Thursday, August 28, 2014

302 Tweets of Wisdom from Yesterday's #FutureCare Tweetchat

Yesterday HIMSS Future Care and the Center for Connected Medicine hosted a #futurecare tweetchat that explored the social media landscape. I've gone ahead and curated the tweets from that chat. Here they are for your pleasure and use:

Note: I've left off who tweeted each of the following. If you want more information, see the @Symplur transcript here.


T1: What needs in healthcare does social media address?

1. Tremendous opportunities that remain untapped in #healthcare and #SoMe!

2. SoMe is the new go to place for community, support, & resources that HC no longer provides.

3. We get more engaged patients http://t.co/udi67FOoAH

4. First and foremost, healthcare needs to understand how social can actually drive outcomes. Work backward from there.

5. The Social Media Space is the Public Square of our time:a place learn fr neighbors far &near re healthcare needs/desires ~

6. In #healthcare, the qn for many involved in pt care is "To Tweet or Not To Tweet?!" My answer: "Embrace Thy Twitterfeed!"

7. #hcsm is *the* tool for PtEngagement

8. I think SM is great platform for education/awareness, but still need to find how it can drive outcomes

9. #SocialMedia in #Healthcare - possibilities! Grassroots interest in #health matters, broad reach, flattens the medical hierachy.

10. #hcsm address patient engagement, communication needs - can also dispell myths in health care

11. I think social media is a way to reach communities who are resistant or hesistant to reach doctors in a more traditional way

12. #HCSM can support patient engagement with health team and other patients, can help educate and motivate entire health team!

13. I think SoMe is a symptom of HC no longer being patient centered. Ironically it is also the cure I believe

14. Personally, I find #SoMe to be a tremendous and STILL underutilized resource in #healthcare!!

15. Social media in #healthcare brings health care professionals to where their patients are - in the digital space

16. Social media is a major driver of democratization of access to healthcare information.

17. #Socialmedia #analytics also incredibly useful for monitoring and predicting #health conditions - outbreaks, sentiment, etc.

18. For MDs:it is the opportunity not only to learn about/from patients but to impart knowledge when appropriate, correct rumor~

19. #HITsm expands the audience from local to international in 1 click

20. #SocialMedia gives almost instance access to #healthcare #resources, #discussions, #forums as search engines do

21. We have to USE #SoMe to take the conversations to where our patients are!!

22. I wrote about how physician can leverage SM to increase patient engagement here: http://t.co/6oKLTMzWk9

23. I think social media can add great value to the #ptexp & #patientengagement.

24. Can we clarify how social can be used for improved #ptexp? Platform to just share info? Or is social pivotal to care delivery?

25. "Next top priority for HIT investment" seemed to be in area of #PatientEngagement #ptexp http://t.co/prkBNWcJeu

26. SOME patients. RT @RasuShrestha: We have to USE #SoMe to take conversations to where our patients are!!

27. #HCSM is a tool for connecting people, offers support in a comfortable way, reaches people that might otherwise not engage.

28. In the recent case of #RobinWilliams and his #suicide, spread the word, facilitated access to crisis lines. #spsm

29. In #Healthcare, you have to go to where your patients are! And today, patients more than ever before are in #SoMe.

30. In the case of #ALS & the #IceBucketChallenges, presented an innovative way to raise awareness, #fundraising.

31. #HCSM makes world smaller and brings the conversation local, even if the patents are on different continents.

32. Here's why: Go where the patients are: Why this doctor is active on social media http://t.co/pSY2JZwwN9

33. Any healthcare at home is an improved patient experience.

34. While I feel #Some is inappropriate for direct medical advice, it is revolutionary for getting resources out.

35. Patients are on social media, physicians should be as well-best way to reach younger demo

36. Both,base on #patient demographics, #hclit, #privacy concerns. Embracing #SoMe involves complex #ptexp variables.

37. Would this be by searching for key words in certain locations? I.e. a lot of "I feel sick" tweets in Atlanta

38. Will the "marketing" messages meet the needs of patients currently as is?

39. That's more sentiment analytics than SM

40. Social media could be used as a platform to get a second opinion from top doctors that are not in a patients area

41. It needs to focus on increasing overall #healthliteracy, to facilitate #PatientEmpowerment.

42. Through social, e-consults, and #telehealth, docs can provide care to patients in home , where patient is comfortable

43. Interesting blog: "ER Doctors Excel at Social Media: Here’s Why" http://t.co/0zwLcEyrFG

44. Seeing great value of #SoMe here:democratization,track dz,patient comfort, MD outreach & education,global, find HC info Etc

45. Key words in certain locations? I.e. "I feel sick" tweets in Atlanta

46. SoMe isn't a place for diagnosis, it's for raising med literacy rate so patients can help diagnosis with their doc.

47. REALITY CHECK >> Patients often go to Dr Google before they come to Dr Shrestha in the clinic.
48. Is there a role for sentiment analysis in social media in healthcare to analyze #ptexp - #hcsm

49. Connecting patients is big. As a patient you can be lost and overwhelmed, connecting with others in same situation is a gift.

50. Privacy/security = huge. Consumers losing faith in platforms bc of trust. Begs question Public v. private communties

51. It is a given that when it comes to #patienteducation, encouraging #healthliteracy in our #patients, we need help

52. Telehealth has the potential to reduce the distance from clinic to patient. Face to face is reality via phone. #patientsfirst

53. I'm quite impressed that so many are gathering, sharing info on #cancer #diabetes #lupus, and so on.

54. It can drive outcomes if people know where to look and find trusted/credible info.

55. There is little if any regulation, standardization, credentialing in internet #healthcare, #BuyerBeware.

56. With stories every week of firings over #socialmedia postings, #HIPAA violations, can understand hesitation.

57. Yes, but we can be careful around #HIPAA, and not be held back. Agree?

58. When a carelessly composed tweet, #Facebook posting can get you fired, many pick "Not To Tweet."

59. #Hotspotting Amanda. Identify most at risk patients, lead them to resources, counseling, help online.

60. If more people knew eating #Salad could trip up their #Coumadin levels, we'd have fewer crises.

61. More connections will hopefully break the sillos of knowledge experience sharing what have others done and what r they doing now

62. #Twitter is a tool, not an end all be all. Agree?

63. Social Media has the potential to turn the #medicalprofession #healthcare on it's ear :)

64. Yes, spend a good deal of time clearing up #Myths #Misconception #Misinformation on #MHStigma

65. Social media provides informal, communal space for essential dialogue on cutting edge research. #CER #PCOR

66. We do have mint for healthcare http://t.co/1jKTgqJRQm <- start

67. Conversely, those that #Trailblaze #AdoptEarly will make mistakes, will reap huge benefits.

68. #SocialMedia is moving very quickly, especially in the area of #healthcare.

69. #SocialMedia is moving quickly, With or Without, the support of #healthcare #modernmedicine.

70. When four #nursingstudents posted #placentapictures on #Facebook, it all changed.

71. Within weeks to months, every #hospital, #nursingschool created #socialmedia guidelines

72. It is worth to note the #expelled #nursingstudents were reinstated by a federal judge.

73. Apparently the #studenthandbooks had no mention of #SocialMedia in 2010.

74. Yes, though it is basic commonsense and courtesy.

75. Lotsa #EarlyAdopters, #PositiveRoleModels on #Some.

76. Per PEW Internet Research, 6/10 Americans turn to the Internet First, for health inquiries.


T2: How can social media be utilized in the transition from volume-based to value-based medicine?

1. Value comes through better engaged patients who utilize less resources and are proactive.

2. VALUE based medicine trumps Volume based care any day of the week #SoMe is the vehicle!

3. SM can help physicians check in with patients to ensure positive treatment outcomes, thereby increasing reimbursements

4. VALUE based medicine is about promoting APPROPRIATENESS in care. #SoMe creates useful dialogue around this.

5. #HCSM at its tops has ability to educate the public re self care,basic diseases,lifestyle~if heed>get less volume, more value

6. It helps foster better understanding of a patients life & struggles. It gives a more complete pic of the patient

7. #SoMe can be a tremendous vehicle for care TRANSFORMATION - spreading #healthcare info!

