Feature Image
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Our Corona Safe Office Facilities
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Dedicated:
Gloria and Melvin Shanks
Gloria 2020 Congressman Correa Woman of the Year
Double Doctor Ahnika Kline MD PhD
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In Memory Of:
New Old Man John (B.? – D.2020)
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Title
202004 Teladoc Quality Review (II) by MSG and Keith E
Torkelson, MS for Brand New Day
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Authors:
Keith E Torkelson, MS (Pathology)
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Editor:
Avey CE Asus (Non-IBM)
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Blog(s)
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Brand New Day HMO
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With this report we primarily address the Teladoc Phone
Health Service (PHS). The Teladoc PHS
is provided FREE of charge by Brand New Day (BND). BND is Keith “Buster” Torkelson insurer. “Buster” is our principal around here at
Mentalations Solutions Group or MSG. We
here at MSG agree that Healthcare is a team effort. With this study we evaluate a few of “Buster’s” service and
support teams including: A Primary Care Physician (PCP) and a Behavioral Health
Doctor (BHD). As for Teladoc we
evaluate “Buster’s” first (2019) Tela-doctor Annie Nguyen. For her services for our 2019 transaction we
give her a MSG Star Equivalent Score of 5.0 with high scores being
superior. We also award Dr. Annie
Nguyen 5.0 about our Star Screener Tool (SST).
At this point Teladoc is largely limited to treating physical
conditions. We rely much on “Buster’s”
Lived Experience (LxE). We do not have
a service to compare with Teladoc.
After an eligible consumer sets up a basic Teladoc account they are
ready to make the call. Associated with
a Teladoc telephone consult the consumer may submit three documents including
images. For “Buster’s” 2019 call (“visit”) we felt that his Complete Blood
Count labs over time might be helpful.
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The Work of Teladocs
In the end Dr. Nguyen agreed with “Buster” that he had a
treatable condition needing treatment.
She prescribed “Buster” an antibiotic: Doxycycline. After sleeping one night with “Doxy” in his
system “Buster” felt more hopeful.
Kudos Annie Nguyen MD! Applying
another one of our MSG authored assessments we scored Annie again highly (4.8
MSG-SEs). With over five years
experience about measuring MD performance we find that a few items carry a
heavier weight: Time Spent, Agent of
Remedy and Beside Manner. Yet nothing has the weight of a superior:
Practitioner driven Quality Assurance Program (QAP). Teladoc has a rather nice QAP.
To a lesser extent than with Annie Nguyen we evaluate “Buster’s” 2020
Teladoc – Kevin Weiss. “Buster” was
fortunate to have appointments with his primary support network during Winter
Quarter 2020. On 20200226 (W) he had a
phone visit from a new Teladoc Kevin Weiss.
On 20200317 (TU) he attended an in-person visit with his PCP Chester D
Mojica. On 20200318 (W) he participated
in this year’s in person kick-off visit with his BHD Rimal B Bera. We award each 5.0 Stars, 2.8 Stars, and 2.6
Stars respectively. At his point
Teladoc appears quite promising.
-
Meaningful Engagements
Buster takes his engagements with professionals
seriously. Buster prepares a good deal
for his engagements. We here at
Mentalation Solutions Group (MSG) call the engagements that meet our
proprietary and specific criteria a Health Related Engagement or HRE. Here at MSG we spend a good deal of time on
External Quality Review (EQR). One of
our intentions is to help our professionals in proving their concepts using
quantifiable means. During the Winter
Quarter (2020) “Buster” was fortunate enough to see in person his
Ophthalmologist doctor Boyce. On
20200409 (TH) we compared Boyce with Bera.
Boyce earned 5.0 Stars whereas Bera earned 3.0 Stars. Boyce’s office solicits quality input from
the consumer whereas Bera’s office does not.
On Average we are more confident with Teladoc’s doctors than our
in-person doctors.
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Coronavirus
Enter Corona. If
Corona were to take hold of “Buster” he could have a tough go of it. On 20200408 (W) we discovered that “Buster”
has Respiratory Complication Co-morbidity Risk Level of 56.7%. Most of “Buster’s” risks stem from the fact
that he smokes cigarettes. In this
report we use an MSG Product In The Making (PITM). We call it Structured Temporal Reconciliation (MSG-STR). The more we use it the more it is proving
itself As Measured By (AMB) Quality of Life and Satisfaction.
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Steinberg Programming Language – Ameliorating
We also rely heavily on what we call: Steinberg
Programming Language (SPL). Two of the
hard hitting commands in (SPL) Account (Accountability) and Transpire
(Transparency) or A & T. Teladoc is
superior to Bera and Mojica about A & T.
Our next steps are to engage Teladoc again well before “Buster” is very
sick and help Doctor Bera transition into a leader with what he calls “Video
Conferencing”. “Buster” and MSG are positioned to really help him out. Our Executive Summary component is that we
are going to promote with Brand New Day (BND Insurer) that they subsidize
member respites to the tune of $100.00 per month. An investment of $100.00 each month could divert some that would
end up hospitalized.
