CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 33 0000, ref SDS 32 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 091202 Millie had the 3rd treatment in the 1st cycle of Navelbine.
040902 - ref SDS 20 625I
040904 -  ..
040905 - She is experiencing some possible recovery, but also evident worsening
040906 - of cancer due to lack of treatment targeted to her patient profile.
040908 -  ..
040909 - On 091203, Millie submitted a letter notifying the medical team about
040910 - possible progression of disease, and requesting treatment targeted to
040911 - her patient profile, ref SDS 21 4P7G, following up the letter on
040912 - 091112, ref SDS 16 IL8L, and meeting with Doctor Johnson at Kaiser
040913 - later that day on 091112. ref SDS 17 UT7M  The following letter
040914 - confirms understandings from meeting on 091112, and sets agenda for
040915 - meeting at Kaiser on 091210.
040917 -  ..
040918 - On 091211 0018 Millie letter confirms understandings from meeting at
040919 - Kaiser and thanks thanked medical team for excellent care, ref SDS 23
040920 - BW8I, based on Doctor Johnson's report in the meeting at Kaiser on
040921 - 091210 that Kaiser is collaborating with Doctor Rugo for UCSF to
040922 - prescribe treatment targeted to Millie's patient profile. ref SDS 23
040923 - XM3X
040925 -  ..
040926 - On 091211 1452 Doctor Johnson reports collaborating with Doctor Rugo
040927 - for UCSF as planned during the meeting yesterday. ref SDS 24 BW8I
040929 -  ..
040930 - On 091211 1648 Millie notifies Doctor Johnson to submit correspondence
040931 - of Kaiser collaborating with Doctor Rugo at UCSF on prescribing
040932 - treatment targeted to Millie's patient profile. ref SDS 25 BW8I
040934 -  ..
040935 - On 091214 1649 Doctor Johnson notifies Millie that Doctor Rugo has not
040936 - replied to Kaiser's letter on 091211. ref SDS 26 BW8I
040938 -  ..
040939 - On 091215 0852 Millie asks Doctor Johnson about sending a copy of
040940 - Kaiser's letter to Tara for assisting Doctor Rugo developing UCSF's
040941 - treatment plan targeted to Millie's patient profile. ref SDS 27 BW8I
040943 -  ..
040944 - On 091215 1557 Millie reports blood counts fall, still permit getting
040945 - 1st treatment 2nd cycle Navelbine, ref SDS 28 BW8I, asks about
040946 - progress collaborating on prescribing next treatment to recover from
040947 - 10th relapse of cancer.
040949 -  ..
040950 - On 100103 1147 Millie asks medical team about progress prescribing
040951 - treatment targeted to Millie's patient profile to recover from 10th
040952 - relapse of cancer. ref SDS 29 BW8I  Millie reports new symptom of rash
040953 - on right side of forehead, which is swelling the right eye; requests
040954 - examination tomorrow to prescribe immediate remedy. ref SDS 29 FZ6V
040956 -  ..
040957 - On 100103 1652 Millie receives automated reply that Doctor Johnson is
040958 - out of the office until 100105, and so cannot make examination
040959 - tomorrow on 100104 requested in Millie's letter this afternoon.
040960 - ref SDS 30 BW8I
040962 -  ..
040963 - On 100103 2023 Millie reponds to notice that Doctor Johnson is out of
040964 - the office tomorrow and so cannot make examination requested in
040965 - Millie's letter earlier today. ref SDS 31 BW8I
040967 -  ..
040968 - On 100104 0830 Millie needs examination of facial blisters today.
040969 - ref SDS 32 BW8I
040971 -  ..
040972 - On 100104 2144 Mille notified medical team on results of meetings
040973 - today at Kaiser that diagnosed and prescirbed treatment for Shingles.
040974 - ref SDS 33 BW8I
040976 -  ..
040977 - On 100106 1327 Doctor Johnson called to ask about meeting with Millie,
040978 - on recovering from shingles, ref SDS 0 BW8I, diagnosed by Doctor Zhang
040979 - at Kaiser, as reported in Millie's letter to the medical team on
040980 - 100104 2144. ref SDS 33 BW8I  Millie is too ill for meeting at Kaiser;
040981 - hoping to be able to meet next week as currently scheduled on 100112.
