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
Patient Assistant
Questions, Suggestions
Medical History, Xrays Not Submitted for Meeting
Medical Chart Missing Information
Policy Procedures on Communication
Team Care
Primary Care Physician
Team Care No Process Address Medical Mistakes

1210 -    ..
1211 - Summary/Objective
1212 -
121201 - Follow up ref SDS 82 0000, ref SDS 79 0000.
121202 -
121203 - Received ref DRT 1 0001 from Mark responding to my letter, ref DIP 17
121204 - 0001, asking for a meeting with Kaiser management on Team Care and
121205 - communication procedures to avoid future mistakes, using Kaiser's
121206 - partnership procedures.
121207 - ..
121208 - Mark says he will...
121209 -
121210 -       ...work on finding out who the most appropriate person would be
121211 -       for you to address your concerns to. ref DRT 1 0001
121212 -
121213 -     [On 991016 followed up. ref SDS 83 0001]
121214 -
121215 -     [On 991021 Doctor Ross Armstrong is chief of Internal Medicine.
121216 -     ref SDS 85 0001]
121217 -
121218 - He also maintains that...
121219 -
121220 -       ...if I were not off work, I'm sure I could have ensured your
121221 -       request was facilitated. Therefore, please use me for such
121222 -       purposes as I am more than happy to help. ref DRT 1 2784
121223 -
121224 - This misses the mark of improving procedures in the absence of patient
121225 - reminders, as set out in the letter, ref DIP 17 0001,
121226 - ..
121227 - Mark seems to be placing the Patient Assistance role as the
121228 - Patient Advocate, set out in my letter, ref DIP 17 1581, on 991006.
121229 - ref SDS 82 5208
121230 -
121231 -      This might work, but Patient Assistance seems to be just one of
121232 -      many avenues for dealing with the Kaiser organization, and
121233 -      Patient Advocate contemplates a single point of contact, as
121234 -      explained on 990625. ref SDS 41 0899
121235 - ..
121236 - Submitted ref DIT 1 0001 linked to Mark's letter agreeing to
121237 - facilitate a meeting with the supervisor of the doctors and medical
121238 - practice. ref SDS 0 5832
121239 -
121240 - Request that if an approprite person cannot be found by 991015, then
121241 - provide name and email address of the supervisor for the Park
121242 - Shadelands clinic.
121243 -
121244 -     [On 991016 followed up. ref SDS 83 0001]
121245 -
121246 -     [On 991021 Doctor Ross Armstrong Chief Internal Medicine assigns
121247 -     people to respond. ref SDS 85 0001]
121248 -
121249 -     [On 991206 Tom Driscoll will review with Jeanne. ref SDS 92 0899]
121250 -
121251 -    ..
121252 - Issues for review at the meeting include...
121253 -
121254 -    1.  Team Care policy and procedures, ref DIT 1 7360, cited in the
121255 -        letter to Mark on 991006, ref DIP 17 0001, and in the record on
121256 -        991006, ref SDS 82 9499, for submitting medical history to
121257 -        attending physicians, correcting the mistake that occurred
121258 -        September 10 at a meeting with Doctor Boulris. ref SDS 66 3038
121259 -
121260 -           [On 991216 3 ancillary issues cited. ref SDS 93 0784]
121261 -
121262 -           [000118 Jeanne reviews medical mistakes. ref SDS 97 3248]
121263 -
121264 -           [000121 Jeanne submits letter responding to medical mistakes.
121265 -           ref SDS 98 0863]
121266 -        ..
121267 -    2.  Procedures for xray and other processes, ref DIT 1 1080,
121268 -        that avoid giving patients the wrong Kaiser medical card and
121269 -        preparing work orders for the wrong patient, correcting
121270 -        mistakes that occurred September 10 at a meeting with Doctor
121271 -        Boulris. ref SDS 66 6305
121272 -
121273 -           [000118 Jeanne reviews medical mistakes. ref SDS 97 3248]
121274 -
121275 -           [000121 Jeanne submits letter responding to medical mistakes.
121276 -           ref SDS 98 0863]
121277 -        ..
121278 -    3.  Assigning a new primary care physician, ref DIT 1 1938,
121279 -        based on Mark's report dated 991006, ref DRP 17 0001, that
121280 -        Doctor Naqvi has confirmed he cannot support patient
121281 -        communication using web mail, without evidence that this
121282 -        presents a hardship in time, cost or effectiveness. ref SDS 82
121283 -        0669
121284 -
121285 -           [000118 Jeanne reviews medical mistakes. ref SDS 97 3248]
121286 -
121287 -           [000121 Jeanne submits letter responding to medical
121288 -           mistakes. ref SDS 98 0863]
121289 -  ..
121290 -    4.  Obtaining guidance on dosage for Glucosamine and Chrondroitin,
121291 -        witheld by doctor on 991028. ref SDS 87 2596
121292 -
121293 -           [000118 Jeanne reviews medical mistakes. ref SDS 97 3248]
121294 -
121295 -           [000121 Jeanne submits letter responding to medical mistakes.
