmHskL
Raymond Hsu @drraymondhsu
@Samuel_A_Silver is the negative cost associated with GI bleed due to adjusting away by the transfusion procedure? collinear? #jhmchat
Matt Sparks @Nephro_Sparks
@RJmdphilly never seen that. GI not deterred by AKI to scope. #jhmchat
Nephrology Jrnl Club @NephJC
Bing Bing Bing. We have a winner RT @RJmdphilly: @Nephro_Sparks @michellebr00ks AKI in GIB is $ saver cause GI less likely to scope #jhmchat
Kenar Jhaveri @kdjhaveri
@DrRaymondHsu @DoctorGates Some hospitals have an "outpatient" bed for some of those AKI-D patients as they can come outpatients #jhmchat
Irsk Anderson @ijanders1
@Nephro_Sparks @DoctorGates until attending lurking in EHR:) #jhmchat
Irsk Anderson @ijanders1
RT @Pahwa: @FutureDocs @arvindcanchi - read about it here - https://t.co/d2nJq0ksHO #JHMChat
Edgar V. Lerma 🇵🇭 @edgarvlermamd
@Samuel_A_Silver @hswapnil Just to be clear residual confounding is N🚫T the same as #alternatefacts#JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @NephJC: Bing Bing Bing. We have a winner RT @RJmdphilly: @Nephro_Sparks @michellebr00ks AKI in GIB is $ saver cause GI less likely to s…
Matt Sparks @Nephro_Sparks
@kdjhaveri @DrRaymondHsu @DoctorGates not anymore #PolicyChange #jhmchat
Nephrology Jrnl Club @NephJC
See a smart comment? Punch the follow button. Improve your personal learning network! #jhmchat
Rebecca Jaffe @RJmdphilly
@Nephro_Sparks tongue in cheek. Depends on anesthesia. #jhmchat
Nathaniel Reisinger @nephrothaniel
@NephJC #jhmchat Mentioned in the Discussion section. Were not able to assess severity.
Vinny Arora MD MAPP @FutureDocs
RT @DoctorGates: @NephJC @hswapnil @JHospMedicine Correct. Residents can hide unnecessary NEG tests by conveniently not mentioning them in…
Jay Koyner @jaykoyner
@Nephro_Sparks @RJmdphilly agreed Matt- GI will scope with AKI - the other day tried to scope patient while getting IHD.... #jhmchat
Gates Colbert, MD @DoctorGates
@Nephro_Sparks No Resident blurts out PET-CT was negative! on the "tummy ache" chief complaint :) #jhmchat
Matt Sparks @Nephro_Sparks
RT @jaykoyner: @Nephro_Sparks @RJmdphilly agreed Matt- GI will scope with AKI - the other day tried to scope patient while getting IHD....…
Samuel Silver @samuel_a_silver
GI bleed low likely from case mix and residual confouding; low LOS also #jhmchat
Nephrology Jrnl Club @NephJC
@Nephro_Sparks @RJmdphilly disagree, see "will scope as outpatient" lots in medically complex pts (i.e. AKI) #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @NephJC: Bing Bing Bing. We have a winner RT @RJmdphilly: @Nephro_Sparks @michellebr00ks AKI in GIB is $ saver cause GI less likely to s…
J Hospital Medicine @JHospMedicine
RT @NephJC: See a smart comment? Punch the follow button. Improve your personal learning network! #jhmchat
Society of Hospital Medicine @SHMLive
Claim your #CME after tonight's #JHMChat here: https://t.co/hhCBLWa26a Eval is open til 11PM EST!
Joel Topf, MD FACP @kidney_boy
RT @Samuel_A_Silver: GI bleed low likely from case mix and residual confouding; low LOS also #jhmchat
J Hospital Medicine @JHospMedicine
Couple more minutes until T3 is up…#JHMChat
Swapnil Hiremath, MD, MPH @hswapnil
also, Hospitals in New England most expensive! #JHMChat Unlike @Atul_Gawande stories https://t.co/LczTXHwvKL https://t.co/MUwQG510Ej
Scherly Leon, MD @SLeonMD
RT @SHMLive: Claim your #CME after tonight's #JHMChat here: https://t.co/hhCBLWa26a Eval is open til 11PM EST!
Matt Sparks @Nephro_Sparks
@NephJC that's too bad. Have not seen that happen in AKI for me #jhmchat
Irsk Anderson @ijanders1
@jaykoyner @Nephro_Sparks @RJmdphilly that is plain awesome! #jhmchat go @UChicagoMed
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: See a smart comment? Punch the follow button. Improve your personal learning network! #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @NephJC: Why was COPD and CHF not included in Table 2. Very common hospital admissions. Surprised not to find them. #jhmchat
Gary Singer @garysingermd
RT @DoctorGates: @Nephro_Sparks No Resident blurts out PET-CT was negative! on the "tummy ache" chief complaint :) #jhmchat
J Hospital Medicine @JHospMedicine
RT @SHMLive: Claim your #CME after tonight's #JHMChat here: https://t.co/hhCBLWa26a Eval is open til 11PM EST!
Swapnil Hiremath, MD, MPH @hswapnil
RT @Samuel_A_Silver: GI bleed low likely from case mix and residual confouding; low LOS also #jhmchat
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: Couple more minutes until T3 is up…#JHMChat
Society of Hospital Medicine @SHMLive
RT @NephJC: See a smart comment? Punch the follow button. Improve your personal learning network! #jhmchat
HofNorthwell Kidney @hofstrakidney
Do you think our workup is expensive for #AKI? #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @DoctorGates: @NephJC @hswapnil @JHospMedicine Correct. Residents can hide unnecessary NEG tests by conveniently not mentioning them in…
Daniel Wolfson @WolfsonD
#jhmchat Why is there no discuss of shared decision making w hemodialysis? @JHospMedicine @SHMLive @FutureDocs
Pablo Garcia @pablogarciamd
RT @NephJC: See a smart comment? Punch the follow button. Improve your personal learning network! #jhmchat
HofNorthwell Kidney @hofstrakidney
Do all patients need renal sonograms? #jhmchat
Matt Sparks @Nephro_Sparks
don't think it is workup. it is LOS other complications RT @HofstraKidney: Do you think our workup is expensive for #AKI? #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @Samuel_A_Silver: GI bleed low likely from case mix and residual confouding; low LOS also #jhmchat
Jay Koyner @jaykoyner
@HofstraKidney great point - no they dont - but often happen like knee jerk - just like echos.... #jhmchat
Matt Sparks @Nephro_Sparks
@WolfsonD shared decision making for HD is routine IMO #jhmchat
Roger Rodby @NephRodby
@HofstraKidney great ?, Hmm, USound often waste of time, urine lytes often waste of time (don't shoot me) #jhmchat
Arvind Canchi 🇮🇳 @arvindcanchi
@NephJC Your costs r driven by the way you code/how insurance charges applied. Trust hosps here charge per material & costs not ⬆️ #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @WolfsonD: #jhmchat Why is there no discuss of shared decision making w hemodialysis? @JHospMedicine @SHMLive @FutureDocs
Samuel Silver @samuel_a_silver
May explains higher costs in @gchertow original study...from Boston #jhmchat https://t.co/y8UfjLLNo8
J Hospital Medicine @JHospMedicine
T3: How is this new cost/LOS information going to change the way you think about AKI in hospitalized patients? #JHMChat
HofNorthwell Kidney @hofstrakidney
@jaykoyner Adds cost and the time to get results- especially weekend stays? #jhmchat
Hector Madariaga, MD @hecmagsmd
RT @NephRodby: @HofstraKidney great ?, Hmm, USound often waste of time, urine lytes often waste of time (don't shoot me) #jhmchat
