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0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 14 0000, ref SDS 13 0000.
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Background...
040902 -
040903 -    1.  CT test was prescribed by Doctor Rugo at UCSF on 081126, as
040904 -        noted in Millie's letter to the medical team on 081202,
040905 -        ref SDS 3 AT9T; on 081203 Glenna's letter confirmed the CT test
040906 -        was needed in time for the meeting at UCSF on 090108,
040907 -        ref SDS 4 ZP4Y; on 081210 the primary care physician at Kaiser
040908 -        ordered the test, ref SDS 5 H48N  A few weeks later on 081219
040909 -        the primary care physician modified the order for the CT test
040910 -        to specify a consolidated report for efficient case management,
040911 -        ref SDS 6 587G, rather than issue multiple reports that caused
040912 -        problems for patient care on 081113. ref SDS 1 VL5L
040914 -         ..
040915 -    2.  Coordination for CT test on 081229 to verify work lined up for
040916 -        the next day on 081230. ref SDS 7 T55G
040918 -         ..
040919 -    3.  On 081230 notified medical team in letter that CT test was
040920 -        coordinated to implement requirements ordered by the doctor.
040921 -        ref SDS 8 4W9V
040923 -         ..
040924 -    4.  On 081230 CT test was performed at Kaiser. ref SDS 9 3G5I
040925 -        Coordinated with  Kaiser CT Department staff to issue report
040926 -        wtih consolidated findings, rather than publish multiple
040927 -        reports for the test. ref SDS 9 FF8M
040929 -         ..
040930 -    5.  On 081231 notified medical team that CT test was performed
040931 -        successfully, and that UCSF needs the report in time to be
040932 -        prepared for meeting on 090108, ref SDS 10 LL5H, and that the
040933 -        staff added another note to consolidate findings into a single
040934 -        report. ref SDS 10 RS3W
040936 -         ..
040937 -    6.  On 090106 Glenna called and advised that Kaiser has not
040938 -        submitted the report for the CT test on 081230; requests help
040939 -        coordinating with Kaiser to get the report in time for the
040940 -        meeting at UCSf on 090108. ref SDS 11 JW5N
040942 -         ..
040943 -    7.  On 090106 called Arlette about Kaiser sending the report to
040944 -        UCSF for Millie's CT test on 081230.  Arlette disclosed that
040945 -        Kaiser prepared multiple reports for the CT test on 081230, and
040946 -        so failed to perform the doctor's order to consolidate findings
040947 -        into a single report for efficient case management. ref SDS 11
040948 -        N09L
040950 -         ..
040951 -    8.  Arlette reported problems with Kaiser computer systems may
040952 -        delay sending the report to UCSF. ref SDS 11 JW6X
040953 -
040954 -            [On 090109 Kaiser CT Department they get paid more money by
040955 -            insurance companies if they issue multiple reports for a CT
040956 -            test and ignore the doctor's order to consolidate findings
040957 -            for efficient case management. ref SDS 15 CE7R
040959 -         ..
040960 -    9.  On 090106 Arlette will ask the doctor to send the report for
040961 -        Millie's CT test on 081230 to Millie using electronic mail for
040962 -        the record on patient history that enables efficient case
040963 -        management. ref SDS 11 B47I
040965 -         ..
040966 -   10.  On 090106 Arlette reported the report on Millie's CT test was
040967 -        faxed to Glenna at UCSF. ref SDS 11 UT8M
040969 -         ..
040970 -   11.  On 090107 Millie drove to Kaiser and received from Arlette in
040971 -        Oncology 2 reports for the CT test on 081230.  The first report
040972 -        was for the neck, and the second was on the "chest, abdomen,
040973 -        and pelvis." ref SDS 13 OR4I
040975 -         ..
040976 -   12.  On 090108, UCSF did not receive the report on the CT test from
040977 -        Kaiser; backup copy was provided by the patient from the trunk
040978 -        of the car, reported in Millie's letter to the medical team on
040979 -        090109. ref SDS 14 UE6U
040981 -         ..
040982 -   13.  On 090109 Millie's letter to medical team reminds primary care
040983 -        physician to submit the report for Millie's CT test on 081230
040984 -        using Kaiser's electronic Knowledge Management system for
040985 -        efficiently entering patient history into the record that
040986 -        enables effective case management. ref SDS 14 UE6X
040987 -
040989 -  ..
