Feature Image
Dedicated To Sofia & Howard
Fitted with a pacemaker in her 80s
She is 93 in this photo
[INSERT PHOTO]
Title
For Brand New Day HMO - MSG and Keith “Buster” Torkelson MS Evaluates new contractor Alliance Medical Consulting Peripheral Vascular Exam
Twitter
For Brand New Day HMO - MSG and Keith “Buster” Torkelson MS Evaluates new contractor Alliance Medical Consulting Peripheral Vascular Exam – don’t die of treatable heart conditions https://brandnewdayhmo.blogspot.com/2021/02/for-brand-new-day-hmo-msg-and-keith.html #sheerheartattack #brandnewdayhmo #stigmafreeoc @KeithTorkelsonMS
Promotions at the End
Stigma Free OC
&
Intellectual Partners
Abstract
This report is centered about the
consumer perspective and experience of Keith “Buster” Torkelson MS. Here we address a new Brand New Day (BND)
associated service. BND is Buster’s
health insurer. Late last year 2020
Keith “Buster” Torkelson MS was assigned by a BND Rep to participate in this
new service provided by a contractor: Alliance Medical Consulting (AMC). AMC’s delivers a product centered about a Peripheral
Vascular Exam (PVE). Since AMC’s product
was new Buster with Mentalation Solutions Group (MSG) decided to allocate a bit
of time to initialize the service for BND.
The PVE as a whole has a half dozen or so stages. At the first in-person appoint AMC provided
two documents. The first was what to
expect about their telemedicine product.
This document satisfied a criterion for Informed Consent. The second document was AMC’s Patient Intake
Form. It was a checklist of cardiovascular
associated health problems and risk factors.
In all AMC satisfied the upfront document phase. Where he found it good practice Buster took
photos capturing the AMC experience.
Alliance V Teladoc – Telemedicine
Issue Evaluation (TIE)
The Alliance Experience (TAE)
falls into the category of telemedicine.
With Brand New Day (BND) Buster has previously taken a telemedicine product
for two test drives. This other product
is called Teladoc. Buster used Teladoc’s
telephone appointment option twice: 2019 & 2020. Here we compare TAE with Teladoc. On January 30, 2021 (SAT) we applied
Mentalation Solutions Groups (MSGs) Telemedicine Value Instrument (TVI). Overall Teladoc earned a Telemedicine Value
Score (TVS) of 88.3%. Higher TVI scores
are favorable. Alliance earned a TVS of 45.0%. These numbers in Star Equivalents (SEs)
translate as: Teladoc 4.4 SEs and Alliance 2.3 SEs. Higher SEs are favorable.
Alliance Medical Consulting (AMC)
As we mentioned The Alliance Experience (TAE) has multiple states. Half way through they execute the telemedicine element. On January 30, 2020 (SAT) there came a Video Conference. The Alliance Rep Bianca Allen failed to connect. Within five minutes of the Video crash she called by phone. Our encounter with Blanca was of average quality.
Summary Risk Level Range – Risk
of Heart & Cardiovascular Disease
It would appear that The Alliance
Experience (TAE) addresses cardiovascular pathology. They promise to detect issues that Buster’s
Primary Care Physician (PCP) may miss.
From online literature we here at Mentalation Solutions Group (MSG)
derived an assessment tool. We call it
our Cardiovascular Risk Evaluation 14 item Screener. In terms of Buster suffering a Cardiovascular
Event (CER) we determined he is at a risk of 42.9%.
The Alliance Experience (TAE) Formative
Evaluation
For Buster and us here at
Mentalation Solutions Group (MSG) The Alliance Experience (TAE) is now summative
in nature. After publishing and a bit of
housekeeping we will put Alliance behind for the remainder of 2020. For Alliance our findings here are formative. We here at MSG constructed an Alliance
Specific Assessment Tool. We call it our
Alliance Plus Assessment 23 item (APA-23).
Our APA-23 delivers an AMC Vascular Exam Proof of Concept Score. About TAE for Proof of Concept AMC earned
themselves 34.8%. Higher Proof of
Concept scores are favorable.
In Appendix - Links to Teladoc
Related Reports
Other MSG Articles Addressing
Tele-medicine (Teckno-health)
In the Appendix we include a link
and extracted information about Buster’s Teladoc Telemedicine Experience. In addition we include objective information
regarding Brand New Day’s expected 2021 performance. If Alliance doesn’t step it up they could
drive down BND’s performance.
FYI - Appendix – PDF – 2021
Summary Star Ratings for Brand New Day
Winter Quarter 2021
2020 was quite a year. Most importantly Buster as well as other Mentalation
Solutions Group (MSG) players did not suffer COVID associated illness or
DEATH. Yet, our overall productivity was
lower than prior years. Near the end of
this report we address an optimistic list of about twelve (12) priority work
efforts. Our primary concern is selling
our Housing Fixes for the disadvantaged including the Homeless.
Promotions
As is often the
case with Mentalation Solutions Group (MSG) publications we use our momentum to
promote Buster’s interests. At the end
we push our World Wafer End Famine Initiative and a movement we believe in called
Stigma Free OC. Well that’s a wrap with
this study’s Abstract.
Contents (Major)
Assigned by Brand New Day Life Coach
Introduction: Promises – Proactive Program (AMC)
Vascular Screening V Telemedicine
Value of TecknoHealth
A Result AMC Medical Records
Alliance Assignment
Alliance V Teladoc – Telemedicine Issue Evaluation (TIE)
Our Alliance association
Process Results
Summary Risk Level Range – Risk of Heart & Cardiovascular Disease
Alliance Plus Assessment (APA-23)
The N in VANS
Detection & Diagnosis
Live With It V Curtail It V Reverse It
Recovery V RIGHTing
SOAP About Telehealth/telemedicine/TecknoHealth
Brief Summary
Appendix - Links to MSG’s Teladoc Related Reports
Winter Quarter 2021
Work Efforts (Sample)
Promotions
World Wafers & Stigma Free OC
Page 1 of 2
Assignment – Brief Summary - Follow
through with the new Alliance service process
Assigned by Brand New Day Life Coach
In House Due Date: 20210212-F:
Briefly: Alliance Medical Consulting Services are Not Recommended at this time due to failure to prove their Vascular Exam concept
After working with Alliance Medical Consulting (AMC) for more than a month we here at Mentalation Solutions Group (MSG) do not recommend their services. It appears that AMC is a new contractor for Brand New Day (BND). BND is Keith “Buster” Torkelson’s health insurer. The costs very likely exceed the benefits in the case of Keith “Buster” Torkelson MS. On November 17 (TU), 2020 AMC entered into Buster’s theater of action. Because The Alliance Experience (TAE) was recommended by someone not in Buster’s treatment team we denied Buster’s participation. On November 24 (TU) 2020 someone on Buster’s treatment team asked him to participate with AMC. On December 8 2020 (TU) Buster showed at 1130 am for his Appointment with AMC. It lasted about 20 minutes. At the onset of what AMC calls a Vascular Exam Buster was presented with: “What to Expect” Information (Informed consent = Pass).
