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: June 2, 2009 01:40 PM Tuesday; Rod Welch

Millie asks Doctor about Kaiser's response to work plan for Gemzar.

1...Summary/Objective
........Millie Over-treated Cannot Estimate Time to Progression
........May Not Work at All Millie Over-treated Patient Profile Resists Chemo
........Unfortunately Chemotherapy Drugs Proposed by Kaiser May Not Work at All
........Targeted Treatment Essential Millie's Patient Profile to Recover 8th Relapse
........Demand for Treatment Standard of Care Millie's Patient Profile
........Kaiser Defaults Insurance Contract Millie Orders Work from Others
........UCSF Prescribes Gemcitabine Treatment for Millie at Kaiser
........Millie Requests Prescription and Comparison of Treatment Choices
........Complex Patient History Causes Confusion Mistakes Conflict
........Misleading Correspondence Kaiser Complains Against Patient
........Millie Requests Treatment from UCSF to Replace Kaiser
........Work Plan Implement Kaiser's Order for Gemzar Treatment
........Kaiser Pays 300% to 400% More For Patient Care than Necessary
2...Secure Confidential Mail Not Accessible Wastes Time Money


..............
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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 89 0000. ref SDS 87 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 -    1.  On 090121 1041 Glenna called and said that progression of
040902 -        Millie's cancer, most notably in the breastbone area requires
040903 -        UCSF to change treatments, as ordered by Doctor Johnson at
040904 -        Kaiser on 081219.  Doctor Rugo needs a list of treatments from
040905 -        Millie's records which UCSF has planned to treat Millie's
040906 -        cancer as a chronic disease, ref SDS 24 Y67L, further ordered
040907 -        by Doctor Johnson at Kaiser on 081219. ref SDS 23 V93O
040909 -         ..
040910 -    2.  On 090123 1326 Doctor Johnson confirms prior guidance that
040911 -        multiple (7) relapses have mutated Millie's cancer into a very
040912 -        aggressive disease that requires immediate change in treatment
040913 -        in order for Millie to recover. ref SDS 26 RK6O
040915 -         ..
040916 -    3.  On 090129 0800 UCSF delayed Millie's treatment 1 week due to
040917 -        problems of missed communication between Oncology and Infusion,
040918 -        reported on 090130 1722. ref SDS 27 AY8Q
040920 -         ..
040921 -    4.  On 090129 1036 Doctor Rugo at UCSF notified Kaiser that Millie
040922 -        needs immediate treatment to recover from 7th relapse of
040923 -        cancer, which is worse in the breastbone area, and proposes
040924 -        treatment in UCSF Radiation Oncology Department with
040925 -        hyperthermia and Doxil, reported on 090130 1722. ref SDS 27
040926 -        TZ6H
040928 -         ..
040929 -    5.  On 090201 2017 UCSF delayed treatment for Millie's 7th relapse
040930 -        of cancer, because the Radiation Oncology Department needed
040931 -        more time to schedule the work. ref SDS 28 GV4M
040933 -         ..
040934 -    6.  On 090202 1047 Kaiser delayed authorization for Millie's
040935 -        treatment because the doctor did not fill out a form correctly
040936 -        referring Millie's treatment to UCSF. ref SDS 29 9Y5I
040938 -         ..
040939 -    7.  On 090202 1353 UCSF delayed treatment again for 6 weeks to
040940 -        maintain an orderly schedule. ref SDS 30 SP6H
040942 -         ..
040943 -    8.  On 090202 1932 Doctor Rugo at UCSF Oncology Department notified
040944 -        the medical team that Millie needs urgent treatment quickly in
040945 -        time to be effective. ref SDS 31 Y15J
040947 -         ..
040948 -    9.  On 090203 1438 UCSF Radiation Oncology Department advances
040949 -        Millie's treatment 4 weeks to begin in time to be effective.
040950 -        ref SDS 32 XX5I
040952 -         ..
040953 -   10.  On 090204 0219 Millie's letter asks Doctor Rugo to submit
040954 -        proactive planning for follow on treatment after hyperthermia
040955 -        and Doxil for Millie's 6th relapse of IBC. ref SDS 33 278T
040957 -         ..
040958 -   11.  On 090204 1914 Doctor Rugo defers teamwork for practice synergy
040959 -        and proactive management to plan for alternate scenarios that
040960 -        optimize coprehensive care is prevented because Millie's case
040961 -        is very complicated. ref SDS 34 063I
040963 -         ..