8. Social Media Validation of Appropriateness of care key input to Pt Decision making

9. #telehealth initiatives and #mhealth apps, and #hcsm can help raise medical literacy rates and connect w/patients easily.

10. Value based medicine = better care coordination. #SoMe is a powerful change agent for care coordination

11. Value based care = transparency AND accountability. #SoMe is a great vehicle for both.

12. The (intended) core of social media IS VALUE.

13. SM is personal, sometimes a one-on-one connection, it's not always an ice bucket challenge and that can be more meaningful.

14. Superior #PtExp and Healthcare Price Transparency #hcpt are key drivers of VALUE based care

15. SoMe also brings patients into HC training/education which needs to happen in med school more

16. In order to find it, we have to be consistent about putting messages in one place. Means COMMITMENT.

17. Value based medicine must be defined by the pt. In telehealth, better engagement potential, easier use of standardized tools

18. #ACOs are looking at #SoMe to engage in meaningful dialogue and #PatientEngagement

19. Where do you see "one place" for msgs?

20. SM is personal, valuable patient info. Plus people feel more comfortable asking questions online/anonymously

21. #socialmedia sites from hospitals and health systems promote community health initiatives, play role of engaging/informing

22. SM = value based when you reach a pt pop that might not have gotten the message or connected - look at recent #COPD tweetchats

23. Can I get the info i need from Twitter? Or is it required to build a secure platform/portal for health msgs? Not sure.

24. SM can be less threatening, let people get used to their DX, see what others day, feel they are part of community = value

25. Reality Check >>> Value in health care remains largely unmeasured and misunderstood http://t.co/jtEwmibco5 Agree?

26. Good read for later: What Is Value in Health Care? @NEJM http://t.co/jtEwmibco5

27. SoMe puts the individual back into HC instead of just corporate profits. People centered solutions add value

28. HUGE opportunity for mobile apps & #gamification of #healthcare to impact outcomes!

29. "Social media & mobility - Empowering citizens toward social and economic participation" http://t.co/zkxVwGXNgT

30. Key is to reach other areas that #some might not. Learn from #globalhealth?

31. Re SoMe not able to reach all~access,age etc>need to brainstorm on #SoMe how to take info/experience>real life 4 those ppl ~

32. How about educational twitter feeds into patient portals?

33. Here's where I can see a real value to SM in healthcare -- from a consumer buying perspective.

34. Patients will continue to search web b4 talking to Dr. Need for increased access to personalized research-based health info.

35. Yes, because it is much cheaper to #SelfDiagnosis, Treat than pay astronomical medical bills :(

36. Where does that leave #patients who incorrectly diagnose, treat, stay ill because thought they had credible info?

37. Payers and providers alike are looking at #SoMe to ENGAGE patients and members


T3: How would you connect specific types of healthcare information and needs with specific social media platforms?

1. SM can also impact communities that are notoriously distrustful of doctors. They can source others opinions

2. Yes, in #globalhealth and local health, cell phones seem prevalent. Access seems there.

3. Patient portals are the best opportunity to connect healthcare and social media in a place where phys and pts already are

4. #SoMe depth and breadth can be astounding! Healthcare organizations should get ahead of the trends. Skate to puck?

5. SMhas power to connect #healthcare researchers with people they may not always meet at a conference of colleagues.

6. We know from marketing literature that certain #SoMe platforms better suited 2certain ppl/functions ~must utilize that exp.

7. Patients likely to seek answers online thru: 1 WebMD 2 Wikipedia 3 Facebook 4 Youtube 5 Blogs 6 Pt communities 7 Twitter

8. Pick social platforms of where their patients are... match community to platform.

9. Patient portals as they are today are not the answer. #HCSM is an active dialogue, no dialogue is happing in these portals

10. Digital activities online vs Impact on healthcare outcomes @connectedmed http://t.co/rNBlF5APuE

11. For example:Facebook appeals to older demographic, is long form.Twitter younger audience, mobile~ Pinterest:women ~Video>ALL!

12. Need patient portals that incorporate patient online communities, social media streams

13. hospitals & doc in box clinics should have easily accessed iPads/laptops for patient research opp. Docs should help

14. How many patient portals incorporate sm? I haven't seen that yet, but it would be cool.

15. Wikipedia is the LEADING single source of healthcare information for patients and healthcare professionals #hcsm

16. If the technology is in their pocket (phone), then ensure the approach works with their mobile device.

17. @Technology_Adv did a study on patient portal usage and what patients want to use them for http://t.co/mP86hJOvqB

18. How would you use instagram? Younger demo moving here leaving facebook

19. Jumping in. T3. Social media gives patients a collective voice & community. Can be a comm tool with providers.

20. Pts are concerned about the validity and neutrality of the info they seek out. Wikipedia is an interesting play in this.

21. I use Wikipedia only as a starting point to educate myself about a topic - any topic. @RasuShrestha

22. HC education should happen in elementary thru high school. Let kids today design better SoMe portals/experience

23. #Wikipedia may be the leading source, but it is also rife with misleading information.

24. Absolutely agree, with laggy or anemic turnaround in existing portal messaging

25. Twitter is great for SPECIFIC patient groups to engage continually or in regular Tweetchats e.g. #BCSM #LCSM

26. The only challenge is when have multiple docs and multiple portals... role of PHR, maybe.

27. What about the role of #SoMe in connecting patients and their doctors?

28. SOME ads leading them to resources @JohnSharp @nxtstop1 How would you use instagram? Younger demo moving here leaving facebook

29. Facebook great 4 community engagement, Twitter for info-content sharing. Content can be translatable across platforms

30. Vine would be interesting too. You can communicate a lot in 6 seconds.

31. There is a reason #collegeprofessors will not accept #Wikipedia as references in research papers.

32. Twitter is also great for superb dialogue around healthcare leaders and pt advocates etc e.g. #HCLDR #HITsm

33. Also important for journals to encourage research that is more patient-accessible.

34. All of them to a small degree, mostly with #SoMe buttons to share their own content.

35. Patients are more open to getting at "any" info through. This is a challenge/opportunity? @nursefriendly

36. Maybe 1 portal, it goes with pt and docs get access, its not about the doc. @jonmertz @katseyemedia @JohnSharp challenge when...

37. Regional dialogue can open doors to international conversations via Tweetchats such as #HCSMCA & #HealthXPh

38. #SoMe presents healthcare with the question of "Is the medium the message?"

39. SoMe & HC need more main stream media time. We need more people in conversion cause that will expand opportunities

40. Audiences moving from one social network to another is another good example to remember to make your website your hub.

41. Interesting article: "Facebook and physicians: Not good medicine" http://t.co/4wH434dizK

42. Key point - it IS about the patient so make it patient-centered.

43. Think and see that #hospitals are getting more proactive in monitoring #patients, encouraging wellness.

44. I don't see much about Reddit in these convos—opportunity for longer posts, audience targeting, visibility etc. Thoughts?

