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 - Background
0409 -
040901 - On 100501 1037 Millie sent a letter to the medical team asking for a
040902 - work plan to recover from the 11th relapse, caused by UCSF medical
040903 - mistakes providing radiation services on referral from Kaiser, which
040904 - have caused her cancer to spread. ref SDS 16 F25O
040906 -  ..
040907 - On 100501 2017 Millie received letter from Doctor Rugo saying she will
040908 - communicate with Doctor Johnson at Kaiser on the work plan for Millie
040909 - to recover from the 11th relapse of cancer. ref SDS 17 HH4I
040911 -  ..
040912 - On 100502 0140 Millie responds to Doctor Rugo's letter reporting
040913 - commitment to communicate with Doctor Johnson at Kaiser on the work
040914 - plan for Millie to recover from 11th relapse of cancer. ref SDS 0 HH4I
040915 -
040916 -
040918 -  ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Millie says to the doctor...
041302 -
041303 -    1.  Subject: Doctor Rugo Coordinating with Doctor Johnson on Treatment 11th Relapse of Cancer
041304 -        Date: Sun, 02 May 2010 03:55:49 -0700
041316 -         ..
041317 -    2.  Thanks very much for timely response to my letter yesterday on
041318 -        100501 1149, ref SDS 16 F25O, with your letter in the afternoon
041319 -        at 1721. ref SDS 17 HH4I  I am grateful and relieved by your
041320 -        plans to collaborate with Doctor Johnson at Kaiser on my next
041321 -        phase of care to recover from the 11th relapse of cancer.
041322 -
041323 -            [On 100503 1522 Millie notifies medical team that time of
041324 -            the essence to get the next treatment going. ref SDS 18
041325 -            TD5W
041327 -             ..
041328 -            [On 100504 1609 Sara, Practice Manager for Oncology at
041329 -            UCSF, reported that Doctor Rugo plans to collaborate with
041330 -            Doctor Johnson on treatment for Millie to recover from 11th
041331 -            relapse of cancer. ref SDS 19 SN6L
041333 -         ..
041334 -    3.  Doctor Johnson reported on 100427, that my cancer has become
041335 -        resistant to conventional chemotherapy, and so requires agents
041336 -        "targeted" to my cancer. ref SDS 14 VL6N  At that time, Doctor
041337 -        Johnson, also, cited your expertise and experience at UCSF
041338 -        working with "targeted" therapies for breast cancer, which at
041339 -        this time are crucial to my survival and quality of life.
041340 -        ref SDS 14 WT9M
041342 -         ..
041343 -    4.  Your letter yesterday raised concern about the email "list"
041344 -        citing worry over patient confidentiality [reported on 100501
041345 -        2017, ref SDS 17 HH4I].  This is misplaced.
041347 -         ..
041348 -    5.  I waive any liability for Kaiser and UCSF from inadvertent
041349 -        disclosure that might occur using public domain email, like
041350 -        this letter and hundreds of others which you and the medical
041351 -        team have issued in my case.  The medical team needs timely,
041352 -        accurate communication for me to survive, far more than I need
041353 -        confidentiality, in that Doctor Johnson gave me less than a
041354 -        year to live on 090213. ref SDS 4 646L  Since the year has
041355 -        run, I am on a razor's edge for getting things done correctly
041356 -        and in time to be effective.  Since confidentiality is for my
041357 -        benefit, I am entitled to waive it in order to secure the
041358 -        larger benefit of survival, and I do so.  Attempts to use
041359 -        secure email in this case by Brigid, Doctor Johnson, and others
041360 -        shows significant loss of efficiency, and that multiple
041361 -        environments greatly increases complexity of the record,
041362 -        causing confusion, error, and delay.
041363 -
041364 -            [On 100504 1609 Sara, Practice Manager for UCSF Oncology
041365 -            Breast Care Clinic, called and notified Millie that lawyers
041366 -            in the UCSF Risk Management Department want Millie to use
041367 -            secure email to comply with Federal regulations; Sara does
041368 -            not know what Federal regulations apply in this case, nor
041369 -            what the regulations say that justify denying the patient
041370 -            the right to choose the level of confidentiality suited to
041371 -            the patients need for communicating effectively with her
041372 -            medical team, and with transparency that encourages
041373 -            accuracy and timeliness. ref SDS 19 ZV6M
041375 -             ..
041376 -            [On 100601 0830 Doctor Johnson reported he received
041377 -            securemail from Doctor Rugo at UCSF encrypted to protect
041378 -            confidentiality of Millie's health records, but he could
041379 -            not open the letter; he sent Doctor a securemail advising
041380 -            he could not open her securemail, and he received back a
041381 -            public domain email from Doctor Rugo that she could not
041382 -            open Doctor Johnson's letter from Kaiesr; as a result of
041383 -            failed communcation, Doctor Johnson was unable to prescribe
041384 -            treatment for Millie to recover from medical mistakes
041385 -            getting radiation treatments at UCSF on referral from
041386 -            Kaiser; resulting in Millie being forced into Hospice to
041387 -            die. ref SDS 20 D658
041389 -         ..