040964 -   12.  On 090205 0830 Doctor Hsu examination in UCSF Radiation
040965 -        Oncology Department finds Millie's cancer has progressed
040966 -        significantly due to delays starting treatment; changes
040967 -        treatment protocol from hyperthermia and Doxil to radiation and
040968 -        hyperthermia. ref SDS 35 EY5F
040970 -         ..
040971 -   13.  On 090213 1140 Doctor Johnson notifies Millie that she has less
040972 -        than 1 year to live, ref SDS 37 646L, unless she gets effective
040973 -        treatment quickly for cancer that has mutated into aggressive
040974 -        disease that will cascade out of control. ref SDS 37 ES7I
040976 -         ..
040977 -   14.  On 090218 1205 Millie notifies Doctor Rugo again that Doctor
040978 -        Johnson has authorized UCSF Cancer Center to begin planning
040979 -        Millie's next treatment after radiation and hyperthremia,
040980 -        because she has a narrow margin for delay getting treatment to
040981 -        survive. ref SDS 38 TH6U
040983 -         ..
040984 -   15.  On 090219 1315 UCSF begins treatment 4-weeks late on referral
040985 -        from Kaiser for Millie to recover from 7th relapse of cancer.
040986 -        ref SDS 39 E57G
040988 -         ..
040989 -   16.  On 090310 0351 after 3-weeks treatment with radiation and
040990 -        hyperthermia Millie notifies medical team that cancer in the
040991 -        breastbone area seems worse. ref SDS 41 O56X
040993 -         ..
040994 -   17.  On 090331 2947 Millie notified medical team of possible IBC
040995 -        progression on lower left arm, and asked about starting
040996 -        treatment to recover from 8th relapse of cancer. ref SDS 45
040997 -        Q64R
040999 -         ..
041000 -   18.  On 090401 0032 Doctor Hsu diagnosed new rash on Millie's lower
041001 -        left arm as progression of IBC. ref SDS 46 R24X
041003 -         ..
041004 -   19.  On 090401 0046 Millie asks about getting treatment of IBC
041005 -        spreading to lower left arm, which establishes the 8th relapse
041006 -        of cancer diagnosed by Doctor Hsu. ref SDS 47 RE8P
041008 -         ..
041009 -   20.  On 090401 0121 Doctor Rugo reports Millie's wound in breastbone
041010 -        area diagnosed as reaction to 4-weeks of radiation that ended
041011 -        on 090317 must heal before starting treatment for IBC relapse,
041012 -        and so defers the meeting scheduled on 090402 0800; Doctor Rugo
041013 -        expects full recovery from IBC in areas treated with radiation
041014 -        and hyperthermia because this regimen to be very effective.
041015 -        ref SDS 48 K56O
041017 -         ..
041018 -   21.  On 090412 2241 Millie reports again to the medical team that
041019 -        IBC on lower left arm is getting worse, and requests immediate
041020 -        treatment in order to prevent problems cited by Doctor Johnson
041021 -        that delay risks losing control and death. ref SDS 49 9S8Y
041023 -         ..
041024 -   22.  On 090510 1220 Millie reports wound in the breastbone diagnosed
041025 -        as reaction to radiation looks worse; asks if this might be IBC
041026 -        because of a mistake in performing radiation treatments?
041027 -        Millie further asked about doing a biopsy to test for cancer,
041028 -        so that treatment can begin immediately under Doctor Johnson's
041029 -        warning that immediate treatment is essential for recovery.
041030 -        ref SDS 52 LJ5T
041032 -         ..
041033 -   23.  On 090514 0830 Doctor Rugo prescribes treatment with MPA,
041034 -        ref SDS 54 D647, and submits a letter to Kaiser submitting the
041035 -        protocol, ref SDS 54 DI63, as previously requested by Doctor
041036 -        Johnson on 081219 1140. ref SDS 23 V93O
041038 -         ..
041039 -   24.  On 090515 0800 Doctor Rugo notifies medical team that Kaiser
041040 -        failed to perform requirements for referral to pay for Millie's
041041 -        treatment recommended by UCSF Cancer Center as the best
041042 -        evidence of care that has the best chance for Millie to
041043 -        recover, which Kaiser is required to provide under section 2 of
041044 -        EOC. ref SDS 55 WP6S
041046 -         ..