HofNorthwell Kidney @hofstrakidney
RT @WolfsonD: #jhmchat Why is there no discuss of shared decision making w hemodialysis? @JHospMedicine @SHMLive @FutureDocs
Malvinder Parmar @wittykidney
@HofstraKidney No, No, No! #JHMchat
Bea Concepcion @kidneybea_n
it's expensive to watch the creatinine in-house. pts need quick nephro outpatient f/u for earlier d/c #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @JHospMedicine: T3: How is this new cost/LOS information going to change the way you think about AKI in hospitalized patients? #JHMChat
J Hospital Medicine @JHospMedicine
LOS and/or subsequent procedures... https://t.co/Wy70ATISOV
HofNorthwell Kidney @hofstrakidney
@NephRodby FENA was best studied in oliguric white men, not sure if FENA is validated in non oliguric AKI and AKI on CKD #jhmchat
Michelle Rheault @rheault_m
@JHospMedicine Research focused on prevention of AKI will be important for cost control for the entire healthcare system. #JHMChat
Matt Sparks @Nephro_Sparks
True AKI on Friday cost more than Mon RT @HofstraKidney: Adds cost and the time to get results- especially weekend stays? #jhmchat
John Pickering @kiwiskinz
@NephJC @Nephro_Sparks @tony_breu Surely it is a combination of spec v sen that is important. If sen too low what’s the point? #jhmchat
Irsk Anderson @ijanders1
@jaykoyner @HofstraKidney &b4 attending rounds, & def b4 nephro consult #jhmchat
Gary Singer @garysingermd
@Nephro_Sparks @HofstraKidney agree that cost of AKI due to LOS complications procedures #jhmchat
Nephrology Jrnl Club @NephJC
We need an AKI pathway and clear signals for discharge. Some thoughts here: https://t.co/H7M0seBkeG #jhmchat
Tulun Sokit @tulunsokit
@JHospMedicine I would start moving towards a protocol driven management of AKI based on this. Something like the SCAMP form #jhmchat
HofNorthwell Kidney @hofstrakidney
RT @Nephro_Sparks: True AKI on Friday cost more than Mon RT @HofstraKidney: Adds cost and the time to get results- especially weekend stays…
Swapnil Hiremath, MD, MPH @hswapnil
T3: not really sure. AKI is expensive: hope greater research efforts on AKI, esp prevention, if possible? #jhmchat
Samuel Silver @samuel_a_silver
@WolfsonD makes a great point we had an abstract at ASN that suggests palliative care may be under utilized for AKI @jaykoyner mod #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @Samuel_A_Silver: May explains higher costs in @gchertow original study...from Boston #jhmchat https://t.co/y8UfjLLNo8
J Hospital Medicine @JHospMedicine
RT @rheault_m: @JHospMedicine Research focused on prevention of AKI will be important for cost control for the entire healthcare system. #J
Roger Rodby @NephRodby
@tulunsokit @JHospMedicine Another protocol? Shoot me. #jhmchat
Vinny Arora MD MAPP @FutureDocs
Wonder if this has something to do w culture or availability of nephrology? #jhmchat https://t.co/Hzvs3tWBSp
Gates Colbert, MD @DoctorGates
@HofstraKidney Almost all organ disfunction get an imaging test. Many R compelled to get the "kidney version" even if not helpful #jhmchat
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: T3: How is this new cost/LOS information going to change the way you think about AKI in hospitalized patients? #JHMChat
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Natural history of AKI from @croncoIRRIV #JHMChat https://t.co/CRSDmQdSPw https://t.co/FnAiFHmVEc
Pravir @proximal_baxi
RT @DoctorGates: @HofstraKidney Almost all organ disfunction get an imaging test. Many R compelled to get the "kidney version" even if not…
Amit Kumar Pahwa @pahwa
T3 - tough - comes down to do they cost more because we do more or because they need more inpatient care #jhmchat
Malvinder Parmar @wittykidney
@JHospMedicine The issues is the underlying problems, those who had AKI had higher rates of co-mobidities, nothing else #JHMChat
Scherly Leon, MD @SLeonMD
RT @edgarvlermamd: Natural history of AKI from @croncoIRRIV #JHMChat https://t.co/CRSDmQdSPw https://t.co/FnAiFHmVEc
Nephrology Jrnl Club @NephJC
I can give a liter of saline in a few hours a FENa takes 24 hours. Gives the same in info and the former may be therapeutic. #jhmchat
HofNorthwell Kidney @hofstrakidney
Original FENA study https://t.co/l5akauWZIw #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
T3: Also, some of this bugs me (eg CPR = less length of stay, cheaper). Sometimes more = more, ie money well spent, appropriate? #JHMChat https://t.co/PdDJ7cGq7h
Tulun Sokit @tulunsokit
@NephRodby @JHospMedicine SCAMP form by Binghams Hospital seems pretty logical, my scenario here is late referrals #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
T3:I think this was my biggest question - how to we recognize/prevent/treat? As far as I know, not much prevention/treatment avail #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: #JHMChat had a discussion about this a few months back. Residents under lots of pressure to order tests https://t.co/cuX…
Gary Singer @garysingermd
RT @Samuel_A_Silver: @WolfsonD makes a great point we had an abstract at ASN that suggests palliative care may be under utilized for AKI @j
Gates Colbert, MD @DoctorGates
@KidneyBea_n Sadly the data shows you are more likely to see a CARDS than a NEPH at discharge if you have #AKI #jhmchat
Joel Topf, MD FACP @kidney_boy
RT @DoctorGates: @HofstraKidney Almost all organ disfunction get an imaging test. Many R compelled to get the "kidney version" even if not…
Pravir @proximal_baxi
Routinely, the renal ultrasound has been ordered and resulted well before we are consulted #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @DoctorGates: @HofstraKidney Almost all organ disfunction get an imaging test. Many R compelled to get the "kidney version" even if not…
J Hospital Medicine @JHospMedicine
Would you get rid of anything in particular in this pathway @NephJC? FeNA, Renal US? #jhmchat https://t.co/AzP4rFL9yC
Matt Sparks @Nephro_Sparks
unless Friday RT @Proximal_Baxi: Routinely, the renal ultrasound has been ordered and resulted well before we are consulted #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @Samuel_A_Silver: @WolfsonD makes a great point we had an abstract at ASN that suggests palliative care may be under utilized for AKI @j
Samuel Silver @samuel_a_silver
nephro or PCP f/u as outpatient after AKI #lostintransition #jhmchat https://t.co/j1IO8ALHw8
Nephrology Jrnl Club @NephJC
I always U/S. Missing an obstruction is not tolerable. Treatment of obstruction is not dialysis. #jhmchat
Rebecca Jaffe @RJmdphilly
RT @KidneyBea_n: it's expensive to watch the creatinine in-house. pts need quick nephro outpatient f/u for earlier d/c #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @NephJC: We need an AKI pathway and clear signals for discharge. Some thoughts here: https://t.co/H7M0seBkeG #jhmchat
Amit Kumar Pahwa @pahwa