Medical Records
Keith “Buster” Torkelson MS also filled out a Patient Intake form. The exam went rather well. In order to reduce stigma about healthcare we attach these forms in our longer report. After failure to connect via video conference (telehealth) twice Buster’s worker Blanca Allen at AMC called by telephone on January 30 2021 (SAT). She indicated nothing truly remarkable in Buster’s results. Buster requested twice that AMC Email the medical records about these encounters. First time AMC’s “Leo” said he would. Leo didn’t provide any records. Second time his worker Blanca said it cannot be done. Blanca advised to “go to your doctors (Mojica) office to get them”. On February 2, 2021 Buster had his pre-physical. He mentioned to the temporary doctor (Reyes) that AMC had some records for them. Doctor Reyes had Buster fill out a release of information from AMC to Buster’s doctor office.
Proof of Concept
Today is February 9, 2021 (TU) Buster had his Annual Wellness Visit (AWV) this morning with doctor Mojica. Dr. asked Buster if he had anything to say or add. Buster said: “Can you check to see if Alliance Medical Consulting (AMC) sent to this office the results of our Vascular Exam. Dr. Mojica checked his Electronic Health Record – Keith “Buster” Torkelson’s record finding nothing. This is a case of the right information not being in the right place at the right time. Overall we wanted to be done with our information gathering phase in conjunction with this new service today. Neither Buster nor Mentalation Solutions Group (MSG) recommend AMC due to evidence that in Buster’s case they “Failed to prove their concept”. Doctor Mojica was not impressed as we discussed AMC because we were talking about something he was unawares.
February 9, 2021
Introduction: Promises –
Proactive Program (AMC)
Doing independent research the
following represents what Buster initially discovered regarding the Alliance
Product.
Quote and Promises
“That is why here at Alliance
Medical we are dedicated to helping patients identify their risk factors
earlier. Our proactive program allows for physicians and patients to take
action together to live better, healthier, longer lives.”
Assessing for Vascular Risk(s) -
Alliance Medical Consulting (AMC)
AMC Notion - Are you at risk?
“Anyone, including children, can
develop heart disease. It occurs when a substance called plaque builds up in
your arteries. When this [build up] happens your arteries can narrow over time
reducing blood flow to the heart.”
Introduction - Research Phase
& Informed Consent
Early on we here at Mentalation
Solutions Group (MSG) were given very little information about the adventure
with Alliance that Buster was signing on for.
Alliance provided Buster a service Rep named Leo on November 16, 2020
(M). Over the phone Leo offered up a few
clues in his keywords: Vascular Exam, Arterial Exam and Neurological Exam. During this conversation Buster indicated he
could make use of a Neurological Exam if it included a CAT scan, MRI, SPECT any
or all of theml. Leo indicated those are
out of the scope of the Alliance Product.
Advance Preparation – Knowledge
Base
Peripheral Vascular Exam (PVE) –
Checklist Excerpt
Figure
Introduction – Research
With this our current adventure Buster
and Mentalations Solutions Group (MSG) were brought on board for Alliance upon
a Brand New Day worker’s/helper’s request.
We were given little information until we received: Calls, Emails, and
Messages from Alliance. Since we knew
very little about what Alliance wished of Buster we went online searching about
“alliance” and “vascular exam”. Here is
what we feel is the link to a site associated with Alliance Medical Consulting
or AMC. We attempted cross-connecting
information. We here at MSG cannot say with
100% certainty that the Alliance we found online (“allimed”) is the Alliance
that served Buster. Yet the site does
have some good information about cardiovascular physiology, testing and
disease.
Alliance Medical Consulting
“Alliance Medical's goal is to
become a leader in preventative healthcare services that are designed to
improve the quality of care in chronic conditions…Turning value-based care
strategy into action”. You visited this page on 11/16/20.
FYI - Helping healthcare
providers effectively move from volume to value-based care
https://geekymedics.com/peripheral-vascular-examination/
Introduction – Vascular Screening
V Telemedicine
FAQ - Does Medicare pay for
vascular screening?
Obviously someone or something
other than Buster is paying for Buster’s Alliance Experience! So considering Buster is not paying for it we
will not linger about payment issues too much.
We found that: “Medicare Part B (Medical Insurance) covers
cardiovascular screening blood tests once every 5 years”. We assume these are tests such as a lipid
panel that make sense and have routinely been paid for by Buster’s insurer. Alliance’s product has no lab work
component. Alliance’s product appears to
rely on extended sampling of traditional sampling such as blood pressure. They also include sensitivity testing. Yet it looks like how they are compensated is
for their telemedicine component.
FAQ - How Much Does Medicare pay
for telemedicine?
Coverage
"Medicare covers all types
of telehealth services under Part B, so beneficiaries in traditional Medicare
who use these benefits are subject to the Part B deductible of $198 in 2020 and
20% coinsurance," says Juliette Cubanski, deputy director of the Program
on Medicare Policy at the Kaiser Family Foundation. Mar 27, 2020
How to Use Medicare's New
Telehealth Coverage | Medicare | US News
Telehealth and TecknoHealth
Medicare’s Position
“A telehealth visit allows you to
talk with your doctor over the phone instead of visiting a medical facility.
Medicare will cover telehealth visits with doctors, nurse practitioners,
clinical psychologists and licensed clinical social workers beginning March 6,
2020. Medicare beneficiaries will be able to receive services including common
office visits, mental health counseling and some types of preventive health
screenings from home.”
Value of TecknoHealth
Buster has been engaged about telehealth
since 2009. He was immersed in the
promise as a county Technology Advisory Committee (TAC) advisor. He represented the consumer position. In order to get up to speed on the Mental
Health Services Act (MHSA) Technological Needs funding stream and related projects
Buster referenced Los Angeles County (LAC-DMH).
LAC-DMC had about six projects in the works. On the larger end was LAC-DMH’s Electronic
Health Record and on a smaller side is their Telepsychiatry initiative. For the most part Busters assignments
centered about delivering computing resources for Behavioral Health (BH) consumers
and BH consumer Personal Health Records (PHRs).
Reports such as this are born out of Buster’s PHRs (BusterBase). We know the Alliance product is not BH yet it
fits in with our TecknoHealth thinking.
We seriously have to ask: Why have face-to-face appointments and
engagements?
COVID is Going to Stick
COVID is offering a good
opportunity to refine telehealth and telemedicine. In the pursuit for TecknoHealth some of the
shortfalls of traditional medicine may at last be remedied. As people age it becomes less ideal to have
them show in person. When telemedicine
is optimized fewer doctors can better manage larger caseloads. This is favorable in the US because some sources
predict it hard to rejuvenate the workforce after doctors’ time out or
retire. One last benefit is that with
TecknoHealth collection, processing, and distribution of quality assurance
materials is more efficient. As one
source puts it: "The current situation is creating an eminent need for
telehealth…to free up our health care system's resources”.
Materials
In the process of
bringing a report to fruition we here at Mentalation Solutions Group (MSG) do
pretty much what it takes to publish our material with ever improving style. The materials we used to participate in the
Alliance process represent one set of materials whereas the materials necessary
for good report are another set of material.
Keeping it short some of the materials contributing to publication are: Documents,
records, Cardiovascular Related Records, Lab Results and most importantly
internet Connectivity. Buster freely
authorizes the use of his medical records in this report. Below we included two Alliance documents
after Buster examined them: AMC – Telemedicine: What to expect: Satisfies
Informed Consent element & AMC – Patient Intake Form.