041047 -   25.  On 090515 1017 Millie notified medical team that Doctor Rugo's
041048 -        letter was received; that Kaiser is responsible for Millie's
041049 -        care, and Millie will meet with the primary care doctor at
041050 -        Kaiser on 090515 1140 and request that Kaiser prescribe care
041051 -        for Millie's 8th relapse of cancer based on the best evidence,
041052 -        ref SDS 56 6Q8W, as shown in Doctor Rugo's letter to Kaiser on
041053 -        090514 0830. ref SDS 54 DI63
041055 -         ..
041056 -   26.  On 090515 1518 Doctor Rugo responds wishing Millie "good luck."
041057 -        ref SDS 58 PW7H
041059 -         ..
041060 -   27.  On 090515 1140 Millie met with Doctor Johnson at Kaiser and the
041061 -        doctor said that he was told by Doctor Mason that the primary
041062 -        care physician, Doctor Johnson, cannot prescribe standard of
041063 -        care treatment for Millie in a clinical trial, despite patient
041064 -        history having prescribed prior clinical trials 4 times
041065 -        previously for standard of care in oncology, and as a result,
041066 -        Doctor Johnson requested a draft to assist him preparing an
041067 -        appeal to file with Member Services so that Kaiser can expedite
041068 -        Millie's recovery from the 8th relapse of cancer. ref SDS 57
041069 -        655R
041071 -         ..
041072 -   28.  On 090516 0858 Millie notified Doctor Rugo that Doctor Johnson
041073 -        is filing an appeal for Kaiser to treat Millie with MPA
041074 -        protocol recommended by UCSF to recover from the 8th relapse of
041075 -        cancer. ref SDS 59 SY4J
041077 -         ..
041078 -   29.  On 090518 0017 Millie submits letter to Doctor Johnson with
041079 -        copy to Doctor Rugo at UCSF, and transmitting a draft to assist
041080 -        Doctor Johnson filing his appeal with Member Services to
041081 -        assisting Kaiser implement Doctor Johnson's strategy to treat
041082 -        Millie's cancer as a chronic disease in time for Millie to
041083 -        recover from the 8th relapse of cancer. ref SDS 60 R16I
041085 -         ..
041086 -   30.  On 090519 1536 Doctor Johnson changed his mind; he sent the
041087 -        draft appeal to Doctor Mason, and tells Millie to file an
041088 -        appeal with Member Services, which is incorrect since at this
041089 -        time Millie has not been denied medical services; and the
041090 -        doctor further says he is suddenly relieved of responsibility
041091 -        performed continuously the past 8 years to prescribe treatment
041092 -        for Millie to recover from cancer, because Kaiser's Outside
041093 -        Referrals Department has a better understanding of Medicare.
041094 -        ref SDS 61 5K7H
041096 -         ..
041097 -   31.  On 090519 1613 Millie responded, ref SDS 62 8V8H, to the
041098 -        Doctor's letter earlier yesterday afternoon on 090519 1536,
041099 -        ref SDS 61 5K7H; and, Millie asks the doctor to prescribe
041100 -        treatment so she can recover from cancer, as done previously in
041101 -        patient history, ref SDS 62 TY3X, and further as planned by the
041102 -        doctor during the meeting on 090515 1140. ref SDS 57 655R
041103 -        Millie also asked the doctor to call on expediting treatment in
041104 -        time to be effective, see again on 090520 1613, ref SDS 62
041105 -        TY4W; and Millie asks Doctor Rugo for a "drop dead" date on how
041106 -        soon treatment must start in order to be effective, also,
041107 -        reported on 090519 1613. ref SDS 62 TX4W
041109 -         ..
041110 -   32.  Since Kaiser has delayed ordering treatment, reported on 090520
041111 -        1710. ref SDS 69 ZF4Q, then on 090521 0211 Millie's letter to
041112 -        Doctor Rugo at UCSF with copy to Doctor Hsu asks about getting
041113 -        treatment with hyperthermia and Doxil, while Kaiser resolves
041114 -        delays ordering MPA prescribed by Doctor Rugo for Millie to
041115 -        recover from 8th relapse of cancer, which Millie reports is
041116 -        getting worse every day, ref SDS 70 FM7Q, and since Kaiser has
041117 -        previosuly authorized treatment with hyperthermia and Doxil,
041118 -        which Doctor Rugo recommended earlier on 090129 for Millie to
041119 -        recover from the 7th relapse. ref SDS 70 6M4F
041121 -         ..
