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 28, 1999 08:32 AM Monday; Rod Welch

Submitted example using Com Metrics for medical practice.

1...Summary/Objective


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CONTACTS 
0201 - Intel Corporation                                                                                                                                                  O-00000704 0201
020101 - Mr. Morris E. Jones; Director of Architecture

SUBJECTS
Medical, Kaiser
Exam 990625 Knee, Physical, Prostrate Cancer
Medical Practice Requires Records
Medical Practice

0606 -
0606 -    ..
0607 - Summary/Objective
0608 -
060801 - Follow up ref SDS 27 0000, ref SDS 11 0000.
060802 -
060803 - Morris suggested on 990527 that lawyers are a better market for
060804 - Communication Metrics than engineers and managers. ref SDS 25 1233
060805 -
060806 - It occurred to me that Kaiser's strong guidelines for patients and
060807 - doctors to improve communication through partnership, by taking notes
060808 - and getting feedback, and that Kaiser equates this with "good
060809 - medicine," as reported on 990625. ref SDS 27 0806  It follows
060810 - therefore, that failure to take notes and get feedback causes poor
060811 - medicine, or, at least, not as good as when a proactive effort is made
060812 - to improve understanding by gathering and analysing medical
060813 - "intelligence."  Yet, doctors feel they do not have enough time to
060814 - for a medical intelligence function. ref SDS 27 0889
060815 -
060816 -      [On 990719 articles seem to support need for cooperation or
060817 -      partnership to maintain useful medical history. ref SDS 29 0846]
060818 -
060819 - I was struck further today, that an article in Forutne magazine says
060820 - CEOs fail because they do not take notes and get feedback, and that
060821 - the lack of this management "intelligence," hampers effective follow
060822 - up on commitments. ref SDS 28 1024  The article calls these tasks
060823 - "execution," and reports that failure to perform these mundane, simple
060824 - tasks is the main reason CEOs fail. ref SDS 28 0460
060825 -
060826 - Sent ref DIT 1 to Morris explaining conflict in work standards and
060827 - work practice concerning management intelligence, commonly called
060828 - "documentation," cited on 990625. ref SDS 27 4620  Noted that failure
060829 - to follow good practices to develop "intelligence" for performing the
060830 - work correctly on time and within budget, causes extra cost and delay,
060831 - which is endured under the guise of "expediting" and that cost savings
060832 - of improvement have not been established.
060833 -
060834 -      [On 990722 explained again role of alignment as critical part of
060835 -      intelligence. ref SDS 30 0001]
060836 -
060837 -      [On 990912 article on high cost of mistakes in medical practice
060838 -      shows need for patient support of medical history. ref SDS 31
060839 -      0001]
060840 -
060841 -      [On 990924 explained cause and solution to mistakes. ref SDS 32
060842 -      0001]
060843 -
060844 -      [On 991001 NASA lost $125M space ship due to little deviation
060845 -      that exploded in the end. ref SDS 33 0001]
060846 -
060847 - Managers by off poor execution by visiting the lawyer, when events do
060848 - not align with budget and schedule objectives. ref DIT 1 2337
060850 -  ..
060851 -
060852 - However, lack of medical "intellignece" causes pain and suffering. The
060853 - desire to avoid pain and suffering may justify efforts by people to
060854 - generate good medical intelligence, as recommended by professional
060855 - guidelines, ref DIT 1 5159, and this might provide the base of
060856 - experience people need in their in own professions to grasp the cost
060857 - savings that come from investing intellectual capital.
060858 -
060859 - Linked to discussion on 990527 and to explanation on 990303 of the
060860 - correlation between Morris' explanation of SDS as 3 x 5 cards, with
060861 - intelligence, ref SDS 19 2838, which is in the letter at ref DIT 1
060862 - 3364
060863 -
060864 - Linked to discussion on 990525 where it was revealed that engineers
060865 - prefer to ignore documentation requirements, ref SDS 24 0966, and that
060866 - managers support this under the guise of meeting tight schedules,
060867 - reported on 990524. ref SDS 23 6892
060868 -
060869 - Linked to NWO explaining legal discovery is a "metric", ref DIT 1
060870 - 3102, that comprises the only "intelligence" component of management.
060871 - ref OF 6 2536
060872 -
060873 - Linked to discussion on 990425 where Morris explained that errors in
060874 - email do not get attention, ref DIT 1 2200, because executives work on
060875 - big problems. ref SDS 22 9544  This leads to the imposition of
060876 - Aristotle's rule. ref OF 6 JV3G
060877 -
060878 - Linked to example of discussion with Sylvia at Kaiser on 990625 to
060879 - show how Communication Metrics, ref SDS 27 4420, can help people
060880 - ensure good medical care based on self-interest dynamics. ref DIT 1
060881 - 5159
060882 -
060883 - Linked to Kaiser's call on 980625 for partnerhsip, ref SDS 27 4185,
060884 - per ref DIT 1 5159.
060885 -
060886 - Linked to ref DIP 2 as an example of how send summary linked to
060887 - critical details of good medical history, called out in Kaiser's
060888 - Healthwise handbook, to...
060889 -
060890 -    Yanna Hunter   925 671 2222
060891 -
060892 -        Yanna works with orthopedic surgeons who may be able to provide
060893 -        additional information and pricing on fixing my knees.
060894 -
060895 -        Yanna does not have an email address at the hospital.
060896 -
060897 -        Only the medical director has an email address.  Her name is...
060898 -
060899 -           Virginia...      Executive Director
060900 -
060901 -        The receptionist transferred my call.
060902 -
060903 -        Left message for this person to give me her email address so I can
060904 -        send her a letter.
060905 -    ..
060906 -    Kathy Welch, who works as a nurse at a hospital.
060907 -
060908 -        Sent the letter to Amy for submission to her mother, who may be
060909 -        able to find some legs for this method at her hospital.
060910 -
060911 -        Called and talked to Kathy about this.  She will ask Amy for
060912 -        the letter.
060913 -
060914 -        [On 990719 got letter from Kathy. ref SDS 29 0001]
060915 -
060916 -    Sent ref DIT 1 to Morris linked to the record on 990625 as an
060917 -    example of using "intelligence" to help doctors avoid mistakes. ref
060918 -    SDS 25
060919 -
060920 -        Cited Morris' point on 990525 that engineers don't like to read
060921 -        an write, so intelligence is not helpful to them. ref SDS 24
060922 -        0966
060923 -
060924 -        Cited Andy Grove's concurrance on 990527. ref SDS 25 5110
060925 -
060926 -        Cited explanation of "thinking" on 990303. ref SDS 19 1032
060927 -
060928 -        Cited Concurrent Discovery on 960620. ref SDS 9 1101
060929 -
060930 -        Doctors don't want to use "intelligence" any more than do
060931 -        engineers, mechanics and construction managers. Regardless what
060932 -        doctors want, patients have an interest in helping doctors use
060933 -        intelligence, because medical mistakes cause a lot of pain and
060934 -        suffering.  That is the key point of Kaiser's Healthwise
060935 -        Handbook encouraging constructive doctor/patient partnership.
060936 -        ref SDS 27 4185
060937 -
060938 -        [On 990719 got letter from Kathy with articles that seem to
060939 -        support this position. ref SDS 29 0846]
060940 -
060941 -
060942 -
060943 -
060944 -
060945 -
0610 -
Distribution. . . . See "CONTACTS"