CONTACTS
SUBJECTS
2nd Opinion Metastatic Cancer Treatment Chemotherapy New Trial Drug
Patient Information Admission Forms UCSF Download Millie Prepares
2nd Opinion Requested from UCSF, Stanford, UC Davis Cancer Centers
UCSF Schedule Meeting 041015 2nd Opinion Records Transfer Sheridan T
UCSF Meeting Confirmation 041018 0930 Received Planning to Submit Me
1007 -
1007 - ..
1008 - Summary/Objective
1009 -
100901 - Follow up ref SDS 22 0000. ref SDS 21 0000.
100902 -
100903 - Millie submitted ref DIT 1 0001 to Sheridan saying...
100904 -
100905 - 1. I have written and called several times, see below, but have
100906 - not heard from you, ref DIT 1 0001, since your letter on Oct 7
100907 - saying you have not heard from me. ref SDS 20 0001 On Oct 8, I
100908 - wrote to you explaining my medical records have been
100909 - transferred to UCSF, ref SDS 21 9N8K, in accordance with your
100910 - instructions in an attached document UCSF submitted on Oct 6.
100911 - ref SDS 17 RK6M
100913 - ..
100914 - 2. Today, I would like to fax "Patient Information" filled out
100915 - from the download accessed in the attachment to your letter of
100916 - Oct 6, ref DIT 1 RY6F, explaining "What to Bring." ref SDS 17
100917 - WL3N UCSF's instructions say to list on the fax cover sheet
100918 - the date, time, and name of the doctor, shown in our record
100919 - yesterday. ref SDS 22 HN8K Can you get this to me, or should I
100920 - reference your name in the cover sheet for this information?
100922 - ..
100923 - 3. Yesterday, Rod called Kaiser and found that they messed up
100924 - transferring the medical records, ref SDS 24 PQQY, so we have
100925 - arranged to hand carry the records. ref SDS 24 TB7I I plan to
100926 - pick them up at the Business Office on Thursday when I have a
100927 - treatment. ref DIT 1 YF6M Your last letter on Oct 7 said a
100928 - meeting could be this Friday, Oct 15, or the following Monday.
100929 - ref SDS 20 0001 When time permits, please let me know the date,
100930 - time and the name of the doctor.
100931 -
100933 - ..
1010 -
1011 -
1012 - 1146 called Sheridan
1013 -
101301 - Left another message for Sheridan confirming email, asking for date,
101302 - time, and name of doctor for meeting on 2nd opinion.
101303 -
101305 - ..
1014 -
1015 -
1016 - 1205 called EJ.....................800.888.8664 or 415.885.7777
1017 -
101701 - Called EJ who helped register Millie on 041004. ref SDS 16 5183
101702 -
101703 - Talked to Carol.
101705 - ..
101706 - Carol said there is no record of a meeting.
101708 - ..
101709 - Patient Relations............... 415 353 1936
101711 - ..
101712 - Talked to Asha.
101714 - ..
101715 - Asha will contact Sheridan and ask her about Millie's case.
101717 - ..
101718 - Asha will call back by the end of the day, or Sheridan will call to
101719 - follow up.
101720 -
101722 - ..
1018 -
1019 -
1020 - 1356
1021 -
102101 - Asha called back.
102102 -
102103 - She talked to the manger of the patient schedule process, or something
102104 - like that. Asha understands that Sheridan has information on Millie
102105 - and is working on scheduling a meeting.
102107 - ..
102108 - Asha said that Sheridan will call us a couple of days.
102109 -
102110 -
102111 -
102112 -
102113 -
1022 -
SUBJECTS
Facilitate Meetings Be Prepared Writing Record Organizational Memory
Intelligence Adds Alignment Improves Communication Listening Underst
Patient Organize Medical Record Organizational Memory Critical Facto
Doctors Do Not Have Time to Analyse Test Results for Developing Trea
Doctors Not Enough Time Follow Kaiser Guidelines for Medical Practic
2707 -
2708 - 1431
270901 - ..
270902 - Hectic Too Much Going On Not Enough Time to Think Busy Being Busy
270903 - Not Enough Time to Think Requires Role for Accuracy Analysis Planning
270904 - Organizational Memory Critical Factor Productivity Medical Practice
270905 -
270906 - Sheridan called back.
270908 - ..
270909 - She has received Millie's letters and calls to confirm date, time, and
270910 - name of doctor for meeting to get a 2nd opinion, per above,
270911 - ref SDS 0 0001, but Sheridan has been swamped, and so has been unable
270912 - to respond the past few days. She said the past week or so has been a
270913 - very hectic time. There is hardly time to think.
270915 - ..