@hswapnil this one may be hard. as our inpatients get sicker i think we are going to have a lot of issues with organ damage #jhmchat
Nephrology Jrnl Club @NephJC
@Samuel_A_Silver nephrology's. Always. Need to discuss future risk of CKD. #jhmchat
Tulun Sokit @tulunsokit
@hswapnil does CPR imply a shorter LOS if unsuccessful? #jhmchat
Scherly Leon, MD @SLeonMD
RT @NephJC: I always U/S. Missing an obstruction is not tolerable. Treatment of obstruction is not dialysis. #jhmchat
Matt Sparks @Nephro_Sparks
@NephJC why not post void residual. Or US by nephron #jhmchat
Nathaniel Reisinger @nephrothaniel
RT @NephJC: I always U/S. Missing an obstruction is not tolerable. Treatment of obstruction is not dialysis. #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
@DoctorGates @KidneyBea_n that's another @samuel_a_silver paper: https://t.co/hVjcvIhgsN w/ @drRonWald et al #jhmchat
J Hospital Medicine @JHospMedicine
@tulunsokit Can you elaborate or provide a ref for those not familiar, Tulun? #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: I always U/S. Missing an obstruction is not tolerable. Treatment of obstruction is not dialysis. #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
Exactly. So less cost = not always better RT @tulunsokit: @hswapnil does CPR imply a shorter LOS if unsuccessful? #jhmchat
Raymond Hsu @drraymondhsu
high cost of AKI is driven (acutely) by sepsis and (co-morbidity) by CKD which is likely undercoded (insensitive) #jhmchat
Gary Singer @garysingermd
Expect AKI-D cost and LOS to fall now that @CMSGov covers outpt RRT for AKI #JHMChat
Shannon K. Martin @shannonmartinmd
@NephJC this is one of my favorite hospitalist teaching points about the diagnostic and therapeutic value of a fluid challenge! :) #jhmchat
Nephrology Jrnl Club @NephJC
@Nephro_Sparks @NephJC post-void only gets lower obstruction. #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @DrRaymondHsu: high cost of AKI is driven (acutely) by sepsis and (co-morbidity) by CKD which is likely undercoded (insensitive) #jhmchat
Joel Topf, MD FACP @kidney_boy
RT @ShannonMartinMD: @NephJC this is one of my favorite hospitalist teaching points about the diagnostic and therapeutic value of a fluid c…
Bea Concepcion @kidneybea_n
RT @hswapnil: @DoctorGates @KidneyBea_n that's another @samuel_a_silver paper: https://t.co/hVjcvIhgsN w/ @drRonWald et al #jhmchat
Matt Sparks @Nephro_Sparks
this is BIG!!! RT @GarySingerMD: Expect AKI-D cost and LOS to fall now that @CMSGov covers outpt RRT for AKI #JHMChat
HofNorthwell Kidney @hofstrakidney
RT @Nephro_Sparks: this is BIG!!! RT @GarySingerMD: Expect AKI-D cost and LOS to fall now that @CMSGov covers outpt RRT for AKI #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @Samuel_A_Silver: nephro or PCP f/u as outpatient after AKI #lostintransition #jhmchat https://t.co/j1IO8ALHw8
Matt Sparks @Nephro_Sparks
RT @DrRaymondHsu: high cost of AKI is driven (acutely) by sepsis and (co-morbidity) by CKD which is likely undercoded (insensitive) #jhmchat
Amit Kumar Pahwa @pahwa
@tulunsokit @JHospMedicine Sometimes protocols and order sets can make us do more #JHMchat
Nephrology Jrnl Club @NephJC
TOTN? RT @GarySingerMD: Expect AKI-D cost and LOS to fall now that @CMSGov covers outpt RRT for AKI #JHMChat
Swapnil Hiremath, MD, MPH @hswapnil
QFT MT @Pahwa: this one may be hard. as our inpatients get sicker i think we are going to have a lot of issues with organ damage #jhmchat
Roger Rodby @NephRodby
@tulunsokit @JHospMedicine can you explain SCAMP for me? I assume not a large shrimp? #jhmchat
Malvinder Parmar @wittykidney
@michellebr00ks this study shows that pts with higher comorbidities are at risk for AKI, so mainstay is to control those, but ... #JHMChat
Society of Hospital Medicine @SHMLive
Don't forget! You can claim #CME after #JHMChat by clicking this link: https://t.co/obP9Fel9kZ
Bea Concepcion @kidneybea_n
RT @DrRaymondHsu: high cost of AKI is driven (acutely) by sepsis and (co-morbidity) by CKD which is likely undercoded (insensitive) #jhmchat
Vinny Arora MD MAPP @FutureDocs
#jhmchat great post gonna share this w @MedChiefs for our residents if @jaykoyner agrees;) https://t.co/bEAUnK6v4E
Samuel Silver @samuel_a_silver
UK inquiry showed 30% AKI preventable and in 50% care/trmt could have been improved #jhmchat
Rebecca Jaffe @RJmdphilly
@NephJC I like "signals for discharge." How many kept in house for extra days just watching labs when o/w stable? Waste of time #JHMchat
HofNorthwell Kidney @hofstrakidney
@Nephro_Sparks @NephJC totally Point of care US is the most useful here just done by nephrologist #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @Nephro_Sparks: this is BIG!!! RT @GarySingerMD: Expect AKI-D cost and LOS to fall now that @CMSGov covers outpt RRT for AKI #JHMChat
Jay Koyner @jaykoyner
@Nephro_Sparks @GarySingerMD @CMSGov true except we still have units pushing back about taking these folks - #jhmchat - but eventually yes
Tulun Sokit @tulunsokit
@JHospMedicine #jhmchat https://t.co/zfT4ZOaEhv
J Hospital Medicine @JHospMedicine
RT @ShannonMartinMD: @NephJC this is one of my favorite hospitalist teaching points about the diagnostic and therapeutic value of a fluid c…
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @GarySingerMD: Expect AKI-D cost and LOS to fall now that @CMSGov covers outpt RRT for AKI #JHMChat
Malvinder Parmar @wittykidney
@Pahwa @tulunsokit @JHospMedicine Often, not sometimes. Most have the habit of checking all the check boxes #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @FutureDocs: #jhmchat great post gonna share this w @MedChiefs for our residents if @jaykoyner agrees;) https://t.co/bEAUnK6v4E
Edgar V. Lerma 🇵🇭 @edgarvlermamd
AKI: There is an inverse relationship between each dip ⬇️ and cost 💵 #JHMChat https://t.co/sbK8oLyXdF
Swapnil Hiremath, MD, MPH @hswapnil
@NephRodby @tulunsokit @JHospMedicine This 2cjasn paper https://t.co/ZsJ3qMd2Tk (not sure I buy evidence behind it though...) #jhmchat
HofNorthwell Kidney @hofstrakidney
@jaykoyner @Nephro_Sparks @GarySingerMD @CMSGov No fistula= no entry into outpatient unit #jhmchat
Daniel Wolfson @WolfsonD
#jhmchat Amazing SDM is routine - perhaps it depends on what you think are the attributes of shared decision making @ChrisMoriates https://t.co/CO8pkHh9hH
J Hospital Medicine @JHospMedicine
RT @Pahwa: @tulunsokit @JHospMedicine Sometimes protocols and order sets can make us do more #JHMchat
Rebecca Jaffe @RJmdphilly
RT @Pahwa: T3 - tough - comes down to do they cost more because we do more or because they need more inpatient care #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @Nephro_Sparks: this is BIG!!! RT @GarySingerMD: Expect AKI-D cost and LOS to fall now that @CMSGov covers outpt RRT for AKI #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@wittykidney Right - so...specific. I'll get right on that. 😀 #JHMChat.