041122 -   33.  On 090521 2006, Millie received a letter from Doctor Johnson
041123 -        responding to Millie's letter to the medical team on 090520
041124 -        1710, and requesting that Kaiser prescribe treatment suitable
041125 -        for Millie's patient profile for recovering from 8th relapse of
041126 -        cancer. ref SDS 69 P65H   Doctor Johnson's letter was sent
041127 -        through Kaiser's Knowledge Management System and so was not
041128 -        disclosed to the medical team, and it did transmit the Doctor
041129 -        Johnson's medical chart for the meeting on 090515, ref SDS 57
041130 -        YT5N, and said that Millie could "choose" any treatment she
041131 -        wants, and no treatment is superior for Millie's patient
041132 -        profile, 090521 2006, ref SDS 72 9Q9H; the doctor noted
041133 -        Millie's cancer is progressing and so she needs to start
041134 -        treatment by the end of the week, which was in just 12 hours,
041135 -        which means today, ref SDS 72 HC8O, and the doctor told Millie
041136 -        to call Medicare for prescribing treatment to recover from the
041137 -        8th relapse of cancer. ref SDS 72 HC93
041139 -         ..
041140 -   34.  On 090522 0813 Millie responded to Doctor Johnson's letter on
041141 -        090521 2006 and submitted copies to the medical team to
041142 -        maintain collaboration that has been effective treating Millie
041143 -        the past 8 years.  Millie also sent a copy to Jullian Kwok to
041144 -        notify Medicare that Kaiser is refusing treatment. ref SDS 73
041145 -        RX6L  Millie asked Kaiser to prepare a workup and Tumor Board
041146 -        to evaluate Millie's next treatment, including trade-offs
041147 -        comparing all of the treatments available for Millie.
041148 -        ref SDS 73 7Z5Y  Millie reports having called Kaiser numerous
041149 -        times to speak with the doctor on prescribing treatment.
041150 -        ref SDS 73 7Z9Y  Millie notifies medical team she chooses
041151 -        hyperthermia and radiation, Doxil, or other agent suitable for
041152 -        Millie's patient profile. ref SDS 73 715V
041154 -         ..
041155 -   35.  On 090522 1247 Millie received a response from Doctor Johnson
041156 -        to Millie's letter on 090522 0813. ref SDS 73 RX6L who sent
041157 -        copies to the medical team, and saying Kaiser has performed
041158 -        workups, but does not submit any workups, and says Millie's
041159 -        patient profile is too complex for Tumor Board to evaluate best
041160 -        course of treatment, and that Millie's patient profile resists
041161 -        single agent treatments like Gemzar and Navelbine, and that
041162 -        Millie can choose Hospice instead of treatment with drugs which
041163 -        her patient profile now resists. ref SDS 74 XO5O
041165 -         ..
041166 -   36.  On 090522 1351 Millie responded to Kaiser's letter submitted by
041167 -        Doctor Johnson on 090522 1247, ref SDS 74 XO5O, confirming
041168 -        Millie needs urgent treatment to start quickly, reported on
041169 -        090522 1351, ref SDS 75 7R7J; Millie asks if treatment with
041170 -        Gemzar, Navelbine, and possibly CTP, ref SDS 75 2T9W and
041171 -        ref SDS 75 2T4P, will be weeks of agony then progression of
041172 -        cancer that requires another treatment "targeted" to treat
041173 -        Millie's patient profile. ref SDS 75 2T4S  Millie requested
041174 -        advice on treatment with a clinical trial at Kaiser, based on
041175 -        patient history, ref SDS 75 2T4V, and further requested
041176 -        trade-offs getting more hyperthermia and radiation and Doxil or
041177 -        other appropriate agent, including vaccines. ref SDS 75 2T4Y
041178 -
041180 -         ..
041181 -        Millie Over-treated Cannot Estimate Time to Progression
041182 -        May Not Work at All Millie Over-treated Patient Profile Resists Chemo
041183 -        Unfortunately Chemotherapy Drugs Proposed by Kaiser May Not Work at All
041184 -        Targeted Treatment Essential Millie's Patient Profile to Recover 8th Relapse
041185 -
041186 -        Follow up ref SDS 89 NM6J, ref SDS 87 NM6J.
