CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 6 PQ4S.
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Neupogen 1 Treatment Prescription Confirmed by UCSF
040902 -
040903 - Follow up ref SDS 6 YU8W.
040904 -
040905 - Millie received a letter from Brigid confirming prescription for
040906 - Neupogen today...
040907 -
040908 -    1.  Subject:  NEUTS .74 Very Low Neupogen Prescribed for Treatment Next Week
040910 -         ..
040911 -    2.  Date: Fri, 20 Jun 2008 07:12:23 -0700
040919 -         ..
040920 -    5.  Yes I think only one neupogen shot will be necessary as you
040921 -        didn't receive any chemo this week.
040923 -  ..
040924 - This feedback from Brigid confirms understandings of instructions
040925 - yesterday in the Infusion Clinic. ref SDS 5 7L6G
040927 -  ..
040928 - Brigid concludes UCSF instructions...
040929 -
040930 -    6.  thanks
040931 -
040951 -  ..
040952 - Millie went to the Oncology Department at Kaiser in Walunt Creek.
040954 -  ..
040955 - She checked into the reception counter.
040957 -  ..
040958 - The attendant found Millie's meeting scheduled for getting Neupogen
040959 - treatment today.  She said that Zan scheduled the work for 1500, as
040960 - shown below. ref SDS 0 YY88
040962 -  ..
040963 - Millie reported that she received in the mail yesterday a letter from
040964 - Kaiser that was undated, but confirmed understandings from Zan's call
040965 - on 080609 that scheduled a meeting for Neupogen treatment on 080627 at
040966 - 1500.  Kaiser has not notified that the meeting today was for a
040967 - particular time.  This was reported in a letter yesterday on 080619 to
040968 - the medical team, which includes Kaiser.  The letter asked for the
040969 - time of treatments that Zan has scheduled. ref SDS 6 YU7Q
040971 -  ..
040972 - Millie was grateful that Zan's planning on 080609 for treatment today,
040973 - ref SDS 3 016S, has turned out to be scheduled correctly.  She related
040974 - having asked Kaiser in a letter yesterday to confirm the schedule,
040975 - ref SDS 6 YU7Q, but all she received was the letter for treatment next
040976 - week, and nothing about today.
040978 -  ..
040979 - The attendant apologized for Kaiser's letter confirming only 1 of the
040980 - many meetings scheduled, failing to mention the meeting today, and not
040981 - disclosing times of the meetings.  She explained that everybody is
040982 - busy; things have been hectic at Kaiser.
040983 -
040984 -
0410 -

SUBJECTS
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0503 -
050401 -  ..
050402 - Neupogen Treatments Schedule Kaiser Infusion Clinic
050403 - Kaiser Infusion Clinic Schedule Neupogen Treatments
050404 - Schedule Neupogen Treatments Kaiser Infusion Clinic
050405 -
050406 - Millie received the following schedule...
050407 -                                                        UCSF Chemo
050408 -        Date    Time   Provider         Services      Cycle Treatmnt
050409 -
050410 -        080620  1500   Infusion Nurse   Neupogen        4     4
050411 -        080621  1100   Infusion Nurse   Neupogen        4     4
050412 -         ..
050413 -        080627  1200   Primary Care Phy Examination     5     1
050414 -        080627  1500   Infusion Nurse   Neupogen        5     1
050415 -        080628  1100   Infusion Nurse   Neupogen        5     1
050416 -         ..
050417 -        080705  1100   Infusion Nurse   Neupogen        5     2
050418 -        080707  1030   Opthalmology     Vision test
050419 -        080711  1630   Infusion Nurse   Neupogen        5     3
050420 -        080712  1200   Infusion Nurse   Neupogen        5     3
050421 -         ..
050422 -        080718  1030   Infusion Nurse   Port access     5     4
050423 -        080718  1100   Imaging Dep      CT scan test    5     4
050424 -        080718  1300   Infusion Nurse   Neupogen        5     4
050425 -        080719  1100   Infusion Nurse   Neupogen        5     4
050426 -        080725  1300   Infusion Nurse   Neupogen        6     1
050427 -        080726  1100   Infusion Nurse   Neupogen        6     1
050428 -
050429 -            [On 080711 Zan extended Kaiser's schedule for Millie's
050430 -            Neupogen treatments through August. ref SDS 10 RW38
050432 -  ..
050433 - Florida in the Infusion Clinic explained Kaiser's flexibility to
050434 - ensure treatments are given, even when the exact times don't always
050435 - work out, per below. ref SDS 0 YZ46
050437 -  ..
050438 - Kaiser's schedule today confirms the work plan for a CT test on 080718
050439 - at 1100, ref SDS 0 YY4X, developed on 080617 by Cal in the Imaging
050440 - Department at Kaiser, ref SDS 4 DF55  The schedule provides feedback
050441 - showing plans on 080617 for the Infusion Clinic to support the CT test
050442 - by accessing the Power Port on 080718 1030. ref SDS 4 OQ61
050444 -  ..
050445 - This schedule accomplishes the action item from telecon on 080619 for
050446 - Kaiser to confirm "standing order" for Neupgoen treatments.
050447 - ref SDS 6 YU7Q
050449 -  ..
050450 - Kaiser's schedule appears correctly synchronized with UCSF schedule of
050451 - chemotherapy treatments reported on 080529, ref SDS 2 IK7H, reflecting
050452 - discussion with Zan on 080609. ref SDS 3 M37G
050454 -  ..
050455 - There seems to be a gap in Kaiser's work plan.