Michelle Rheault @rheault_m
RT @RJmdphilly: @NephJC I like "signals for discharge." How many kept in house for extra days just watching labs when o/w stable? Waste of…
Amit Kumar Pahwa @pahwa
@wittykidney @tulunsokit I guess i was trying to underestimate #JHMChat
Don Campbell @dcam31
RT @JHospMedicine: T3: How is this new cost/LOS information going to change the way you think about AKI in hospitalized patients? #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @tulunsokit: @JHospMedicine #jhmchat https://t.co/zfT4ZOaEhv
Samuel Silver @samuel_a_silver
Ed siew done some good work here too https://t.co/K0Z467ylNK most patient do not see nephrons after AKI #jhmchat https://t.co/qp9rWnAuRk
Matt Sparks @Nephro_Sparks
@WolfsonD not sure I follow. You think Neph's put all on HD regardless of patient preferences #jhmchat
Jay Koyner @jaykoyner
@HofstraKidney @Nephro_Sparks @GarySingerMD @CMSGov its not quite that bad in chicago - but lost of push back since jan1 #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
@WolfsonD @nephro_sparks - what do you mean? HD in AKI far different than HD in ESRD. Are you trolling? #jhmchat
J Hospital Medicine @JHospMedicine
Final Topic 4 coming up shortly... #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @Nephro_Sparks: @WolfsonD not sure I follow. You think Neph's put all on HD regardless of patient preferences #jhmchat
Bea Concepcion @kidneybea_n
RT @Samuel_A_Silver: Ed siew done some good work here too https://t.co/K0Z467ylNK most patient do not see nephrons after AKI #jhmchat https…
HofNorthwell Kidney @hofstrakidney
RT @RJmdphilly: @NephJC I like "signals for discharge." How many kept in house for extra days just watching labs when o/w stable? Waste of…
Swapnil Hiremath, MD, MPH @hswapnil
RT @Samuel_A_Silver: Ed siew done some good work here too https://t.co/K0Z467ylNK most patient do not see nephrons after AKI #jhmchat https…
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: Final Topic 4 coming up shortly... #jhmchat
Vinny Arora MD MAPP @FutureDocs
Apparently some research shows #EHR makes us do more! To easy to order anything #jhmchat https://t.co/yyiEr92sJ4
Jay Koyner @jaykoyner
@FutureDocs @MedChiefs happy to discuss - bigger issue is pathway around work up and when to call neph - not to rush to send home #jhmchat
Benji Mathews @benjikmathews
@michellebr00ks #POCUS in AKI is especially valuable. Assess volume (lungs especially), quick look for hydro & bladder. #JHMchat @SHMLive
HofNorthwell Kidney @hofstrakidney
RT @Samuel_A_Silver: Ed siew done some good work here too https://t.co/K0Z467ylNK most patient do not see nephrons after AKI #jhmchat https…
Rebecca Jaffe @RJmdphilly
@GarySingerMD @CMSGov one can dream right? #jhmchat
Edgar V. Lerma 🇵🇭 @edgarvlermamd
@michellebr00ks @wittykidney On improving AKI outcomes #JHMChat https://t.co/KOh8RIphMb https://t.co/e5wNT0ahu5
Gary Beck Dallaghan @glbdallaghan
RT @FutureDocs: Apparently some research shows #EHR makes us do more! To easy to order anything #jhmchat https://t.co/yyiEr92sJ4
HofNorthwell Kidney @hofstrakidney
RT @FutureDocs: #jhmchat great post gonna share this w @MedChiefs for our residents if @jaykoyner agrees;) https://t.co/bEAUnK6v4E
John Pickering @kiwiskinz
@edgarvlermamd this is why I'd like to see studies aimed at rapid measure of renal researve in pts in the ICU #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @ShannonMartinMD: @NephJC this is one of my favorite hospitalist teaching points about the diagnostic and therapeutic value of a fluid c…
Gary Singer @garysingermd
@jaykoyner @HofstraKidney @Nephro_Sparks @CMSGov push back from LDO vs other providers? #jhmchat
J Hospital Medicine @JHospMedicine
T4: How can Hospitalists & Nephrologists work together to prevent and/or treat AKI - so as to avoid these costs? #JHMChat
HofNorthwell Kidney @hofstrakidney
@FutureDocs agree on making us do more and think less #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @benjikmathews: @michellebr00ks #POCUS in AKI is especially valuable. Assess volume (lungs especially), quick look for hydro & bladder.…
Roger Rodby @NephRodby
@benjikmathews @michellebr00ks @SHMLive POCUS, that would be great, you have one in every ICU? #jhmchat
Matt Sparks @Nephro_Sparks
RT @benjikmathews: @michellebr00ks #POCUS in AKI is especially valuable. Assess volume (lungs especially), quick look for hydro & bladder.…
HofNorthwell Kidney @hofstrakidney
RT @benjikmathews: @michellebr00ks #POCUS in AKI is especially valuable. Assess volume (lungs especially), quick look for hydro & bladder.…
Rebecca Jaffe @RJmdphilly
@NephJC @Nephro_Sparks but helpful if positive and quick #jhmchat
Society of Hospital Medicine @SHMLive
T4 is live! https://t.co/B0DUTMRb5g
Swapnil Hiremath, MD, MPH @hswapnil
T4: This looks promising https://t.co/Jgddt3wdFE #NephJC @wepaki #jhmchat
Samuel Silver @samuel_a_silver
NHS doing some great QI with AKI prevention and recognition with care pathways online https://t.co/lRkLQm3yLz @ThinkKidneys #jhmchat
Nephrology Jrnl Club @NephJC
We need to pro-actively track nephrotoxic drugs to intervene as Goldstein did in the NINJA study. Only thing shown to work. #jhmchat
HofNorthwell Kidney @hofstrakidney
@benjikmathews @Nephro_Sparks @michellebr00ks @SHMLive think of #POCUS as your new part of physical exam- not an instrument #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @JHospMedicine: T4: How can Hospitalists & Nephrologists work together to prevent and/or treat AKI - so as to avoid these costs? #JHMChat
Rebecca Jaffe @RJmdphilly
@Pahwa @tulunsokit @JHospMedicine maybe not if they incorporate outpatient and really mean it? #jhmchat
Roger Rodby @NephRodby
@JHospMedicine Hospitalists help me a lot, honestly, biggest move to decrease LOS ever, for me #jhmchat
Malvinder Parmar @wittykidney
@HofstraKidney @FutureDocs shouldn't it be think more & do the most appropriate, thereby less. #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
A https://t.co/5YGhjRtoAq
Nathaniel Reisinger @nephrothaniel
RT @HofstraKidney: @benjikmathews @Nephro_Sparks @michellebr00ks @SHMLive think of #POCUS as your new part of physical exam- not an instrum…
Edgar V. Lerma 🇵🇭 @edgarvlermamd
T4 AKI: Is early prevention cost-effective⁉ #JHMChat #Nephpearls https://t.co/k0oIH2dHRC https://t.co/mEqwf1vfWc
Gary Singer @garysingermd