041187 -
041188 -   37.  On 090522 1953 Millie received a letter from Doctor Johnson
041189 -        responding to Millie's letter to the medical team at Kaiser and
041190 -        UCSF this afternoon, reported on 090522 1351. ref SDS 75 7R7J
041191 -        For some reason, the doctor he did not submit copies to the
041192 -        medical team, demonstrating uneven case management for
041193 -        coordination and collaboration; the doctor confirms that
041194 -        treatment with single-agent chemotherapies presented as the
041195 -        only choices for care may not work at all for Millie to recover
041196 -        from 8th relapse of cancer. ref SDS 76 NV4L
041197 -
041198 -
041200 -         ..
041201 -        Demand for Treatment Standard of Care Millie's Patient Profile
041202 -
041203 -        Follow up ref SDS 89 ON8G, ref SDS 87 ON8G.
041204 -
041205 -   38.  On 090523 0148 Millie sent a letter to Paula in the Kaiser
041206 -        Claims Resolution Department with copy to medical team
041207 -        demanding treatment to recover from 8th relapse applying
041208 -        standard of care for Millie's patient profile. ref SDS 77 2P6J
041210 -         ..
041211 -   39.  On 090528 0803 called Paula for progress processing Millie's
041212 -        claim for treatment with standard of care for Millie's patient
041213 -        profile. ref SDS 79 T04L
041215 -         ..
041216 -   40.  On 090528 1228 Millie sent a letter to Paula confirming claim
041217 -        demanding timely treatment for 8th relapse of cancer.
041218 -        ref SDS 80 UD5H and saying that she will get treatment through
041219 -        another provider and bill Kaiser, because her doctor at Kaiser
041220 -        says Millie needs immediate treatment, and Kaiser has failed to
041221 -        perform. 090528 1228, ref SDS 80 4N8X
041223 -         ..
041224 -        Kaiser Defaults Insurance Contract Millie Orders Work from Others
041225 -        UCSF Prescribes Gemcitabine Treatment for Millie at Kaiser
041226 -        Millie Requests Prescription and Comparison of Treatment Choices
041227 -
041228 -        Follow up ref SDS 89 W39J, ref SDS 87 UD5H.
041229 -
041230 -   41.  On 090528 1334 Millie sent a letter to Doctor Rugo and Doctor
041231 -        Hsu at UCSF requesting treatment, and sent a copy to notify the
041232 -        medical team she has been forced to get treatment from another
041233 -        provider to mitigate damages from Kaiser's failure to provide
041234 -        care. ref SDS 81 UD5H
041236 -         ..
041237 -   42.  On 090528 1613 Doctor Rugo responds to Millie's letter on
041238 -        090528 1334, requesting prescription for treatment because
041239 -        Kaiser has defaulted on insurance contract, ref SDS 81 2L7P;
041240 -        UCSF prescribes treatment with gemcitabine starting next week.
041241 -        ref SDS 82 XZ4M
041243 -         ..
041244 -   43.  On 090528 1652 Millie letter to medical team thanks Doctor Rugo
041245 -        for her letter today suggesting a new treatment, ref SDS 82
041246 -        XZ4M, and asks for comparison with other treatments to recover
041247 -        from 8th relapse of cancer. ref SDS 83 MZ7N
041249 -         ..
041250 -   44.  On 090529 1109 since Kaiser has failed to order treatment,
041251 -        Millie requests treatment date and time from UCSF, ref SDS 84
041252 -        448K, and to compare advantages and costs of treatment options.
041253 -
041255 -         ..
041256 -        Complex Patient History Causes Confusion Mistakes Conflict
041257 -        Misleading Correspondence Kaiser Complains Against Patient
041258 -
041259 -        Follow up ref SDS 89 SZ9J, ref SDS 87 SZ9J.
041260 -
041261 -   45.  On 090529 1751 Doctor Johnson responds to Millie's letter
041262 -        earlier in the day, ref SDS 84 448K; Kaiser complains that
041263 -        patient correspondence is confusing and misleading, and
041264 -        proposes treating Millie with Gemzar and Navelbine starting
041265 -        next week. ref SDS 85 SZ9J
041267 -         ..