45. Also twitter great for rare disease people to find each other. @RasuShrestha

46. It'd be interesting to see ability to search hashtags on dx through portal.

47. I am fascinated with the concept of centralizing social in HC for UX & ptexp.

48. Patients are THIRSTY for knowledge and a helping hand #SoMe delivered intelligently can quench this thirst

49. In some like @grouphealth patient portals are a key way to stay connected to care teams

50. Isn't the challenge with using Google separating signal from noise?

51. Opportunity,also challenge.If MD active #HCSM :try 2 B clued into major sources being looked at & vet/converse

52. How about Vine for Pt education post visit..in keeping with Pt Attention spans?

53. How about this hashtag #secondopinon -

54. Yes! Very improtant to remember that social is a #healthdata source!

55. Sad to say, but having the #patient in the loop is a liability to the bottom line :(

56. I've found G+ communities to be a great way to connect patients, low key, non threatening, supportive to family too.

57. Vine and Instagram great for patient ed. videos. Pintrest for promoting public and community health like menus/exercise

58. Vine for patients. Love this because it plays up simplicity of some health behaviors too. 6 secs. BOOM.

59. #SoMe in health is unique in its ability of communicating 1 to many and linking people to experts & community support

60. YouTube, Vine allow for patient-generated engagement with health. Thinking about videos from @ImproveCareNow.

61. True! Def need to think about what audience you're trying to reach and why—and which you know how to best use.

62. Pinterest can be gr8 tool for health resources! @wingofzock Pinterest for promoting public/community health like menus/exercise

63. Opening up the black hole of pinterest boards of brownie recipes in my EHR scary

64. Here is one hospital's Pinterest http://t.co/QODmsnrDzK

65. Big and small screens in waiting rooms for patient education, resources, community finding, social support.

66. Target information where those specific patients are already comfortable sharing health information.

67. Sending the PT to the Health Information Pinterest Board in a portal, there's

68. Would you say patient chooses best method of communication, which could include #socialmedia? options

69. Needs to include #cloud as part of the #eim and care coordination. #mhealth #ecm http://t.co/DSsXUzdnXF

70. #Bioethx #BCSM #HCLDR #DSMA #HPM #MedEd #Medlibs #Healthxph #hitchicks

71. Jon, you do realize 99.9% of #healthcare focus on "PatientCenteredCare" is lipservice?

72. With 20 cents/dollar going to healthcare in the USA, too many feeding at the trough.


T4: What metrics can be developed to measure the contribution social media makes to healthcare outcomes?

1. Curious, R there any resources that provide evidence of SM influence on better patient health outcomes or speak to more pt eng?

2. #SoMe can provide real-world goldmine of information for drugmakers willing to listen and engage http://t.co/nQyLq0CUnB

3. Remember the real goal of using tech in health is for people to be healthy and no longer need your services

4. So long as the pt gave permission. I bet some would feel violated.

5. Dialogue around #healthcare outcomes needs to focus on metrics such as 1 Patient satisfaction 2 Quality 3 Engagement

6. Discussions between #doctors, #patients, #nurses on most topics here: http://t.co/Z2TM00DKpC

7. Communication, Collaboration and Critical Thinking = Quality Outcomes Do you agree?

8. Metrics that track #SoMe reach, relevance & relationship = basis for assessing a company’s engagement with pts over time

9. @IMSHealth recommends measuring social media indices around: 1 Reach 2 Relevance 3 Relationship

10. How social media influences our behavior is hard to measure. Especially if we want to cite source.

11. Engagement and satisfaction with care are big factors. Increased dialogue on sites determine value of info?

12. #ACA examines bonus and points to health reform priorities in terms of clinical and quality outcomes http://t.co/p5BSjzBLNa

13. Metrics outside of healthcare in regards to social are literally linked to hard ROI - in its many forms. HC similar?

14. As the patients quality of life improving should be the main metric.

15. This one is tough, maybe we start by following our gut, knowing it's next step in evolution of healthcare, let metrics follow

16. Metrics include visits to a particular website, Calls to a crisis line (lots when #RobinWilliams died)

17. Metrics:If MD office /organization using SoMe:do short survey conducted via major platform.Q:Clarity care?Education?Comfort?

18. Quality of life as a metric - - now that's a superb idea!

19. My fitness apps sync w/ social streams: deliver results, warnings to me so I know when I'm unhealthy and when to contact HCP.

20. Tough to reward gut based decisions though! @katseyemedia

21. Can we measure how somebody is feeling by their social media activity? Maybe.

22. How do you define that though? Surveys? People hate surveys.

23. Metrics include compliance with recommended learning activities.

24. Maybe metrics are individual patient specific, outcomes / value tracked in the portal? Could lead to evidenced based examples

25. Should we hold social media to same outcomes standard as any other medical or healthcare intervention?

26. What are some tips for measuring #some engagement metrics? How can we move determining value of #hscm in RT's/page views?

27. Using social to drive use of resources and tools can easily be a social media metric for healthcare.

28. The consumate social media e-patient @ePatientDave would agree! I'm sure.

29. Metrics 2 be gathered via disease management, quality, safety, and med. adherence via #datamining initiatives

30. Sentiment analysis is used for taking the temperture of groups on social media but still evolving

31. Compliance with meds/healthy habits @nursefriendly @CareFuturist Metrics include compliance w/ recommended learning activities

32. Assessment of social media ROI is best done in context of the overall marketing and communication strategy. Agree?

33. Quality of life discussions should happen at initial visit and continue throughout care.

34. FollowTheMoney How many millions were raised for the #IceBucketChallenge for ALS research?

35. Good question. I have concerns w/ tying social so closely to actual medical practice though. Thoughts?

36. How many videos were made, shared, viewed on the #IceBucketChallenge?

37. Medication Management is moving to #social, #mobile and #digitalhealth . Can u imagine the rise n compliance?

38. Measurment of value not be RTs but value in care msrd by imprvmnt in health and Pt satisfaction

39. Reinforces fact that we need savvy marketers in HC to measure & drive success

40. It blows my mind that we haven't started implementing online learning for #patients.

41. There is often a a marketing orientation in #HCSM vs improving health outcomes or experience

42. Quantity, QUALITY and stickiness factor?

43. Your #SoMe need not be intimately tied to specific "outcomes" If patients like what yr doing, it resonates with them>all good

44. If we don't tie #SoMe to clinical care, how big an impact can it have?

45. We have the #computingpower, the programming talent. Excellent way to educate patients.

46. #telehealth, #mhealth and #mobilemed have ability to transform care/add value when used with #hcsm. All part of

47. Access to information is at the core of health behavior change. In short - A TON! :)

48. True that. Outcomes may be a side effect of efficient and effective #SoMe, not a direct effect. @nxtstop1

49. We need to hold medical community responsible for "method of communication" that is best fit 4 pt. situation

50. We could easily gauge potential outcomes by evaluating #patient knowledge online, then FollowUp.

51. Not about clicks imo - its about health, Pts and Providers

52. SoMe simply tool to better health in whatever way suitable 4 your practice & organization.There 2 utilize,b creative,connect

53. Engaged patient = connected patient = informed patient Would that be the goal? @Cascadia

54. For social media, we need to separate the signal from the noise and the hype from the impact for outcomes!

55. Website monitoring, booked appointments, referrals, etc can all be measured when asking " how did u hear this"

56. How a/b a compromise? A bit of patient education and a bit of flexibility of delivery of communicaiton.

57. Social media is soon becoming and important parameter in health

58. Used effectively, social media presents opps across the care spectrum, impacting misdiagnosis, adherence, readmittance...

59. Clicks are a measurable action that, if designed properly, lead to health. IMO.

60. As a movement i guess the biggest draw back is lack of participation from all the elements

61. Naturally, do a #diabetic primer, test at the end before initial visit.

62. Hotspotting, do online #educational modules for most expensive #patients

63. #Hotspotting - , Identify knowedge gaps that lead to increased costs.

64. We can track behaviors online NOW. If that means tracking how patients access digital resources = step toward health

Miscellaneous Tweets (Not sure which topic to assign)

1. #HCSM Pt <----> Provider Provider <--- >Provider Pt<---->Pt Connecting all the elements

2. Yes. Democratization isn't always 100% helpful. Misinformation can spread just as easily.

3. Social media can impact rural areas. http://t.co/0IPQQHIElp This is way to draw in patients and engage them.

4. Secure platforms = silos. I can't wait for the day when we have the @mint for healthcare

5. Unfortunately, #SoMe only reaches % population. Underserved, hi-risk pops may lack access

6. Payers, especially our government is using social media. http://t.co/iOBHEhyWYg

7. A Tool,A Platform>exquisitely designed 4 HC! MT @RasuShrestha #Twitter is a tool, not an end all Agree?

8. Underserved communities may be on social media more that you think - sports, music, why not health?

9. Oddly, a large percentage of underserved in US have a functioning cell phone.

10. Yes! I hope we don't fall prey to shiny object syndrome with social media. Definitely a tool, not a silver bullet

11. Do we engage our provider on SM if we're not a chronic care patient? How does SM help a casual patient w/ the casual encounter?