@JHospMedicine early referral, discharge planning and early nephrology follow up #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @wittykidney: @HofstraKidney @FutureDocs shouldn't it be think more & do the most appropriate, thereby less. #JHMChat
J Hospital Medicine @JHospMedicine
Very cool! The name alone makes it worth a try #jhmchat https://t.co/rKo6x4ts3U
Jay Koyner @jaykoyner
@FutureDocs @MedChiefs care bundles may improve AKI outcomes - when completed in 24hrs PubMed - NCBI https://t.co/ASMBewnMHI #jhmchat
Pravir @proximal_baxi
RT @hswapnil: T4: This looks promising https://t.co/Jgddt3wdFE #NephJC @wepaki #jhmchat
Nephrology Jrnl Club @NephJC
We need to build intelligent protocols and allow for quick follow-up in appropriate patients. #jhmchat
Kenar Jhaveri @kdjhaveri
https://t.co/Al2EKfBlkL #POCUS changed my practice #jhmchat
Bea Concepcion @kidneybea_n
totally agree. RT @GarySingerMD: @JHospMedicine early referral, discharge planning and early nephrology follow up #jhmchat
Society of Hospital Medicine @SHMLive
RT @NephRodby: @JHospMedicine Hospitalists help me a lot, honestly, biggest move to decrease LOS ever, for me #jhmchat
Michelle Rheault @rheault_m
@NephJC Not just track nephrotoxic meds in NINJA, intervention to minimize/stop use. @wepaki1964 #JHMChat
Swapnil Hiremath, MD, MPH @hswapnil
@hswapnil @wepaki1964 is the right handle for #NINJA author Stuart Goldstein #jhmchat
Samuel Silver @samuel_a_silver
simple aki checklist may improve outcomes https://t.co/ctHDC6Rx4g @ThinkKidneys #jhmchat
Joel Topf, MD FACP @kidney_boy
RT @rheault_m: @NephJC Not just track nephrotoxic meds in NINJA, intervention to minimize/stop use. @wepaki1964 #JHMChat
Vinny Arora MD MAPP @FutureDocs
Great study name #ninja #jhmchat what does it stand for? https://t.co/NcQFhjtM4o
Swapnil Hiremath, MD, MPH @hswapnil
RT @Samuel_A_Silver: simple aki checklist may improve outcomes https://t.co/ctHDC6Rx4g @ThinkKidneys #jhmchat
J Hospital Medicine @JHospMedicine
It's a symbiotic relationship, Roger! But glad to hear we're helping out! #jhmchat https://t.co/5phmD6VErk
Matt Sparks @Nephro_Sparks
RT @KidneyBea_n: totally agree. RT @GarySingerMD: @JHospMedicine early referral, discharge planning and early nephrology follow up #jhmchat
Edgar V. Lerma 🇵🇭 @edgarvlermamd
AKI Biomarkers vs the Urinalysis: Have We Found the Kidney Troponin? #JHMChat #Nephpearls https://t.co/zwwy5rLCtO via @AJKDonline
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @NephJC: We need to pro-actively track nephrotoxic drugs to intervene as Goldstein did in the NINJA study. Only thing shown to work. #jh
Trek Langenhan @trekbird
@NephJC @nmandersonmd @IMtylerbrinkman is FeNa obsolete? A hospitalist teaching favorite. #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @hswapnil: T4: This looks promising https://t.co/Jgddt3wdFE #NephJC @wepaki #jhmchat
Amit Kumar Pahwa @pahwa
t4 - most of hospital charges are from the patient being in a hospital - whatever we can do to treat them outside the hospital #jhmchat
Nephrology Jrnl Club @NephJC
NINJA: Nephrotoxic Injury Negated by Just-in-time Action #jhmchat
Vinny Arora MD MAPP @FutureDocs
@NephJC #nevermind! #jhmchat #ninja https://t.co/BWO892l1pM
Swapnil Hiremath, MD, MPH @hswapnil
@FutureDocs NINJA: Nephrotoxic Injury Negated by Just-in-time Action #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: T4: How can Hospitalists & Nephrologists work together to prevent and/or treat AKI - so as to avoid these costs? #JHMChat
Nathaniel Reisinger @nephrothaniel
RT @kdjhaveri: https://t.co/Al2EKfBlkL #POCUS changed my practice #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @jaykoyner: @FutureDocs @MedChiefs care bundles may improve AKI outcomes - when completed in 24hrs PubMed - NCBI https://t.co/ASMBewnMH…
Pravir @proximal_baxi
@NephJC love the name! #ninja #jhmchat
Alyssa Riley @pedinephmd
@michellebr00ks @wittykidney think about renal angina index score & take action to minimize therapies you add up aki risk #jhmchat
Nathaniel Reisinger @nephrothaniel
RT @NephJC: NINJA: Nephrotoxic Injury Negated by Just-in-time Action #jhmchat
Roger Rodby @NephRodby
@TrekBird @NephJC @nmandersonmd @IMtylerbrinkman I need to write a tome on the FENa, rarely helpful really #jhmchat
Tony Breu @tony_breu
@Pahwa To that end, guidance on when in the Cr trajectory we can “safely” discharge is essential. #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
@TrekBird @NephJC @nmandersonmd @IMtylerbrinkman FENa: useful to think of physiology. But many exceptions (CI-AKI, Cardiorenal etc) #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @JHospMedicine: It's a symbiotic relationship, Roger! But glad to hear we're helping out! #jhmchat https://t.co/5phmD6VErk
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @PediNephMD: @michellebr00ks @wittykidney think about renal angina index score & take action to minimize therapies you add up aki risk #…
Amit Kumar Pahwa @pahwa
@TrekBird @NephJC @nmandersonmd @IMtylerbrinkman https://t.co/d2nJq0ksHO #JHMchat
Bea Concepcion @kidneybea_n
easier to discharge when someone takes ownership of AKI outpt f/u- would think that should be the neph who saw patient #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @hswapnil: @FutureDocs NINJA: Nephrotoxic Injury Negated by Just-in-time Action #jhmchat
Gary Singer @garysingermd
RT @hswapnil: @TrekBird @NephJC @nmandersonmd @IMtylerbrinkman FENa: useful to think of physiology. But many exceptions (CI-AKI, Cardiorena…
Matt Sparks @Nephro_Sparks
RT @KidneyBea_n: easier to discharge when someone takes ownership of AKI outpt f/u- would think that should be the neph who saw patient #jh
Jay Koyner @jaykoyner
@hswapnil @TrekBird @NephJC @nmandersonmd @IMtylerbrinkman agreed - but broadly applied with little validation across AKI settings #jhmchat
Vinny Arora MD MAPP @FutureDocs
T4 nephrologists can teach & empower hospitalists on when and when not to order/consult to improve value #jhmchat #choosingwisely
Amit Kumar Pahwa @pahwa
@tony_breu Agree it's like BP we all have our internal cutoffs but don't know if that is safe or not #JHMChat
Benji Mathews @benjikmathews
@HofstraKidney Arguably all undifferentiated AKI should have POCUS. Lung + IVC + kidney + bladder All < 2 min. #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @hswapnil: @FutureDocs NINJA: Nephrotoxic Injury Negated by Just-in-time Action #jhmchat
Pravir @proximal_baxi
@tony_breu @Pahwa Delta Cr is something we discuss a ton on rounds in our AKI pts #jhmchat