041268 -   46.  On 090531 1544 Millie notifies the medical team responding to
041269 -        Doctor Johnson's letter on 090529 1751. ref SDS 85 SZ9J, and
041270 -        reports cancer is getting worse so she needs urgent treatment,
041271 -        and asks Kaiser to provide treatment based on standard of care
041272 -        for Millie's patient profile. ref SDS 86 LD4O
041273 -
041275 -         ..
041276 -        Millie Requests Treatment from UCSF to Replace Kaiser
041277 -
041278 -        Follow up ref SDS 89 2E4K, ref SDS 87 2E4K.
041279 -
041280 -   47.  On 090531 2227 Millie requests treatment from UCSF because
041281 -        Kaiser has failed to provide treatment for Mille's 8th relapse
041282 -        of cancer. ref SDS 87 2E4K
041284 -         ..
041285 -   48.  On 090601 0818 Millie files authorization for representation to
041286 -        provide patient assistance helping Kaiser implement
041287 -        requirements of insurance agreement in EOC Section 2.
041288 -        ref SDS 88 UD5H
041290 -         ..
041291 -   49.  On 090601 0818 at 0820 called UCSF to make arrangmenets for
041292 -        Millie to start treatment of her patient profile for recovering
041293 -        from 8th relapse of cancer. ref SDS 88 VT8M
041295 -         ..
041296 -   50.  On 090601 0818 at 0830 submitted letter to UCSF with copy to
041297 -        Kaiser confirming arrangements for Millie to get treatment
041298 -        based on her patient profile. ref SDS 88 1P8M
041300 -         ..
041301 -   51.  On 090601 0818 at 0910 called counsel for support assisting
041302 -        Kaiser implement insurance requirements. ref SDS 88 0154
041304 -         ..
041305 -   52.  On 090601 0818 at 1051 called Mike at UCSF to coordinate work
041306 -        plan for starting treatment at UCSF; Mike advises that Millie
041307 -        needs another CT test to set baseline for starting treatment.
041308 -        ref SDS 88 PP6U
041310 -         ..
041311 -   53.  On 090601 0818 at 1111 called Kaiser to coordinate schedule for
041312 -        CT test required by treatment protocol at UCSF. ref SDS 88 0285
041314 -         ..
041315 -   54.  On 090601 0818 at 1132 Brad called from the Kaiser Oncology
041316 -        Pharmacy and advised that Doctor Johnson has issued a
041317 -        chemotherapy order to treat Millie with Gemzar, ref SDS 88
041318 -        PQ7V, implementing Doctor Rugo's letter on 090528 1613.
041319 -        ref SDS 82 4T6K  Treatment was scheduled for later in the week,
041320 -        based on Millie passing a blood test later in the day on 090601
041321 -        0818. ref SDS 88 5K94
041323 -         ..
041324 -   55.  On 090601 0818 at 1153 Sheree called in the Kaiser Chemotherapy
041325 -        Infusion Clinic and advised that Millie cannot get a blood test
041326 -        today for starting treatment later in the week, because the
041327 -        doctor did not sign the Chemotherapy Order, and the doctor went
041328 -        home with a headache after delivering an unsigned order for
041329 -        treating Millie with Gemzar which the doctor expects to get in
041330 -        trouble for prescribing a treatment that conflicts with
041331 -        Millie's patient profile, and the order cannot be signed until
041332 -        the doctor recovers and returns to work. ref SDS 88 PQ5Q
041334 -         ..
041335 -   56.  On 090601 0818 1227 Millie received letter from UCSF confirming
041336 -        arrangements for treatment to recover from Kaiser's failure to
041337 -        perform. ref SDS 88 SQ5G
041339 -         ..
041340 -   57.  On 090601 0818 at 1412 Kaiser Expedited Claims called and
041341 -        advised that Paula sent Millie case back to Expedited Claims
041342 -        after Kaiser Expedited Claims sent the case to Paula's office
041343 -        in Member Services Claims Resolution for resolution, and the
041344 -        woman said she does not understand Millie's claim for a
041345 -        treatment plan to recover from the 8th relapse of cancer.
041346 -        ref SDS 88 PR4S
041348 -         ..
041349 -   58.  On 090601 0818 at 1603 called UCSF and deferred treatment
041350 -        pending Kaiser's progress on treating Millie wtih Gemzar, as
041351 -        recommended by Doctor Rugo. ref SDS 88 H14T
041352 -
041354 -  ..