270916 - This problem reflects the report on 970910, ref SDS 6 3479, that is
270917 - totemic of the new world order... ref OF 10 1675
270918 -
270919 - [On 041015 same problem at other big organizations, reported by
270920 - Gary on their project. ref SDS 27 CE6H
270922 - ..
270923 - [On 060809 Margaret at UCSF, Shery's colleague, also, has hectic
270924 - schedule, not enough time to communicate with patient, ref SDS 31
270925 - YK6N, nor to organize the record for the doctor to make a timely
270926 - review and conduct an effective meeting. ref SDS 31 I73H
270928 - ..
270929 - An example of a "hectic" schedule is working with Dave at Intel on
270930 - 960223. ref SDS 4 4992
270932 - ..
270933 - Sheridan asked if it would be possible to get Millie's medical records
270934 - from Kaiser, and hand carry them, rather than have Kaiser send them
270935 - directly to UCSF? She said it would be a big help if we could invest
270936 - time to organize the records according to the UCSF due diligence
270937 - checklist she submitted on 041006. ref DRP 6 7R8Y Sheradin explained
270938 - that doctors and hospitals have difficulty keeping records in
270939 - chronological order, required for creating an intelligible patient
270940 - history, so if the patient can go through and origanize everything
270941 - this is a big help preparing a second opinion.
270943 - ..
270944 - This aligns with Michelle's request at Stanford, yesterday on 041011,
270945 - ref SDS 23 8E66, and also fits research on 010420 that reports
270946 - organizations have very weak ability to manage organizational memory.
270947 - ref SDS 10 IE4M
270949 - ..
270950 - On 040312 lectures on 21st century science present the "locality
270951 - principle" that explains the role of order for predictability that
270952 - converts information into the power of knowledge by adding energy to
270953 - connect cause and effect. ref SDS 13 YH4G
270955 - ..
270956 - Today, we reviewed the record showing that the list UCSF provided was
270957 - attached to the signed Authorization form submitted to Kaiser for
270958 - transferring medical records, reported the next day on 041007.
270959 - ref SDS 18 VN9O Therefore, Kaiser is on notice of the order that UCSF
270960 - requires. Yesterday, on 041011 Kaiser disclosed plans to prepare
270961 - separate sets of medical documents for each of the categories in
270962 - UCSF's list. ref SDS 24 PQUP They have a big staff, and they have a
270963 - duty to perform professional work in order to protect patient rights.
270964 - Time for this task has already been paid through insurance premiums.
270966 - ..
270967 - Why shouldn't Kaiser's work product be adequate for UCSF Medical
270968 - Center to prepare a competent, professional, 2nd opinion on diagnosis
270969 - and treatment to save lives, time, and money?
270970 -
270971 - [On 041019 Todd advised that Stanford empowers patients to hand
270972 - carry medical records because Kaiser, Stanford, and other
270973 - professionals are not empowered to reliably accomplish this
270974 - task. ref SDS 29 BW5J
270976 - ..
270977 - Sheridan explained the problem isn't Kaiser, per se. She indicated
270978 - that even though Kaiser has the list showing the order for assembling
270979 - and transferring patient medical records, most often the actual
270980 - transaction will be received out of order, i.e., in a jumbled mess,
270981 - because "filing" gets minimal supervisor oversight. Similarly, when
270982 - medical records are faxed, they are usually out of order for many
270983 - reasons. For example, interruptions are a common cause of disorder.
270984 - Attendants get distracted by phone calls, personal matters, a
270985 - supervisor directs that work be halted in order to send something on
270986 - another matter with a higher priority. They are sent on errands, and
270987 - so faxing documents is a fill-in task that is performed haphazardly,
270988 - which then has a ripple effect on productivity. She said that
270989 - distractions common at UCSF occur everywhere. The bigger the record,
270990 - and the bigger the organization, the bigger the problem of disorder,
270991 - because organizing information is hard work that requires skills,
270992 - experience, attention and interest.
270993 -
270994 - [On 041213 PET scan films missing from the medical record
270995 - received from Kaiser; staff performed rework to complete the
270996 - submission for UCSF. ref SDS 25 SN5F
270998 - ..
270999 - [On 041213 CT tests were received from Kaiser out of order;
271000 - staff performed rework to organize the record. ref SDS 25 0200
271002 - ..
271003 - [On 041013 medical records for doctor notes are out of order
271004 - and records are incomplete. ref SDS 25 PF7I
271006 - ..
271007 - Sheridan advised that a lot of time is required by UCSF staff to
271008 - organize records for effective use by doctors to help patients. Often
271009 - there isn't enough time to do this, because organizing the record is
271010 - difficult, complex, and boring to everyone except the patient.