040982 - ref SDS 0 TF4F  Doctor Johnson reported that Kaiser has not received a
040983 - response from UCSF to Doctor's letter requesting support for Millie's
040984 - treatment to recover from 10th relapse of cancer; doctor asks if
040985 - Millie has been contacted by Doctor Rugo. ref SDS 0 216K  Doctor
040986 - Johnson sent a copy to Tara of his letter on 091211 to Doctor Rugo, so
040987 - that Tara can assist Doctor Rugo developing a treatment plan in time
040988 - to be effective. ref SDS 0 CX5F  Doctor Johnson sent a copy of his
040989 - letter on 091211 to Doctor Rugo at UCSF to Millie, so that the medical
040990 - team can be supported by the doctor/patient partnership. ref SDS 0
040991 - KN66
040992 -
040993 -
040994 -
040996 -  ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Doctor Johnson called responding to Millie's letter on 100104
041302 - reporting diagnosis and treatment plan to recover from shingles.
041303 - 100104 2144, ref SDS 33 0P9S  The doctor related having received
041304 - notice from Doctor Zhang on examiantion at Kaiser on 100104.
041305 - ref SDS 33 BW8I
041307 -  ..
041308 - Doctor Johnson asked how Millie is doing?
041310 -  ..
041311 - He asked if Millie can come in for examination this week to evaluate
041312 - recovery from shingles, as Doctor Zhang recommended on 100104 2144.
041313 - ref SDS 33 0P4Y
041315 -  ..
041316 - Reviewed Millie's status after 2-days of treatment, shows no evident
041317 - signs of recovery yet.  Shingles disease seems to have significantly
041318 - worsened spreading blisters on the right side of Millie's head,
041319 - forehead, and right eye.  Swelling has also spread to the left eye.
041320 - Hope improvement will begin within the next few days, based on Doctor
041321 - Zhang's prognosis for recovery within 2-weeks, reported on 100104
041322 - 2144. ref SDS 33 0P9S
041324 -  ..
041325 - Since Millie is not feeling well, suffering pain, and emotional trauma
041326 - from shingles affliction, she does not want to get out of bed, dress,
041327 - and do everything required for getting to Kaiser for examination today
041328 - and tomorrow.  Therefore, decided during the call today to defer
041329 - meeting with Doctor Johnson until next week on 100112, which is the
041330 - regularly scheduled examination for starting the next cycle of
041331 - Navelbine chemotherapy.
041333 -  ..
041334 - Doctor Johnson advised that he received Millie's letter to the medical
041335 - team on 100105, reporting plans for Doctor Rugo to prescribe treatment
041336 - for Millie to recover from the 10th relapse of cancer, ref SDS 34
041337 - P74V, and targeted to Millie's complex patient profile, listed on
041338 - 090213. ref SDS 6 AC6G  This confirmed Millie's letter 2 days earlier
041339 - noting Doctor Rugo's delay answering Doctor Johnson's letter on 091211
041340 - requesting UCSF's work plan for Millie to recover from UCSF medical
041341 - mistakes, reported on 100103 1147. ref SDS 29 FZ7Q
041343 -  ..
041344 - During the call, Doctor Johnson further asked if Doctor Rugo has
041345 - contacted Millie about UCSF's treatment plan for the 10th relapse of
041346 - cancer, and targeted to Millie's patient profile listed on 090213
041347 - 1140, ref SDS 6 AC6G, for treating Millie's cancer as a chronic
041348 - disease?  Case study on 090325 shows Doctor Johnson has prescribed
041349 - treating Millie's cancer as a chronic disease at the UCSF cancer
041350 - center. ref SDS 7 L15M
041352 -  ..
041353 - Millie has not heard from Doctor Rugo, contrary to planning in Tara's
041354 - call on 090716. ref SDS 13 EE5W
041356 -  ..
041357 - Doctor Johnson related during the call today having still not received
041358 - a response to his letter on 091211 asking UCSF for support to treat
041359 - Millie's 10th relapse of cancer. ref SDS 24 BW8I
041361 -  ..