Material List –
[INSERT SCANS] – A Result AMC Medical Records
Figures
[INSERT
STIGMA POSITION]
Medical Records
and Stigma Reduction
BND_Alliance_Product_Test_21020203_STR
Buster and MSG’s Alliance
Adventure AKA The Alliance Experience (TAE)
The following represents a good yet partial list of methods we here at Mentalation Solutions Group (MSG) initiated in order to capture Busters’ Alliance Medical Consulting experience. The process for the most part lasted a little less than three months. You will find data and discussion about the items in our list further on in this report. Pictures are worth many words. We here at Mentalation Solutions Group (MSG) find it helpful when Buster photo-documents. Yet try as he may he cannot capture complete film rolls. Below we share photos of Buster during his examination. He is donning his cool happening Corona containment mask and since his feet were a major part of the exams attention he captured his feet. Oftentimes people ask: What are the photos for? Buster says we may work some into a report. Yet few people really know what reporting truly means. Buster likes it when people say oo-ooo-oo take my photo. On average we get much better photos out of the ooo-o-oo-ers.
Alliance Assignment
In person examination
Alliance Equipment
Tele-health Consult (telephone)
Connect up
Keep notes
Leverage MSG STR method
Set due date
Online Research
Persevere
PCP component
Close incidence
Share Brief
Publish longer report
Possibly share direct with BND
Track viewership
Determine value
[INSERT EXAM PHOTOS] – Also a Result
Figures – Buster on exam day
Alliance 2020-2021 & Teladoc 2019-2020
Teladoc is the standard and control
After 20210130-SAT 820am
Appointment
|
- |
|
|
|
|
|
|
## |
Aspect |
Note |
2021 0130 (SA) Alliance Score |
2021 0129 (F-Retro) Teladoc |
|
|
- |
|
|
|
|
|
|
01 |
Informed Consent |
Documented |
1.00 |
1.00 |
|
|
02 |
Value Added |
|
0.50 |
1.00 |
|
|
03 |
No annoying Phone Messages |
|
0.25 |
0.75 |
|
|
04 |
Technical Support (Leo) |
Leo & Blanca |
0.50 |
1.00 |
|
|
05 |
Email Records |
Promised by Leo Refused by Blanca |
0.00 |
0.00 |
|
|
06 |
Continuity of Care |
Pending |
0.50 |
0.75 |
|
|
07 |
Follow Up |
|
0.75 |
0.75 |
|
|
08 |
Health Information Exchange |
Pending |
0.25 |
1.00 |
|
|
09 |
On the Ends Value |
|
0.50 |
1.00 |
|
|
10 |
Platform Kareo Effectiveness |
|
0.00 |
1.00 |
|
|
11 |
Association |
BND |
0.75 |
1.00 |
|
|
12 |
Weekend Follow up |
Undesirable |
0.25 |
1.00 |
|
|
13 |
Time of Day |
820am undesirable |
0.25 |
1.00 |
|
|
14 |
Recommendation(s) |
|
0.75 |
1.00 |
|
|
15 |
Compare with Similar |
Less |
0.50 |
1.00 |
|
|
- |
|
|
|
|
|
|
|
|
|
=6.75/15 |
=13.25/15 |
|
|
|
Telemedicine Value Score (TVS) = |
|
45.0% |
88.3% |
|
|
|
Star Equivalents For Telemedicine = 2021 January |
|
2.3 Alliance Below
Average |
4.4 Teladoc Above Average |
|
|
- |
|
|
|
|
|
Last Reviewed: 20210130-SAT:
Results - 20201224-TH: Alliance
Medical Consulting (AMC)
Participation and Review
Assignment
Early in December 2020 Keith
“Buster” Torkelson’s Personal Service Coordinator (PSC-Howard, 2020) asked
Buster to work with a new contractor.
This contractor’s name was Alliance Medical Consulting. On December 8th, 2020 Buster
attended a ½ hour appointment centered about Vascular Testing. AMC indicated that the results would be
mailed to Buster. We did not have the Alliance
results in time to include with our findings published in MSG 2020 Christmas
Report Card External Quality Review (EQR) report.
Begin better tracking about Our Alliance
association
Track 20201230 Alliance Process –
Key Events
Client – Keith “Buster” Torkelson MS
|
|
- |
|
|
|
|
Time Stamp |
Requirement |
Note |
Note |
|
|
|
- |
- |
|
|
|
Various |
Messaging |
Message under (855) 862-3169 |
|
|
|
Dec 8 2020 (TU) |
In person examination |
@ 1130am |
Unknown clinician |
|
|
Dec 19 2020 (SAT) @4pm |
Kareo Video Appt |
@ 400pm |
Dropped Appt |
|
|
Dec 30 2020 (W) |
Appt made |
For 407pm |
Appt made for Jan 30, 2021 |
|
|
Telehealth Appt |
Service Reps |
With AMC’s Blanca Allen |
Also called telemedicine |
|
|
January 30, 2021 |
Teckno Health Appt |
@ 820am PST |
Blanca Allen Kareo dropped |
|
|
January 30, 2021 |
Phone Appt Contingency |
@ 830am PST |
Connected with Blanca |
|
|
Customer Srvc PRN |
|
Need help call |
833-822-0010 |
|
|
Contact PRN |
|
For Leo |
Need help call 833-822-0010 x5000 |
|
|
|
- |
|
|
|
Last Reviewed: 20210210-W:
Sample AMC Kareo Link
Click in in Messages 5 minutes
before apt
Follow Up Appointment with Blanca Allen (Alliance Rep)
Alliance Medical Consulting (AMC) – Third Attempt – Phone Call
The original or baseline
appointment associating Buster with Alliance was on December 8, 2020 a
Tuesday. On January 30, 2021 a Saturday
AMC attempted to link with Buster via Kareo mediated Video Conference
Call. This was Alliance’s second
attempt. Both efforts failed. On said January date Alliance Rep Blanca
Allen linked up via traditional telephone call.
These last transactions occurred around 820 am on a Saturday
morning. For Alliance and their people
this transaction falls under telemedicine.
For us here at Mentalation Solutions Group (MSG) our dealings with
Alliance we call TecknoHealth (MSG, 2021).
We will point out later some features about Alliance’s Telemedicine
Product (ATP). If we and Buster’s core
treatment team could find any further value in Alliance we will include it in MSG’s
Digital Appointment Product (DAP).
