CONTACTS 

SUBJECTS
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0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 7 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Arlette in the Oncology Department advised this morning that Kaiser
040902 - issued 2 separate reports for Millie's CT test on 081230, rather than
040903 - consolidate findings into a single report to avoid confusion and
040904 - prevent mistakes, ref SDS 7 JW5N, as occurred at UCSF, when Kaiser
040905 - issued multiple reports for the CT test on 081107, reported on 081113.
040906 - ref SDS 2 6V5I
040908 -  ..
040909 - Talked to Lisa in schededuling for Radiology Department at Kaiser in
040910 - Walnut Creek Ca.
040912 -  ..
040913 - Asked about who can discuss Millie getting separate reports for the CT
040914 - test on 081230, reported by Arlette this morning? ref SDS 7 JW5N
040916 -  ..
040917 - Lisa transferred the call.
040919 -  ..
040920 - Chris came on line.  She is the receptionist in the CT Department at
040921 - Kaiser in Walnut Creek.
040923 -  ..
040924 - Chris seemed to say she is in charge of scheduling CT tests at Kaiser
040925 - in Walnut Creek.
040927 -  ..
040928 - Discussed consolidating findings into a single report for CT tests in
040929 - order to avoid mistakes in case management, and cited problems at UCSF
040930 - getting multiple reports for the CT test on 081107, reported on
040931 - 081113. ref SDS 2 6V5I
040932 -
040933 -            [On 090107 Kaiser issued multiple reports again for
040934 -            Millie's CT test on 081230. ref SDS 9 J85F
040936 -  ..
040937 - Chris presented understandings today that Kaiser has never
040938 - consolidated reports for CT tests on the neck.  Kaiser procedures
040939 - require separate reporting on the neck and head.
040941 -  ..
040942 - We reviewed patient history in the case study on 081113 showing that
040943 - until 081107, all eleven (11) of Kaiser's reports on Millie's CT tests
040944 - on the head, neck, chest, abdomen, and pelvis have presented with
040945 - findings consolidated into a single report that makes case management
040946 - fast and easy and accurate. ref SDS 2 HV4H
040948 -  ..
040949 - Chris looked further in Kaiser's computer system.  She found reports
040950 - on Millie's CT tests that are consolidated, as shown in the case study
040951 - on 081113. ref SDS 2 HV4H
040953 -  ..
040954 - Chris advised that a year or so ago, Kaiser changed policy and
040955 - procedures to issue separate reports on CT tests for the neck and head
040956 - from everything else.
040958 -  ..
040959 - We reviewed risks of misunderstanding and mistakes that occur from
040960 - issuing separate reports for a single radiology test.  Reports get
040961 - separated and issued on different days; nobody is aware there are
040962 - other reports, shown in the record on 081113. ref SDS 1 VL5L  On
040963 - 081218 Tara advised that Kaiser did not submit to UCSF the 2nd report
040964 - on the neck for the CT test on 081107, and asked Millie to submit the
040965 - report to UCSF. ref SDS 3 LM4I  Additionally, common findings that
040966 - overlap scanned areas, e.g., supraclavicular in the neck, and axillary
040967 - regions in the chest, are described differently in each report.  The
040968 - same nodes are reported in different sizes in different reports, shown
040969 - in the record on 090108. ref SDS 10 UE6X  Busy people are easily
040970 - confused, and make mistakes when the complexity of health care data is
040971 - compounded by having to read multiple reports for the same test.
040973 -  ..
040974 - Chris checked Doctor Johnson's referral issued on 081219.  She saw
040975 - that the doctor ordered a consolidated report for Millie's CT test on
040976 - 081230. ref SDS 4 587G  Chris feels Kaiser should implement the
040977 - doctor's order.
040978 -
040979 -            [On 090107 1058 Kaiser issued multiple reports again for
040980 -            Millie's CT test on 081230. ref SDS 9 J85F
040982 -             ..
040983 -            [On 090109 0840 meeting with CT Department indicates that
040984 -            within the past 4 - 6 months, Kaiser changed the policy
040985 -            from issuing a single consolidated report that is efficient
040986 -            for doctor's to use, to issuing separate reports for each
040987 -            pass the CT equipment makes to complete a test; this change
040988 -            increases Kaiser's revenues from billing for each pass of
040989 -            the equipment; since Millie's tests for the neck, chest,
040990 -            abdomen, and pelvis require 2 passes of the CT equipment,
040991 -            Kaiser publishes 2 reports in order to increase revenues.
040992 -            ref SDS 11 CE7R
040994 -             ..
040995 -            [On 090109 1537 Millie received from the primary care
040996 -            physician using Kaiser's Knowledge Management system an
040997 -            electronic submission of the report for Millie's the CT
040998 -            test on 081230; the doctor submitted only 1 of the 2
040999 -            reports prepared by the CT Department, ref SDS 12 V53J;
041000 -            mistakes performing case management reflect confusion that
041001 -            increased cost and delayed work, reported on 081219,
041002 -            ref SDS 4 T59G, and caused by failing to consolidate
041003 -            findings into a single report for the CT test, which was
041004 -            ordered by the doctor on 081219. ref SDS 4 WP30
041006 -  ..
041007 - We reviewed Jennifer's plan on 081230 to enter comments in
041008 - documentation on Millie's CT test for the analyst to issue a
041009 - consolidated report. ref SDS 5 SJ3N
041011 -  ..
041012 - Chris will talk to the interim manager of Radiology, Al Hutchins,
041013 - about correcting the problem.  She will try to talk to the
041014 - radiologist, Doctor Susan Hobbs, about consolidating reports.
041015 -
041017 -  ..
0411 -
0412 -
0413 - 1141
0414 -
041401 - Called Chirs back.
041402 -
041403 - She talked to Dennis, and he suggested talking to Al about publishing
041404 - consolidated reports.
041406 -  ..
041407 - Chris also plans to talk with the radiologist, Doctor Susan Hobbs, who
041408 - wrote the report on Millie's CT test on 081230.
041409 -
041410 -        [On 090107 Chris has prepared a report on patient feedback
041411 -        requesting consolidating findings into a single report for CT;
041412 -        her replacement on 090108 will pursue the matter with Doctor
041413 -        Mates in charge of policy and procedure on CT test reporting
041414 -        standards. ref SDS 8 5Y92
041416 -  ..
041417 - Dennis got a copy of Millie's letter to the medical team on 081231
041418 - reporting progress on the CT test, ref SDS 6 LL5H, and so is aware of
041419 - the issue as set out in Millie's letter. ref SDS 6 RS3W
041420 -
041421 -
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041423 -
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0415 -