050457 -  ..
050458 - There is only one (1) Neupogen treatment scheduled on 080705 for the
050459 - 5th cycle 2nd chemotherapy treatment at UCSF on 080703.  As discussed
050460 - with Zan on 080609, the UCSF work plan calls for scheduling 2 Neupogen
050461 - treatments. ref SDS 3 L16I  The missing 2nd treatment reflects that
050462 - the July 4th holiday occurs on Friday, the day after Millie's get
050463 - chemotherapy treatment at UCSF on 080703.  Doctor Rugo, who directs
050464 - Millie's care at UCSF, advised on 080403 that Neupogen treatments can
050465 - be given the following Monday to accomodate Kaiser scheduling.
050466 - ref SDS 1 6Y9K  July 7th is the Monday after treatment on Thursday,
050467 - 080703, at UCSF.
050469 -  ..
050470 - Accordingly, need updated Kaiser schedule showing Neupogen treatment
050471 - on 080707.
050473 -  ..
050474 - Additionally, need to extend the schedule through August correlated
050475 - with UCSF's schedule shown in the schedule on
050476 -
050477 -        [On 080625 Kaiser asked to schedule additional Neupogen
050478 -        treatment on 080707. ref SDS 7 IT6W
050479 -
050480 -        [On 080627 the primary care physician ordered additional
050481 -        Neupogen treatment on 080707. ref SDS 8 XK5K
050483 -         ..
050484 -        [On 080628 Laura scheduled Neupogen treatment on 080707
050485 -        implementing the doctor's order during the meeting on 080627.
050486 -        ref SDS 9 VO7I
050488 -         ..
050489 -        [On 080711 Kaiser extended Millie's schedule for August.
050490 -        ref SDS 10 T23F
050492 -         ..
050493 -        [On 080726 Kaiser's schedule does not show Millie's
050494 -        treatments for August; Bonnie entered in Kaiser's computer
050495 -        system Millie's schedule for Neupogen treatments for
050496 -        August. ref SDS 11 9839
050498 -         ..
050499 -        [On 080809 Donna extended Millie's schedule of Neupogen
050500 -        treatments through September. ref SDS 12 NQ4O
050501 -
050503 -  ..
050504 - The attendant explained that she has logged Millie into the computer
050505 - for treatment today.  Even though the schedule shows 1500, she feels
050506 - that since the treatment only takes 5 minutes, Millie can receive
050507 - care this morning, rather than coming back at 1500.
050508 -
050510 -  ..
0506 -
0507 -
0508 - 1030
0509 -
050901 - Florida came into the Infusion Clinic waiting area and called Millie.
050902 -
050903 - She remembered Millie from giving her treatments at Kaiser for many
050904 - years - 2002 - 2006.
050906 -  ..
050907 - Florida advised that Neupogen does not need to be given through the
050908 - port in order to avoid injuring Millie's arm with needle punctures.
050909 - She explained that Neupogen medication does not require injection into
050910 - a vein, like chemotherapy or CT contrast medium does.  Neupogen
050911 - treatment is merely injected beneath the skin.  Therefore, it can
050912 - always be done on the first try, and requires minimal penetration.
050913 - This significantly reduces trauma to the arm.
050915 -  ..
050916 - Florida seemed to concur with understandings on 080609 that Millie can
050917 - come in any time on the day treatment is scheduled. ref SDS 3 016S
050918 - She indicated that sometimes the time listed Kaiser's schedule today,
050919 - per above, ref SDS 0 YY88, doesn't work out for Millie or for Kaiser
050920 - due to increased activity, staff meetings, emergencies, etc., the
050921 - staff will make every effort to ensure Millie gets her Neupogen
050922 - treatment.  Since Neupogen treatment only takes 5 minutes this can be
050923 - worked into the nurses schedule.  If the clinic is very busy, the
050924 - nurse will ask her to wait until things quiet down, maybe go to the
050925 - cafeteria for a sandwich or something.
050927 -  ..
050928 - Millie reported good news on cost containment that UCSF has prescribed
050929 - only 1 treatment with Neupogen, per Brigid's letter received this
050930 - morning, shown above.
050932 -  ..
050933 - Florida feels the letter from UCSF today prescribing 1 Neupogen
050934 - treatment, ref SDS 0 YY5H, provides documentation modifying the
050935 - Chemotherapy Orders on 080529, which Zan relied on to order Millie's
050936 - treatment today, reported on 080609. ref SDS 3 L16I
050938 -  ..
050939 - Florida cancelled the treatment scheduled for tomorrow, 080621, as
050940 - shown in the list received this morning, above. ref SDS 0 YY88
050942 -  ..
050943 - Florida gave Millie 1 injection with Neupogen of 480 mcg.
050944 -
050945 -            [On 080628 Laura explained Kaiser protocol for Neupogen
050946 -            treatment of 480 mcg to be given with 2 separate injections
050947 -            of 240 mcg each. ref SDS 9 Q74G
050949 -  ..
050950 - Florida seemed familiar with Millie's patient history.  She mentioned
050951 - Millie getting treatments at UCSF on clinical trial, despite Millie
050952 - having not been a customer of the Kaiser Infusion Clinic since
050953 - November 2006.  Florida related policy understandings on Medicare
050954 - payments for clinical trial care, which are very complex and arcane.
050955 - This record suggests recent focus at Kaiser on this issue.
050956 -
050957 -
050958 -
050959 -
050960 -
050961 -
050962 -
050963 -
050964 -
0510 -