CONTACTS 
0201 - Kaiser Permanente - Shadelands       925 906 2200
020101 - Walnut Creek, CA
020102 - Mr. Mark Mangrai; 925 906 2209
020103 - mark.Mangrai@tao.ncal.kp.org
020104 - Patient Assistance

SUBJECTS
Medical, Kaiser
Exam 990910 Knee Treatments
Patient Assistant
Xrays on Knees, 990813
Questions, Suggestions
Medical History, Xrays Not Submitted for Meeting
Medical Chart Missing Information
Syed Doesn't Like Email
Click Links Objectionable, Takes Time
Call Centers Error Pronem, Awkward

1612 -    ..
1613 - Summary/Objective
1614 -
161401 - Follow up ref SDS 76 0000, ref SDS 75 0000.
161402 -
161403 - Mark left a message responding to my letter, ref DIP 14 0001, on
161404 - 990921, ref SDS 75 0477, setting out additional assistance needed, per
161405 - his request. ref DRP 14 2808
161406 -
161407 - Mark wants a discussion rather than respond to pending issues listed
161408 - in the letter on 990921. ref DIP 14 2255
161409 -
161410 -      [On 990927 responded and offered to have a discussion.
161411 -      ref SDS 78 3966]
161412 -
161413 -      [On 990928 discussed issues per request. ref SDS 79 0001]
161414 -
161415 - When he was bed ridden at home due to injury, he checked voice mail,
161416 - but could not check email because Kaiser does not permit off-site
161417 - access to email.
161418 -
161419 - Mark blames his absence due to injury for mistakes that impacted the
161420 - meeting on 990910 with Doctor Boulris. ref SDS 68 3038  The letter to
161421 - Mark on 990921, however, excuses his conduct, ref DIP 14 2255, and
161422 - requests a report on additional efforts that others can take to avoid
161423 - future mistakes, including the patient, the doctor, assistants and
161424 - administrative staff.  Mark was not responsible, and so taking the
161425 - "blame" is not helpful to the process.
161426 - ..
161427 - Mark recommends greater reliance on Kaiser's telephone message
161428 - system, because email is new to doctors at Kaiser.  Doctors check
161429 - phone messages every day, but not email.  He feels dialog expedites
161430 - communication and saves time, which is supported by executive training
161431 - that teaches conversation skills to expedite, reported on 950426.
161432 - ref SDS 16 4392  POIMS explains the genetic drive to rely on speech.
161433 - ref OF 5 5106
161434 -
161435 - Reliance on conversation to "expedite," which is inherently error
161436 - prone due to meaning drift, shows why effective coordination is
161437 - difficult to achieve, as reported on 990915. ref SDS 73 0001
161438 -
161439 -     [On 991001 NASA space probe crashed on Mars due to lack of
161440 -     alignment between communication and requirements, likely another
161441 -     mess from expediting by conversation or email. ref SDS 80 0001]
161442 -
161443 -     [On 991007 notified Intel paradigm shift of the millenium --
161444 -     biggest risk in all forms of enterprise is communication.
161445 -     ref SDS 81 7920]
161446 - ..
161447 - Mark cited Doctor Naqvi's letter, ref DRP 15 0001, on 990923,
161448 - saying he is not comfortable using web mail. ref SDS 76 0001  Mark
161449 - noted in his message this afternoon that web mail is not hard to use,
161450 - since it only requires clicking on a link.  He said that some doctors
161451 - have difficulty with this procedure.
161452 -
161453 -     [On 990927 asked Mark to facilitate communication with Craig.
161454 -     ref SDS 78 3966]
161455 -
161456 -     [On 990928 Mark called Doctor Boulris. ref SDS 79 0001]
161457 -
161458 -     [On 990927 asked Mark to visit with Syed about changing patient
161459 -     assignments to relived burden of clicking on links. ref SDS 78
161460 -     3966]
161461 -
161462 -     [On 990928 Mark will talk to Doctor Naqvi. ref SDS 79 6364]
161463 - ..
161464 - Clicking on links is not difficult and takes less time than
161465 - opening conventional mail, reviewed on 990712, ref SDS 49 5837, and on
161466 - receiving Doctor Naqvi's concerns on 990923. ref SDS 76 1794
161467 -
161468 - On 990802 review showed Call Center message systems are inefficient
161469 - and subject to error. ref SDS 57 9360  Kaiser has an outstanding
161470 - system, but, since it is voice based, mistakes occur because words
161471 - have different meanings to different people and to the same person at
161472 - different times depending upon context, as explained on 940111.
161473 - ref SDS 8 2074
161474 -
161475 - On 990813 considered getting support for Syed on this issues.
161476 - ref SDS 61 3955
161477 -
161478 - On 990912 article in Sunday Times reported the high cost of medical
161479 - mistakes requires better management. ref SDS 69 0001
161480 -
161481 -     [On 990924 sent letter to author of articles explaining solution
161482 -     to mistakes is alignment of communication. ref SDS 77 3922]
161483 -
161484 - On 990625 article in Fortune on successful management says writing
161485 - works better than relying on conversation. ref SDS 44 1024
161486 -
161487 - On 990625 article in Fortune reports that executives, similar to a
161488 - doctor's role, don't execute good management because of personal
161489 - "psyche." ref SDS 44 4914  The article on medical mistakes similarly
161490 - reported that improvement requires overcoming resistance to better
161491 - methods caused by denial. ref SDS 69 3416
161492 -
161493 -
161494 -
161495 -
161496 -
161497 -
161498 -
161499 -
161500 -
1616 -