Matt Sparks @Nephro_Sparks
love this RT @KidneyBea_n: take ownership of AKI outpt f/u- would think that should be the neph who saw patient #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @jaykoyner: @hswapnil @TrekBird @NephJC @nmandersonmd @IMtylerbrinkman agreed - but broadly applied with little validation across AKI se…
J Hospital Medicine @JHospMedicine
No need, Roger. @Pahwa w/a great review https://t.co/Xq1dLTeF2Y #jhmchat https://t.co/Sw9YcGwobl
Samuel Silver @samuel_a_silver
@jaykoyner beat me to the punch...thought I posted this article first!!! Goof read and open access #jhmchat https://t.co/9SklNJgZSQ
Rebecca Jaffe @RJmdphilly
@NephRodby @benjikmathews @michellebr00ks @SHMLive and training badly needed #jhmchat
Bea Concepcion @kidneybea_n
i know my hospitalist husband always consults the neph who lets him d/c the patient sooner! #jhmchat
Matt Sparks @Nephro_Sparks
RT @Samuel_A_Silver: @jaykoyner beat me to the punch...thought I posted this article first!!! Goof read and open access #jhmchat https://t.…
Edgar V. Lerma 🇵🇭 @edgarvlermamd
@kiwiskiNZ Renal functional reserve and renal recovery after AKI #JHMChat #Nephpearls https://t.co/yhEBAPWN7Y https://t.co/6X7L5r2w7d
Gary Singer @garysingermd
@KidneyBea_n great point - should be standard of care #jhmchat
J Hospital Medicine @JHospMedicine
RT @FutureDocs: T4 nephrologists can teach & empower hospitalists on when and when not to order/consult to improve value #jhmchat #choosing
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @FutureDocs: T4 nephrologists can teach & empower hospitalists on when and when not to order/consult to improve value #jhmchat #choosing
Vinny Arora MD MAPP @FutureDocs
. @MedChiefs @jaykoyner @jeannemfarnan this has to be a morning report:) #jhmchat https://t.co/y1GgWHoovI
Tony Breu @tony_breu
@KidneyBea_n With expertise comes comfort #jhmchat
HofNorthwell Kidney @hofstrakidney
@KidneyBea_n agree! A good follow up plan by nephrology team can help Hospitalist discharge faster #jhmchat
Shannon K. Martin @shannonmartinmd
@JHospMedicine help me help you by navigating multiple teams and consultants, eg helping convince ID that i do not need urine eos! #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @kiwiskiNZ: @edgarvlermamd this is why I'd like to see studies aimed at rapid measure of renal researve in pts in the ICU #jhmchat
Gary Singer @garysingermd
RT @FutureDocs: T4 nephrologists can teach & empower hospitalists on when and when not to order/consult to improve value #jhmchat #choosing
Nathaniel Reisinger @nephrothaniel
RT @benjikmathews: @HofstraKidney Arguably all undifferentiated AKI should have POCUS. Lung + IVC + kidney + bladder All < 2 min. #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @FutureDocs: T4 nephrologists can teach & empower hospitalists on when and when not to order/consult to improve value #jhmchat #choosing
Nephrology Jrnl Club @NephJC
We call that a "Practice builder" MT @KidneyBea_n: my hospitalist husband consults the neph who lets him d/c the patient sooner! #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @JHospMedicine: No need, Roger. @Pahwa w/a great review https://t.co/Xq1dLTeF2Y #jhmchat https://t.co/Sw9YcGwobl
Jay Koyner @jaykoyner
@FutureDocs @MedChiefs @jeannemfarnan let me know I will be there #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @HofstraKidney: @KidneyBea_n agree! A good follow up plan by nephrology team can help Hospitalist discharge faster #jhmchat
Amit Kumar Pahwa @pahwa
@JHospMedicine & @celinegoetzmd @mshshospitalist https://t.co/WrfCX0tKCE #jhmchat
Raymond Hsu @drraymondhsu
nephrologists see a small %of AKI. tough to coordinate follow-up 4all. mild/reversible/fluid responsive AKI may not need neph f/u? #jhmchat
J Hospital Medicine @JHospMedicine
RT @ShannonMartinMD: @JHospMedicine help me help you by navigating multiple teams and consultants, eg helping convince ID that i do not nee…
Jay Koyner @jaykoyner
@Samuel_A_Silver agreed sam - great work by nick selby but for the hospitalists only 25-33% of patients complete bundle #jhmchat
Matt Sparks @Nephro_Sparks
RT @DrRaymondHsu: nephrologists see a small %of AKI. tough to coordinate follow-up 4all. mild/reversible/fluid responsive AKI may not need…
John Pickering @kiwiskinz
@tony_breu @Pahwa we tried ratio of cr estimated productn rate to short duration cr clearance - may work #jhmchat https://t.co/oQn3U4Yvfj
Rebecca Jaffe @RJmdphilly
RT @benjikmathews: @HofstraKidney Arguably all undifferentiated AKI should have POCUS. Lung + IVC + kidney + bladder All < 2 min. #jhmchat
J Hospital Medicine @JHospMedicine
Well, we have about 5 more minutes left in our discussion. Please feel free to give some final thoughts #JHMChat
Vinny Arora MD MAPP @FutureDocs
Perhaps nephrology could start a #meded campaign around becoming a NINJA to recruit #Medstudents and residents ? #jhmchat @NephJC
Samuel Silver @samuel_a_silver
only 1 in 10 patients will be seen by nephron within one year...coordination needed #jhmchat https://t.co/4KeczgHufB
Bea Concepcion @kidneybea_n
RT @benjikmathews: @HofstraKidney Arguably all undifferentiated AKI should have POCUS. Lung + IVC + kidney + bladder All < 2 min. #jhmchat
HofNorthwell Kidney @hofstrakidney
@KidneyBea_n a simple follow up appt to check labs and reassure patient and discuss risk factors is a good idea #jhmchat
Matt Sparks @Nephro_Sparks
RT @FutureDocs: Perhaps nephrology could start a #meded campaign around becoming a NINJA to recruit #Medstudents and residents ? #jhmchat @…
Roger Rodby @NephRodby
I'm taking ritalin before the next one of these. I type something and I miss 20 tweets. #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @Samuel_A_Silver: only 1 in 10 patients will be seen by nephron within one year...coordination needed #jhmchat https://t.co/4KeczgHufB
Swapnil Hiremath, MD, MPH @hswapnil
RT @FutureDocs: Perhaps nephrology could start a #meded campaign around becoming a NINJA to recruit #Medstudents and residents ? #jhmchat @…
Nephrology Jrnl Club @NephJC
@ShannonMartinMD @JHospMedicine We have installed cattle prods in the EMR. Order urine eosinophils and get 10,000 volts⚡️⚡️ #jhmchat
Kenar Jhaveri @kdjhaveri
RT @FutureDocs: Perhaps nephrology could start a #meded campaign around becoming a NINJA to recruit #Medstudents and residents ? #jhmchat @…
Scherly Leon, MD @SLeonMD