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List of Figures – Tables – Matrices
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Feature Image
Quality Assurance Promotion – Impetus
Table - Associated Papers – Spring 2020
Table - Common Themes – Information Across Multiple Papers
(Spring 2020)
Table – Morbidity Risk Assessment Tool – Respiratory
Complications
Table - Teladoc Visit Summary – Treatment
Table – Over-The-Counter (OTC) Protections
[INCLUDE PHOTO OF AURORA’S BROTHER
Table - Stages Before Making the Call – Virtual Care
Table - Phone Driven Visit Consult –
Updated Results – Part I of II
Table - Phone Driven Visit Consult –
Updated Results – Part II of II
Table - Doctors in Current Theater (“Cold Season”) of
Operation
Table - TecknoHealth Developments & Ancillary Notions
Table - TecknoHealth Developments & Core Notions
Table – “Service with a smile” (Sample Cohort)
Matrix – External Quality Review
Summary (EQR-S) – Three Service Horizons
Table – Teladoc Centered Themes – Comparison – Teladoc V PCP
Table - Vitals-Plus
Method – Vitals Standard Elements (2019)
Table - Vitals-Plus
Method – Vitals-Plus Elements – Part 1 of 2 (2019)
Table - Vitals-Plus
Method – Vitals-Plus Elements – Part 2 f 2 (2019)
Table - Vitals-Plus
Method – Vitals-Plus Elements – Combined Parts 1 and 2 (2019)
Table - Vitals-Plus
Method – Combined Scores About Teladoc (2019)
Table – CBC - Leukomoid Reaction Complication - Elimination
[INSERT CBC TIME SERIES GRAPH –
MYQUEST]
Table – Infection Elimination
Tool (IET) & History
Matrix – Compare Alternatives In Face of Corona –
Specification Example
Table – Comparing Provision Of Services (POS)
Matrix – Teladoc Driven Statistics - Transparency
Figures – The MSG Cemetery
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Health Technology
“Health technology assessment is
the systematic evaluation of the properties and effects of a health technology,
addressing the direct and intended effects of this technology, as well as its
indirect and unintended consequences, and aimed mainly at informing
decision-making regarding health technologies.” We here at Mentalation Solutions Group (MSG) define Health
Technology as any technology that aids “Buster” and his in their quests for
better health and better outcomes. We
define TecknoHealth as any Health Technology that MSG, “Buster” and any other
consumer uses in delivering ever improving Health Related Engagements
(MSG-HRE-2020)
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Quality Assurance Promotion - Impetus
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|||||
Practitioner (MD)
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QA Program
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A & T
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Note
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-
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|||||
Drive Bys
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Informal
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Insufficient
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Chester D Mojica
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No
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Insufficient
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Abandoned consumer satisfaction survey about five years
ago
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Daniels (???)
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No
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Insufficient
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No digital presence
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Rimal B Bera
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No
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Insufficient
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We are doing our part
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Annie Nguyen
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Yes
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Insufficient
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We are doing our part
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Kevin Weiss
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Yes
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Insufficient
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We are doing our part
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Bum Soo Lee
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Informal
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Sufficient
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We did our part
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David Chandler
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No
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Sufficient
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We did our part
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Ravinder P Singh
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No
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Insufficient
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We did our part
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Andrew Inglis
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Yes
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Sufficient
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Whole QA Division
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Last Reviewed: 20200408-W: A & T = Accountability &
Transparency
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TecknoHealth
Basically Health Technology (HT)
is the strategic use of technology from the provider angle. We here a Mentalation Solutions Group (MSG)
put forth a beta definition for TecknoHealth.
At this time TecknoHealth is the practical use of Health Technology from
the consumer (users) side. TecknoHealth
includes yet is not limited to the following: Access to Electronic Health
Record (E.H.R.), maintenance and leveraging Personal Health Records (PHRs),
Blogging, ownership of a personal computer, access to the world wide web
(Internet), ownership of a SmartPhone, printing facilities, a technical support
budget, telehealth benefits, etc.
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Integrating About Technology
Table - Associated Papers – Spring 2020
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|||||
Theme
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Principal
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Development
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Note
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|||||
Corona
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Chester D Mojica (CDM)
MD-On Call
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Reports PRN
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|||
Digital Appointments Via Smartphone
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Mentalation Solutions Group (MSG)
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Graduate to
TecknoHealth
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|||
GRAVITY
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Avey CE Asus (ACEA)
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Fun Paper
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Pinterest Alternative
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Health and Housing
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Jeffery A Nagel (JAN)
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OCHCA
Housing Help Line
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Stayed for Corona
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Sleep
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MSG
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SleepAbility
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20200408-W
Major change Spice user moves away
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TecknoHealth
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MSG
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Integration
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Consumer side of Health Technology
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Teladoc
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MD-On Call
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Report II
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|||
Telepsychiatry
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Rimal B Bera (RBB)
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P4D Report
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20200408-W
Worker announces Appts by phone only
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Last Reviewed: 20200331-TU:
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[INSERT IMAGEs OF SPICE USER Using]
Under-served & Inappropriately served.
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Associated Document:
04_Case_Study_Mikel_Roby_19052901_Notes II Fixes V2020
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Table - Common Themes – Information Across Multiple Papers
(Spring 2020)
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|||||
Theme
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Note
20200407-TU:
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Detail
|
|||
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|
|||||
Corona Driven Virology
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Net gains desired
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Decreasing risks while increasing protections
|
|||
Digital Appointment
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Pending setting due date
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2020 Text version
|
|||
Housing Help Line
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On hold until summer quarter
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OCHCA funding request
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Mission Schwabe
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World Wafers
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Mask Development
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|||
Mask Management
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Refining bio-security PRN
|
||||
Self Medication
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Prevent Corona
Address respiratory bacteria issues
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1-Re-level prescription medications PRN
2-Daily Over-The-Counter cocktail trials
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|||