271011 - Sheridan explained that when there isn't enough time for the staff to
271012 - organize the record, then it is very difficult for doctors to find
271013 - anything when needed. This increases the time to do the work, well
271014 - beyond the time required to organize the record, and mistakes go up.
271015 -
271016 - [On 041013 added tabs to organize medical records on test
271017 - reports and doctor notes. ref SDS 25 PF7I
271019 - ..
271020 - [On 041013 listed missing records. ref SDS 25 T49J
271022 - ..
271023 - [On 060809 Margaret at UCSF, Shery's colleague, also, has
271024 - hectic schedule, not enough time to communicate with patient,
271025 - ref SDS 31 YK6N, nor to organize the record for the doctor to
271026 - make a timely review and conduct an effective meeting.
271027 - ref SDS 31 I73H
271029 - ..
271030 - UCSF's experience aligns with the study reported on 990912 that found
271031 - medical mistakes cause 300% more deaths than automobile and airplane
271032 - accidents combined. ref SDS 9 0001
271034 - ..
271035 - UCSF's difficulties handling organizational memory supports Bill Gates
271036 - plan to improve Microsoft technology for finding information, reported
271037 - on 021108. ref SDS 11 EF5I Jeff Conklin, also, noted organizational
271038 - memory is weak throughout industry and government, reported on 010420.
271039 - ref SDS 10 IE4M
271040 -
271041 - This issue is addressed in the Business Case section of the ASB on
271042 - SDS for Aerospace company....
271043 -
271044 - http://asc1.web.boeing.com/index.cfm?page=view_asb&asb=1547#DM58
271045 -
271046 - ...discussed with Woody on 041004. ref SDS 15 CB6G
271048 - ..
271049 - Sheridan's experience at UCSF further aligns with the study by the US
271050 - Air Force Institute of Technology that found management degrades to
271051 - entropy on all large operations, reported on 970707. ref SDS 5 0108
271052 -
271053 - [On 050824 Advice Nurse being persistant reminding the surgeon to
271054 - follow up on patient calls. ref SDS 30 4M7N
271056 - ..
271057 - Frank Shults cited similar problems organizing the record at NASA on
271058 - the Space program, reported on 921021. ref SDS 1 4390
271060 - ..
271061 - The only thing bigger than "disorder" in large scale operations, what
271062 - Kissinger calls "bumbling," reported on 940609, ref SDS 2 4238, is
271063 - denial of the problem, enabled on the one hand by mental agility to
271064 - absorb ambiguity, cited by Grove at Intel, reviewed on 980307,
271065 - ref SDS 7 3668, and abetted by fear of accountability, reviewed on
271066 - 980405. ref SDS 8 5065 Sean O'Keefe cited systemic and cultural
271067 - defects in testimony before Congress explaining why NASA cannot
271068 - improve improvement. reported 030826. ref SDS 12 8K4G
271070 - ..
271071 - Experience at UCSF reviewed today, explains in part the study reported
271072 - on 960205 showing that people waste 70% of the day in unproductive
271073 - meetings, because nobody is prepared. ref SDS 3 5902
271075 - ..
271076 - Sheridan said that experience on the job, per above, ref SDS 0 6KO8,
271077 - shows that time is saved and mistakes are reduced when patients take
271078 - time to organize medical records received from hospitals, so they are
271079 - handed over to the next hospital in a form that enables efficient use,
271080 - because patient self-interest helps ensure accuracy.
271081 -
271082 - [On 041004 errors in submission of medical records are
271083 - corrected by Nuclear Medicine Department. ref SDS 25 SN5F
271085 - ..
271086 - [On 041004 errors in submission of medical records are
271087 - corrected by Xray Department. ref SDS 25 0200
271089 - ..
271090 - [On 041004 medical records received from Kaiser are reviewed,
271091 - and tabbed. ref SDS 25 VA9J
271093 - ..
271094 - [On 041004 medical records are missing from submission prepared
271095 - by Kaiser. ref SDS 25 T49J
271097 - ..
271098 - Sheridan's anlaysis also supports the concept of patients preparing
271099 - the record of work with doctors, because doctors don't have time nor
271100 - self-interest to ensure accurate records for accurate work.
271101 -
271102 -
271103 -
271104 -
2712 -
SUBJECTS
Default Null Subject Account for Blank Record
2803 -
280401 - ..
280402 - Meeting for 2nd Opinion Moved from Friday to Monday
280403 -
280404 - Under these circumstances, proposed moving the meeting for a 2nd
280405 - opinion from Friday to Monday in order to relieve pressure on time.
280407 - ..
280408 - Sheridan said that is a good plan. It will make the work less hectic,
280409 - and so reduce the chance of error.