0414 -
0415 -
0416 - Progress
0417 -
041701 -        Work Plan Implement Kaiser's Order for Gemzar Treatment
041702 -        Kaiser Pays 300% to 400% More For Patient Care than Necessary
041703 -
041704 -        Follow up ref SDS 89 9M6F.
041705 -
041706 -   59.  On 090601 1847 notified medical team of Kaiser's work plan for
041707 -        treating Millie with Gemzar to recover from 8th relapse of
041708 -        cancer. ref SDS 89 9M6F
041710 -         ..
041711 -   60.  On 090602 1340 Millie notifies the medical team of receiving a
041712 -        letter from Doctor Johnson with the subject indicating response
041713 -        to Millie's letter yesterday confirming Kaiser's work plan for
041714 -        starting Gemzar, ref SDS 89 9M6F; however, Doctor Johnson's
041715 -        letter required special security measures and so could not be
041716 -        accessed, as occurred previously at Kaiesr being unable to
041717 -        access secure mail sent by UCSF.  Millie asks the team to use
041718 -        regular email for transparency, timely and accurate
041719 -        communications for coordinating her care. ref SDS 0 P73K
041721 -  ..
041722 - Millie's letter to the medical team responding to Doctor Johnson's
041723 - secure letter...
041724 -
041725 -    1.  Subject: Gemzar Treatment Plan 8th Relapse of Cancer Kaiser's Standard of Care
041726 -        Date: Tue, 02 Jun 2009 13:49:13 -0700
041740 -         ..
041741 -    2.  I just got your letter this morning sent at 1135a, and
041742 -        responding to my letter to the medical team yesterday on 090601
041743 -        2002, presenting Kaiser's "work plan" for Gemzar treatment.
041744 -        ref SDS 89 9M6F
041745 -
041747 -  ..
041748 - Secure Confidential Mail Not Accessible Wastes Time Money
041749 -
041750 -
041751 -    3.  Your letter today is a "secure message" that requires accessing
041752 -        another system.  I tried but was unable to open it.  Recall
041753 -        Brigid at UCSF tried sending us a similar "secure message" in
041754 -        about October 2007, and neither you nor I could open it, so we
041755 -        went back to regular email.
041757 -         ..
041758 -    4.  Regular email works better for me with transparency to
041759 -        facilitate coordinating the medical team so things don't fall
041760 -        through the cracks.  Using multiple email systems takes more
041761 -        time, causing fatigue, confusion, and error mentioned in your
041762 -        letter on 090205, and again last week on 090529.  Therefore,
041763 -        please respond with regular mail in order to maintain quality
041764 -        care.  I am fine with any "security" or "confidentiality" risk
041765 -        using regular email. I'm most concerned about getting timely,
041766 -        accurate understandings.
041768 -         ..
041769 -    5.  I didn't hear from anyone this morning about deferring the
041770 -        blood test today, so I got the test at Martinez.  I've got my
041771 -        fingers crossed that ANC will be okay, so I can get treatment.
041772 -        I'm afraid of what CA 15-3 will be after no treatment since
041773 -        January.
041774 -
041775 -            [On 090602 1518 Millie notifies medical team lab shows
041776 -            blood counts good to go for starting Gemzar chemotherapy at
041777 -            Kaiser. ref SDS 90 J47U
041779 -         ..
041780 -    6.  Were you able to schedule my treatment on Monday, 090608,
041781 -        rather than the end of the week, as requested in my letter
041782 -        yesterday? I'm hoping to recover enough energy by Friday to
041783 -        have an active weekend.
041785 -         ..
041786 -    7.  Who is Michale Russin, copied in your letter today?  Has he
041787 -        been added to the medical team?
041788 -
041789 -            [On 090603 1108 Doctor Johnson notifies Millie that Michale
041790 -            Russin is the Chief of the Ontology Department at Kaiser in
041791 -            Walnut Creek. ref SDS 91 07AD
041793 -         ..
041794 -    8.  Hope you are feeling better.  Sheree said you were not well
041795 -        yesterday.  Everybody worries you are stretched thin, with many
041796 -        patients and projects.
041798 -         ..
041799 -    9.  I feel much better now knowing I will get treatment.  Thanks
041800 -        for your support.
041801 -
041808 -
041809 -
041810 -
041811 -
041812 -
041813 -
0419 -