121296 -           ref SDS 98 0863]
121297 -        ..
121298 -    5.  Obtaining second opinion on MRI for right knee from
121299 -        record on 991028. ref SDS 87 0895
121300 -
121301 -           [000118 Jeanne reviews medical mistakes. ref SDS 97 3248]
121302 -
121303 -           [000121 Jeanne submits letter responding to medical mistakes.
121304 -           ref SDS 98 0863]
121305 -
121306 -           [On 000124 got 2nd opinion. ref SDS 99 0001]
121307 -
121308 - Possible additional issues to discuss....
121309 -        ..
121310 -    6.  Colonoscopy scheduled for 60 to 90 days from meeting with
121311 -        Syed on 990628. ref SDS 43 2099
121312 -
121313 -           [000118 Jeanne reviews medical mistakes. ref SDS 97 3248]
121314 -
121315 -           [000121 Jeanne submits letter scheduling procedure under the
121316 -           name sigmoidoscopy. ref SDS 98 1681]
121317 -
121318 -           [On 000208 procedure performed. ref SDS A0 0001
121319 -        ..
121320 -    7.  Patient Assistance department needs support to meet
121321 -        Kaiser goals for quality team care.
121322 -
121323 -        [On 991019 Patient Assistance reports doctors assigned to
121324 -        respond, fail to follow up. ref SDS 84 0001
121325 -
121326 -        [On 991021 Patient Assistance reports failure of doctors to
121327 -        follow up on 991019 was due to failure to perform by Patient
121328 -        Assistance because of excessive work load, plans to work harder
121329 -        on follow up. ref SDS 85 2255]
121330 -
121331 -        [Patient recommends submitting the record to assist busy
121332 -        doctors recognize the priority for improving quality of team
121333 -        care and doctor/patient communication. ref SDS 85 2016
121334 -
121335 -        [On 991024 Patient Assistance plans to submit purpose and
121336 -        agenda of meeting after doctors schedule the meeting.
121337 -        ref SDS 86 0001]
121338 -
121339 -        [On 991101 Patient Assistance sent follow up notice to doctors,
121340 -        but has not received response.  Proposed submitting the record
121341 -        showing purpose and agenda of meeting in order to encourage
121342 -        doctors to schedule the meeting, as proposed by patient on
121343 -        991021. ref SDS 85 2016]
121344 -
121345 -        [Patient suggests contacting management staff that is not
121346 -        burdened by patient load, and has the assignment to support
121347 -        quality team care cited by Bob Pearl in his letter on 991028.
121348 -        ref SDS 87 0800]
121349 -
121350 -        [On 991115 not enough time to follow up. ref SDS 91 0001]
121351 -        ..
121352 -    8.  Training Doctor/patient communication for effective
121353 -        partnership reported on 990625. ref SDS 41 5358
121354 -
121355 -        This is a skill development and support issue.
121356 -
121357 -        [On 991028 example of communication support needed for doctors.
121358 -        ref SDS 87 8499]
121359 -
121360 -        [On 991101 discussed with Jeanne. ref SDS 88 1718]
121361 -
121362 -        [On 991221 study shows doctors omit key information in 90% of
121363 -        communications with patients. ref SDS 94 0001]
121364 -
121365 -        [On 991227 example of communication support needed from letter
121366 -        by medical executive. ref SDS 95 9844]
121367 -        ..
121368 -    9.  Doctor/patient communication problems where patient
121369 -        inquiry from work on 990910 has not been addressed promptly or
121370 -        within a reasonable time.
121371 -
121372 -        This is a Kaiser procedure and process issue.
121373 -
121374 -        990910 medical management problems occurred. ref SDS 66 3038
121375 -
121376 -        990913 solution requested. ref SDS 69 3816
121377 -
121378 -        990921 follow up request. ref SDS 73 0477
121379 -
121380 -        991006 follow up inquiry was made. ref SDS 82 7280
121381 -
121382 -        991008 another inquiry was made identifying specific pending
121383 -        issues, per above. ref SDS 0 5727
121384 -
121385 -        [991101 doctors non-responsive. ref SDS 88 0966]
121386 -
121387 -        [991109 Tom Driscoll assigned to respond. ref SDS 89 0001]
121388 -
121389 -        [991115 no response. ref SDS 90 0001]
121390 -
121391 -        [000113 Doctor Connolly cites doctor patient issue getting
121392 -        patients connected to doctors with email. ref SDS 96 8268]
121393 -
121394 -        [000118 Jeanne reviews medical mistakes. ref SDS 97 3248]
121395 -
121396 -        [000121 Jeanne submits letter responding to medical mistakes.
121397 -        ref SDS 98 0863]
121398 -
121399 -
121400 -
121401 -
121402 -
121403 -
121404 -