Kaiser Permanente
The Permanente Medical Group, Inc.
Park Shadelands
320 Lennon Lane
Walnut Creek, CA 94598

Date: 30 Nov 1999 10:47:44 -0800

Mr. Rod Welch
The Welch Company
440 Davis Court #1602
San Francisco, CA 94111 2496

Subject:   Medical Mistakes - Solution

This is the first opportunity I've had to review the attached [letter dated November 3, 1999, relating a discussion we had on November 1, 1999] and I must say, I have some real concerns.

Not only do I disagree with your interpretation of what was said, but also take issue with the way some of it is written, set up to imply my thoughts, feelings and words. I now have to take the time to thoroughly review and then respond. After this response, I'm sure there will be either an apology and/or at the very least, a lengthy conversation, both of us explaining our views on what was said and how it could have been misinterpreted. This is all very time consuming and as you know, time is a very "Hot Commodity."

The statements that I disagree with or are just not true are below in red. My comments are in blue.


171904 - can be updated.  Jeanne Bradley noticed that Syed has not addressed
171905 - pending issues.  She feels the Welch communication method works better
171906 - than the way Kaiser is doing things, and that the chart can be posted
171907 - with notice of a letter, as well as for a phone call.


172704 - Jeanne said the Message Center is also called the "Call Center."
172705 -
172706 - It works as follows...
172707 -
172708 -     People call the hospital, and are connected to the Call Center.

           Another example of misinterpretation.  No one calling the hospital
           is connected to call center.  This is for outpatient clinics only.


172710 -     They talk to a representative, who then jots down what seems to
172711 -     be important, and a record of the call is entered in the patient
172712 -     chart.
172713 -
172714 - Jeanne said these messages typically comprise a note to the doctor to
172715 - call the patient, without any material content of a message.  In other
172716 - words, the record of the discussion is not captured and entered in the
172717 - chart.

         I wouldn't have said this...It's not true.


172719 - Transcribing verbal expressions accurately is very difficult and time
172720 - consuming for everyone, the doctor, the voice mail clerk, and the
172721 - customer, the patient.  This presents liability issues which restrain
172722 - transcription, and invite duplication that wastes time.

                Very True!!


172753 - information is readily available by clicking on links.  Jeanne said
172754 - this saves a lot of time, storage space, and frustration dealing with
172755 - documents that get mixed up and misplaced, which is a big problem at
172756 - Kaiser.

        This implies that I said, "Kaiser has a big problem with documents
        getting mixed up or misplaced."  Which is simply not true.



Jeanne Bradley