Sleep
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Daily challenge
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20200408-W
All night drug user moves our of room
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Social Pathology
(SOC-PATH)
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Developing portfolio for presentation
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Earn title
Present to Inglis & Chau & Nagel
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|||
Teladoc Series
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Teladoc II
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Service on deck if needed
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|||
Telepsychiatry
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Current Behavioral Health Doctor is entertaining cut over
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20200408-W:
BND worker calls and says “psychiatrists only doing visits
by phone”
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|||
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Last Reviewed: 20200408-W:
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Eliminations – Presenting Problems – Risk Management
Table – Morbidity Risk Assessment Tool – Respiratory
Complications
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|
|||||
##
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Morbidity
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2020
0408
(W)
Risk Level
|
2020
0408
(W)
Risk Level
|
||
-
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-
|
||||
01
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1-Preexisting condition(s)
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SoSo
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0.50
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||
02
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Allergy
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SoSo
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0.50
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||
03
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Bio-security gaps
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SoSo
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0.50
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||
04
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Cocktails OTC
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SoSo
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0.50
|
||
05
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Loss Cascade
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High
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1.00
|
||
06
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Mild Flu
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SoSo
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0.50
|
||
07
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Other infections
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SoSo
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0.50
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||
08
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Pneumonia February 2020
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SoSo
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0.50
|
||
09
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Primary Bacterial Infections
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SoSo
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0.50
|
||
10
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Regular Cold
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SoSo
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0.50
|
||
11
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Rent A Shared Room (RASR)
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High
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1.00
|
||
12
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Secondary Bacterial Infections
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SoSo
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0.50
|
||
13
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Secondary Fungal Infections
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Low
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0.00
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||
14
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Sleep
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High
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1.00
|
||
15
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Other Not Specified
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SoSo
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0.50
|
||
-
|
|||||
CALC
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8.50/15
|
||||
Respiratory Complication Co-morbidity Risk Level =
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56.7%
|
||||
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-
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Last Reviewed: 20200407-TU:
High scores are less favorable
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-
Introducing Structured Temporal Reconciliation (MSG-STR) -
Coarse
Table - Teladoc Visit Summary - Treatment
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|
||||
LxE
Time Stamp
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Practitioner
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Specialty
|
Note
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-
|
||||
20190321-TH
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Annie Nguyen
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Tele-doctor
2019 #1 of 1
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Resolved presenting problems
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20200226-W
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Kevin Weiss
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Tele-doctor
2020 #1
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Resolved presenting problems
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20200320-W
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Teladoc
Phone Teck
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Corona Complications
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Told to stay the call if not life threatening
Wait much longer that usual
No medication yet thus rely on OTC treatment(s)
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-
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LxE = Lived
Experience
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Treatment Strategies
As is usual for “The Cold Season”
we here at Mentalation Solutions Group and Tork Reconstruction Company before
us apply Over-The-Counter (OTC) “Fixes” as needed (PRN) to address “Buster’s”
signs and symptoms. Detailed in the
following table are some of the ingredients about this (2020) year’s OTC
arsenal (20200330-M: OTC Cocktails). We
have three principle types of regimens: 1st nothing at all per day, second
one or two types per day, and third very little of each per day. The biggest change this year (2020) over
last year (2019) is we now watch our intake of Acetaminophen closely. Historically one of our FAV remedies has
been Theraflu Nighttime. We now know
“Buster” was ingesting too much Acetaminophen via Theraflu As Measured By (AMB)
his Liver Lab Work 2019..
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-
20200330-M: OTC Cocktail
Table – Over-The-Counter (OTC) Protections
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|
|||||
Brand
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Description
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Active Ingredients
|
Dosing
|
||
-
|
|||||
Mucinex
|
Children’s Multi-Symptom Cold
|
Dextromethorphan HBr
Guaifenesin
Phenylephrine
|
Teaspoon
|
||
TopCare
|
Mucus Relief Severe Congestion & Cough
|
Dextromethorphan HBr
Guaifenesin
Phenylephrine
|
NA
|
||
Benedryl
|
NA
|
||||
Equate
|
Antihistamine & Nasal Decongestant
|
Chlorpheniramine
Phenyephrine HCl
|
1 tablet
|
||
Baby Aspirin
|
1 tablet
|
||||
Certified
|
Acetaminophen
|
Acetaminophen
Diphenhydramine HCl
|
½ tablet = 250 mg
|
||
HealthA2Z
|
Mucous Relief DM
|
Dextromethorphan HBr
Guaifenesin
|
½ tablet
|
||
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|
Last Reviewed: 20200330-M:
-
Corona Complication – Family
Lived Experience (LxE)
Sometimes it is hard for “Buster”
not to stress over this “Corona” thing.
Too bad the US as a Nation divested about Sanatoriums. During the 1960s there was a really nice one
in which to heal in Garden Grove (Greenbrier).
Also “Fairview” Developmental Center could have come in handy if anyone
had any foresight. We foresee some
“Institutions” revitalized and/or repurposed so we “Won’t Get Fooled Again!”
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[INCLUDE PHOTO OF AURORA’S
BROTHER]
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Sister-in-law's brother dies (2020) of Corona Associated Illness (CAI)
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"Buster" at his doctors office
-
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Table - Stages Before Making the Call – Virtual Care
Steps after a consumer’s Teladoc Account is set up
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|
|||||
Stage
|
Note
|
Detail
|
|||
-
|
|||||
Reservations
|
Our in person doctor makes “Buster” feel he deserves it
|
“Buster” in his stupidity smokes cigarettes
|
|||
Impetus to call
|
Green Mucous
Burning in chest
|
Waited too long if blood is in his mucous
|
|||
Avoidance
|
Let’s give it another day
|
||||
Motivation
|
Extreme fatigue sets in
|
Usually most noticeable when on Respite
|
|||
Decision
|
Use the phone method
|
Online Teladoc method has some glitches
|
|||
Commitment
|
Ready self for phone consultation
|
Mainly list of symptoms
History if necessary
|
|||
Making the call
|
This year “Buster” was served once by doctor Weiss
|
About 1 month later “Buster” was in need again
He was told due to Corona hold off if possible
|
|||
Answer the incoming call
|
Engage in phone consultation (visit)
|
Confidence with Teladoc growing
|
|||
-
|
Last Reviewed: 20200408-W:
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Notes for Making The Call
-
Account Set Up – Have Account
Info on Hand
-
Making “The Call” Teladoc - Account & Contact Info
-
Record Confirmation #: _ _ _ _ _ _ _ (Example 9038312)
-
Sample: “If you have any questions, call 1-800-Teladoc
(835-2362). Keith, Your phone consult begins in 10 minutes.”