Referencing as needed MSG’s Medical Records Program (MRP)
|
- |
|
|
|
|
Item Test Feature |
20210130 (SAT) Blanca’s input |
Our part |
|
|
- |
|
|
|
|
Blood flow recovery |
LT leg moderate problem |
For the most part sensation in Buster’s left leg mirrors
his right leg |
|
|
Blood Pressure |
147/83 |
20210201-M PCPs’ office reports BP = 132/77 |
|
|
On Vascular impact scale |
Implied OK |
In the middle |
|
|
Both feet |
Reports an absence of sensation |
On and off Buster feels his feet |
|
|
- |
|
|
|
Last Reviewed: 20210202-W:
20210130-SAT: Alliance Follow up Appointment – Case Notes
History and Risk – Appointment with Blanca Allen (Alliance Rep)
Client – Keith “Buster” Torkelson MS
|
- |
|
|
|
|
|
Element |
Alliance phone worker |
Buster Reports… |
Detail Note and Actions |
|
|
- |
|
|
|
|
|
Cholesterol |
Queried |
Controlled with RX |
|
|
|
Exercise |
Queried |
Yes |
Corona has messed with the Brand New Day sponsored gym
membership |
|
|
Heart Attack |
Queried |
No |
Grand Father fatal @ age 94 Aunt was fixed with a pacemaker in her 80s |
|
|
Heart Healthy Diet |
Recommended |
NC |
Reduction in simple sugar planned |
|
|
Jog |
Recommends continuing |
NC |
No other person even the owners in Busters house run or
jog |
|
|
Smoking |
No query |
NC |
Remarkable problem for Buster |
|
|
Stroke |
Queried |
No |
If we were referred to proper testing they probably would
find mini-strokes |
|
|
- |
|
|
|
|
Alliance Medical Consulting (AMC)
Client – Keith “Buster” Torkelson MS
|
- |
|
|
|
|
|
Element |
Worker |
Note |
Detail |
|
|
|
|
|
|
|
|
Health Information Transfer |
Blanca Allen (AMC) |
Records not released to consumer Suggested ask PCP’s office about it |
20210201-M pre-physical in office – doctor reports
Alliance notes are not in our medical record |
|
|
Technical Support Value |
|
Moderate |
|
|
|
Kareo TecknoHealth Platform |
Blanca Allen |
Fails twice |
Kareo is Alliance’s Video conference platform |
|
|
Phone Call |
Blanca Allen |
Finally connected |
|
|
|
Health Information Transfer |
Doctor Reyes (BND contractor) |
Suggested ask PCP’s office about it |
20210201-M Pre-physical stand in doctor say Alliance records no there
– She request us to sign a release form |
|
|
Health Information Transfer |
Doctor Mojica (BND contractor) |
Not in Buster’s Electronic Health Record |
20210209-TU Physical Annual Wellness Visit doctor (Mojica)
reports Alliance notes are not in his medical record for us |
|
|
Process Outcome |
Buster (MSG) |
|
Failure to Prove their Alliance Concept |
|
|
- |
|
|
|
|
Last Reviewed: 20210210-W:
If private pay?
First of all we did not get a
"this is not a bill" invoice for how much Alliance was asking as
re-numeration for their efforts. Even so
Buster probably would not have approved for Alliance related spending if it
were private pay.
Process Results - Client – Keith “Buster” Torkelson MS
Sample of AMC Communications
The following communications occur during the Alliance Service Window (ASW) with Buster. Most of the communications were with “Leo” at Alliance Medical Consulting (AMC). We here at Mentalation Solutions Group (MSG) sampled a few by screenshot. We are glad we did not OPTOUT because we would have missed capturing an sufficient and adequate picture. On December 8, 2020 Buster actually connected with AMC at the Brand New Day site for an in-person Vascular Examination. In the second message below “Leo” indicates he is associated with “Dr. Mojica office”. Doctor Mojica has been Buster’s Primary Care Physician since 2012. Using doctor Mojica turned out to be misleading. In hindsight (February 9, 2021) Dr. Mojica is unaware of any goings on with Alliance. This bothers us because things like this generate confusion and conflict with Buster’s PCP.
Figures - Sample Alliance Related Messages
Comment on this Message – Misleading
Notion – 20210209-TU: Proof in the Pudding
[DITTO] On February 9 2021 (TU) Buster’s Primary Care Physician (PCP) confirmed that he was not associated with Alliance Medical Consulting (AMC) and the work they are doing. Obviously, Alliance is associated with Brand New Day (BND).
Video Conference Follow Up
Message
The last message we share addresses
the Video Conference Follow-up component of the Alliance Service. Alliance indicates to use their Kareo
Platform. Buster was on-video two times
and Alliance failed to pick him up on Video.
After the second failure an Alliance Rep phoned Buster and Buster picked
up. The message below demonstrates a
degree of inconvenience: One the day of
the week is Saturday and two time of the day 820 AM. First thing in the morning Buster is less
forgiving of annoyances. One alternative
that we promoted with Alliance was just to let Buster call in and close the
deal more on his terms. We avoid
addressing of seeking healthcare on the weekends.
Figure
Derived Cardiovascular Risk Evaluation (14 Item Screener)
Determining Clinical Need Assessing for Vascular Risk(s)
The three categories of risk factors are detailed here:
Combined List Score for Keith “Buster” Torkelson MS
|
|
- |
|
|
|
|
## |
Risk |
Risk Level QUAL |
2020 1205 SAT QUANT |
|
|
|
- |
|
|
|
|
01 |
Being Overweight |
Semi |
0.50 |
|
|
02 |
Diabetes |
Semi |
0.50 |
|
|
03 |
Eating An Unhealthy Diet |
Semi |
0.50 |
|
|
04 |
Having High Cholesterol |
Low |
0.00 |
|
|
05 |
Heredity (Including Race) |
Semi |
0.50 |
|
|
06 |
High Blood Cholesterol |
Low |
0.00 |
|
|
07 |
High Blood Pressure |
Low |
0.00 |
|
|
08 |
Increasing Age (*) |
Semi |
0.50 |
|
|
09 |
Male Gender |
Semi |
0.50 |
|
|
10 |
Not Getting Enough Exercise |
Semi |
0.50 |
|
|
11 |
Obesity |
Low |
0.00 |
|
|
12 |
Physical Inactivity |
Semi |
0.50 |
|
|
13 |
Smoking |
High |
1.00 |
|
|
14 |
Tobacco Smoke |
High |
1.00 |
|
|
- |
|
|
|
|
|
|
CALC |
|
=6.00/14 |
|
|
|
Cardiovascular Event
Risk Score (CERS-14) = |
|
42.9% |
|
|
- |
|
|
|
|
|
|
|
|
|
|
(*) The majority of people who die of coronary heart disease are 65 or older...
FAQ - AAR = Are Any Reversible
Assess_Alliance_Plus_Process_Benefit_Proof_21020903_Data
Alliance Plus Assessment (APA-23)
Scored by Keith “Buster” Torkelson MS
|
- |
|
|
|
|
|
## |
Dimension |
Note |
2021 0202 (TU) |
|
|
- |
|
|
|
|
|
01 |
New diagnosis |
No |
0.00 |
|
|
02 |
Help physician |
SoSo |
0.50 |
|
|
03 |
Preventive care value |
SoSo |
0.50 |
|
|
04 |
Patient Outcome trend |
Flat |
0.50 |
|
|
05 |
Chronic disease management |
SoSo |
0.50 |
|
|
06 |
Less burden on health team |
SoSo |
0.50 |
|
|
07 |
Help consumer understand health |
Yes |
1.00 |
|
|
08 |
Uncovered situational elements |
No |
0.00 |
|
|
09 |
Diagnostic value |
SoSo |
0.50 |
|
|
10 |
Value-based care value |
SoSo |
0.50 |
|
|
11 |
Saving time |
No |
0.00 |
|
|
12 |
Early detection |
SoSo |
0.50 |
|
|
13 |
Data Management |
Poor |
0.00 |
|
|
14 |
Integrity |
Weak |
0.50 |
|
|
15 |
Innovation |
SoSo |
0.50 |
|
|
16 |
Partnership |
Weak |
0.50 |
|
|
17 |
Solutions |
Weak |
0.50 |
|
|
18 |
Proof of Concept |
Fail |
0.00 |
|
|
19 |
Impact disease reversal |
Unlikely |
0.50 |
|
|
20 |
Cardiovascular Disease |
SoSo |
0.50 |
|
|
21 |
Neuropathic Disorders |
No |
0.00 |
|
|
22 |
Detecting most pressing health concerns |
No |
0.00 |
|
|
23 |
Quality Assurance Program Consumer ratings |
No |
0.00 |
|
|
- |
|
|
|
|
|
|
CALC |
|
=8.00/23 |
|
|
|
AMC Vascular Exam
Proof of Concept Score = |
|
34.8% FAILS |
|
|
- |
|
|
|
|
Last Reviewed: 20210202-TU:
Discussion – Bigger Picture
The N in VANS & Does
neuropathy affect sleep?
