CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 16 0000. ref SDS 15 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040507 -
040508 -
040510 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Millie submitted a letter on 071015, ref SDS 16 KN5K, asking about
040902 - doing labs at Kaiser instead of UCSF, if this will solve the payment
040903 - dispute between Kaiser and UCSF. ref SDS 16 KH5T
040905 -  ..
040906 - Jackie submitted a response from UCSF saying...
040907 -
040908 -    1.  Subject:  Treatment Schedule Blood Tests October 18th
040909 -        Date: Wed, 17 Oct 2007 10:29:33 -0700
040915 -         ..
040916 -        Hi Millie,
040918 -         ..
040919 -    2.  I just faxed over a lab request to Kaiser (Arlette) for you to
040920 -        have your lab work done.  In the future, we can give a lab slip
040921 -        at your appointment that you can bring over to Kaiser.  See you
040922 -        tomorrow.
040924 -  ..
040925 - Handing out lab slips for patients to "bring over to Kaiser"
040926 - introduces a layer of administration requiring coordination of
040927 - multiple parties that increases risks of mistakes and delay, reported
040928 - on 070830 and citing prior experience in this case where compound
040929 - coordination efforts failed. ref SDS 6 T176
040930 -
040931 -
040933 -  ..
0410 -
0411 -
0412 - 1227
0413 -
041301 - Millie arrived home from meeting with Wellness Community, a cancer
041302 - support group in Walnut Creek, Concord, Pleasant Hill.
041304 -  ..
041305 - Millie sent a letter to UCSF thanking Jackie for timely coordination
041306 - following up Millie's letter on 071015 in time to get blood draw
041307 - before close of business today so results are available for the
041308 - medical team at UCSF when needed tomorrow at 0800...
041309 -
041310 -    1.  Subject: Blood Tests at Kaiser today
041311 -        Date: Wed, 17 Oct 2007 12:27:25 -0700
041320 -         ..
041321 -    3.  thanks so much.  I'll get the test done today at kaiser.  Hope
041322 -        this works so everything gets back to normal.  They sent me a
041323 -        letter to attend a hearing at Kaiser next month and I don't
041324 -        know what i would say, except I'm confused.  Hopefully doing
041325 -        what Kaiser wants will end the nightmare, even though it makes
041326 -        your work harder.
041328 -         ..
041329 -    4.  See you tomorrow.
041330 -
041332 -  ..
0414 -
0415 -
0416 - 1242
0417 -
041701 - Millie called Kaiser to ask Arlette in the Oncology Department about
041702 - scheduling the blood draw ordered by UCSF, per Jackie's letter earlier
041703 - today saying information was sent to Arlette, per above. ref SDS 0
041704 - Q45F
041706 -  ..
041707 - There was a message saying the Oncology Department is closed for calls
041708 - from customers until after 1330.
041709 -
041711 -  ..
0418 -
0419 -
0420 - 1332
0421 -
042101 - Millie called Arlette at Kaiser again.
042102 -
042103 - Arlette answered.
042105 -  ..
042106 - Arlette said she received the fax from Jackie and the doctor ordered
042107 - the blood test, so everything is all set.
042109 -  ..
042110 - Millie asked if blood draw for the test can be scheduled in the
042111 - Infusion Clinic that uses the port rather than a needle that has
042112 - become difficult to use, reported at UCSF 3 months ago when Jackie had
042113 - Millie get the blood draw in the lab, rather than in the Infusion
042114 - Clinic.  At that time, several attendants tried several times before
042115 - they finally found a vein to draw blood for the test.  This happened
042116 - again last month, when Millie's arm swelled up after the technician
042117 - could not find a vein for injection required for CT tests, leading to
042118 - Doctor Rugo requesting permission for extending the time between tests
042119 - to give Millie's arm more time to heal.
042121 -  ..
