CONTACTS 

SUBJECTS
Schedule CT Test 070328 UCSF Clinical Study Cetuximab Assess Effecti

0903 -
0903 -    ..
0904 - Summary/Objective
0905 -
090501 - Follow up
090502 -
090503 -
090504 -
090505 -
090507 -  ..
0906 -
0907 -
0908 - Progress
0909 -
090901 - Arlette said the earliest the doctor could schedule the CT test was
090902 - 070328 at 0845a, following up the reminder on 070307. ref SDS 9 9Z9N
090903 - On 070301 UCSF requested a test "before" 070328, in order to have
090904 - results in time for Doctor Rugo to meet with Millie on 070329.
090905 - ref SDS 8 UR9J
090907 -  ..
090908 - Millie explained that Kaiser's schedule for the CT test on 070328
090909 - conflicts with the UCSF request for a test before 070328, and disrupts
090910 - her work schedule at N&P.  Since she is only working 3 days a week,
090911 - taking another day off, or even half-day off, creates a hardship at
090912 - work.  Additionally, testing on 070328 may not give Kaiser enough time
090913 - to prepare a report and submit to UCSF in time for the doctor to
090914 - review in the meeting on 070329 required to approve Millie for another
090915 - cycle of treatment.  Arlette indicated there are no other dates
090916 - available for testing Millie earlier in the week, and in the evening
090917 - to avoid work disruption at N&P, and coordinate the work with clinical
090918 - study treatment requirements.
090919 -
090920 -     [On 070314 Kaiser changed the schedule for the test to 070326 at
090921 -     2000, which provides more time for preparing the analyst's report,
090922 -     and distribution in time to prepare for the meeting at UCSF on
090923 -     070329. ref SDS 10 VP5N
090925 -      ..
090926 -     [On 070315 progress report submitted to primary care physician at
090927 -     Kaiser on recovering from IBC 3rd relapse with treatment that
090928 -     started 070201 under a clinical study for cetuximab at UCSF.
090929 -     ref SDS 11 VP5N
090931 -  ..
090932 - The imaging department should send Millie a letter confirming the date
090933 - and time of the test.
090935 -  ..
090936 - This conflicts with planning to perform the test before 070328, but
090937 - aligns with objectives to correlate testing with treatment cycles.
090938 - Testing on 070328 risks a few days lag completing the pathology
090939 - report, which in that case could not be discussed with the doctor
090940 - during the meeting the next day on 070329.
090941 -
090942 -
090944 -  ..
090945 - Doctor Wants Direct Communication Rather than Staff Support
090946 - Coordination Not Enough Time to Get Communication in Doctor's Computer
090947 -
090948 - Arlette also said that her schedule has changed.  She can no longer
090949 - coordinate Millie's case for the doctor.  The doctor understandably
090950 - wants patient communications in his computer program, and nobody has
090951 - enough time to support that work.  It is not clear whether this
090952 - requires transcribing that takes a lot of time, or using Windows cut
090953 - and paste technology that takes a few seconds, shown by the doctor's
090954 - submission of progress notes in the Medical Chart to confirm
090955 - understandings meeting with the patient, e.g., on 060711. ref SDS 1
090956 - FE4I
090958 -  ..
090959 - Previously, Arlette has been very effective forwarding correspondence
090960 - from UCSF and Millie to the people at Kaiser skilled and responsible
090961 - for taking action, which is the essence of "coordinating."  For
090962 - example, Arlette's correspondence on 060807 expedited review at Kaiser
090963 - on 060808, ref SDS 2 0001, and on 060809 she facilitated review at
090964 - UCSF, ref SDS 3 0001, which led to current and dramatic success at
090965 - UCSF, reported on 070307. ref SDS 9 9Z9N  Her letter on 070124
090966 - coordinated resolution of delays starting treatment at UCSF.
090967 - ref SDS 5 GD6M  Earlier,  Arlette also coordinated scheduling a CT
090968 - test on 070126 needed to start treatment at UCSF by forwarding email
090969 - to the doctor. ref SDS 6 Z24H  Now this level of coordinating cannot
090970 - be supported by Arlette.
090972 -  ..
090973 - Millie gets a lot of responses sending letters to Kaiser's email
090974 - program that say the doctor is not available.  Previously, Arlette has
090975 - coordinated to get things done, shown by work on 070123. ref SDS 4
090976 - LP4L
090977 -
090978 -     [On 070330 the doctor approved coordination through Michele,
090979 -     Arlette's colleague assisting doctors in the oncology clinic.
090980 -     ref SDS 12 W43H
090982 -  ..
090983 - This is part of the coordination plan proposed by Jackie on 070215.
090984 - ref SDS 7 VK5N
090985 -
090986 -
090987 -
090988 -
090989 -
090990 -
090991 -
090992 -
0910 -