CONTACTS 
0201 - Kaiser Permanente - Shadelands       925 906 2200
020101 - Walnut Creek, CA
020102 - Ms. Jeanne Bradley; Coordinator =925 906 2204
020103 - Jeanne.Bradley@ncal.kaiperm.org
020104 - Administration Department
0202 - Kaiser Permanente - Shadelands       925 906 2200
020201 - Walnut Creek
020202 - Dr. Thomas E. Connolly; Physician Leader  =Telephone
020203 - tom.connolly@ncal.kaiperm.org
020204 - Physician in Chief =925 206 2040

SUBJECTS
Medical Practice Requires Records
Team Care in Medical Practice
Kaiser Medical Group
Kaiser Computers Can't Open Links in Email
Medical Mistakes Require Review

0907 -    ..
0908 - Summary/Objective
0909 -
090901 - Follow up ref SDS 60 0000, ref SDS 57 0000.
090902 -
090903 - Tom Connolly reports having been assigned to a new position as
090904 - Physician Leader.  In that capacity he reviewed Welch correspondence
090905 - to improve medical management, and notes that doctor patient
090906 - communication is a critical issue at Kaiser.  He suggests sending
090907 - proposals to CIS, but does not schedule a meeting on medical issues
090908 - pending since 991008. Tom says not to contact Mark and Jeanne about
090909 - Kaiser's email system. He says to contact Member Services on medical
090910 - issues, but does explain how to do this.
090911 -
090912 - Submitted ref DIT 1 0001 to Tom linked to this record for reference.
090913 - and to record on 991021 where Ross Armstrong assigned local doctors to
090914 - review the record. ref SDS 26 0001  Linked to Clinton's announcement
090915 - on reducing medical mistakes.
090916 -
090917 -     [On 000121 received letter from Tom. ref SDS 63 4216]
090918 -
090919 -     [On 000116 reviewed medical mistakes with Jeanne. ref SDS 62 3248]
090920 -
090921 -     [On 000121 received letter from Jeanne on pending issues.
090922 -     ref SDS 63 0863]
090923 -
090924 -     [On 000211 Dale Ames experienced 9 months comedy of errors
090925 -     treating his sinus problems. ref SDS 64 3600]
090926 -
090927 -
090928 -
0910 -
0911 -
0912 - Progress
0913 -
091301 -  ..
091302 - Physician Leader Problem Handlng Role Shelds Team from Responsibility
091303 -
091304 - Received ref DRT 1 0001 from Doctor Tom Connolly evidently responding
091305 - to the letter, ref DIP 1 0001, to Jeanne on 000104, ref SDS 60 0001,
091306 - requesting that we schedule a meeting per Tom Driscoll's letter,
091307 - ref DRP 4 0001, received on 991227. ref SDS 57 0001
091308 -
091309 - Tom advises he has been assigned as Physician Leader to facilitate
091310 - management of patient and doctor communication.  This is a positive
091311 - step toward a system solution to implement Kaiser's requirements for
091312 - effective doctor/patient partnership through stronger communication,
091313 - as reported on 990625.
091314 -
091315 - Tom's letter does not facilitate any action, but rather seeks to
091316 - shield Kaiser from responsibility to investigate, improve process, and
091317 - correct mistakes.  This is classic "problem handling" that defers and
091318 - transfers responsiblity to another time and another person, division,
091319 - organization, cited in letter on medical mistakes, ref DIP 3 6048,
091320 - issued on 990924. ref SDS 21 5576  On 980724 "problem handling" that
091321 - leads to bumbling, delay, increased cost, was reviewed. ref SDS 9 3379
091322 -
091323 - The purpose of the proposed meeting with Kaiser is to review issues on
091324 - 991008. ref SDS 24 9055  On 991217 I discussed meeting with Jeanne.
091325 - ref SDS 53 0001
091326 -
091327 -     [On 000116 Jeanne Bradley reviews medical mistakes, takes action.
091328 -     ref SDS 62 3248]
091329 -
091330 -     [On 000121 received letter from Jeanne on pending issues.
091331 -     ref SDS 63 0863]
091332 -
091333 -     [...Jeane reports new computer will solve medical management
091334 -     mistakes. ref SDS 63 0783
091335 -
091336 - Tom is Sylvia's husband who I requested for a Primary Care Doctor on
091337 - 990625 because he has a message in his examination room for patients
091338 - to leave their email address. ref SDS 11 6800
091339 -
091340 - Tom does not mention the letter to Jeanne, ref DIP 1 0001, on 000104,
091341 - ref SDS 60 0001, nor offer to meet as requested in the letter.
091342 - ..
091343 - Tom indicates having reviewed correspondence from Welch on
091344 - physician, patient communication, which he says is clearly a critical
091345 - issue to Kaiser.  However Tom does not say what he reviewed.