040990 - Today, Millie received a letter from the primary care physician
040991 - transmitting the report for the CT test on 081230, as requested in the
040992 - call to Arlette on 090106. ref SDS 11 B47I
040994 -  ..
040995 - This is an electronic transmission using Kaiser's Knowledge Management
040996 - system for email, and was received a day after the report was needed
040997 - for the meeting at UCSF on 090108, and which is reported in the record
040998 - today in a letter to the medical team on 090109 0027. ref SDS 14 UE6R
040999 - As noted in the letter, UCSF did not receive the report for the CT
041000 - test from Kaiser, and so a printed copy which Millie picked up the day
041001 - before at Kaiser was provided from the trunk of the car after pausing
041002 - the meeting. ref SDS 14 UE6U
041004 -  ..
041005 - Content on the CT test report transmitted with Doctor Johnson's letter
041006 - today is entered in the record on 090107, from re-entering a printed
041007 - copy which Millie picked up by driving to Kaiser on 090107 1058.
041008 - ref SDS 13 6V5I
041009 -
041010 -    1.  Subject:  CT Report
041011 -        Received: 1/9/09 2:34 PM
041018 -         ..
041019 -    2.  [Here is the report on the CT test performed December 30, 2008
041020 -        at Kaiser in Walnut Creek, and requested in your letter earlier
041021 -        today to the medical team supporting your treatment on referral
041022 -        to UCSF under my care, and previously discussed with Arlette in
041023 -        my office on January 6th.]
041025 -  ..
041026 - There is a mistake in Kaiser's submission today.  The doctor attached
041027 - only a single report on the "chest, abdomen, and pelvis." Arlette
041028 - advised on 090106 that the CT Department ignored the doctor's order
041029 - for a consolidated report and instead published 2 reports for the test
041030 - on 081230. ref SDS 11 N09L  The next day Millie drove to Kaiser and
041031 - received from Arlette printed copies of 2 reports; the second is for
041032 - the "neck," report on 090107. ref SDS 13 YO7M
041034 -  ..
041035 - This morning on 090109 0840 meeting at Kaiser indicated that multiple
041036 - reports are issued in order to increase revenues from billing for 2
041037 - reports instead of 1. ref SDS 15 CE7R
041039 -  ..
041040 - This is the second time in a row Kaiser has transmitted findings for
041041 - CT tests in seperate reports that increase complexity, confusion,
041042 - error, and frustration that diminishes patient care.  On 081113 Millie
041043 - received a second report for the test on 081107, ref SDS 2 RU6R, and
041044 - which was not submitted to UCSF for examination the day before on
041045 - 081112, when at that time the medical team was concerned about
041046 - mistakes in the CT test report.
041048 -             ..
041049 -            [On 090409 2018 Doctor Davidson, Director fo Radiology of
041050 -            Kaiser Mt Diablo Service Area, advised that Kaiser CT
041051 -            Department Walnut Creek made a mistake issuing multiple
041052 -            reports for the CT test on 090413, ref SDS 16 WB6G, and
041053 -            advised that findings for future CT tests will consolidate
041054 -            findings into a single report for each test. ref SDS 16
041055 -            XZ6U
041057 -  ..
041058 - On 090106 Chris in Radiology Department reported that the referral by
041059 - the primary care physician ordered consolidated report for Millie's CT
041060 - test on 081230. ref SDS 12 OO82
041062 -  ..
041063 - The doctor's letter today responds to Millie's letter earlier this
041064 - morning submitting the record to the medical team on meeting with UCSF
041065 - yesterday on 090108 to evaluate response to treatment with sunitinib,
041066 - and further asking Kaiser for electronic transmision of the report for
041067 - the CT test, in order to save time creating patient history for
041068 - efficient case management. ref SDS 14 UE6X  Further responds to
041069 - Arlette's plan on 090106 to ask the doctor to submit the report to the
041070 - patient. ref SDS 11 B47I
041071 -
041081 -
041082 -
041083 -     ************************************************
041084 -     ************************************************
041086 -  ..
041087 - Content on the CT test report transmitted with Doctor Johnson's letter
041088 - today is entered in the record on 090107, from re-entering a printed
041089 - copy which Millie picked up by driving to Kaiser on 090107 1058.
041090 - ref SDS 13 6V5I
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