-
Wait and Pick Up Call
Reference Presenting Problems
-
-
Date of Service: Service Windows: 20190321-TH: 20200224-M:
20200226-W:
Table - Phone Driven Visit Consult –
Updated Results – Part I of II
Concern Logger
-
|
||||||
##
|
Item
|
Addressed
2019
0321
(TH)
|
2020
0224
(M)
|
2020
0226
(W)
|
||
-
|
||||||
01
|
Doctor’s Name
|
Annie Nguyen (F)
|
CDM (M)
|
Kevin Weiss
|
||
02
|
Argument for Antibiotic Fix
|
PASS
|
Self-Referral
|
PASS
|
||
03
|
Mucous Color
|
Pink
May be blood
|
Green
|
Green
|
||
04
|
Addressed as allergy
|
Yes
|
No
|
Yes
|
||
05
|
Addressed as cold
|
Yes
|
No
|
Yes
|
||
06
|
Confidence with Doctor
|
PASS (33%)
|
Fail (0%)
|
PASS (66%)
|
||
07
|
Diagnosis
|
Infection
(Respiratory)
|
Not
|
Pneumonia
|
||
08
|
Elevated Neutrophils
(See lab)
As Measured by CBC
|
Yes
|
Not
|
No
|
||
09
|
Extreme Fatigue
|
Yes
|
SoSo
|
Yes
|
||
10
|
Heterogeneous household symptom density in play
|
Yes
|
SoSo
|
SoSo
|
||
11
|
Impetigo Indicator for stress
|
No
|
No
|
No
|
||
-
|
Last Updated: 20200408-W: CDM = Chester D Mojica MD
-
-
Date of Service: Service Windows: 20190321-TH: 20200224-M:
20200226-W:
Table - Phone Driven Visit Consult –
Updated Results – Part II of II
Concern Logger
-
|
||||||
##
|
Item
|
Addressed
2019
0321
TH
|
2020
0224
M
|
2020
0226
W
|
||
-
|
||||||
Doctor’s Name
|
Annie Nguyen (F)
|
CDM (M)
|
Kevin Weiss
|
|||
-
|
||||||
12
|
Interfering with Sleep
|
Yes
|
Yes - Cough
|
Yes
|
||
13
|
Left ear blockage
|
No
|
No
|
No
|
||
14
|
Mucous on & off green
|
Yes
|
Not Yet
|
Yes
|
||
15
|
On Health Respite
|
Yes
|
Yes
|
Yes
|
||
16
|
Onset
|
Chronic Cough
Nov 2018
|
20200220-TH
Sore Throat
|
20200220-TH
Sore Throat
|
||
17
|
OTCs Tried (Listed)
|
Yes
|
Not
|
Said would not help
|
||
18
|
Prescription(s)
|
Doxycycline
|
Not
|
Doxycycline
Albuterol Inhalation
|
||
19
|
Satisfied
|
YES
|
No
|
YES
|
||
20
|
Sore glands in neck
|
No
|
No
|
Yes
|
||
Time Spent about concern and presenting problem
|
20 minutes
|
None
|
8 minutes
|
|||
22
|
Waking up sicker than when going to bed
|
No
|
Yes
|
Yes
|
||
-
|
Last Updated: 20200408-W: CDM = Chester D Mojica MD
-
-
FYI
Teladoc Health - Healthcare
company
Description
“Teladoc Health, Inc., formerly
referred to as Teladoc, Inc. and Teladoc Medical Services, is a multinational
telemedicine and virtual healthcare company based in the United States. Primary
services include telehealth, medical opinions, AI and analytics, and licensable
platform services.”
-
20200408-W: Stock price: TDOC
(NYSE) $139.10 -2.15 (-1.52%)
Apr 8, 4:02 PM EDT
Customer service: 1 (800)
835-2362
Headquarters: Purchase, Harrison,
NY
Revenue: 417.9 million USD (2018)
Subsidiaries: HealthiestYou, Inc., BetterHelp, AmeriDoc,
LLC, and more
-
-
Structured Temporal Reconciliation (MSG-STR)
Table - Doctors in Current Theater (“Cold Season”) of
Operation
Lived Experience (LxE) with All
-
|
||||||
Lived Experience
Time Stamp
|
Practitioner
(MD)
|
Specialty
|
Note
|
|||
-
|
-
|
|||||
Circa 2007
|
Andrew Inglis
|
Public Health
Medical Director
OCHCA
|
Model of competent Psychiatrist
|
|||
20190321-TH
|
Annie Nguyen
|
Tele-doctor 2019 #1 of 1
|
||||
20200317-TU
|
Chester D Mojica
|
Primary Care Physician
|
||||
2009 till present
|
Clayton Chau
|
|||||
20200318-W
|
Rimal B Bera
|
Behavioral Health Doctor
|
Introduces his Video Appt pursuit
|
|||
20200226-W
|
Kevin Weiss
|
Tele-doctor 2020#1
|
||||
20200325-W
|
Told to wait on it
|
Tele-doctor 2020#2
|
Wait time 2 hours or more
Call back in the morning
|
|||
-
|
Last Reviewed: 20200409-TH:
-
-
Introducing TecknoHealth
Table - TecknoHealth Developments & Ancillary Notions
Development
-
|
|||||
Specification
|
Note
|
Detail
|
|||
-
|
|||||
Computer-driven Assessment
|
Helpful for “”Proof of Concept”
|
||||
Environmental Samplers
Address the Environment Element in
Epidemiology
|
Stage 1 Smartphone capture
|
Stage to capture what Smartphone cannot
|
|||
Lessons Learned from Corona
|
Social Poverty
|
Technology driven social lives
|
|||
Neurofunctionality Panel & Battery
|
Helpful for “”Proof of Concept”
|
||||
Recovery Technology
|
Promote Life Long Learning
|
TV Baby sitter for the old
|
|||
Smartphones for Consumers
|
Free SmartPhones and Internet
|
Promised years ago
|
|||
SuperUsers
Napa County Model
|
What “Buster” was helping the county with
|
Issue of confidentiality
Consumers get rewarded for Technology Driven Productivity
(TDP)
|