RT @FutureDocs: Perhaps nephrology could start a #meded campaign around becoming a NINJA to recruit #Medstudents and residents ? #jhmchat @…
Shannon K. Martin @shannonmartinmd
@DrRaymondHsu so important for helping us risk stratify on d/c and f/u, would be a great "signoff" consult note to help guide #jhmchat
Rebecca Jaffe @RJmdphilly
RT @NephRodby: I'm taking ritalin before the next one of these. I type something and I miss 20 tweets. #jhmchat
Jay Koyner @jaykoyner
@Samuel_A_Silver if only someone had an AKI follow up clinic??? (i have an underused one....) #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @ShannonMartinMD: @JHospMedicine help me help you by navigating multiple teams and consultants, eg helping convince ID that i do not nee…
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @FutureDocs: Perhaps nephrology could start a #meded campaign around becoming a NINJA to recruit #Medstudents and residents ? #jhmchat @…
Vinny Arora MD MAPP @FutureDocs
RT @tony_breu: @KidneyBea_n With expertise comes comfort #jhmchat
Furqan Raja @furqi
We have also stopped talking to each other. A simple phone call prior to placing a consult order helps a lot. #📞memaybe #jhmchat
Bea Concepcion @kidneybea_n
RT @Samuel_A_Silver: only 1 in 10 patients will be seen by nephron within one year...coordination needed #jhmchat https://t.co/4KeczgHufB
Kenar Jhaveri @kdjhaveri
@DrRaymondHsu it's doable with a good collaboration w an internist #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @Samuel_A_Silver: @jaykoyner beat me to the punch...thought I posted this article first!!! Goof read and open access #jhmchat https://t.…
Kenar Jhaveri @kdjhaveri
RT @benjikmathews: @HofstraKidney Arguably all undifferentiated AKI should have POCUS. Lung + IVC + kidney + bladder All < 2 min. #jhmchat
Samuel Silver @samuel_a_silver
think what could be down then if completion rate up to 75%!!! #jhmchat https://t.co/Za51q25nwe
J Hospital Medicine @JHospMedicine
For you NINJA novices, courtesy of @NephJC https://t.co/Vzld63WtFD #jhmchat https://t.co/Wra9AXD4kF
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: No need, Roger. @Pahwa w/a great review https://t.co/Xq1dLTeF2Y #jhmchat https://t.co/Sw9YcGwobl
Michelle Brooks, MD, FACP, FHM @michellebr00ks
CT: not going to have the flu next time, so hopefully will be more involved/engaged! :) #jhmchat
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Potential role for novel biomarkers in AKI #JHMChat #Nephpearls https://t.co/k0oIH2dHRC https://t.co/ov2jAp9UKf
Swapnil Hiremath, MD, MPH @hswapnil
@NephRodby or this? #jhmchat https://t.co/MUoWarmaav
Gary Singer @garysingermd
We typically have AKI pts repeat labs and follow up with NP in 1 week #jhmchat https://t.co/HZO2xbQEfm
Matt Sparks @Nephro_Sparks
send me your AKIs.... i will pack them in my clinic. #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @tony_breu: @Pahwa To that end, guidance on when in the Cr trajectory we can “safely” discharge is essential. #jhmchat
Rebecca Jaffe @RJmdphilly
Take home 1) admin data is a headache 2) unclear where costs lie 🙁3) care coordination to address LOS and POCUS to dec imaging $s #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
RT @RJmdphilly: Take home 1) admin data is a headache 2) unclear where costs lie 🙁3) care coordination to address LOS and POCUS to dec imag…
Vinny Arora MD MAPP @FutureDocs
RT @Pahwa: t4 - most of hospital charges are from the patient being in a hospital - whatever we can do to treat them outside the hospital…
Rebecca Jaffe @RJmdphilly
RT @ShannonMartinMD: @DrRaymondHsu so important for helping us risk stratify on d/c and f/u, would be a great "signoff" consult note to hel…
Michelle Rheault @rheault_m
@ShannonMartinMD @DrRaymondHsu Important point. We often "sign off" AKI well before discharge and follow up with nephrology is lost #JHMChat
Bea Concepcion @kidneybea_n
RT @Nephro_Sparks: send me your AKIs.... i will pack them in my clinic. #jhmchat
Samuel Silver @samuel_a_silver
this is where I need to be better prepared with a link to our pilot RCT FUSION...early vs no follow-up after AKI #jhmchat https://t.co/WL6C0H1l3o
Jay Koyner @jaykoyner
@FutureDocs happy to work with you to have @wepaki1964 come to UChicago for a talk - he is an AKI rockstar even if he's viking fan #jhmchat
Swapnil Hiremath, MD, MPH @hswapnil
Great chat! thanks to @jhospmedicine and @futuredocs for inviting @kidney_boy and the #NephJC crew #jhmchat
Matt Sparks @Nephro_Sparks
true story from primary team. "something bad is about to happen... consult renal" #jhmchat
Bea Concepcion @kidneybea_n
We do this too. RT @GarySingerMD: We typically have AKI pts repeat labs and follow up with NP in 1 week #jhmchat https://t.co/FpJAIFN8tC
Nathaniel Reisinger @nephrothaniel
Surviving fellowship 101 https://t.co/tEN4mCeH04
Edgar V. Lerma 🇵🇭 @edgarvlermamd
@michellebr00ks @wittykidney NINJA Protocol #JHMChat #Nephpearls https://t.co/PibNuPzjWV
Vinny Arora MD MAPP @FutureDocs
This could be name of @SHMLive mentored implementation program for hospitals: NINJA #jhmchat https://t.co/qrYyJJnWpC
Nephrology Jrnl Club @NephJC
I'm so proud of the #NephJC community. We changed days, changed hashtags and the nephrons still came out in force! #jhmchat
Kenar Jhaveri @kdjhaveri
@Nephro_Sparks usually detectives help out in tough times ! #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @NephJC: We need to build intelligent protocols and allow for quick follow-up in appropriate patients. #jhmchat
Society of Hospital Medicine @SHMLive
RT @hswapnil: Great chat! thanks to @jhospmedicine and @futuredocs for inviting @kidney_boy and the #NephJC crew #jhmchat
Scherly Leon, MD @SLeonMD
RT @NephJC: I'm so proud of the #NephJC community. We changed days, changed hashtags and the nephrons still came out in force! #jhmchat
Matt Sparks @Nephro_Sparks
RT @nephrothaniel: Surviving fellowship 101 https://t.co/tEN4mCeH04
Scherly Leon, MD @SLeonMD
RT @hswapnil: Great chat! thanks to @jhospmedicine and @futuredocs for inviting @kidney_boy and the #NephJC crew #jhmchat
Amit Kumar Pahwa @pahwa
@Nephro_Sparks @HopkinsMedicine is not too far! #jhmchat
Furqan Raja @furqi
Along with the clergy. https://t.co/a3gX4n8erP
Hector Madariaga, MD @hecmagsmd
RT @Nephro_Sparks: true story from primary team. "something bad is about to happen... consult renal" #jhmchat
J Hospital Medicine @JHospMedicine
That's a wrap..Loved having the joint #JHMChat #NephJC chat! Thanks everyone for participating!