Online Alliance Medical
Consulting or Consultants (AMC) discusses a VANS approach. Try as we here at Mentalation Solutions Group
(MSG) might we could not find a perfect and fitting translation for VANS. We do know that in person Buster had what was
called Peripheral Vascular Examination (PVE).
We interpret the V to be Venous, the A Arterial, and the N
Neuropathic. One of Buster’s elivated
health concerns is SLEEP. If Alliance
could have detected issues about SLEEP with their PVE our time would have been
worthwhile. Online neuropathy can be
associated to SLEEP annoyances.
“Neuropathy can affect sleep in
several ways. For some people, neuropathy symptoms, such as abnormal sensations
or hypersensitivity to touch, particularly in the feet and legs, may make it
difficult to fall asleep or stay asleep.” Nov 14, 2017
Discussion - Value Added &
Medicare Approval
The Alliance literature indicates
their method is a Value-added service.
At some point Medicare has approved Vascular Examinations of the
Alliance type for reimbursement.
Actually we here at Mentalation Solutions Group (MSG) believe Alliance garnered
approval for a telehealth rider.
Specifically Alliance has a rider under telehealth disease
management. We here at MSG are not
one-hundred percent certain that all the material online under Alliance Medical
Consulting is precisely associate with the Alliance that served Buster.
FYI - Alliance Medical Consulting
IPAs/ACOs
The Alliance literature makes reference to IPAs/ACOs. We ferreted around Alliance's web material a bit yet as with VANS below we could find no real good definition for IPA/ACO. ADSC dot come indicates the following definitions for IPA and ACO.
“ACO means Accountable Care
Organization, formed by a group of doctors or hospitals to improve healthcare
delivery to Medicare patients…An IPA or Independent Physician Association helps
doctors negotiate better terms with insurance companies.” Apr 22, 2016
3-Letter Acronyms You Need to
Know: HIE, ACO, MSO, IPA…
https://www.adsc.com/blog/3-letter-acronyms-you-need-to-know-hie-aco-mso-ipa-rcm
People also ask - FAQ: What is
the difference between an IPA and an ACO?
HIN dot come indicates that: “An
IPA traditionally is an Independent Practice Association, which is a rather
loose affiliation of physicians that come together for the purpose of engaging
in joint managed care contracting…The difference between an IPA and an ACO is
that IPAs have traditionally been loosely structured”.
From IPA to ACO - Healthcare
Intelligence Network
Risk Adjustment – Missed
Diagnoses
Alliance indicates with its’
Vascular Exam associated process they will make it easier for physicians. They imply they will catch conditions that
the doctors miss. With the VANS program
Alliance promised accurate documentation.
Yet in practice Alliance document stream fell short. The Alliance process promises to reduce burdens
on MD’s practices. When we addressed our
Alliance Experiment with Buster’s Primary Care Physician (PCP) he indicated it
to be another burden on his time and he was unawares. A goal for any health related program or
product as Alliance is impacting in a positive way: “Patients’ Wellness”. We here at MSG translate this as improved
services, measurably better outcomes - for less cost overall.
The VANS program
“The VANS program is dedicated to
helping patients understand their health.
Today’s healthcare model is moving from volume to value-based care. Many
practitioners are trying to achieve value-based care and meet the expectations
that are set upon them.”
Detection & Diagnosis
Of course Prevention of serious
health conditions, physical, mental, and criminal, is desirable. Yet, the Alliance Vascular Exam process is
one of early intervention. Knowing Buster’s
Primary Care Physician’s time constraints Alliance could be helpful. The Alliance process includes an in-person
examination lasting about twenty (20) minutes.
The whole exam including paperwork takes about thirty (30) minutes. From the data Alliance collects they propose
an appropriate diagnosis. When Buster
had his follow up appointment the video conference element fell through
twice. Buster and Alliance finally
connected by telephone. During the phone
call Busters’ Alliance phone technician failed to make an appropriate
diagnosis. Yet they did succeed in
helping Buster become more aware of his Cardiovascular (CV) health.
The Solution: The VANS Program
“Alliance Medical’s goal is to
become a leader in preventative healthcare services that are designed to
improve the quality of care in chronic conditions. Our program is built to
adapt to any existing medical practice or health system to achieve better
chronic disease outcomes and improve under diagnosed diseases.” We get leery when services promise
“Solutions”. And we get even more leery
when a service declares a monopoly by stating “The Solution. We find that written evaluations can stand up
to the Alliance Method.
Early Intervention - VANS Program will help physicians to?
Alliance indicates that they will
help Buster’s PCP Dr. Chester D Mojica “monitor complications of chronic disease”. We assume that this is not general addressing
any and all chronic health conditions.
While researching Mentalation Solutions Group (MSG) came across an
association between Alliance and a VANS program. Try as we may we could not find a valid
definition for VANS. We assume the
following: V for Vascular or Venous, A for Arterial, N for Neuropathic, and we
draw a blank for the S. Alliance
promised quick analysis of data yet denied Buster his medical records. Alliance promises an efficiency improvement
for in Busters’ case his PCP. Yet as
needed Buster’s PCP did not have access to the Alliance findings. Alliance indicates their Vascular Exam
Process (VEP) may help in “reversing disease progression”. Their process includes: “Proactively detect(ing)
risk factors associated with CVD [cardiovascular disease] and Neuropathic
disorders”. Buster found he could detect
CVD related problem by scoring as few Cardiovascular Risk Event (CVE) written evaluations. He also adds to his CVD evaluation with
objective material from routine and thorough clinical lab testing. Buster is at risk for a Cardiovascular Event
or CVE.
Discussion - Fill in gaps as
necessary
Alliance Medical Consulting appears to be a new service (contractor) for Brand New Day (BND). BND-HMO-SNP is Keith “Buster” Torkelson MS’s health insurer. Buster has been with BND as of 2021 just over eight (8) years. When presented with the Alliance assignment by BND not many knew what is was happening: Fellow consumers, BND staff, Primary Care Physician Staff, etc. Alliance promotes itself as telemedicine. It is due to Buster’s relationship with another BND telemedicine contractor (Teladoc) that Buster vested some effort in closing the Alliance deal for BND. As we addressed earlier: Our dealings with Teladoc has on two occasions blossomed with favorable outcomes. In short, Teladoc is user friendly and Alliance is error prone. For Alliance we applied multiple fixes. Yet in the end we failed to have for our Primary Care Physician (PCP) the Alliance records for him.
