CONTACTS 

SUBJECTS
Planning Evaluate SDS Endorsement Reverse Denial Authorization Payme

2703 -
2703 -    ..
2704 - Summary/Objective
2705 -
270501 - Follow up ref SDS 74 0000. ref SDS 73 0000.
270502 -
270503 -
270504 -
270505 -
270506 -
270507 -
270509 -  ..
2706 -
2707 -
2708 - Progress
2709 -
270901 - Kaiser Experience Medical Case Management Doctor Patient Partnership
270902 -
270903 - Follow up ref SDS 74 TH8L, ref SDS 73 TH8L.
270904 -
270905 - USACE published a report dated 970327 on using SDS for the Oakland
270906 - Harbor project. ref DRP 4 6172  PG&E had earlier commented on using
270907 - SDS. ref DRP 2 0001  Wayne Wetzel, Deputy Director at DNRC reported on
270908 - SDS dated 010717, ref DRP 3 0001, and received on 010725. ref SDS 10
270909 - WJ7L
270911 -  ..
270912 - The past 6 years Kaiser has been exposed to SDS for Knowledge
270913 - Management, Communication Metrics, and intelligence support.  Most of
270914 - this support has been passive, without direct use of SDS records by
270915 - medical professionals at Kaiser, because starting out on 020403 the
270916 - doctor's desk was already piled high with papers, similar to Pat
270917 - Lincoln, Director of Computer Science at SRI, reported on 000725,
270918 - ref SDS 9 I3R5, and to Tom Keesling, Deputy Director of Operations at
270919 - USACE, San Francisco, reported on 960418. ref SDS 4 8840  At that time
270920 - on 020403 the doctor's secretary advised that getting an SDS record
270921 - would overwhelm the doctor, because the doctor likes to work by
270922 - conversation to expedite getting things done. ref SDS 12 V168  As a
270923 - result, SDS work product was withheld, and so over the next 3 years,
270924 - the doctor gradually became aware that case management for Millie was
270925 - aided by SDS, as explained in POIMS. ref OF 3 1X6G
270927 -  ..
270928 - On 040520 met with the doctor and discussed Knowledge Management, and
270929 - prospects for doing a study at Kaiser to evaluate SDS support for
270930 - medical management using the doctor/patient partnership advocated by
270931 - Kaiser. ref SDS 14 0001
270933 -  ..
270934 - Would like to get comments from Paula on SDS support for medical
270935 - management based on successful claims review reported today of Kaiser
270936 - approving payment for Millie's care at UCSF on referral from Kaiser.
270937 - ref SDS 74 TH8L
270938 -
270939 -               [On 071202 submitted letter thanking Paula for support
270940 -               correcting case management problems and explaining role
270941 -               of SDS. ref SDS 75 FC5M
270943 -                ..
270944 -               [On 071203 0926 Paula feels SDS was helpful to Kaiser
270945 -               resolving case management problems for Millie's
270946 -               treatment on referral to UCSF. ref SDS 76 TH8L
270948 -  ..
270949 - Paula has direct experience with SDS from...
270950 -
270951 -        1.  Review on 071006 using SDS records to understand complex
270952 -            patient history. ref SDS 45 EX8K
270954 -             ..
270955 -        2.  Kaiser and UCSF unable to develop information required for
270956 -            case management, reported on 071105. ref SDS 69 K37X
270958 -             ..
270959 -        3.  Kaiser and UCSF computers have only partial and conflicting
270960 -            records on case history needed to assess UCSF charges for
270961 -            Millie's treatment, reported on 071114. ref SDS 70 NE5P
270963 -             ..
270964 -        4.  Document management hard to perform without SDS, reported
270965 -            on 071126. ref SDS 73 H68Y
270967 -             ..
270968 -        5.  Kaiser applied doctor patient partnership model, shown by
270969 -            work on 071126, ref SDS 73 OS4N, to solve problem finding
270970 -            relevant information for case management, as proposed on
270971 -            071105. ref SDS 69 K44S
270973 -             ..
270974 -        6.  Cite prior endorsements by Doctor Zipperstein on 940728,
270975 -            ref SDS 2 0001, who later advised on 940920 that SDS
270976 -            record of medical history saved time and money. ref SDS 3
270977 -            5922; by Jeane Bradley medical coordinator at Park
270978 -            Shadelands, received in the record on 990802, ref SDS 6
270979 -            0406; another support comment was received from Doctor
270980 -            Racah on 000208. ref SDS 7 0001
270982 -  ..
270983 - Then get endorsements from Doctor Johnson, and from Doctor Rugo.
270985 -  ..
270986 - Propose clinical trial applying SDS for case management, possibly
270987 - funded by NIH, and/or AARQ, reviewed on 041125. ref SDS 16 UW8M
270988 -
270989 -
270991 -  ..
270992 - SDS Support Knowledge Management at Kaiser
270993 -
270994 - Paula draft endorsement...
270995 -
270996 -      Dear Millie,
270997 -
270998 -      Thanks very much for use of Schedule Diary system (SDS) records
270999 -      to assist Kaiser in solving health care problems on referral to
271000 -      UCSF Medical Center.  As you know, understanding regulations and
271001 -      insurance provisions were complicating factors.
271003 -       ..
271004 -      The SDS system of precision access organized by chronology and
271005 -      context proved effective finding details in patient history.
271006 -      Everything in the right place at the right time seemed like a
271007 -      miracle making sense of complex issues.  This saved me a lot of
271008 -      time on the telephone waiting to talk to doctors and staff, and
271009 -      searching our computers with only partial and conflicting data
271010 -      from UCSF, reported on 071114. ref SDS 70 NE5P  Additionally,
271011 -      using a patient assistant facilitates communications in the
271012 -      doctor/patient partnership, adding value to our team care
271013 -      practice.  Kaiser employs analysts to save time for the doctor by
271014 -      writing reports on tests.  SDS records extend these benefits by
271015 -      integrating patient history of symptoms, examinations, and
271016 -      treatment to provide a complete picture that aids decisions.
271018 -       ..
271019 -      Your primary care physician reports having evolved his practice,
271020 -      over the past six (6) years, to apply SDS work product for case
271021 -      management.  Synergy with the patient assistant role supports
271022 -      proactive planning.  Kaiser's recent innovation providing the
271023 -      medical chart online in the computer complements the SDS plan,
271024 -      perform, report "intelligence process" that makes Knowledge
271025 -      Management more than a high tech cliche.  HIPAA regulations for
271026 -      doctors to enter patient communications in the medical chart will
271027 -      improve accuracy with efficient electronic feedback loops.
271028 -      Better accuracy reduces mistakes and avoids disputes.
271030 -       ..
271031 -      Cost containment doing a greater share of medical examinations
271032 -      online with SDS records from the patient has been noted by our
271033 -      Doctors Zipperstein and Rocah.  As well, Jeanne Bradley at the
271034 -      Park Shadelands facility commends quality control for health care
271035 -      enabled by SDS traceability to orginal sources.  Doctor Rugo's
271036 -      letter at UCSF on 071009 reflects potential for improving care
271037 -      with electronic communications. ref SDS 47 4P6I
271039 -       ..
271040 -      Accordingly, experience saving time and money in your case
271041 -      justifies studying SDS to improve quality of care by reducing
271042 -      medical mistakes with proactive case management.  Cost advantages
271043 -      of better care by adding self-interest patient assistance seems
271044 -      self-evident.
271046 -       ..
271047 -      Sincerely,
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2711 -