091346 - ref DRT 1 0001
091347 -
091348 -    1.  Did he review the letter on medical mistakes. ref DIP 3 0001
091349 -
091350 -    2.  Did he review the letter to Jeanne, ref DIP 1 0001, on 000104,
091351 -        ref SDS 60 0001, asking for a meeting to discuss doctor-patient
091352 -        issues reported on 991008, and recommended by Tom Driscoll in a
091353 -        letter received on 991227. ref DRP 4 0001
091354 -
091355 -    3.  Did he review the record on 991008 listing medical mistakes to
091356 -        be reviewed? ref SDS 24 9055
091357 -
091358 -    4.  Did he review the record on 990625 showing Kaiser procedures
091359 -        for doctor patient partnership, and see Sylvia's remarks that
091360 -        doctors do not have time to perform communication requirements?
091361 -        ref SDS 11 1978
091362 -
091363 -    5.  Did he review analysis on 991028 of Bob Pearl's letter showing
091364 -        the need for Kaiser to support Doctor communication, and
091365 -        improve the quality of care. ref SDS 28 0800
091366 - ..
091367 - Tom asked the Associate Director of Kaiser's regional Clinical
091368 - Information Systems who can review Communication Metrics?  The
091369 - Associate Director failed to designate anyone at Kaiser who can do
091370 - this directly. ref DRT 1 2072  Tom was told that patients can sign on
091371 - to Kaiser's web site...
091372 -
091373 -
091374 -                        www.kponline.org
091375 -
091376 -
091377 - ...and send a letter to the webmaster there.  This will be the most
091378 - facile method of getting your message to the people who are working on
091379 - exactly this issue, that is getting our patients
091380 -
091381 -
091382 -                 electronically connected (i.e., email)
091383 -
091384 -
091385 - ...to the organization, ref DRT 1 1914, which repeats misperception in
091386 - Tom Driscoll's letter on 991227, ref SDS 57 9844, carrying forward
091387 - error from 991216. ref SDS 52 5846  The difficulty getting Kaiser to
091388 - focus on medical mistakes reflects report on 991221 by ABC News of
091389 - communication problems in medical practice. ref SDS 54 0001
091390 -
091391 -      [On 000114 sent follow up letter. ref SDS 61 0001]
091392 - ..
091393 - On 991106 submitted inquiry to Kaiser's web site, as Tom
091394 - suggests today, and never heard anything further on it. ref SDS 32
091395 - 4505  This experience does not support Tom's recommendation.
091396 -
091397 -     [On 000121 Tom maintains that KPOnline is the best way for Kaiser
091398 -     to review webmail. ref SDS 63 7565]
091399 -
091400 - Email between doctors and patients is an ancillary issue, that can
091401 - play a role in reducing medical mistakes. But it is not listed in the
091402 - record on 991008 among the medical issues pending for resolution by
091403 - Kaiser. ref SDS 24 9055
091404 -
091405 - The big issues are how doctor patient partnership can improve health
091406 - care by implementing Kaiser's procedures, shown in the record on
091407 - 990625, ref SDS 11 4185, and how Team Care through communication can
091408 - be improved to reduce mistakes, also reviewed on 990625. ref SDS 11
091409 - 6970
091410 -
091411 - Email will not get medical history delivered on time, nor incorporate
091412 - accurate history in the medical chart.  It will not empower patients
091413 - to change doctors, get a second opinion, nor get clinical procedures
091414 - performed on time.  It will not empower doctors to communicate
091415 - accurately and effectively as discussed on 991028. ref SDS 28 8499
091416 -
091417 - Tom asks that communication about electronic communication between
091418 - doctors and patients not be directed to Patient Assistance and Jeanne.
091419 - ref DRT 1 1325
091420 -
091421 - Tom says to direct proposals to the regional CIS staff. ref DRT 1 3978
091422 -
091423 - Tom says to contact Kaiser's...
091424 -
091425 -
091426 -                      Member Services department
091427 -
091428 -
091429 - ...about specific medical issues pertaining to care at Park
091430 - Shadelands, that cannot be resolved through the physician. ref DRT 1
091431 - 4814  He does not provide a name, phone number nor address for making
091432 - this contact.
091433 -
091434 -
091435 -
091436 -
091437 -
0915 -
0916 -
0917 - 1538 called Jeanne
0918 -
091801 - Thanked Jeanne for facilitating Tom's response, and apologized for any
091802 - inconvenience or burden our communication has caused her the past few
091803 - months.
091804 -
091805 - We reviewed background on 990625 when Sylvia advised that Tom could
091806 - not address these issues.  In fact I requested him for a primary
091807 - doctor. ref SDS 11 8008
091808 -
091809 - Jeanne said Tom has only recently been assigned to a new job, and so
091810 - he is now able to respond to patients issues on a global basis, as in
091811 - his letter.
091812 -
091813 -
091814 -
091815 -
091816 -
091817 -
091818 -
091819 -
091820 -
091821 -
091822 -
091823 -
091824 -
0919 -