12. True! & if we stopped focusing #healthcare industry assessments on #Medicare, how #SoMe/#hclit perception would change?

13. You bet - SM ongoing engagement with Provider for healthy choices, support and +ve reinforcement

14. No surprise #studenthandbooks dont mention #SoMe - #MedEd Waaay behind

15. The Gravity of Misinformation http://t.co/R9e6kdmTbw via @HealthyLiving

16. Saw a great response yesterday in real time from @IntermtnMedCtr - what a triumph in #ptengagement! http://t.co/H2xrzZWstF

17. Very cool. See this one? Not sure this counts as education, but interesting nonetheless http://t.co/X9VUXqToqE

18. Yes- #SoMe isn't joining FB ( many think). It's resources like health edu., prevent. care via info links

19. Including access to all the org's #SoMe accounts w/i portal must be just around corner.

20. This is the only resource I know, for Instagram. Called #hyperlapse http://t.co/wbuH1Oalrg

21. I think the ultimate transformation would be through advances in other "media" : mobile telemed especially telemed IMHO

22. Portal provides the filter and limits the wikipedia misinformation, but do they know that it exists?

23. Access & curation of info is key MT @arwmd @SamRyanTMED portal provides limits to wikipdia misinfo, but do pts know it exists?

General and Off the Wall Tweets

1. Had to pause - Blue Angels overhead practicing for Cleveland Airshow

2. Got scared first time CMS account followed me on twitter

3. Jumping back out of to meet my FAVORITE #EHR vendor's client delivery VP, ask him why his CEHRT can't provide IHE-compliant CCDA

4. Imagine opening pt page in EHR and his/her twitter/fb/pintrest pops up

5. My favorites: #Bioethx #Nurseup #HCLDR #MedPsych #HPM #DSMA #MHStigma #Meded #Healthxph #MHPchat

6. How Twitter helped saved a life. Hospital arrange livesaving transport by discussing directly w/ patient. http://t.co/KGvFiLQRVn

7. @nursefriendly Issues with self/misdiagnosis cannot be addressed with any single platform or channel, including social media.

8. Very cool initiative from @DartmouthHitch - Using Pinterest 2 help w/ideas 4 healthy school lunches: http://t.co/AUJa9nquV0

9. Thoughts on securing social properties in light of the recent #malware attacks at CHS and UPMC?

10. From long ago ('99) and originally a non-HC view, spirit of "Cluetrain" important in ? http://t.co/wudDlBr02a

11. Opportunity to improve #patientsatisfaction using social media, both while in facility and immediate following discharge

12. 41% of people said #SoMe would affect their choice of a specific doctor, hospital, or medical facility http://t.co/CUVHW4mQJN

13. 40% of consumers say that info found via social media affects the way they deal with their health http://t.co/Vv3FqhXoHQ



CT: Any closing thoughts or nuggets you may have learned today that you apply immediately? 

1. The rise of the empowered patient may threaten the previous stature of the physician as the sole decision maker! Ger ready!

2. This is a new world for all stakeholder and especially caregivers who bear the burden of much care.

3. HCPs can learn from pts engaging in #SoMe about their conditions and the realities of living with them = OPPORTUNITY!

4. In the future can our emotions automatically go into mobile devices and social media? Do we want this? It could help.

5. Let's pick 2 #hcsm tools and focus on making them effective and useful tools for patient engagement - let's start now!

6. Simplify AND exemplify!!

7. Closing thought - 1 real power of SoMe in health when it pulls (vs pushes) knowledge in & redistributes it equitabily


Thursday, August 7, 2014

How Much Do We Really Pay for “Physician Services?”


How much of our healthcare spending goes for “medical professional, physician services?” Meaning how much is paid for the services doctors provide? Depending on how you define “medical professional, physician services” it seems to range from approximately 22% to 35%.

So do Physicians Get 10% or Maybe 35% of Our Healthcare Dollar?


This tweet by Mary Pat Whaley sharing some info that doctors account for about 10% of healthcare spending elicited my response that it was actually closer to 30%. Then a series of tweets erupted.

It became clear that we were talking apples and oranges. So per Mary Pat’s request, I'm posting some info to back up my tweet.

It’s Way More Than 10%

Bottom line is that for “medical professional, physician services?” account for way more than 10% of our healthcare spending. And I’d argue that the 22-35% figures are actually higher given a physicians role in providing Inpatient and Outpatient care; which are broken out of the “physician services.”

Information & Statistics – You Decide

What do you think? Show me the stats...


Sunday, August 3, 2014

Best Journalists and Media Outlets Covering Healthcare and Healthcare Technology Topics

And when I say "best" I mean best for my needs: your mileage may vary and past performance is no guarantee of future results.

Here are some of my primary sources for keeping up to date with all the healthcare and healthcare information technology-related topics and new I find of particular value to me. I’ve listed individuals and companies in no particular order and included their Twitter handle where available.

Healthcare Journalists & Individuals


Alicia Caramenico (FierceHealthPayer) Profile

Anthony Brino (Healthcare IT News)      

Bob Laszewski (Independent) Profile

Brian Eastwood (CIO Online)

Carl Natale (ICD10 Watch)

Chris Seper (MedCity Media) Profile

Christopher Cheney (HealthLeaders Media)

Deanna Pogorelc (MedCityNews)

Diana Manos (Independent?)

Dina Overland (FierceHealthPayer) Profile

Erin McCann (Healthcare IT News)

Fred Pennic (HIT Consultant)

Gabriel Perna (Healthcare Informatics)

Ken Congdon (HIT Outcomes)  

Kevin Fuller (HIMSS Media)

Marty Stempniak (H&HN)

Michelle McNickle
(Independent?)

Mike Miliard (Healthcare IT News)

Neil Versel (Meaningful Healthcare IT News)

Stephanie Baum MedCityNews  Profile

Tom Sullivan Government Health IT

Veronica Combs MedCityNews Profile

Twitter List of the above and many others



All of the above healthcare journalists/individuals are included in the following  Twitter list I maintain. There are dozens of others on that list too. Twitter List of Healthcare Journalists 

Media Outlets

Here are the primary media outlets/companies I review for healthcare and healthcare information technology-related topics and information. Most or all of the following have newsletters to which you can subscribe. If I had to choose one outlet over all the others, I’d say it would have to be MedCityNews.


CIO Online  Web Site 

EMR & EHR News Web Site  

FierceHealthFinance  Web Site  

FierceHealthIT  Web Site 

FierceHealthPayer  Web Site  

Health Data Management  Web Site             

Health IT Exchange  Web Site 

Health IT Outcomes  Web Site 

Health IT SmartBrief  Web Site 

The "SmartBrief" outlet has several industry related "sub-sites" and I find the AHIP Solutions SmartBrief  site particularly useful.

Healthcare IT News  Web Site   

iHealthBeat  Web Site        


So I'm sure I missed a few and will loop back to add those later on. If anyone has any others I should be considering, please forward them to me.

Thanks

Wednesday, July 23, 2014

Adding Some Structure to Last Week’s #HITsm Tweetchat

Last week’s #HITsm tweetchat topic – Unstructured Data – was of particular interest to me. Kudos to Bernadette Keefe (@nxstop1) for wrangling some good information, ideas and opinions out of the participants. The tweets were flying through my tweet stream fast and furious.  In an attempt to pull a little more value from that stream, I went ahead and added a little order and structure. Here’s what I came up with.

Note: Thanks to all who contributed. I’ve not noted who tweeted each item in this post as I didn’t want to misquote or omit anyone – which I surely would have done. You can learn who said what and to whom via the transcript of last week’s #HITsm tweetchat here.