041390 -    6.  During the meeting at UCSF on 080403, you asked me to use the
041391 -        email "list" to coordinate work between Kaiser and UCSF on my
041392 -        care.  At that time, you related not having enough time, due to
041393 -        a hectic schedule, for communicating directly with Doctor
041394 -        Johnson at Kaiser, and that your team at UCSF needed timely
041395 -        support for communication on case management.  You cited
041396 -        experience over the prior year in 2007, showing I produce an
041397 -        accurate record in time to be effective distributed by public
041398 -        domain email.  As a result, you asked to rely on me for
041399 -        communication services between UCSF and Kaiser. ref SDS 1 4U9O
041401 -         ..
041402 -    7.  Throughout my care for the past 9-years the doctor/patient
041403 -        partnership has been effective using public domain email to
041404 -        integrate Comprehensive Care at UCSF with Team Care at Kaiser.
041405 -        Over a year ago, on 090213, Doctor Johnson reported that I have
041406 -        survived 3 times longer that expected for my rare, aggressive
041407 -        form of cancer. ref SDS 4 4W72  With your outstanding efforts,
041408 -        the team has extended this excellent record by orders of
041409 -        magnitude.  Doctor Johnson attributed successful treatment in
041410 -        part to strong case management, ref SDS 4 JL5I, which at all
041411 -        times has relied on public domain email.  You made a similar
041412 -        point in the meeting at UCSF on 090514, noting benefits of a
041413 -        well ordered record to leverage medical practice with timely
041414 -        access to patient history. ref SDS 8 LS5M
041416 -         ..
041417 -    8.  As a result, on 090616 you seemed to say that you wanted to
041418 -        remain on the mailing list for my care recovering from cancer.
041419 -        ref SDS 10 HL6I
041421 -         ..
041422 -    9.  Since UCSF is liable for the cost of my care to recover from
041423 -        medical mistakes performing radiation on referral from Kaiser
041424 -        [reported on 090609 0900. ref SDS 9 W65W], someone must be on
041425 -        the mailing list so that UCSF has the opportunity to mitigate
041426 -        damages.  For the past year since 090616, you have not objected
041427 -        to being that person getting relevant correspondence.
041428 -
041429 -            [On 100503 1522 Millie notifies medical team that time of
041430 -            the essence to get the next treatment going. ref SDS 18
041431 -            TD5W
041433 -             ..
041434 -            [On 100504 1609 Sara, Practice Manager for UCSF Oncology
041435 -            Breast Care Clinic, called and notified Millie that lawyers
041436 -            in the UCSF Risk Management Department want Millie to use
041437 -            secure email to comply with Federal regulations; Sara does
041438 -            not know what Federal regulations apply in this case, nor
041439 -            what the regulations say that justify denying the patient
041440 -            the right to choose the level of confidentiality suited to
041441 -            the patients need for communicating effectively with her
041442 -            medical team, and with transparency that encourages
041443 -            accuracy and timeliness. ref SDS 19 ZV6M
041445 -         ..
041446 -   10.  Again, I am grateful beyond measure that you plan to coordinate
041447 -        with Doctor Johnson on determining my care based on the best
041448 -        evidence of clinical effectiveness, minimal side effects, and
041449 -        cost.  As you know, HIPAA entitles me to all communication
041450 -        related to my care.  I don't want to make a Federal case out of
041451 -        it, so by all means communicate separately with Doctor Johnson,
041452 -        as set out in your letter yesterday. [on 100501 2017,
041453 -        ref SDS 17 456L].  Please do it soon, and submit a report on my
041454 -        options with an opinion comparing trade-offs, as previously
041455 -        requested [...in Millie's letter yesterday, on 100501 1037.
041456 -        ref SDS 16 U44V...]
041457 -
041458 -            [On 100503 1522 Millie asks Doctor Johnson for results of
041459 -            communication with Doctor Rugo that relates to her health
041460 -            care, and for the purpose of comprehensive case management
041461 -            to get treatment in time to be effective. ref SDS 18 TD7U
041463 -             ..
041464 -            [On 100504 1609 Sara, Practice Manager for Oncology at
041465 -            UCSF, reported that Doctor Rugo plans to collaborate with
041466 -            Doctor Johnson on treatment for Millie to recover from 11th
041467 -            relapse of cancer. ref SDS 19 SN6L
041468 -
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0415 -