|||
-
|
Last Reviewed: 20200408-W:
-
-
Introducing TecknoHealth
Table - TecknoHealth Developments & Core Notions
Development
-
|
|||||
Specification
|
Note
|
Detail
|
|||
-
|
|||||
All-around free Wi-Fi
|
Help avoid disparity in health related resources
|
||||
Computers for Consumers & Families
|
OCHCA Kiosk Project
|
Team “Kathleen” including “Buster” close out the project
|
|||
Computers for K-12 Students
|
|||||
Electronic Health Record
|
OCHCA Cerner
|
Request turned down to be trained as a “SuperUser”
|
|||
Personal Health Record
|
OCHCA Assignment
|
||||
Tele-health
Video Conferencing
|
Proposed as telepsychiatry about ten years ago by LAC-DMH
|
LAC-DMH as model system
|
|||
-
|
Last Reviewed: 20200325-W:
-
-
External Quality Review (EQR) - Surveying by Customer
(Brief)
Table – “Service with a smile” (Sample Cohort)
-
|
||||
Entity
|
Method
|
2020
0409
(TH)
Q*M
|
||
-
|
||||
Rimal (RBB-MD)
|
Vitals Plus
|
3.0
|
||
Chester (CDM-MD)
|
Vitals Plus
|
3.5
|
||
Motel 6
|
Email
|
4.0
|
||
TQ Nguyen (TQN-MD)
|
None
|
4.0
|
||
Teladoc (MDs)
|
On Line
|
5.0
|
||
Microcenter
|
Email
|
5.0
|
||
Boyce (MD)
|
On Line
|
5.0
|
||
-
|
Last Reviewed: 20200408-W:
-
-
Service
Matrix – External Quality Review
Summary (EQR-S) – Three Service Horizons
Consumer – Keith “Buster”
Torkelson
QSM – Quick Score Method -
Teladoc Call Form
-
|
||||||
##
|
Facet
|
Teladoc
2020
0226
(W)
Weiss
|
F2Fdoc
2020
0317
(TU)
Mojica
|
F2Fdoc
2020
0318
(W)
Bera
|
||
-
|
||||||
01
|
Call Center Representative
|
1.00
|
1.00
|
1.00
|
||
02
|
Physician
|
1.00
|
0.50
|
0.50
|
||
03
|
Prescription Service
|
1.00
|
0.75
|
1.00
|
||
04
|
Service/ Timeliness Of The Service
|
1.00
|
0.33
|
0.25
|
||
05
|
Compare Face-to-face
|
1.00
|
0.33
|
0.25
|
||
06
|
Access
|
1.00
|
0.33
|
0.25
|
||
07
|
Endorsement
|
1.00
|
0.66
|
0.33
|
||
-
|
||||||
CALC
|
7.00/7
|
3.90/7
|
3.58/7
|
|||
TecknoHealth Service
& Support Score =
|
100.0%
|
55.7%
|
51.1%
|
|||
MSG Star Equivalent
|
5.0
|
2.8
|
2.6
|
|||
-
|
Last Reviewed: 20200408-W:
--
Quality Assurance – Ratings
External Quality Review (EQR) –
Our Part
One of our specialties here at
Mentalation Solutions Group (MSG) is External Quality Review (EQR). “Buster” really enjoys offering up positive
reviews. Teladoc asks each time one
uses their service that the consumer reviews them using their standard format. We have a more rigorous review in the works:
-
01_Asssess_Teladoc_Assigned_Format_19063001_Transformation
-
Our last transaction with Teladoc
was on February 26, 2020 with Teladoc Kevin Weiss. We reward Doctor Weiss 5.0 MSG Stars.
-
-
Table – Teladoc Centered Themes – Comparison – Teladoc V PCP
-
|
|||||
Themes
|
Teladoc
|
Regular PCP
|
|||
-
|
|||||
Respites Asset
|
Proven
|
SoSo
|
|||
Doctor Full Vitals Plus
Our Measure
|
Annie
|
Chester
|
|||
Objective Online
|
NA
|
SoSo
|
|||
Satisfaction
|
Yes
|
SoSo
|
|||
Performance Earned Value
|
Yes
|
SoSo
|
|||
Health Risk Assessment (HRA)
|
Decreased risks
|
SoSo
|
|||
COPD Risk Management
|
Complimentary
|
Weak
|
|||
Antibiotics
|
Used properly when indicated
|
Never prescribed over 7 seasons
|
|||
Respiratory probiotics
|
NA
|
Not discussed
|
|||
Brand New Day
|
Free service
|
No Invoicing
|
|||
Other Partners
|
Pharmacy
|
Pharmacy & Quest
|
|||
Doctor written Follow Up Reports
|
Weak
|
Weak
|
|||
Continuity of Care Report
|
Promised
|
Never says he received one
|
|||
Blog
Sharing and Promotion
|
Yes
|
Yes
|
|||
-
|
Last Reviewed: 20200408-W:
-
Respites & Subsidy Notion
“Buster” lives in what we here at
Mentalation Solutions Group (MSG) call a heterogeneous population. Of the some odd fifteen people that frequent
“Buster’s” home at least one third (1/3) suffer respiratory tract signs and symptoms. Every two months or so “Buster” needs to get
away. In general he takes leave to a
relatively safe local Motel 6. It is
not until he is on his own with Respite that he knows his health status. If he is not sick he is either on
Productivity or Adventure Respite. An
Adventure Respite is one where he meets up with his childhood neighborhood
friend for dinner. We here at
Mentalation Solutions Group (MSG) would like “Buster’s” insurer to subsidize
their members’ Respites to the tune of one hundred dollars ($100.00) every
month. We figure it could save Brand
New Day (BND-Insurer) about the hospitalization recourse.
-
-
20190322_0700 - “Greetings and
happy ItSaFriday!