Topic 1: How will the analysis of Unstructured Data aid in healthcare delivery: for MDs/Providers/Patients/Payers?

Are we talking systemic use or manual? If data can be systemically used, a flood gate of use cases open up.

Think the promise is truly in analysis of the unstructured data~eventually.

Gain valuable info about patient experience with drugs and interactions

Well good portion is 'the patient's story' how their health makes them feel. may never be structured

Yes, lets talk re value in unstructured data. It contains all patient narratives, the stories told to countless MDs ~inval…

Agree but worth asking the question, problem is too structured means less innovative thinking

IMO, biggest #unstructured data miss is in the 4th "P" a patient's peers. Blog: http://t.co/BEZaYlSTnL

No because there is high value in "the narrative" for telling and communicating the patient story

Need all: structured, unstructured, human intelligence together

For Providers – reduce over-utilization, eliminate redundant diagnostic tests see JACR http://t.co/cCXnWl8E6A

Value in unstructured data--patient narratives, the stories told to countless MDs ~invaluable

Interpreting clinical text ultimately requires more than just sound, structure & meaning. It involves goal, plan & task recognition

#1 question I always ask when someone brings up BI and BIG DATA is what problem are we trying to solve

It's possible NOW to analyze unstructured data - query it & add value to existing structured datasets

What percentage is unstructured today? Seems like a big hole in the "complete record". Possible risks for systemic analysis.

Yes, the benchpoint number given is 80% ~ Massive!

Should we make HCP use structured data only, or develop tools to analyse unstructured data?

Unstructured data is ALL TEXT ~ so all MD/ other HCP provider notes, all radiolog reports, surgical reports, etc

Indexing a semantic searching is a good start and facilitate finding relevant data, but still may require manual analysis.

SOAP notes and plans the gold mine of unstructured, free-text data. RT @nxtstop1 T1 Unstructured data is ALL TEXT

My MAC just puked some 0s and 1s out the side seeing "SOAP"

Please educate me - what about data from wearables? Is that unstructured? I believe @Brian_Eastwood touched on this recently.

One benefit of "unstructured data" is that using can can add value w/o changing physician workflow.

If no impact, no worth RT @JMCelio RT @georgemargeli yes -- how is data driving clinical decision-making, improving quality of life?

But have to keep in mind safety issues, ambiguity can be dangerous

Can analyze common terminology used...first within institutions & expanding outward-->standard terminology-->structured data

I suppose we only know a little if funnel is limited to ‘structured data’ & way beyond nuance?

Explicit or implied delimiters, tags and/or “context” can add structure to unstructured data.

Any analysis & exchange between these constituents (structured, semi-structured or unstructured) can only help.

Topic 2: How can you, your firms, #HealthIT in general, help in the retrieval & analysis of Unstructured Data?

Really like this from @CLOUDHealth "Structure is not defined by databases but by relationships with people."

Yes -- how is data driving clinical decision-making, improving quality of life? #NoDataForDatasSake

No #data is #unstructureddata Structure is not defined by databases but by relationships with people.

We get so excited over having more data > don't spend enough time *thinking* about what it's really for

Adding time layer to storytelling aspect of Patient's history. It's very complex and multi dimensional story to tell.

Realized I'd misspoken. Data is structured, identifying quantifiable things, but unreadable to clinical systems.

T%, or ‘business as usual no longer an option…question is ‘what is new biz model’? Is there ‘one’?

That's the common problem, right? There's structured data here, but won't make sense there

Asking questions of unstructured narrative isn't an exact science but it's a better than spending valuable clinical sight time

Unstructured just a tech term b/c its unstructured TO TECH.New thought:text data is Gr8>& tech will step up 


I believe the solution we're looking for is I-N-T-E-R-O-P-E-R-A-B-I-L-I-T-Y.

I wrote bit of a rant on #wearabletech and an inability to get tangible insight from it: http://t.co/nD61pkh9Cg Does that count?

Some standardisation around terminology would make it easier, just because its free text doesn't mean we need to be too free :)

SNOMED gives us some reference clinical terminology

Room for Web crawlers in EHRs? :) Think unstructured data us fine if smartly presented in collective to MD viewing files.

Start turning unstructured data to semi-structured data. Turn semi-structured data to structured data.

Consider adding delimiters, tags & considering “context” for everything you touch and/or have control over.

Don’t just run on sentences. Add white space. Use CR/LF’s… Spell correctly. Make the text “processable”

Actually, IMO it's really just grunt work and getting people to agree on "code translations"

Whoa! Not one single ‘de-limiting’ reference to HIPAA today. A miracle? Or simply context/competence appropriate?

Topic 3: If you have worked on a project with Unstructured Data-please describe pros/cons of the experience. 

One benefit of "unstructured data" is that using can can add value w/o changing physician workflow.

Unstructured healthcare data is not just free text, it includes a variety of multimedia content: video, audio, etc.

One challenge of unstructured data is that using it allows physicians to avoid change

Other hard part is asking the right Qs @HealthFusionKMc: Agree! And if do the data prep right, analysis even easier

Attributing data to member and provider (provider in all its variations: individual, practice, network, etc) is hard.

Biggest prsnl complaint: get unstructured data of my Rx. So tired of getting the wrong thing at the Pharm

A concern kinda BUT~ MDs will always (and should always) use free text to render appropriate nuance to pts stories

Con=Unstructured text includes ambiguity. Need to balance specificity with sensitivity. May result in FP/FN. Set user expectations.

I collect a lot of data which has never been used...yet. I'm confident it will be one day.

Will be even huger with HIEs RT @ShimCode: identifying and properly handling CHANGES to data previously processed is huge.

I'd almost rather see investment in smarter systems to interpret unstructured data then more standards

Wide variation of how “standards” are used & re-purposing of fields without consistent use are 2.

You know hand writing is a type of encryption, especially coming from docs :)

This may generate some controversy but analyzing data is easy. It’s getting the data ready to analyze that’s hard.

Yep. Cleaning data is supposedly 80% of the workload.

Agree! And if do the data prep right, analysis even easier @ShimCode analyzing data easy

Exactly @nickdawson: when I've done big financial models, most of the work is in prepping and normalizing the data

I used to do NLP, which got me into standards like #CDA, here are some of my observations: http://t.co/sQzKspzLZx

Workflow highly important 2 speech recognition & text disambiguation. Used 2 more accurately estimate tokens & meaning probabi…

Topic 4: Given the base data is text,can you think of creative presentations of the analyzed data which might especially engage MDs/Providers/Patients/Payers? 

Can you think of creative presentations of the analyzed data/text that may engage caregivers/Patients/Payers?

IMAGINE all of us having our INDIVIDUALIZED , PERSONALIZED WORD CLOUD AT THE BEGINNING OF #EHR -and it could chg (improve hope)

"Creative" is key. As a patient, I don't get pumped about taking charge of my health by looking at pie charts, bar graphs

Yes, lets get around to the creative presentation. Particularly fond of this as we see w/ Pinterest Interest, FB pix, VISUALS ROCK

Longitudinal progression of a health concern over time, from out of shape to overweight to diabetic...

Good txt summarizer can [make] pages of unstructured text afew sentences

MDs, MAs, Nurses.. Always looking for data on patient. Spending more time being a detective than doing actual work.

It's all about the use case - not the tech, not the data - but the value in unstructured clinical narrattive to improve healthcare

Tie in the social #data for prevention will be good

Word clouds hit the popular pairs but the real relationships are often hidden

Nice, but might b better to see (creatively) predictions of how my lifestyle choices will affect me 5, 10, 15 years on.

NLP is cool tech but it should be about solving problems - not tech for tech sake

Crawl it, index it, search it, rank it, and present it. http://t.co/izYhdV8BRZ

Here is a great tool to help convey your analyzed data "Visualizing Health" http://t.co/y4fDCnAFIS

Teaching clinical analytics key to future HIT pros - http://t.co/cxNzzfQXbd

"Communicating Data for Impact" http://t.co/vaE0DOccen

Absolutely!!! Crawl it, index it, and apply context.