041362 - Discussed whether the doctor sent a copy of Kaiser's letter on 091211
041363 - to UCSF, ref SDS 24 BW8I, to Tara Lacey, NP, which was planned in the
041364 - meeting at Kaiser on 091210? ref SDS 22 UX50
041366 -  ..
041367 - Doctor Johnson checked Kaiser's records and reported he did not send a
041368 - copy to Tara.  This answers reminders and inquiries previously
041369 - submitted to Kaiser on...
041370 -
041371 -             091211 0018........................ ref SDS 23 XM4T
041372 -             091211 1648........................ ref SDS 25 174W
041373 -             091215 0852........................ ref SDS 27 I15R
041375 -  ..
041376 - We reviewed advantage of sending a copy of Kaiser's letter sent to
041377 - Doctor Rugo on 091211, to the doctor's assistant for Millie's case,
041378 - Tara, who can remind Doctor Rugo and assist with analysing Millie's
041379 - complex patient history for determining the next line of care.  This
041380 - may expedite response to Doctor Johnson's letter to Doctor Rugo in the
041381 - same way that Arlette reminds and assists Doctor Johnson handling a
041382 - lot of complex details about patient care, noted for example in the
041383 - letter to the medical team on 090610 2213, ref SDS 11 WX9Y, and again
041384 - on 090617 1715. ref SDS 12 6F4M  Millie's letter to the medical team
041385 - on 090725 commended Arlette for performing "yeoman's work" assisting
041386 - Doctor Johnson. ref SDS 14 T55P
041388 -  ..
041389 - Doctor Johnson decided during the call to send a follow up letter to
041390 - remind Doctor Rugo that Millie requires timely support to prescribe
041391 - care targeted to Millie's patient profile that treats her cancer as a
041392 - chronic disease.  The doctor asked for Tara's address so that Doctor
041393 - Rugo has assistance to respond in time to be effective.
041395 -  ..
041396 - Explained that Tara's address is in all of the correspondence
041397 - submitted to the medical team for the past 2 years, e.g., most
041398 - recently 2-days ago on 100104 2144, ref SDS 33 BW8I; in the letter the
041399 - day before on 100103 2023, ref SDS 31 BW8I, and earlier the same day
041400 - on 100103 1147. ref SDS 29 BW8I
041402 -  ..
041403 - Doctor Johnson advised that he is working in a different part of
041404 - Kaiser's Knowledge Management program, and so cannot access prior
041405 - correspondence to get Tara's address.
041407 -  ..
041408 - Gave the doctor Tara's email address.
041410 -  ..
041411 - Doctor Johnson also asked for Millie's address to implment prior
041412 - requests for Kaiser correspondence with UCSF and other providers, as
041413 - required by HIPAA, which enables an effective doctor/patient
041414 - partnership, cited by Doctor Johnson during the meeting at Kaiser on
041415 - 090725, ref SDS 14 T55V, and more recently requested in this case
041416 - on...
041418 -            ..
041419 -           091210........................... ref SDS 22 OJ9F
041420 -           091211 0018...................... ref SDS 23 XM4T
041421 -           091211 1648...................... ref SDS 25 174W
041422 -           100108 0852...................... ref SDS 35 MW3U
041424 -  ..
041425 - Reviewed the record of Doctor Johnson receiving and sending email to
041426 - Millie on providing timely health care.  The doctor explained he
041427 - cannot Milli's email address for the same reason, in Kaiser's
041428 - Knowledge Management system for the same reason he needed Tara's
041429 - address, per above. ref SDS 0 KN5N
041431 -  ..
041432 - Gave the doctor Mil's email address.
041434 -  ..
041435 - During the call, the doctor's letter to Doctor Rugo at UCSF was
041436 - received, however, it could not be accessed due to "secure email"
041437 - protocol, per below. ref SDS 0 CX9G
041438 -
041439 -        [On 100108 0852 Millie asked the doctor to send the letter by
041440 -        regular email for timely access; and, alternatively, to print
041441 -        the letter for pickup by driving to Kaiser. ref SDS 35 MW4P
041443 -         ..
041444 -        [On 100502 0140 Millie letter to medical team explains
041445 -        advantages of public domain email, and waives liability for
041446 -        UCSF and Kaiser from inadvertant breach of patient
041447 -        confidentility in her case. ref SDS 36 CO3W
041449 -         ..