Yesterday I gave service called
Teladoc a try. It is covered free of
charge by my health plan. It is
designed as an alternative to Urgent Care or the Emergency Room. We phone consulted with Teladoc doctor Annie
Nguyen for 20 minutes and in the end she agreed with us that we had an
infection that could be treated with antibiotics. Yeah! Teladoc encourages
us to “Spread the word”. For this
transaction we score doctor Nguyen 5.0 Stars with 5.0 Stars being best. (KET, 2019)
-
Teladoc Homepage
-
Transaction & Treatment Notes
& Progress Notes
Compare Annie with Chester
Here we briefly compare Doctor
Annie Nguyen (Teladoc) with Doctor Chester Mojica (In person PCP). On March 21st, 2019 (TH) we here
at Mentalation Solutions Group (MSG) set up “Busters” account with Teladoc. Teladoc is a telehealth service provided
FREE of charge by “Buster’s” insurer Brand New Day (BND). Later in the day, March 21st,
2019 “Buster” made the call to Teladoc.
“Buster” was triaged by a Teladoc phone representative and
scheduler. Within the hour “Buster” had
what he needed to get well. We offer
Kudos to Teladoc and Teladoctor Annie Nguyen.
“Buster” had already let his PCP Chester Mojica have a shot at helping
“Buster” with what was needed. What was
needed is defined by what Doctor Nguyen (Teladoc) delivered in service and
treatment.
-
-
-
Doctor Nguyen diagnosed “Buster’
as suffering an unspecified respiratory infection. She prescribed Doxycycline Hyclate 100 Generic for
Vibramycin. “Take one capsule by mouth
twice daily for 7 days for infection”.
She indicated “Buster” needed to link up with his normal doctor within
two (2) weeks in order to meet the Continuity Of Care (COC) requirement. She indicated that documentation concerning
the current Teladoc Consult would be transferred to “Buster’s” normal
doctor. She wrote the prescription and
the prescription was delivered by “Buster’s” normal pharmacy. “Buster” took the “Doxy” as prescribed and
began feeling better by morning time.
-
-
MSG Assessment – About Teladoc
Table - Vitals-Plus
Method – Vitals Standard Elements (2019)
Measures of Quality and Satisfaction – Process Phone Visit
(Consult)
Date of Encounter: 20190321-TH:
-
|
|||||
Clinical
|
Clerical &
Scheduling
|
||||
Item
#
|
Patient Ratings
Service Element
|
20190321
(TH)
Teladoc
Annie Nguyen
MD
|
Appt Made
20190321-TH
Teladoc
Phone Srvc Rep
|
Sample
CALC
|
|
-
|
|||||
01
|
Ease of Appointment
|
1.00
|
1.00
|
1.00
|
|
02
|
Promptness
|
1.00
|
1.00
|
1.00
|
|
03
|
Courteous Staff
|
1.00
|
1.00
|
1.00
|
|
04
|
Accurate Diagnosis
|
1.00
|
NA
|
X
|
|
05
|
Bedside Manner
|
1.00
|
1.00
|
1.00
|
|
06
|
Spends Time w Me
|
1.00
|
1.00
|
0.50
|
|
07
|
Follows Up After Visit
|
1.00
|
NA
|
X
|
|
-
|
|||||
Items = 7 (MAX)
|
7.00/7
100.0%
|
5.00/5
100.0%
|
Sum/#Scored
5.00/5*100
|
||
Star Equivalents =
|
5.0
|
5.0
|
|||
-
|
Last Reviewed: 20200408-W:
Indications of Satisfaction:
Actual Data from 20190321-TH: Encounters
Service Rep and Teladoc Annie Nguyen
-
Email Satisfaction Survey (Pending)
After the encounter is closed Teladoc asks that the consumer
review their services. For both the
2019 & 2020 service windows we here at Mentalation Solutions Group (MSG)
give Teladoc five (5.0) MSG Stars. On 20190630-SUN we removed Teladoc Survey
Material as Stand Alone study. In this
Teladoc Survey Study (TSS) we use Teladoc’s instrument rather than ours’.
-
-
MSG Assessment
Table - Vitals-Plus
Method – Vitals-Plus Elements – Part 1 of 2 (2019)
Measures of Quality and Satisfaction – Process Teladoc
Encounter
Date of Encounter: 20190321-TH:
-
|
|||||
Clinical
|
Clerical &
Scheduling
|
||||
Item
#
|
Patient Ratings
Service Element
|
20190321
(TH)
Teladoc
Annie Nguyen
MD
|
Appt Made
20190321-TH
Teladoc
Phone Srvc Rep
|
Sample
CALC
|
|
-
|
|||||
01
|
Accountability
|
1.00
|
1.00
|
1.00
|
|
02
|
Clozapine Awareness
|
1.00
|
0.50
|
1.00
|
|
03
|
Doctor’s Orders
|
1.00
|
1.00
|
0.50
|
|
04
|
Error Free
|
1.00
|
1.00
|
1.00
|
|
05
|
Guidance
|
1.00
|
1.00
|
X
|
|
06
|
Paper Trail
(E-Paper Trail)
|
1.00
|
1.00
|
1.00
|
|
07
|
Pharmacy
|
1.00
|
NA
|
X
|
|
08
|
Phone Support
|
1.00
|
1.00
|
X
|
|
09
|
Promotes Recovery
|
1.00
|
1.00
|
1.00
|
|
10
|
Satisfaction Survey Offered
|
0.00
|
0.00
|
0.00
|
|
-
|
|||||
9.00/10
|
7.50/9
|
||||
Carry
|
Carry
|
Stayed
|
|||
-
|
Last Reviewed: 20200408-W:
Indications of Satisfaction:
Actual Data from 20190321-TH: Encounters
Service Rep and Teladoc Annie Nguyen
-
-
MSG Assessment
Table - Vitals-Plus
Method – Vitals-Plus Elements – Part 2 f 2 (2019)
Measures of Quality and Satisfaction – Process Teladoc
Encounter
Date of Encounter: 20190321-TH:
-
|
|||||
Clinical