There are some real HIPAA issues with web crawlers in EHR.

Topic 5: Any other thoughts on the current use of EHR data? 

Creating registries for reseach and quality. Have worked on this for CKD successfully

Need to teach HCP value of EHR data and focus on clinical outcome, not just data for data sake

Developing tools to analyze both structured and unstructured data will be incredibly valuable

Really need tools to make data collection passive. I'm not slowed down @ bedside,you get your data

Painful doing manual abstractions for research in #EHR feels like little progress from paper#decretefields

Your point well taken & key 2emphasize. he goal is actionable data which will better Rx/prevent disease

I think about data libraries and a place to house all the structured data once it's clean. But may violate HIPAA 


"The Business Case for Using Unstructured Text Analytics for Critical Decision Making"

Comments on Statistics about Unstructured Data

Good question. Do you know how much health data is unstructured today?

We're talking about how much HIT data is currently unstructured & how to address that.

Said to be 80% , but that's a quess RT @jonmertz @Greg_Meyer93 Good question. Do you know how much health data is unstructured today?

I’ve seen estimates that up to 90& of healthcare ‘data points’ are unstructured. Is that true?

I'd also say 90% of collected data is never used again

Of 1.2 billion clinical docs produced-US each year, approx 60% valuable data unstructured documents

And what would any #healthit discussion be without some chatter about 'Standards?'

A ‘what if? Might single payer enable a ‘standards’ agenda? Or pluralism worshipped at any cost?

The industry really need standards defined. without that we will have this discussion forever

We have standards.... just may need to be more firm than fuzzy.

That there are no standards is a common complaint. It usually indicates lack of knowledge OR lack of implementation

Agree! No shortage of standards. Some are even worthwhile.. Some result from confusing activity w/results.

Standards are one thing: but anything can be structured with any standard. Get to structure first, then apply standards.

Which we won't have until we start thinking message sets as opposed to documents (so 1950s like carbon paper). (Forgot)


Even without standards master data management can help


Could addressing unstructured data be elementary for Watson?

Any #watson projects happening in this area? Sorry if someone already mentioned it.


Couldn't that be a #watson job? dealing with legacy code?


The installed base of legacy code prolly won't go away under Single Payer. Still need to process data? 

Closing Tweet

Can't forget ultimate end user... The patient. "How will this data help them be healthy in future?"



Sunday, July 20, 2014

Inspiration, Insight, Facts, Opinion & Tips from Recent #ClinicalCoding14 Meeting

On June 6th, 2014, AHIMA sponsored a Clinical Coding Meeting. Coding tips, education & training, working with payers, impact of coding on financial performance and clinical documentation improvement programs were shared on Twitter using the #ClinicalCoding14 hashtag. Here are some select tweets from that conference that I think will provide some inspiration, insight, facts, opinion and tips relevant to clinical coding under ICD-10.

"The will to succeed is important, but what’s more important is the will to prepare." ‐ Bobby Knight

“Before everything else, getting ready is the secret of success.”-Henry Ford

Coding Wisdom

1. Coding should always completely & accurately represent the diagnoses & procedures for a patient-Susan Belley

2. Physician documentation is the cornerstone of accurate coding- Jon Elion

3. Data Should be Relevant, Timely, Accurate, Accessible, Comprehensive, Consistent, Current, Defined, Granular & Precise.

4. Essential Components of Coding Compliance Detection, Correction, Prevention, Verification & Comparison

5. Dual coding benefits can be very substantial but it can be expensive & resource-intensive, thus having a plan is key.

6. Root operations division and release may cause the biggest challenges in ICD-10-PCS.

7. ICD-10 PCS will improve accuracy & efficiency of procedure coding & replace ICD-9 CM w/a more logical system- Laura Leg…

8. ICD-10-CM’s use of 6th & 7th characters allows for more granular data capture within the fracture codes-Marty Beckman

9. Home Health coders must know how to code in #icd10 by August 3, 2015 because of HH billing requirements.

10. Analyze your data and GEM MAPS to discover the hidden impact of less specified codes.

Impact to Financial Performance & Working with Payers

1. If you pursue the High Quality Medical Record, the proper reimbursement will follow. -Jon Elion


2. The premise is why would payers pay for procedures when the reason for it can't be specified? Joanne Schade-Boyce.

3. Measures will increase though claims-based data. - Cheryl Bowling

4. Improving the accuracy of clinical documentation is the greatest opportunity for financial improvement

5. 50% of healthcare organizations are experiencing positive ROI results in data analytics & reporting technologies

6. Pay for performance outcome measures will continue to expand. -Cheryl Bowling

7. Important success factor in the move to #ICD10 relates to enabling the exchange of clinical information w/payers

8. Dr. Elion: "If the high quality medical record is pursued, reimbursement will follow."

9. 5-Phases to Engaging Payers Contract Management, Payer Communication, Implementation, Payer Testing, Post-Implementation

Process, Training and Project Management

1. It’s time for physicians to show what they know w/the robust #ICD10 coding system & begin to report 21st Century medicine


2. Coding clinics are the key to success in clinical documentation improvement

3. Work hard to get on your payer's testing schedule and coordinate with clearing houses.

4. MTs are a Key Resource. They already know clinical content & healthcare documentation-Claudia Tessier

5. Five Steps To Pass The CCS Exam Change your perspective, have a plan, prioritize your life, practice, prepare


6. Simplify the educational process with the ICD-10-CM transition by first identifying stakeholder needs. - Deborah Neville

7. Get creative. Establish an internal post graduate program that involves training and mentoring new graduates. Kayce Dover

8. Data Mining & Machine Learning are closely tied and often used interchangeably.

9. Growing your own coders can help you marry CDI and coding.

10. Plan for the worst. Utilize tools to analyze the new standards. Kayce Dover

General Tips

1. More specific documentation is needed when reporting sepsis. -Laura Legg


2. Develop documentation tip sheets for providers to utilize to help in documenting services in the emergency department.

3. Prior to implementation of #ICD10, have 2 or more coders code same case & review any discrepancies in codes or DRGs

4. Dual coding benefits can be very substantial but it can be expensive & resource-intensive, thus having a plan is key.

5. Develop documentation tip sheets for providers to utilize to help in documenting services in the emergency department.

6. Mapping from NOS to NOS is not good enough. Elevate that Not Otherwise 'Satisfied' documentation - Andrea Clark

7. Don't NOS (Not Otherwise Specified) your data! Consider the CHDA

8. Top worry of Home Health agencies regarding #icd10 is ADRs and denials caused by face to face documentation.

9. Ensure coding professionals have access to all reference material such as device formulary says Susan Belley.

10. The most challenging aspect of CDI is physician buy in- Laura Legg

11. Data Mining & Machine Learning are closely tied and often used interchangeably.

12. Concurrent CDI and coding = the route toward data improvement and integrity

Closing

As Claudia Tessier, ‏co-founder of Coding for Healthcare Professionals, posited to the crowd:

"What do #CD-10 & death have in common? Everybody tries to delay them, but they are inevitable."


Note: Thanks to all the Twitter accounts who shared info from this meeting including a few who stood out - as noted by Symplur@ahimaresources @louwiedemann @julezd @lhima1 @acomfort03 

Wednesday, July 16, 2014

266 Tweeps Sharing #healthit & #HITsm Content, Insight & Commentary

Here are 266 people or companies that I believe offer up good content, insight and/or commentary on healthcare information, technology and related topics on Twitter. Every one of these people or companies received at least one vote in this years #HIT100 Contest.