042122 - Arlette said Millie would have to call the Infusion Clinic and ask if
042123 - they can fit a 5 minute blood draw into the schedule this afternoon.
042124 - Arlette transferred the call to the Infusion Clinic.
042126 -  ..
042127 - The attendant said the Infusion Clinic cannot schedule Millie for a
042128 - blood draw until next week.  Said to get the blood test at Kaiser in
042129 - Martinez, because they can also use the port.
042130 -
042132 -  ..
0422 -
0423 -
0424 - 1347
0425 -
042501 - Called Arlette back.
042502 -
042503 - Millie asked about getting the doctor to order the test at the
042504 - Martinez Clinic, where blood draws are also performed using port
042505 - catheters.
042507 -  ..
042508 - Arlette said the doctor has already placed the order, so it is up to
042509 - the patient to coordinate scheduling the blood draw.
042511 -  ..
042512 - Arlette transferred the call to the Kaiser Clinic in Martinez.
042514 -  ..
042515 - The attendant said Millie can come in this afternoon for the blood
042516 - draw.
042517 -
042519 -  ..
0426 -
0427 -
0428 - 1403
0429 -
042901 - Millie left for Kaiser in Martinez.
042902 -
042904 -  ..
0430 -
0431 -
0432 - 1444
0433 -
043301 - Millie called.  She said the nurse at Martinez cannot find the order
043302 - for the blood draw submitted by Jackie via fax to Arlette this
043303 - morning, and which Arlette said was entered into Kaiser's computer
043304 - during the call earlier, per above. ref SDS 0 02EC
043306 -  ..
043307 - Millie asked for Jackie's number at UCSF to call for getting blood
043308 - draw order faxed to Kaiser in Martinez.  She also asked for Arlette's
043309 - number to see if there was a mixup or something entering the order.
043310 -
043312 -  ..
0434 -
0435 -
0436 - 1717
0437 -
043701 - Millie arrived home.
043702 -
043703 - She got the blood draw.
043705 -  ..
043706 - The nurse first tried calling Arlette, but could not make contact at
043707 - Kaiser in Walnut Creek.  She then tried calling Jackie at UCSF, and
043708 - left a voice mail and page.  Afer waiting 30 minutes or so, the nurse
043709 - decided to check Kaiser's records on the computer.  She found a blood
043710 - test for Millie from back in January, and used that to enter an order,
043711 - assuming it is close enough to what Jackie ordered, and sent notice to
043712 - the doctor on what was done.  Since Millie is familiar with the scope
043713 - of monthly draws, shown by the record on 070524, ref SDS 4 075H, she
043714 - was able to verify the likely order placed by UCSF via fax to Arlette
043715 - this morning, per Jackie's letter. shown above. ref SDS 0 Q45F
043717 -  ..
043718 - This record reflects challenges arising from multiple handling of
043719 - complex transactions across organizations, cited as one reason for
043720 - doing blood tests at the organization with primary responsibility to
043721 - provide care, explained in 070830, ref SDS 6 L94G, and noted in
043722 - Millie's letter to Kaiser on 071015. ref SDS 16 KH4S
043723 -
043724 -     [On 071018 blood test results were not available for review during
043725 -     examination, ref SDS 17 HL7O, treatment at UCSF was delayed for an
043726 -     hour or so until Kaiser submitted blood test results via fax.
043727 -     ref SDS 17 6N9F
043729 -      ..
043730 -     [On 071019 UCSF clinical trial staff confuses Neutrophils in
043731 -     Kaiser's blood test report on 071017, for NEUTS used by UCSF to
043732 -     assess patient safety for treatment. ref SDS 18 EU5U
043734 -      ..
043735 -     [On 071024 letter to UCSF proposes returning to system of blood
043736 -     tests at UCSF in order to avoid problems of confusion and delay,
043737 -     provided UCSF demonstrates there are no extra charges in billings.
043738 -     ref SDS 19 EP5W
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0438 -