041450 -        [On 100502 2143 Millie received another letter from the
041451 -        medical team at Kaiser which could not be opened again.
041452 -        ref SDS 37 HH4I
041454 -         ..
041455 -        [On 100504 1609 Sara, Practice Manager for UCSF Oncology
041456 -        Breast Care Clinic, called and notified Millie that lawyers
041457 -        in the UCSF Risk Management Department want Millie to use
041458 -        secure email to comply with Federal regulations; Sara does
041459 -        not know what Federal regulations apply in this case, nor
041460 -        what the regulations say that justify denying the patient
041461 -        the right to choose the level of confidentiality suited to
041462 -        the patients need for communicating effectively with her
041463 -        medical team, and with transparency that encourages
041464 -        accuracy and timeliness. ref SDS 40 ZV6M
041466 -  ..
041467 - Doctor Johnson asked about Gloria's role on Millie's medical team --
041468 - he asked "Who is Gloria?"
041470 -  ..
041471 - We reviewed paragaph 10 in the letter to the medical team on 100104
041472 - which says Gloria has been Kaiser's case manager for Coumadin
041473 - treatment that controls Millie's pulmonary embolism status for the
041474 - past 5 years. ref SDS 33 0P5T  Gloria routinely gets correspondence to
041475 - the medical team that deals with Coumadin case management issues.
041476 - Doctor Johnson then recalled that Millie was diagnosed with pulmonary
041477 - embolism 5 years ago in his office on 041104 1030, ref SDS 1 RZ4I, and
041478 - as a result gets treatment everyday since that time, based on Gloria's
041479 - evaluation of changes in medical status, in this case diagnosis of
041480 - shingles, and adding new medications.
041481 -
041483 -  ..
0415 -
0416 -
0417 - 1343
0418 -
041801 - After the call with Doctor Johnson, Millie received a letter from
041802 - Kaiser saying...
041803 -
041804 -    1.  Subject: Fw: Mutual Patient (phi)
041805 -        Date: Wed, 6 Jan 2010 13:28:38 -0800
041810 -         ..
041811 -    2.  You have received a secure message. Please scroll down for
041812 -        further instructions.  Kaiser SecureMail
041814 -         ..
041815 -    3.  To view your secure message:
041816 -
041817 -        1. Open the attachment to this email
041818 -        2. Follow the instructions
041820 -         ..
041821 -    4.  This message was sent using Kaiser SecureMail. Click here to
041822 -        learn more
041823 -
041824 -           <https://voltage-ps-0000.kp.org/brand/zdm/about.ftl>
041825 -
041826 -    5.  *NOTICE TO RECIPIENT:*T If you are not the intended recipient of this e-mail,
041827 -        you are prohibited from sharing, copying, or otherwise using of disclosing its
041828 -        contents. If you have received this e-mail in error, please notify the sender
041829 -        immediately by reply e-mail and permanently delete this e-mail and any
041830 -        attachments without reading, forwarding, or saving them. Thank you
041832 -         ..
041833 -        Email Security Powered by Voltage IBE(TM)
041835 -         ..
041836 -        Copyright 2003-2007 Voltage Security, Inc. All rights reserved.
041838 -         ..
041839 -        Proofpoint is a registered trademark of Proofpoint, Inc. in the
041840 -        United States and other countries.
041842 -         ..
041843 -    6.  Kaiser SecureMail
041845 -         ..
041846 -    7.  The attachment was opened successfully.
041847 -
041848 -        To read the message, click the button below.
041850 -         ..
041851 -        If you are a *first time user*, you will be prompted to create
041852 -        an account.
041853 -
041854 -           This message was sent using Kaiser SecureMail. Click here to
041855 -           learn more
041856 -
041857 -               https://voltage-ps-0000.kp.org/brand/zdm/about.ftl
041859 -         ..
041860 -    8.  *NOTICE TO RECIPIENT:*T If you are not the intended recipient
041861 -        of this e-mail, you are prohibited from sharing, copying, or
041862 -        otherwise using of disclosing its contents.  If you have
041863 -        received this e-mail in error, please notify the sender
041864 -        immediately by reply e-mail and permanently delete this e-mail
041865 -        and any attachments without reading, forwarding, or saving
041866 -        them. Thank you
041868 -         ..