@2healthguru http://www.twitter.com/2healthguru
@A_Burkey http://www.twitter.com/A_Burkey
@adamdole http://www.twitter.com/adamdole
@AGWesterfield http://www.twitter.com/AGWesterfield
@ahier http://www.twitter.com/ahier
@AllenDoumaMD http://www.twitter.com/AllenDoumaMD
@AmanKhanna http://www.twitter.com/AmanKhanna
@annelizhannan http://www.twitter.com/annelizhannan
@Anthony_Guerra http://www.twitter.com/Anthony_Guerra
@ashleyrgold http://www.twitter.com/ashleyrgold
@askjoyrios http://www.twitter.com/askjoyrios
@bacigalupe http://www.twitter.com/bacigalupe
@bdmoyer http://www.twitter.com/bdmoyer
@Berci http://www.twitter.com/Berci
@bharris_HITN http://www.twitter.com/bharris_HITN
@bhparrish http://www.twitter.com/bhparrish
@Bill_McCann http://www.twitter.com/Bill_McCann
@bobkocher http://www.twitter.com/bobkocher
@boltyboy http://www.twitter.com/boltyboy
@Brad_Justus http://www.twitter.com/Brad_Justus
@Brian_Eastwood http://www.twitter.com/Brian_Eastwood
@CancerGeek http://www.twitter.com/CancerGeek
@carenovatemag http://www.twitter.com/carenovatemag
@carimclean http://www.twitter.com/carimclean
@CarlNatale http://www.twitter.com/CarlNatale
@carlyholstein http://www.twitter.com/carlyholstein
@carolflagg http://www.twitter.com/carolflagg
@Cascadia http://www.twitter.com/Cascadia
@CDW_Healthcare http://www.twitter.com/CDW_Healthcare
@chasedave http://www.twitter.com/chasedave
@chimoose http://www.twitter.com/chimoose
@Christianassad http://www.twitter.com/Christianassad
@Christina_HIT http://www.twitter.com/Christina_HIT
@ClaudiaWilliams http://www.twitter.com/ClaudiaWilliams
@cmaer http://www.twitter.com/cmaer
@ColeFACHE http://www.twitter.com/ColeFACHE
@Colin_Hung http://www.twitter.com/Colin_Hung
@colleen_young http://www.twitter.com/colleen_young
@ctffox http://www.twitter.com/ctffox
@cyberslate http://www.twitter.com/cyberslate
@CyndyNayer http://www.twitter.com/CyndyNayer
@Dan_Bowman http://www.twitter.com/Dan_Bowman
@danamlewis http://www.twitter.com/danamlewis
@dandunlop http://www.twitter.com/dandunlop
@daniel_kraft http://www.twitter.com/daniel_kraft
@danmunro http://www.twitter.com/danmunro
@David_Pittman http://www.twitter.com/David_Pittman
@davidfcarr http://www.twitter.com/davidfcarr
@dirkstanley http://www.twitter.com/dirkstanley
@dlschermd http://www.twitter.com/dlschermd
@DocForeman http://www.twitter.com/DocForeman
@Docweighsin http://www.twitter.com/Docweighsin
@DonFluckinger http://www.twitter.com/DonFluckinger
@DrAaronLove http://www.twitter.com/DrAaronLove
@DrDannySands http://www.twitter.com/DrDannySands
@DrDave01 http://www.twitter.com/DrDave01
@drexdeford http://www.twitter.com/drexdeford
@DrJosephKim http://www.twitter.com/DrJosephKim
@DrLeanaWen http://www.twitter.com/DrLeanaWen
@drlfarrell http://www.twitter.com/drlfarrell
@DrLindaMD http://www.twitter.com/DrLindaMD
@DrNanN http://www.twitter.com/DrNanN
@drnic http://www.twitter.com/drnic
@drnic1 http://www.twitter.com/drnic1
@drsanders http://www.twitter.com/drsanders
@drtom_kareo http://www.twitter.com/drtom_kareo
@drttsang http://www.twitter.com/drttsang
@dsgold http://www.twitter.com/dsgold
@DShaywitz http://www.twitter.com/Dshaywitz
@dz45tr http://www.twitter.com/dz45tr 