Greatest Gaps
Across our Alliance adventure we here at Mentalation Solutions Group (MSG) found many gaps: Up front gaps, mid-stream gaps, and summative gaps. First we were informed of the Alliance process directly from Alliance. We asked around Brand New Day (BND) a bit. BND workers were not well informed. Next when Buster asked BND to get onboard we remained poorly informed about the Alliance process. Since Buster is a high performer about BND we decided to follow through. Telemedicine, telehealth, and TecknoHealth (MSG) are supposed to be completely remote. In order get their process going Alliance required an in-person exam. During their process we found a few gaps in their telehealth component. An example is the Video (Kareo) conference element. After two attempts Buster was unable to link up with the Alliance side. Fortunately, Buster finally connected with his Alliance Rep via old fashion phone call. Yet the biggest gap, one that Buster was unable to bridge, was when his Primary Care Physician (PCP) needed Buster’s Alliance records they were not made available to him
Health Information Transfer (HIT)
For nearly five (5) years Buster did a gig with the Orange County Health Care Agency (OCHCA) Mental Health Service Act (MHSA) Technical Needs Component Advisory Committee (TAC). He was with them while they, the OCHCA, implemented their Electronic Health Record. One benefit of Buster’s MHSA related meaningful engagement was he educated himself on language of progressive Digital Health. A major feature promised by Electronic Health Records is a streamlined exchange of records. The concepts we are addressing are Health Information Exchanges (HIEs) and Health Information Transfers (HITs). The due date for Alliance to transfer their medical records about Buster to his Primary Care Physician (PCP) Dr. Mojica was February 9, 2021. This was the day Buster saw his PCP for his Annual Wellness Visit AKA Physical. Buster did his best to push the records in the right direction. Buster asked Alliance to email them. Buster brought up the outstanding records to a stand in doctor (Reyes) during his Pre-physical. Buster signed for Dr. Reyes an Alliance associated medical records release form. And in the end Dr. Mojica did not get the Alliance records. Overall, Buster’s Alliance records were “not in the right place at the right time”. Alliance failed Buster and Dr. Mojica with regards to a key process for executing HIEs/HITs.
With Rework
Even in the case when a health related agency such as Alliance discovers and adopts a Best Practice they need to prove it in their arena. We found that Alliance did not fully prove their concept: Vascular Exam Product (VEP). Not only in comparing Alliance apple for apple, Alliance V Teladoc, we determine in our Vacuum Test (MSG-VT) Alliance failed to impress. The Alliance Product Value (APV) is low yet with a bit of rework could be substantially improved. Alliance promotes their Vascular Exam product as telehealth yet due to the in person exam component it is not fully telehealth. Last we ask ourselves: Is it necessary? Surprisingly, YES. We suggest they rework the product including capturing Consumer Satisfaction Data (CSD). Here in this report we get Alliance on a better track with satisfying their clients.
[INSERT THE SCARED RABBIT]
Discussion - Phone Etiquette – Alliance
Leo V Blanca
“This call may be recorded for
Quality Assurance purposes”
For the most part most any adult has experienced hearing the statement above or the like at one time or another. Our Alliance partnership lasted just over two (2) months. During that timeframe we managed multiple Alliance related communications. The transactions were by multiple means: Phone calls we picked up, phone calls going to voicemail, Video conferencing, email, and text messages. We address the phone call element here. On the phone we talked with both our Alliance Reps Leo and Blanca. We found Leo hard to understand. His tone is like a gangbanger. He said things such as he is associated with Doctor Mojica’s Office (DMO) that did not pan out. He gave us few good answers. Some of his promises he did not keep. In the end Blanca was better about her phone skills. Overall our phone transactions with Alliance were disappointing.
Discussion - Prevention
Heart
dot Org - Heart Health Risks
Understand Your Risks to Prevent a Heart Attack | ©2021
American Heart Association, Inc.
|
- |
|
|
|
|
|
# |
Risk Factor Type |
Note |
Detail |
|
|
- |
|
|
|
|
|
1 |
Major |
Research has shown that these factors significantly
increase the risk of heart and blood vessel (cardiovascular) disease. |
20201205 SAT QUANT Cardiovascular Event Risk Score (CERS-14) = 42.9% |
|
|
2 |
Modifiable |
Some major risk factors can be modified, treated or
controlled through medications or lifestyle change. |
AAR Are Any Reversible |
|
|
3 |
Contributing |
These factors are associated with increased risk of
cardiovascular disease, but their significance and prevalence haven’t yet
been determined. |
Such as SLEEP |
|
|
- |
|
|
|
|
Last Reviewed: 20210210-W:
Live With It V Curtail It V Reverse
It
The Alliance Medical Consulting AKA The Alliance Experience (TAE) exercise did for us here at Mentalation Solutions Group (MSG) did have some value. It encouraged Buster as well as MSG to address Buster’s cardiovascular (CV) health on a deeper level. Buster’s single biggest CV integrity hurdle is his smoking cigarettes. Buster offsets his daily intake of toxins found in smoking with restorative SLEEP. If he doesn’t get good SLEEP his cardio-pulmonary system begins to fail. One indicator of Buster's failure has been demonstrated by a series of Respiratory Tract Infections (RTIs). As Brand New Day (BND) taught him in their multi-week workshop addressing COPD management much of the damage to his overall health is not reversible. Yet there are some qualities of breathing health (MSG-Respire 2021) we feel Buster can regain. For Buster we are going to restart him on Over-the-counter (OTC) smoking cessation concoctions such as lozenges. BND has an OTC benefit. We plan to ask Busters’ new and improved Worker/helper about the OTC benefit. This proactive pursuit is an act of a ProSumer (MSG) ProSuming (MSG).
Recovery V RIGHTing
Years ago (1989) Keith “Buster”
Torkelson was diagnosed with atypical behavior.
Two separate doctors evaluated Buster in an inpatient setting. Both indicated that not only was Buster
demonstrating atypical behavior(s) yet he would never recover. Buster’s behavior issues have been
periodic. During good periods Buster has
been able to make substantial gains yet never recover. A new hope for recovery blossomed in the form
of the California State Mental Health Services Act (MHSA) language, principles
and new allies. One MHSA principle is
that consumers of health services including behavioral health services do get
better. Yet following MHSA exposure and
new hope Buster fell ill and buried under catastrophe another time. We here at Mentalation Solutions Group (MSG) promote
setting things RIGHT rather than recovering.
Awhile back two diagnoses were reframed into dual diagnosis then co-occurring
disorders (CODs). We posit that a better
catch-more net is Triple Occurring Diagnoses.
First is the atypical behavior, second substance use problems, and last are
legal costs and consequences. When it
comes to legal status Buster has rarely encountered felons that recovered to their
pre-existing favorable states (thriving).
We will continue to develop our (MSG’s) Set Things RIGHT notion. As recovery pertains to Alliance we find
unlikely that Buster even while taking substantial corrective behavioral
measures: He very unlikely to achieve by recovery a prior level of
cardiovascular health and fitness.
Cross Applications
This new and
improve Brand New Day (BND) assignment gave us the opportunity to evaluate a
new process. We now have something in the
BND network to compare the BND Teladoc contractor with. In the advent of Corona we see the utility of
more telehealth products. The Alliance
process we here at Mentalation Solutions Group (MSG) find rather disappointing
and at times frustrating. We include
some Smart Phone screenshots that capture Buster’s Alliance Experience. Basically, the screenshots document Buster’s frustration
with the Alliance process.
Discussion - Howard & Buster Association Kick off date 20201020-TU
Near the end of 2020 (last year) Buster was fortunate enough to be referred to a new Brand New Day (BND) Worker/helper. The referral was executed by BND’s Lampson site Director Sofia. We here at Mentalation Solutions Group (MSG) have been working to get Buster re-assigned for more than two (2) years. Buster’s new and improved BND Worker/helper goes by the name of Howard T. Buster and Howard met briefly in the context of developing rapport and defining the partnership for the first time on October 20, 2020 (TU). If all goes well in 2021 they will get to meet at least once per month. Our Alliance adventured was assigned to us by Howard. We have worked hard about Alliance so as to give Howard a good impression and promote our ProSumer Methods Movement (PSMM).