|
Clerical &
Scheduling
|
||||
Item
#
|
Patient Ratings
Service Element
|
20190321
(TH)
Teladoc
Annie Nguyen
MD
|
Appt Made
20190321-TH
Teladoc
Phone Srvc Rep
|
Sample
CALC
|
|
-
|
|||||
11
|
Scheduling
|
1.00
|
1.00
|
1.00
|
|
12
|
Situational Awareness
|
1.00
|
0.50
|
1.00
|
|
13
|
Timeliness
|
1.00
|
1.00
|
1.00
|
|
14
|
TimeSpent
|
1.00
|
1.00
|
1.00
|
|
15
|
Values Consumer
(Member-Account)
|
1.00
|
1.00
|
1.00
|
|
16
|
Values Consumers Time
|
1.00
|
0.50
|
1.00
|
|
17
|
Healthful Environment
|
1.00
|
1.00
|
1.00
|
|
18 (8)
|
Agent of Remedy
|
1.00
|
1.00
|
1.00
|
|
-
|
|||||
8.00/8
|
7.00/8
|
||||
Carry
|
Carry
|
||||
-
|
Last Reviewed: 20200408-W:
Indications of Satisfaction:
Actual Data from 20190321-TH: Encounters
Service Rep and Teladoc Annie Nguyen
-
-
Table - Vitals-Plus
Method – Vitals-Plus Elements – Combined Parts 1 and 2 (2019)
Measures of Quality and Satisfaction – Process Teladoc
Encounter
Calculations
Date of Encounter: 20190321-TH:
[ERRORS FOUND
20180926 Recalculations]
-
|
|||||
Clinical
|
Clerical &
Scheduling
|
||||
Item
#
|
Patient Ratings
Service Element
|
20190321
(TH)
Teladoc
Annie Nguyen
MD
|
Appt Made
20190321-TH
Teladoc
Phone Srvc Rep
|
Sample
CALC
|
|
-
|
|||||
Plus Part 1
|
9.00/10
|
7.50/9
|
Carried Forward
|
||
Plus Part 2
|
8.00/8
|
7.00/8
|
Carried Forward
|
||
-
|
|||||
Plus Parts 1 & 2
Items = 18 (MAX)
|
17.00/18
94.4%
|
14.50/17
85.3%
|
Sum/# Scored
13.5/15*100
|
||
MSG Star Equivalents =
|
4.7
|
4.3
|
|||
Impressions - Sustained or Improvement Bonus
|
1.00
|
||||
-
|
Last Reviewed: 20200408-W:
Indications of Satisfaction:
Actual Data from 20190321-TH: Encounters
Service Rep and Teladoc Annie Nguyen
-
-
-
Measures of Quality
& Satisfaction
Table - Vitals-Plus
Method – Combined Scores About Teladoc (2019)
Measures of Quality and Satisfaction – Process Teladoc
Encounter
Date of Encounter: 20190321-TH:
-
|
|||||
Clinical
|
Clerical &
Scheduling
|
||||
Patient Ratings
Service Experience Element
|
20190321
(TH)
Teladoc
Annie Nguyen
MD
|
Appt Made
20190321-TH
Teladoc
Phone Srvc Rep
|
Sample CALC
|
||
-
|
|||||
Items = 7
|
7.00/7
100.0%
|
5.00/5
100.0%
|
Sum/# Scored
4.50/5
%
|
||
Items = 18
|
17.00/18
94.4%
|
14.50/17
85.3%
|
Sum/ # Scored
13.50/15
%
|
||
-
|
|||||
Items = 25 (CALC)
|
24.00/25
96.0%
|
19.50/22
88.6%
|
Sum/# Scored
18.00/20
%
|
||
-
|
|||||
MSG Star Equivalents
(5.0 Stars is the Best)
|
4.8
|
4.4
|
4.5
|
||
With Bonus
IF – THEN Impression
Add 1 to Numerator
|
Stayed
|
Stayed
|
(18+1)/20 * 100 =
95.0%
|
||
-
|
Last Reviewed: 20200408-W:
Indications of Satisfaction:
Actual Data from 20190321-TH: Encounters
Service Rep and Teladoc Annie Nguyen
-
-
Table – CBC - Leukomoid Reaction Complication - Elimination
The major causes of leukemoid reactions are
-
|
|||
Major Cause
|
2020
0408
(W)
Likelihood
|
||
-
|
|||
Severe Infection
|
SoSo
|
||
Intoxications
|
Little
|
||
Malignancies
|
SoSo
|
||
Severe Hemorrhage
|
Little
|
||
Acute Hemolysis
|
Little
|
||
-
|
-
“Doxy”
“Doxycycline is a tetracycline
antibiotic that fights bacteria in the body. Doxycycline is used to treat many
different…” Our Teladoc doctors have
now prescribed “Buster” Doxycycline twice: Once in 2019 and again in 2020. For the most part the course of antibiotics
remedied “Buster’s” presenting problems.
-
[INSERT CBC TIME SERIES GRAPH –
MYQUEST]
-
-
-
Table – Infection Elimination
Tool (IET) & History
-
|
||||
Bacterial Infection
|
“Buster”
Ever
|
2020
0408
(W)
Likelihood
|
||
-
|
||||
Acne
|
A Little
|
Little
|
||
Urinary Tract Infections
|
Yes
|
Little
|
||
Intestinal Infections
|
Yes
|
SoSo
|
||
Respiratory Infections
|
Yes
|
Yes
|
||
Eye Infections
|
Yes
|
SoSo
|
||
Gonorrhea
|
No
|
No
|
||
Chlamydia
|
No
|
No
|
||
Syphilis
|
No
|
No
|
||
Periodontitis (Gum Disease)
|
Yes
|
Yes
|
||
-Others such as…
|
||||
Impetigo
|
Yes
|
Little
|
||
Ear Infection
|
Yes
|
Little
|
||
Infected Wound
|
Yes
|
Little
|
||
Last Reviewed: 20200408-W:
-
Discovering Alternatives
Matrix – Compare Alternatives In Face of Corona –
Specification Example
Teladoc V HeyDoctor Online Care – Models
-
|
|||||
Feature
|
Note (2020)
HeyDoctor (Promises)
|
Note (2019 & 2020)
Teladoc
|
|||
-
|
|||||
On Wait Time
|
Members can receive treatment
within minutes for many common conditions
|
Before Corona
Less than one hour
|
|||
Capacity Building
|
Teladoc caught off guard by Coronavirus
Translates into greater wait times
|
||||
About the doctors
|
Medical visits with board-certified doctors
|
High performing
|
|||
Insurance
|
No insurance required
|
Benefit FREE included with BND Universal Care insurance
|
|||
Prescriptions sent to your pharmacy
|
Discounts of up to 80%.