@EdBennett http://www.twitter.com/EdBennett
@eHealthMusings http://www.twitter.com/eHealthMusings
@ehrandhit http://www.twitter.com/ehrandhit
@ejpeacock http://www.twitter.com/ejpeacock
@ElinSilveous http://www.twitter.com/ElinSilveous
@EMcCannHITN http://www.twitter.com/EMcCannHITN
@EMRAnswers http://www.twitter.com/EMRAnswers
@EndoGoddess http://www.twitter.com/EndoGoddess
@ePatientDave http://www.twitter.com/ePatientDave
@EricTopol http://www.twitter.com/EricTopol
@ErikPupo http://www.twitter.com/ErikPupo
@Farzad_MD http://www.twitter.com/Farzad_MD
@fasanophil http://www.twitter.com/fasanophil
@FierceHealthIT http://www.twitter.com/FierceHealthIT
@FLBlue http://www.twitter.com/FLBlue
@fredtrotter http://www.twitter.com/fredtrotter
@ftvelasco http://www.twitter.com/ftvelasco
@GabrielSPerna http://www.twitter.com/GabrielSPerna
@GailZahtz http://www.twitter.com/GailZahtz
@GarryChoy http://www.twitter.com/GarryChoy
@GaryPalgon http://www.twitter.com/GaryPalgon
@georgemargelis http://www.twitter.com/georgemargelis
@gerrywieder http://www.twitter.com/gerrywieder
@GhIdeas http://www.twitter.com/GhIdeas
@giasison http://www.twitter.com/giasison
@Gienna http://www.twitter.com/Gienna
@givoly http://www.twitter.com/givoly
@GlennLanteigne http://www.twitter.com/GlennLanteigne
@gnayyar http://www.twitter.com/gnayyar
@GoKareo http://www.twitter.com/GoKareo
@GovHITeditor http://www.twitter.com/GovHITeditor
@Greg_Meyer93 http://www.twitter.com/Greg_Meyer93
@harrygreenspun http://www.twitter.com/harrygreenspun
@health_xl http://www.twitter.com/health_xl
@healthblawg http://www.twitter.com/healthblawg
@HealthcareMBA http://www.twitter.com/HealthcareMBA
@HealthcareWen http://www.twitter.com/HealthcareWen
@HealthEugene http://www.twitter.com/HealthEugene
@HealthisCool http://www.twitter.com/HealthisCool
@HealthIT_Policy http://www.twitter.com/HealthIT_Policy
@HealthPolicyGrp http://www.twitter.com/HealthPolicyGrp
@HealthStandards http://www.twitter.com/HealthStandards
@healthythinker http://www.twitter.com/healthythinker
@HenryWeiMD http://www.twitter.com/HenryWeiMD
@HIMSS http://www.twitter.com/HIMSS
@HIStalk http://www.twitter.com/HIStalk
@HITBlogger http://www.twitter.com/HITBlogger
@HITConsultant http://www.twitter.com/HITConsultant
@HITECHAnswers http://www.twitter.com/HITECHAnswers
@HITLeaders http://www.twitter.com/HITLeaders
@HITNewsTweet http://www.twitter.com/HITNewsTweet
@HITpol http://www.twitter.com/HITpol
@hjluks http://www.twitter.com/hjluks
@HlthCrUsability http://www.twitter.com/HlthCrUsability
@HollyCassano http://www.twitter.com/HollyCassano
@ICD10monitor http://www.twitter.com/ICD10monitor
@IThealthnonprof http://www.twitter.com/Ithealthnonprof
@janicemccallum http://www.twitter.com/janicemccallum
@janoldenburg http://www.twitter.com/janoldenburg
@JBBC http://www.twitter.com/JBBC
@jchevinsky http://www.twitter.com/jchevinsky
@jeffbrandt http://www.twitter.com/jeffbrandt
@JeffCampsenMD http://www.twitter.com/JeffCampsenMD
@JeffClarkCT http://www.twitter.com/JeffClarkCT
@jen_NurseEditor http://www.twitter.com/jen_NurseEditor
@JennDennard http://www.twitter.com/JennDennard
@jennylaurello http://www.twitter.com/jennylaurello
@jess_jacobs http://www.twitter.com/jess_jacobs
@jhalamka http://www.twitter.com/jhalamka
@Jim_Rawson_MD http://www.twitter.com/Jim_Rawson_MD
@jimmyweeks http://www.twitter.com/jimmyweeks
@jimtate http://www.twitter.com/jimtate
@jkvedar http://www.twitter.com/jkvedar
@joannkareo http://www.twitter.com/joannkareo
@JoeBabaian http://www.twitter.com/JoeBabaian
@john_chilmark http://www.twitter.com/john_chilmark
@JohnNosta http://www.twitter.com/JohnNosta
@JohnSharp http://www.twitter.com/JohnSharp
@JonMertz http://www.twitter.com/JonMertz
@JoshGray_hit http://www.twitter.com/JoshGray_hit
@JulieWMaas http://www.twitter.com/JulieWMaas
@Kamiyamay http://www.twitter.com/Kamiyamay
@KarenAWay1 http://www.twitter.com/KarenAWay1
@katgleason http://www.twitter.com/katgleason
@kathymccoy http://www.twitter.com/kathymccoy
@KBDeSalvo http://www.twitter.com/KBDeSalvo
@KenOnHIT http://www.twitter.com/KenOnHIT
@KentBottles http://www.twitter.com/KentBottles
@kevinclauson http://www.twitter.com/kevinclauson
@kevinmd http://www.twitter.com/kevinmd
@khgamble http://www.twitter.com/khgamble
@khidenfelter1 http://www.twitter.com/khidenfelter1
@KittermanMG http://www.twitter.com/KittermanMG
@klsalzman http://www.twitter.com/klsalzman
@ktdonnelly http://www.twitter.com/ktdonnelly
@laurencstill http://www.twitter.com/laurencstill
@LeeAase http://www.twitter.com/LeeAase
@leonardkish http://www.twitter.com/leonardkish
@leslieakirk http://www.twitter.com/leslieakirk
@lisacrymes http://www.twitter.com/lisacrymes
@lizasisler http://www.twitter.com/lizasisler
@LizGoodale http://www.twitter.com/LizGoodale
@loranstefani http://www.twitter.com/loranstefani
@lori_schoenhard http://www.twitter.com/lori_schoenhard
@lsaldanamd http://www.twitter.com/lsaldanamd
@lucienengelen http://www.twitter.com/lucienengelen
@Lygeia http://www.twitter.com/Lygeia
@lzipperer http://www.twitter.com/lzipperer
@Mahek_MD http://www.twitter.com/Mahek_MD
@MandiBPro http://www.twitter.com/MandiBPro
@MarkHagland http://www.twitter.com/MarkHagland
@martykelly http://www.twitter.com/martykelly
@marxists http://www.twitter.com/marxists
@Matt_R_Fisher http://www.twitter.com/Matt_R_Fisher
@MattA_PCMH http://www.twitter.com/MattA_PCMH
@matthawkinsmd http://www.twitter.com/matthawkinsmd
@MatthewBrowning http://www.twitter.com/MatthewBrowning
@mdcapsule http://www.twitter.com/mdcapsule
@Med_writer http://www.twitter.com/Med_writer
@medcitynews http://www.twitter.com/medcitynews
@MedicalQuack http://www.twitter.com/MedicalQuack
@MelSmithJones http://www.twitter.com/MelSmithJones
@MeredithGould http://www.twitter.com/MeredithGould
@MichaelCrosnick http://www.twitter.com/MichaelCrosnick
@michnoteboom http://www.twitter.com/michnoteboom
@MightyCasey http://www.twitter.com/MightyCasey
@miller7 http://www.twitter.com/miller7
@mjadala http://www.twitter.com/mjadala
@mloxton http://www.twitter.com/mloxton
@motorcycle_guy http://www.twitter.com/motorcycle_guy
@NaomiFried http://www.twitter.com/NaomiFried
@nickgenes http://www.twitter.com/nickgenes
@nursefriendly http://www.twitter.com/nursefriendly
@nversel http://www.twitter.com/nversel
@nxtstop1 http://www.twitter.com/nxtstop1
@OchoTex http://www.twitter.com/OchoTex
@PamVMatthews http://www.twitter.com/PamVMatthews
@Patrick_Hankey http://www.twitter.com/Patrick_Hankey
@Paul_Sonnier http://www.twitter.com/Paul_Sonnier
@Perficient_HC http://www.twitter.com/Perficient_HC
@pfanderson http://www.twitter.com/pfanderson
@PhilBaumann http://www.twitter.com/PhilBaumann
@pjmachado http://www.twitter.com/pjmachado
@planetjohnlopez http://www.twitter.com/planetjohnlopez
@poikonen http://www.twitter.com/poikonen
@RaelShark http://www.twitter.com/RaelShark
@RasuShrestha http://www.twitter.com/RasuShrestha
@RebeccaCoelius http://www.twitter.com/RebeccaCoelius
@ReginaHolliday http://www.twitter.com/ReginaHolliday
@Resultant http://www.twitter.com/Resultant
@RichieEtwaru http://www.twitter.com/RichieEtwaru
@rilescat http://www.twitter.com/rilescat
@RJSzczerba http://www.twitter.com/RJSzczerba
@RobNaylor_ http://www.twitter.com/RobNaylor_
@RossMartin http://www.twitter.com/RossMartin
@ruby_raley http://www.twitter.com/ruby_raley
@RunCrissieRun http://www.twitter.com/RunCrissieRun
@RyPan http://www.twitter.com/RyPan
@SacJai http://www.twitter.com/SacJai
@sandrafancher http://www.twitter.com/sandrafancher
@Sarah_MModal http://www.twitter.com/Sarah_Mmodal
@sarahbennight http://www.twitter.com/sarahbennight
@sarascoulter http://www.twitter.com/sarascoulter
@scottmace http://www.twitter.com/scottmace
@ShahidNShah http://www.twitter.com/ShahidNShah
@sjdmd http://www.twitter.com/sjdmd
@skram http://www.twitter.com/skram
@StanKutcher http://www.twitter.com/StanKutcher
@stedavies http://www.twitter.com/stedavies
@StephLBaum http://www.twitter.com/StephLBaum
@Steven_Paul http://www.twitter.com/Steven_Paul
@StorkBrian http://www.twitter.com/StorkBrian
@subatomicdoc http://www.twitter.com/subatomicdoc
@Sullden http://www.twitter.com/Sullden
@SusannahFox http://www.twitter.com/SusannahFox
@symplur http://www.twitter.com/symplur
@TAG_Health http://www.twitter.com/TAG_Health
@techguy http://www.twitter.com/techguy
@techydoc http://www.twitter.com/techydoc
@TedEytan http://www.twitter.com/TedEytan
@telmer http://www.twitter.com/telmer
@TheGr8Chalupa http://www.twitter.com/TheGr8Chalupa
@thehealthmaven http://www.twitter.com/thehealthmaven
@TheNerdyNurse http://www.twitter.com/TheNerdyNurse
@ThePatientsSide http://www.twitter.com/ThePatientsSide
@ThinkPatient http://www.twitter.com/ThinkPatient
@todd_mcguire http://www.twitter.com/todd_mcguire
@toddschnick http://www.twitter.com/toddschnick
@VentureValkyrie http://www.twitter.com/VentureValkyrie
@VinceKuraitis http://www.twitter.com/VinceKuraitis
@vmcombs http://www.twitter.com/vmcombs
@wayne_oliver http://www.twitter.com/wayne_oliver
@westr http://www.twitter.com/westr
@williamhersh http://www.twitter.com/williamhersh
@wilson_to http://www.twitter.com/wilson_to
@ZGJR http://www.twitter.com/ZGJR


Note: I'm not wholeheartedly recommending every one of these people and companies. In fact, I disagree with most of what a few of these Twitter accounts regularly emit. But I do follow all of them directly or via various lists I maintain.