Mystery Appointment – Mixed
Messages
The Alliance process AKA The Alliance Experience (TAE) for Buster was initiated when we received phone calls and text messages from “Leo” at Alliance Medical Consultants (AMC). On the phone and in the messages he indicated that he is associated with Buster’s Primary Care Physician (PCP) Chester D Mojica. The communications sounded bogus. We asked around and received further other communications related to AMC. In all people in the know stated it was: Diabetes related, vascular related, and heart related. When our new and improved helper, Howard, asked us to attend the AMC exam we agreed. The exam took place on December 8, 2020 at the Brand New Day (Lampson) location. Up until the AMC situation Buster had perfect attendance for the year. If Buster missed anything associated with AMC he was not a fault. We finally closed the AMC exam-results cycle with an over-the-phone consult. We are in the process of pushing the records through in time for Buster’s February 9, 2021 Annual Wellness Visit. AMC doesn’t seem to offer a Consumer Satisfaction Survey (CSS) as does our control agency Teladoc. Rather than the video conference route we would have preferred calling in to close the deal at a time convenient to us. Last note: The AMC records were not available for Buster’s PCP at his Annual Wellness Visit (AWV),
Apply Teladoc Assessment to
Teladoc (TMD) and Alliance (AMC)
“Buster” has been served by Teladoc since March of 2019. He set up his account with Teladoc and pursued two phone consultations with two separate medical doctors. On both occasions Buster was suffering advanced respiratory infections. At least that is what his Teladocs’ posited. Both prescribed antibiotics. Teladoc's treatment worked and got Buster back up on his feet. We here at Mentalation Solutions Group (MSG) use our Structured Temporal Reconciliation (STR) method to close out encounters and balance our books. We also log anything remarkable in Progress Note Format (PNF). Both STR (MSG) and PNF methods come in handy if we need to wage a formal complaint or shut down an inappropriate charge. The deal with Alliance has yet to be closed. At some point they may offer us a Service Satisfaction Survey (SSS or Triple S). In the mean time we applied Teladoc’s SSS to The Alliance Experience (TAE).
Compare Alliance Medical Consulting & Teladoc
Includes Worker’s Position
|
- |
|
|
|
|
|
|
Element |
Teladoc (Buster has a matured partnership) |
Alliance (New Contractor) |
Howard (Worker/Helper) |
|
|
|
- |
|
|
|
|
|
|
(S)ubjective |
Respiratory symptom intensity that needs medication Prescribed antibiotic |
Minor risks or complaints |
Respiratory systems and COPD Focus on impact and associations with housing |
|
|
|
(O)bjective |
Teladoc doctors’ interpretation(s) |
Findings from testing appointment |
His interpretation on Buster’s progress |
|
|
|
(A)ssessment |
Share current complaints |
Various sampling devices |
Progress on Brand New Day related publication(s) |
|
|
|
(P)lan |
Prescribed antibiotics Check point with phone consultation (visit) 2020 February |
Stop follow through after Buster’s Annual Wellness Visit (AWV) |
Share some telehealth summaries and abstracts |
|
|
|
- |
|
|
|
|
|
Last Reviewed: 20210211-TH:
Brief Summary
To sum up Buster and The Alliance
Experience (TAE) association: In short on the part of Keith “Buster” Torkelson
we here at Mentalation Solutions Group (MSG) will promote Teladoc. With respect to Alliance we suggest they
rework their service. We would not
recommend Alliance to Buster’s friends and family members. In addition, we would not advise other Brand
New Day (BND) members to a lot the time necessary to work through the
Alliance-driven process. For Buster he
had the opportunity to address another Healthcare process. He found more value about BND’s Teladoc Benefit. Last he succeeded with the work his new BND
Worker/helper asked him to do :o)
-
Other MSG Articles Addressing Tele-medicine (Teckno-health)
[TELADOC RELATED BACKCOPY]
Tuesday, September 10, 2019
2018-2019 COPD Season By and For
Keith “Buster” Torkelson, MS Brand New Day Teladoc Benefit Pulls Through
http://brandnewdayhmo.blogspot.com/2019/09/2018-2019-copd-season-by-and-for-keith.html
Interventions
During the 2018-2019 COPD Season Buster asked for help more than five (5) times. For the most part all interventions fell short about what was needed. Buster saw his PCP a few times. His PCP wasn’t very helpful. His PCP’s bedside manner floundered once again. He doesn’t seem to have the time or skills to be of any real assistance. At one point Buster activated a BND benefit. This is the telehealth Teladoc service. For her help we award our Teladoc doctor, Annie Nguyen MD, 5.0 stars for excellent service. In sum we asked a minimum of four (4) people for help this COPD season.
Teladoc Update
“keith torkelson teladoc”
201904 > Teladoc Benefit
Practical - Brand New Day HMO
[EMBEDDED LINK]
http://brandnewdayhmo.blogspot.com/2019/04/brand-new-day-teladoc-benefit-practical.html
Apr 4, 2019 - Brand New Day – Teladoc Benefit Practical – Central City Community Health Center - This report addresses the client Keith Torkelson.
Teladoc To The Rescue
Mike O has been our control for Brand New Day interventions about COPD. Buster Rents A Shared Room (RASR). The health of his roommates’ impact Buster’s sleep. Buster is attended ((to) by his Primary Care Physician (PCP) CDM MD. Buster’s doctor: CDM has earned for himself (longitudinal) Virtue scores with a high degree of variation (CDVA - Comparative Doctor Virtue Assessment). On again we used the (our) Boy Scout America virtue assessment to capture Buster’s PCP’s CDVA score. What has changed is Buster doesn’t feel comfortable asking CDM for help. In other words CDM has a low value for interventionism. We demonstrate this (comparing) with our Teladoc consult to Annie Nguyen MD.
[TELADOC RELATED BACKCOPY]
201906 - Digital Appointment for Behavioral
Health Doctor by Keith Torkelson MS - Torkelson Pathology (201906) [AnimaCules
Blog]
http://ktork46.blogspot.com/2019/06/technologicalneeds-in-human-services.html
Jun 23, 2019
Introduction - Appointment Brief
Our (Keith “Buster” Torkelson’s)
last appointment with our New and Improved Behavioral Health Doctor (RBB-BHD)
was April 3, 2019 (W). Doctor RBB
changed our protocol enough that we call this encounter The Crash Appointment
(TCA). It could have been worse
qualifying as a Crash & Burn Appointment.
Our next appointment for which this digital entry pertains is scheduled for
July 3, 2019 (W). We had the opportunity
this year to test a service our insurer Brand New Day (BND) provides free of
charge. This service is called
Teladoc. For us Teladoc falls under the
classification Technological Needs about Health & Human Services. We were delighted that Teladoc delivered as
promised. We have been investigating
another technological promising practice telepsychiatry. At this time we still feel it necessary to
visit our Behavioral Health Doctor (BND) face-to-face. We see him roughly quarterly. We deprioritized our quarterly report about
said BHD regarding The Crash Appointment to move forward. Teladoc has some policies and procedures
(PNPs) that address the Teladoc product we used via a phone consultation.
Promising Practices -
Telepsychiatry
We borrow some of Teladoc’s ideas
to apply to our emerging telepsychiatry needs.
Our insurer Brand New Day (BND) is investigating and delivering some new
case management and treatment bundles.