041869 -    9.  Email Security Powered by Voltage IBE(TM)
041871 -         ..
041872 -   10.  Copyright 2003-2007 Voltage Security, Inc. All rights reserved.
041873 -        Proofpoint is a registered trademark of Proofpoint, Inc. in the
041874 -        United States and other countries.
041876 -  ..
041877 - Following instructions, clicked on "Attachment" at the bottom of
041878 - Doctor Johnson's letter...
041879 -
041880 -                  message_zdm.html
041882 -  ..
041883 - This opened a file from the Internet using Internet Explorer web
041884 - browser with the title...
041885 -
041886 -        Voltage SecureMail - Zero Download Messenger
041888 -  ..
041889 - Content....
041890 -
041891 -        Kaiser Permanente                      Help
041892 -
041893 -        Please enter your password
041894 -
041895 -        Your Email Address    [Millie's email address is already entered}
041897 -         ..
041898 -        Password
041900 -         ..
041901 -        Forgot your password or need to change it.
041903 -         ..
041904 -        You may also call the Kaiser Permanente Member Services
041905 -        Helpline at 866 529 0776
041907 -         ..
041908 -        Your personal information is kept private with Kaiser
041909 -        Permanente SecureMail
041911 -         ..
041912 -        Click here to learn more
041914 -         ..
041915 -        Email Security Powered by Voltage IBE(TM)
041917 -         ..
041918 -        Copyright 2003 - 2007 Voltage Security, Inc.  All rights
041919 -        reserved.  Proofpoint is a registered trademark of Proofpoint
041920 -        Inc., in the United States and other countries.
041922 -  ..
041923 - After all of this could not get the content of the letter Doctor
041924 - Johnson sent to Millie and to UCSF.  This aligns with Doctor Johnson's
041925 - experience failing to open secure email from UCSF on 080305.
041926 - ref SDS 3 US6I
041928 -  ..
041929 - After communicating timely, accurate information in thousands of
041930 - letters among the medical team for 9 years, suddenly this one letter
041931 - is a total mystery.
041932 -
041933 -        [On 100108 0852 Millie asked the doctor to send the letter by
041934 -        regular email for timely access; and, alternatively, to print
041935 -        the letter for pickup by driving to Kaiser. ref SDS 35 MW4P
041937 -  ..
041938 - These methods were tried in 2008.  On 080304 UCSF sent a letter to the
041939 - medical team, and nobody could read it, ref SDS 2 0T8F  The next day,
041940 - Doctor Johnson advised that Kaiser could not open UCSF's letter.
041941 - ref SDS 3 US6I  Similarly, on 081103 Doctor Johnson sent a "secure
041942 - email" which could not be opened. ref SDS 4 XO8J
041943 -
041944 -        [On 100502 2143 Millie received another letter from the
041945 -        medical team at Kaiser which could not be opened again.
041946 -        ref SDS 37 HH4I
041948 -         ..
041949 -        [On 100503 1522 Millie notifies medical team of difficulty
041950 -        handling secure email. ref SDS 38 TD5T
041952 -         ..
041953 -        [On 100503 1945 Kaiser resubmitted letter sent initially
041954 -        with "secure email" for protecting patient confidentiality,
041955 -        and using public domain email with level of confidentiality
041956 -        acceptable to the patient for efficient communication.
041957 -        ref SDS 39 YL5N
041959 -         ..
041960 -        [On 100504 1609 Sara, Practice Manager for UCSF Oncology
041961 -        Breast Care Clinic, called and notified Millie that lawyers
041962 -        in the UCSF Risk Management Department want Millie to use
041963 -        secure email to comply with Federal regulations; Sara does
041964 -        not know what Federal regulations apply in this case, nor
041965 -        what the regulations say that justify denying the patient
041966 -        the right to choose the level of confidentiality suited to
041967 -        the patients need for communicating effectively with her
041968 -        medical team, and with transparency that encourages
041969 -        accuracy and timeliness. ref SDS 40 ZV6M
041970 -
041971 -
041972 -
041973 -
041974 -
041975 -
041976 -
041977 -
0420 -