HofNorthwell Kidney @hofstrakidney
RT @NephJC: I'm so proud of the #NephJC community. We changed days, changed hashtags and the nephrons still came out in force! #jhmchat
Nephrology Jrnl Club @NephJC
When you need the A-Team! RT @JHospMedicine: That's a wrap..Loved having the joint #JHMChat #NephJC chat! Thanks everyone for participating!
Matt Sparks @Nephro_Sparks
this was a great chat. need to partner more ofter. next time join our channel #NephJC #jhmchat
Society of Hospital Medicine @SHMLive
@hswapnil @JHospMedicine @FutureDocs @kidney_boy thank you all for joining us! #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @hswapnil: Great chat! thanks to @jhospmedicine and @futuredocs for inviting @kidney_boy and the #NephJC crew #jhmchat
Samuel Silver @samuel_a_silver
thanks all!!! Was great to brainstorm ways to improve AKI care. That was the whole point of our article #jhmchat
Alfred Kim @alhkim
This what rheumatology hears: “Crap, something bad happened. Consult #rheum.” Cc @jeffsparks #SparkyPower #PrednisoneToTheRescue https://t.co/ys1am4VkDI
Alyssa Riley @pedinephmd
@jaykoyner @Samuel_A_Silver I wish they were on every corner! #jhmchat
Roger Rodby @NephRodby
Damn Patriots! #jhmchat
Bea Concepcion @kidneybea_n
RT @NephRodby: Damn Patriots! #jhmchat
J Hospital Medicine @JHospMedicine
RT @Samuel_A_Silver: thanks all!!! Was great to brainstorm ways to improve AKI care. That was the whole point of our article #jhmchat
Tony Breu @tony_breu
@JHospMedicine Thanks @WrayCharles for moderating! #jhmchat
Alyssa Riley @pedinephmd
RT @rheault_m: @NephJC Not just track nephrotoxic meds in NINJA, intervention to minimize/stop use. @wepaki1964 #JHMChat
Nephrology Jrnl Club @NephJC
Hey what college did that Tom Brady go to? I forget? #jhmchat
J Hospital Medicine @JHospMedicine
Totally agree, Matt. Give us a time and place #jhmchat https://t.co/rY6dgwKoLT
Nephrology Jrnl Club @NephJC
Thanks everyone! Great chat! #jhmchat
Kenar Jhaveri @kdjhaveri
@Nephro_Sparks just one more thing Before we sign off #stopPPI in patients that don't need it #jhmchat
J Hospital Medicine @JHospMedicine
Be sure to join #JHMChat again on March 13th 9PM EST when we'll discuss "Attending rounds and Patient Satisfaction" w/@BradMonash #jhmchat
Joel Topf, MD FACP @kidney_boy
RT @kdjhaveri: @Nephro_Sparks just one more thing Before we sign off #stopPPI in patients that don't need it #jhmchat
Jay Koyner @jaykoyner
RT @kdjhaveri: @Nephro_Sparks just one more thing Before we sign off #stopPPI in patients that don't need it #jhmchat
Kenar Jhaveri @kdjhaveri
@Nephro_Sparks at my hospital , I am the #ppi police 😜#jhmchat
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: Be sure to join #JHMChat again on March 13th 9PM EST when we'll discuss "Attending rounds and Patient Satisfaction" w/@B
Rebecca Jaffe @RJmdphilly
@gretchendiemer @JeffIMchiefs @estewart2099 https://t.co/aN26mIw6Wr
HofNorthwell Kidney @hofstrakidney
RT @kdjhaveri: @Nephro_Sparks just one more thing Before we sign off #stopPPI in patients that don't need it #jhmchat
Shannon K. Martin @shannonmartinmd
Agreed, great to have different perspectives! Thanks @WrayCharles for moderating another great #jhmchat :) https://t.co/MWHtsbAW5R
Benji Mathews @benjikmathews
#JHMChat Fun to be a part of this. Thanks everyone for the chat!
Matt Sparks @Nephro_Sparks
The numbers: 571 Tweets. 64 Participants. More #JHMChat analytics here: https://t.co/zt53eaPJud via @symplur
Society of Hospital Medicine @SHMLive
Thanks to our partners @ABIMFoundation & @CostsofCare for helping to spread the word and for participating in #JHMChat!
Society of Hospital Medicine @SHMLive
Thanks to @JHospMedicine @WrayCharles @kidney_boy & the #nephJC community for a great #JHMChat! Claim your #CME: https://t.co/gPcZr7BKFI
Joel Topf, MD FACP @kidney_boy
Big Chat! The numbers: 571 Tweets. 64 Participants. More #JHMChat analytics here: https://t.co/mwEAc8357H via @symplur
J Hospital Medicine @JHospMedicine
RT @SHMLive: Thanks to @JHospMedicine @WrayCharles @kidney_boy & the #nephJC community for a great #JHMChat! Claim your #CME: https://t.co/…
Nathaniel Reisinger @nephrothaniel
RT @kidney_boy: Big Chat! The numbers: 571 Tweets. 64 Participants. More #JHMChat analytics here: https://t.co/mwEAc8357H via @symplur
Dr KirikRad @drlighthunter
RT @DrRaymondHsu: high cost of AKI is driven (acutely) by sepsis and (co-morbidity) by CKD which is likely undercoded (insensitive) #jhmchat
Vinny Arora MD MAPP @FutureDocs
Special thx to @WrayCharles for moderating a killer #NINJA @JHospMedicine #jhmchat w @NephJC @kidney_boy @Samuel_A_Silver @SHMLive https://t.co/HuoQoiYL4r
Andrew M. Ibrahim MD @AndrewMIbrahim
RT @FutureDocs: Special thx to @WrayCharles for moderating a killer #NINJA @JHospMedicine #jhmchat w @NephJC @kidney_boy
Jorge Huertas @alfilmal
RT @edgarvlermamd: Natural history of AKI from @croncoIRRIV #JHMChat https://t.co/CRSDmQdSPw https://t.co/FnAiFHmVEc
Charlie M. Wray @WrayCharles
RT @FutureDocs: Special thx to @WrayCharles for moderating a killer #NINJA @JHospMedicine #jhmchat w @NephJC @kidney_boy
Pravir @proximal_baxi
thanks to everyone, amazing discussion! #jhmchat
Vinny Arora MD MAPP @FutureDocs
Gladly! #cme for #jhmchat https://t.co/s9oIM4kwAd
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Be sure to join #JHMChat again on March 13th 9PM EST when we'll discuss "Attending rounds and Patient Satisfaction" w/@B
Vinny Arora MD MAPP @FutureDocs
Great one for #Meded community to join @MedEdChat #jhmchat @WrayCharles @SHMLive https://t.co/4c2s4wgDHD
Society of Hospital Medicine @SHMLive
Mark your calendars! The next #JHMChat is March 13 at 9PM EST w/ @JHospMedicine @FutureDocs & @BradMonash on standardizing rounds!
J Hospital Medicine @JHospMedicine
RT @FutureDocs: Great one for #Meded community to join @MedEdChat #jhmchat @WrayCharles @SHMLive https://t.co/4c2s4wgDHD
J Hospital Medicine @JHospMedicine
RT @FutureDocs: Special thx to @WrayCharles for moderating a killer #NINJA @JHospMedicine #jhmchat w @NephJC @kidney_boy
Johndbaptist! @brosobio
(((((( Please tell the urologists!!!!!!! )))))) https://t.co/x6kSqQeb0W
#JHMChat content from Twitter.