In another form we will share our telepsychiatry findings with Brand New
Day (BHD) in a letter to their corporate offices. Teladoc encourages sending images before your
phone consult. They limit the consumer
to 5 images per consult. Teladoc also
promises that the doctor (MD) will stay with on the phone until you reach a
satisfactory fix about your presenting problem.
In our case it was for them to urgently issue (prescribe) much needed
antibiotics for our (Buster’s) COPD concerns.
After a seven (7) day course of antibiotic treatment our (Buster’s) COPD
related concerns were substantially remedied.
Appendix – FYI
Research and Literacy
OSCE Checklist: Peripheral Vascular Examination
FYI - TeachMeSurgery Checklist
TeachMeSurgery
Vascular Exam Checklist PDF
FYI - The Peripheral Vascular
System Examination (Content and Assessment)
https://teachmesurgery.com/examinations/vascular/peripheral-system/
Figure - Peripheral Vascular Examination Checklist: Of what to expect
FYI - Appendix – PDF – 2021
Summary Star Ratings for Brand New Day
2021 Medicare Star Ratings -
Brand New Day - H0838
Every year, Medicare evaluates
plans based on a 5-star rating system. Medicare Star Ratings help you know how
good a job our plan is doing. You can use these Star Ratings to compare our
plan's performance to other plans. The two main types of Star Ratings are:
1. An Overall Star Rating that
combines all of our plan's scores.
2. Summary Star Ratings that focus
on our medical or our prescription drug services.
How our members rate our plan's services and care
How well our doctors detect illnesses and keep members healthy
How well our plan helps our members use recommended and safe prescription medications
For 2021, Brand New Day received
the following from Medicare.
Overall Star Rating: 3.5 Stars
Health Plan Services: 3.5 Stars
Drug Plan Services: 4 Stars
The number of stars shows how
well our plan performs.
|
|
- |
|
|
|
Stars |
Interpretation |
2021 CMS Rating For Brand New Day |
|
|
|
- |
|
|
|
5.0 |
Excellent |
|
|
|
4.0 |
Above Average |
Drug Plan Services |
|
|
3.5 |
|
Overall Star Rating Health Plan Services |
|
|
3.0 |
Average |
|
|
|
2.0 |
Below Average |
|
|
|
1.0 |
Poor |
|
|
|
|
- |
|
|
Note: Nothing much pertains to Brand New Day the Medicare link
Winter Quarter 2021
Work Efforts (Sample)
Assessment PRN
Brand New Day Rewards Process
Housing Help Line
Housing Work Group
Grieve
Improve Publication Market Penetrations
Initialize 2021 with Brand New Day
Kill Unproductive Efforts
Medication Management – Lesson Plans
Problem Solving PRN
Sleep Studies
Stabilize New Relationships
TecknoHealth
Telemedicine
Value Added for Routine Physical Exam
Appendix - Associated MSGBase Metadata
In Scope Starts - 2020 Starts
09_BND_Life_Coach_Howard_Via_Sofia_20102001_Notes
11_BND_CCCHC_AWV_AWE_Heart_Health_20111702_Notes
13_MSG_EQR_BND_Telemedicine_Alliance_20122101_Notes
13_MSG_EQR_BND_Telemedicine_Finding_20122006_Notes
Assess_BGL_Diabetes_REN_18020104_Develop V2020
2021 Starts
GHlth_CCCHC_21012903_Physical_Report V2021 Practice
20201020-TU: F2F with Howard T – Developing Rapport (Notes Moved)
Assessing for Cardiovascular Associated Event Risk(s)
CERS-6 Item Screener Survey
Consumer = Buster
|
- |
|
|
|
|
|
|
# |
Risk Factor Category |
Risk Level |
2020 1205 SAT QUANT |
Note |
|
|
- |
|
|
|
|
|
|
1 |
Smoking |
High |
1.00 |
Serious Issue |
|
|
2 |
Eating An Unhealthy Diet |
Semi |
0.50 |
|
|
|
3 |
Not Getting Enough Exercise |
Semi |
0.50 |
|
|
|
4 |
Having High Cholesterol |
Low |
0.00 |
Controlled with Atorovastatin |
|
|
5 |
High Blood Pressure |
Low |
0.00 |
|
|
|
6 |
Diabetes |
Semi |
0.50 |
|
|
|
|
|
|
|
|
|
|
|
CALC |
|
=2.00/6 |
|
|
|
|
Cardiovascular Event
Risk Score (CERS-06) = |
|
33% |
|
|
|
- |
|
|
|
|
|
Assessing for Cardiovascular Associated Event Risk(s)
CERS-9 Item Screener Survey
Consumer = Buster
|
- |
|
|
|
|
|
|
Risk Category |
Risk Level QUAL |
2020 1205 SAT QUANT |
|
|
- |
|
|
|
|
|
01 |
Increasing Age. The majority of people who die of coronary
heart disease are 65 or older. ... |
Semi |
0.50 |
|
|
02 |
Male Gender |
Semi |
0.50 |
|
|
03 |
Heredity (Including Race) |
Semi |
0.50 |
|
|
04 |
Tobacco Smoke |
High |
1.00 |
|
|
05 |
High Blood Cholesterol |
Low |
0.00 |
|
|
06 |
High Blood Pressure. |
Low |
0.00 |
|
|
07 |
Physical Inactivity. |
Semi |
0.50 |
|
|
08 |
Obesity |
Low |
0.00 |
|
|
09 |
Being Overweight |
Semi |
0.50 |
|
|
- |
|
|
|
|
|
|
CALC |
|
=3.00/9 |
|
|
|
Cardiovascular Event
Risk Score (CERS-09) = |
|
33.3% |
|
|
- |
|
|
|
|
Last Reviewed: 20210206-SAT:
Images @ The End
Including Impression Photos of Buster
Promotion - World Wafers Initiative
and Movement (MSG)
Commitment – Calvin Schwabe
Legacy – World Wafer Fixes
When Keith was a student of Doctor
Calvin Schwabe in the late 1980s he committed to Act Locally while thinking
globally. At the time Dr. Schwabe’s
strategy appeared as grandiose. Doctor
Schwabe is considered by many of his contemporaries to be the Father of
Veterinary Epidemiology. He wrote and
published at least three (3) editions of his groundbreaking work: Veterinary
Medicine & Human Health. If you
suffer your way partially through the book you know that it is substantial. Keith's early work in Poultry Nutrition as an
undergraduate in Avian Sciences and later as a graduate student gave him keen
insight in to both individual and population nutrition. Adequate food for human health is still a
huge issue on Earth. Once in lecture Dr.
Schwabe discussed the North-South imbalance and how it is up to the North, the
haves, to better feed the South. Our
idea does not deal with food distribution as much as what to
re-distribute. The North might best
create complete nutrition World Wafers and re-distribute them to the areas in
both the south and north in need!
MSGBase Metadata >
07_Dream_World_Wafers_19042201_Develop V2021
Intellectual & Knowledge Partner
Promotion - Stigma Free OC
Mentalation Solutions Group’s (MSG’s) position on stigma reduction about health and healthcare is that of promoting Transparency and Accountability. Obviously it may never become that healthcare agencies and professionals will be permitted to share raw records for consumers. That is why MSG is proactive with sharing (guarded sharing) Keith “Buster” Torkelson MS’s health records. They might come in handy in the future for others to determine accountability around Buster’s healthcare lived experiences addressing real world phenomena. Another reason we share health records is that they represent a fair degree of objectivity.
