CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 17 0000. ref SDS 16 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Background on biopsy status change test issue is shown in the earlier
040902 - record today on 081113, ref SDS 10 ED5J, citing Millie's letter to
040903 - Kaiser on 081111 requesting results on tests the past week,
040904 - ref SDS 9 DJ6N, to prepare for Millie to start treatment for cancer at
040905 - UCSF today, on 081113.
040907 -  ..
040908 - Objectives for testing status change are reported in the record on
040909 - 081022 for the first biopsy at Kaiser. ref SDS 5 RS8M  Subsidiary
040910 - objective is to get actualy pathology findings to compare with
040911 - possible modified criteria, reported on 071007. ref SDS 3 S68T
040913 -  ..
040914 - Yesterday on 081119, Millie received a letter from Kaiser submitting
040915 - parts ofthe pathology report showing status has not changed, and
040916 - remains triple negative. ref SDS 13 5O8G
040918 -  ..
040919 - Millie sent Kaiser's letter to the medical team notifying that the
040920 - biopsy on 081107 shows status has not changed and so is still triple
040921 - negative, ref SDS 14 V14I, since the original biopsy on 020304,
040922 - reported at Kaiser on 020321. ref SDS 1 6Q6J  Millie's letter on
040923 - 081119 also requested from Kaiser the complete pathology report,
040924 - ref SDS 14 L34X, citing objective to evaluate test results agains
040925 - possible changed criteria for Her2 neu. ref SDS 14 GH5I
040927 -  ..
040928 - This morning, Millie received a letter from Kaiser saying the doctor
040929 - wants Millie to have the entire pathology report. ref SDS 17 VU9N
040930 - Since Millie needs the complete report, and so far has only received
040931 - partial extracts, another letter was sent asking for the full report
040932 - again...
040933 -
040934 -    1.  Subject: Pathology Report Biopsy 081107
040935 -        Date: Thu, 20 Nov 2008 09:36:30 -0800
040942 -         ..
040943 -    3.  Responding to your letter this morning on my getting the
040944 -        pathology report, ref SDS 17 VU9N, I haven't received it.  I
040945 -        think I have parts extracted and submitted with your two
040946 -        letters.
040948 -         ..
040949 -    4.  Typically, my primary care physician, Doctor *******, uses
040950 -        Kaiser's internal email system to send me the entire report,
040951 -        including document header that has essential identification
040952 -        data for managing the work.   He uses regular email for routine
040953 -        communication among the medical team, but uses the internal
040954 -        Kaiser system for increased patient confidentiality.  I have
040955 -        explained priority is timeliness and accuracy, and that
040956 -        Kaiser's email system is inefficient for reasons listed on
040957 -        060106. ref SDS 2 FE4I
040959 -         ..
040960 -    5.  None-the-less PCP feels comfortable sending reports with the
040961 -        internal system, so I get them and make distribution to the
040962 -        medical team [supplements fax submission by the doctor's
040963 -        assistant Arlette, always very conscientious].
040965 -         ..
040966 -    6.  I have already requested the report on the biopsy for 081107,
040967 -        and on the first FNA biopsy you did on 081022 several times.
040968 -        Have not pushed this, because thanks to you we have the gist of
040969 -        the story for purposes of decision support [...on 081023 the
040970 -        doctor called with results, ref SDS 6 W15N, and submitted a
040971 -        letter, ref SDS 6 4Q9Q, confirming results of the biopsy on
040972 -        081022; yesterday on 081119, the doctor submitted partial text,
040973 -        ref SDS 13 UQ5P, from the report for the biopsy on 081107.]
040975 -         ..
040976 -    7.  In any case, if it is not a big job, can you please submit the
040977 -        full text of pathology reports for the biopsies on 081022, and
040978 -        on 081107.  I realize this is extra work, and that, like the
040979 -        primary care physician, you have limited time.
040980 -
040981 -            [On 081120 Kaiser confirms plans to submit full pathology
040982 -            report to Millie. ref SDS 18 VU9N
040984 -             ..
040985 -            [On 081120 Millie received full pathology report for biopsy
040986 -            on 081107 to check status change, ref SDS 19 1E6K, and
040987 -            found the report is incomplete. ref SDS 19 LF9R
040989 -             ..
040990 -            [On 081202 1456 Kaiser submitted results of pathology for
040991 -            biopsy on 081107 showing HER2 neu FISH test = 1.1,
040992 -            ref SDS 20 FG5G, well below criteria for positive 2.0, and
040993 -            below change in criteria to 1.6 reported under
040994 -            consideration on 071007. ref SDS 3 S68T
040996 -         ..
040997 -    8.  Getting the full report adds value to medical practice, shown
040998 -        from review of my CT tests, illustrated by the record on
040999 -        080912. ref SDS 4 OO6M
041001 -         ..
041002 -    9.  Again, I will understand if this request seems over the top.
041003 -        If you don't have time for this, I will get it from PCP.
041005 -         ..
041006 -   10.  You have been great.
041007 -
041013 -
041014 -
041015 -
041016 -
041017 -
0411 -