THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rodwelch@pacbell.net
S U M M A R Y
DIARY: November 28, 2007 10:27 PM Wednesday;
Rod Welch
Planning comments from Kaiser and UCSF on using SDS for medical management.
1...Summary/Objective
2...Kaiser Experience Medical Case Management Doctor Patient Partnership
3...SDS Support Knowledge Management at Kaiser
..............
Click here to comment!
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,
271048 -
271049 -
271050 -
271051 -
271052 -
271053 -
271054 -
271055 -
271056 -
271057 -
2711 -