280411 - ..
280412 - Millie and I will collect her medical records from the various Kaiser
280413 - departments on Thursday, while at the hospital for Millie's
280414 - chemotherapy treatment. Thursday evening and Friday morning, we will
280415 - organize the records, and then hand carry to UCSF about noon on
280416 - Friday. UCSF can then input the records into UCSF's system, so they
280417 - are available for the Doctor in time for the meeting on 041018.
280419 - ..
280420 - Sheridan will direct the doctor's attention to the case studies on
280421 - Millie's condition listed in the letter to UCSF dated 041002,
280422 - ref DIP 5 VX91, and which is reported in the record on that date.
280423 - ref SDS 14 Y29R
280424 -
280425 - [...below, received Sheridan's letter confirming plans to
280426 - submit links to the case studies for Doctor Benz review in
280427 - preparing to meet with the patient. ref SDS 0 N25U
280429 - ..
280430 - Initially, Sheridan planned to print the case studies. We reviewed
280431 - the challenge people have handling paper cited by Sheridan in
280432 - connection with handling medical records, per above. ref SDS 0 NV9F
280434 - ..
280435 - Sheridan will instead send an email to the doctor with a link to the
280436 - case studies, so that the doctor has access to the original sources,
280437 - including applicable test results. She will submit a copy of the
280438 - letter to the doctor to Millie, so there is a record showing the
280439 - doctor was given notice and access to the record.
280441 - ..
280442 - Sheridan suggested reviewing the biography of Doctor Benz on the UCSF
280443 - website that shows his extensive experience.
280444 -
280445 -
280446 -
280447 -
280449 - ..
2805 -
2806 -
2807 - 1551
2808 -
280801 - Received ref DRT 1 0001 from Sheridan saying...
280802 -
280803 - 1. This note is to confirm your appointment on 10-18-04 at 9:30
280804 - with Dr. Christopher Benz who will see you at the below
280805 - address. Please arrive a bit early so we can complete your
280806 - sign in and get you roomed to meet your doctor. ref DRT 1 0001
280808 - ..
280809 - 2. I have emailed Dr. Benz regarding the links to the 2 case
280810 - studies you referenced in your first letter.
280812 - ..
280813 - Sheridan's reference to the "first" letter relates to the record on
280814 - 041002. ref SDS 14 Y29R
280816 - ..
280817 - Millie can now fax "Patient Information" to UCSF, using the telephone
280818 - number (415) 353-7021, which is in document attached to Sheridan's
280819 - letter on 041006. ref DRP 6 01ZU
280821 - ..
280822 - 3. I look forward to seeing you on Monday. ref DRT 1 OI6M
280823 -
280824 - [On 041018 Sheridan was not in the office on Monday.
280825 - ref SDS 28 LW5V
280826 -
280827 -
280829 - ..
2809 -
2810 -
2811 - 2313
2812 -
281201 - Millie sent ref DIT 2 0001 to Sheridan responding to her call, per
281202 - above, ref SDS 0 NW55, and to Sheridan's letter, confirming the date
281203 - and time for meeting Doctor Benz. ref SDS 0 NW55
281204 -
281205 - 1. Thanks very much for your letter today, ref SDS 0 NW55, setting
281206 - a meeting with Doctor Benz on 041018 0930, ref DIT 2 0001, and
281207 - for notifying the doctor via email of "case studies" that focus
281208 - review of my condition submitted in my letter to UCSF on
281209 - 041002, as shown in the record on that date. ref SDS 14 Y29R
281210 -
281211 -
281213 - ..
281214 - 2. Look forward to meeting you, Doctor Benz, and the UCSF team on
281215 - Monday. ref DIT 2 6G6K
281217 - ..
281218 - 3. Tomorrow, I will fax the Patient Information documents to UCSF.
281219 - ref DIT 2 HG6N, which were prepared using UCSF's link in your
281220 - letter on 041006. ref SDS 17 WL3N
281222 - ..
281223 - 4. We will do our best to organize medical records according to
281224 - the Oncology Check List in your letter, ref DRP 6 7R8Y, dated
281225 - 011006, ref SDS 17 WL4Q, and will deliver them to UCSF Friday
281226 - afternoon, ref DIT 2 IG7G, so there is time to process them
281227 - into the UCSF system to prepare for meeting with Doctor Benz on
281228 - Monday. ref SDS 0 HW4R
281229 -
281230 - [On 041015 notified Sheridan that medical record has been
281231 - organized, and will be delivered to UCSF later today.
281232 - ref SDS 26 Y93G
281233 -
281234 -
281235 -
281236 -
281237 -
281238 -
281239 -
281240 -
281241 -
281242 -
281243 -
2813 -