|
Seamless thus far
|
|||
Question:
Does this replace my regular doctor?
|
No. We treat specific issues and can coordinate care with
your regular doctor.
|
One day it may for certain concerns such as Coronavirus
Treatment
|
|||
Treatment Mode
|
Talk to a doctor and start your treatment online
|
By telephone
|
|||
Wait times
|
Skip the waiting
|
Lengthen due to Coronavirus
|
|||
Promoting Experience
|
Our experience makes the difference
|
We chose Teladoc
|
|||
-
|
Last Reviewed: 20200407-TU:
-
-
Featuring – CBC Requirement
Routine Complete Blood Count
(CBC) Lab – Plan B
On April 1, 2020 (W) @ 10
“Buster” showed up at the Central City Community Health Center (CCCHC) Garden
Grove site for his routine monthly CBC lab work. CCCHC is a Brand New Day contractor. CCCHC staff was still in the process of developing sound
bio-security measures. “Buster” waited
until 1030am to be served. A clinical
staff person triaged “Buster”. She
asked have you been coughing or sneezing within the last couple of days? She also asked do you have shortness of
breath? To all three of these questions
“Buster” answered No. Yet he wondered
if indeed he is symptomatic what would happen with his medically necessary
monthly CBC. We here at Mentalation
Solutions Group (MSG) are investigating alternatives in the case that “Central
City” cannot serve him.
-
Cut Costs
The best alternative at this
point would be to go directly to Quest Diagnostics in Garden Grove. Quest is that lab that delivers about his
CBCs. Teladoc cannot help with this CBC
issue. Actually tele-health is unlikely
to substitute for in-person phlebotomies.
In the future we here at Mentalations Solutions Group (MSG) see with
optimism consumer-driven lab work from specimen collection to reporting
results. In a few of our prior reports
we discussed The Clozapine Registry the body that requires monthly CBC testing
for those taking Clozapine. Before
“Buster” graduated away from Doctor Bum Soo Lee doctor Lee agreed with “Buster”
that CBC testing every-other-month would “save much money”.
-
-
Applying TecknoHealth
Table – Comparing Provision Of Services (POS)
-
|
||||||
Provider
|
Feature(s)
|
QSM
|
Service window
|
Note
|
||
-
|
||||||
Teladoc
(N2CD)
|
Physical health
Limited
Telehealth
|
5.0
|
2019-2020
|
Stellar service with a smile
|
||
RBB
|
Behavioral health
|
3.3
|
2018-2020
|
Fails to impress
|
||
CDM
|
Physical health limited
|
3.5
|
2012-2020
|
Slight improvement
|
||
APD
|
Legacy
Behavioral health
|
4.0
|
1978
|
Missed call on causation
|
||
GoodRX
(N2CD)
|
Pharmacy only
Coupon Site
|
NA
|
NLxE
Not Tested
|
|||
Gilbert Pharmacy
|
Pharmacy
|
4.5
|
2012-2020
|
A few challenges here and there
|
||
HeyDoctor
By GoodRX
|
Online Care
|
NA
|
Not Tested
|
|||
-
|
Last Reviewed: 20200406-M:
-
Nothing To Compare Directly
(N2CD)
All of the Providers addressed in
the table above are not perfect pairs.
Earlier we here at Mentalation Solutions Group (MSG) address our notion
about TecknoHealth. In creating the
table above we are practicing Consumer Driven TecknoHealth. At one point we will better define the
principles of TecknoHealth (MSG, 2020).
-
Not Lived Experience (NLxE)
As is the usual case with us here
at MSG as centered about our principal, “Buster”, we strive to include many of
our Lived Experiences (lxE). We here at
MSG have been working formally in External Quality Review (EQR) since 2012. At this point we need to point out more
positives and strengths with those who serve us. The focus of this report is Teladoc and not any of the
under-performing providers. We include
under-performers in the context of comparison.
We also offer any provider included in this report to share their position(s).
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Objective Statistics
Matrix – Teladoc Driven Statistics - Transparency
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||||||
Spec
|
Teladoc
|
Us
2019
|
Us
2020
|
PCP
2020
|
||
-
|
||||||
Avg. years of experience of Teladoc physicians
|
20+
|
NA
|
NA
|
|||
Rate
Visits every 10 seconds during peak hours
|
1 /10
|
NA
|
NA
|
NA
|
||
Median call back time
|
10 minutes
|
Yes
|
Yes
|
Wait
> 10 minutes
|
||
Fraction of issues are resolved
|
92%
|
Yes
|
Yes
|
50%
|
||
Fraction member satisfaction
|
95%
|
Yes
|
Yes
|
50%
|
||
All time number of visits
|
> 1E6
|
|||||
Number of doctor in Teladoc network
|
> 3100
|
|||||
Affordable
|
Yes
|
Yes
|
SoSo
|
|||
Convenient
|
Yes
|
Yes
|
No
|
|||
Teladoc NCQA score
(Certifications)
|
Perfect
|
Unknown
|
||||
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Last Reviewed: 20200408-W:
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Promotions @ The End
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Example of Relief Measures
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"Buster" Promoting Brand New Day in the Asian Community
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"Buster" A couple of years back visiting a roommate on the infectious disease ward
Roommate being treated for Flu + Pneumonia
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"Buster" on Adventure Respite - Carlsbad California
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No Time 4 Old Men
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[DITTO]
MSG Cemetery
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The End
-30-
999
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