Thursday, April 4, 2019

Brand New Day – Teladoc Benefit Practical – Central City Community Health Center – Alternatives and Betterment - Innovation

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Blog – Brand New Day HMO
Blog Title Information
Brand New Day – Teladoc Benefit Practical – Central City Community Health Center – Alternatives and Betterment - Innovation
Administrator – Keith Torkelson MS

Partners

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20190404-TH: Special Topic –Promotion – Structural Temporal Reconciliation (STR)
Our developments about STR first appear in our database on September 24, 2014 when we define some elements about charting and reconciliation.  As a minimum STR is a promising practice when preparing a complaint or grievance.  It leverages the project management dimension “TIME”.  It also leverages the paralegal competency Structured Case Analysis.  We use it here to help process the information in this report.


FYI - From
H0838_Member Complaint Form Accepted date: 01/26/10 
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Simple STR
“Please state the nature of the complaint: Giving dates, times, persons, places, etc. involved.  Please attach copies of any additional information that may be relevant to your complaint or appeal.”
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Abstract – Summary
This report addresses the client Keith Torkelson.  He is a patient of Chester D Mojica MD (CDM).  CDM either is employed by or contracts for Central City Community Health Center (CCCHC) in Garden Grove California.  This paper addresses the topic applied Telehealth.  Keith’s insurer is Universal Care Brand New Day (BND).  BND provides free of charge a service called Teladoc.  Teladoc provides Telehealth services.  On March 21, 2019 Keith initialized his Teladoc account using both telephone and the Internet.  In the midafternoon Keith received a phone call from his assigned Teladoc doctor, Annie Nguyen.  Keith was very satisfied with Dr. Nguyen because she immediately provided for his unmet need.  Annie prescribed the antibiotic Doxycycline hyclate.  For this she provided a solution.  Applying our Vital Plus (25 Item) Assessment about Satisfaction we score Teladoc Clerical 4.4 Star Equivalents with 5.0 SEs being Superior.  Applying the same assessment we offer up 4.8 SEs to Doctor Annie Nguyen.
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Quality Of Life – Respite - Hospital
She both impacted our Quality Of Life (QOL) and left us feeling Satisfied.  Our tentative diagnosis was unspecified chronic bronchitis.  Doctor Nguyen specified some after care measures.  The Continuity Of Care has been broken.  We were hoping to deal with one of the causes of our bronchitis and that is smoking cigarettes.  We were hoping the get Chantix yet we cannot afford the $250.00/Mos. Out of Pocket.  Yesterday, April 3 (W), 2019 we met with our Behavioral Health Doctor.  Our transaction was poor.  He would qualify as a risk for relapse once we do quit smoking.  In the process of satisfactorily addressing bronchitis we invested for us quite a bit of money.  On January 14, 2019 we started an allergy respite which cost about $400 over the course if 4 days.  On March 19, 2019 we started a Respiratory Health Respite.  We promised Teladoc we would spread the word.  In the end Teladoc was unexpected helpful.  Every year we submit to a Flu Vaccine.  When it comes to antibiotics we need our Primary Care Doctor to get on board.  The episode we had to dilly dallies about way “Toooo” long!
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FYI - Metadata > Alternate Timeline
Assess_CIM_Sleep_Related_19031203_Results
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List of Tables (T) – Figures (F) – Matrices (M) – Etc.
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List of Acronyms & AcroCodes
T – Assessment Theme (Elimination)
F – Results Up Front - Teladoc Clinical Notation
T – Results Up Front - Vitals-Plus Method – Combined Scores – For Teladoc
T – Chest Health Related Needs - Tablized
Timeline – Pre-Teladoc Activity (STR)
Timeline – Pre-Teladoc Activity – PCP Care (STR)
T – Teladoc Activity (STR)
F – A Teladoc Waiting Room
T – Teladoc Follow Up Activity
T – Antibiotic Log – Antibiotic Awareness
T – First String Cast of Characters – Centered About COPD (2019)
T – Second String Cast of Characters – Centered About COPD (2019)
F – Family Inspiration – Ordinal Sister #3
Theme – Teladoc - Continuity of Care – Via Email
T - Issue Type Elimination List (In Scope of Teladoc)
F – Teladoc Solicitation
T - Spreading The Word Promise
F - A Word on Antibiotic Resistance
T - 20190321-TH @330 pm Phone Visit Consult - Results
M – Objective - Insider Scoring of Teladoc
F – CBC Results
F – Our Cohort Exposure - On Taking Home the Germs [DITTO]
F – Sputum (Mucous) with Possible Blood
A-Table – Teladoc Performance Statistics As Reported By (ARB) Teladoc
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List of Acronyms & AcroCodes
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Acronym / Code
Meaning

 -


AVG
Average

BHD
Behavioral Health Doctor

BR
By Report

BND
Brand New Day

CBC
Complete Blood Count

CCCHC
Central City Community Health Center

CCCHC
Central City Community Health Center

CCR
Continuity of Care Record

CCR
Continuity Of Care Record

CCR
Continuity of Care Report

CDB
Family Member

CDM
Our PCP

CMS
Centers for Medicare & Medicaid Services

COC
Continuity Of Care

DL
Dead Line

DOW
Day Of the Week

DX
Diagnosis

ENT
Ear Nose and Throat

FV
Fountain Valley Hospital

GTD
Go To Dude

HHSHs
Health & Human Services Helpers

HRA
Health Risk Assessment

IAF
Incidental Antibiotic Fix

MD
Medical Doctor

MIP
Medical Intake Paperwork

NEI
Not Enough Information

OTCs
Over-The-Counters

PA
Physician’s Assistant

PCP
Primary Care Physician

PRN
As Needed

PX
Prescription

QOL
Quality Of Life

RAT
Risk Assessment Tool

RT
Resolution Team (Teladoc)

SE
Star Equivalents

SPC
Single Point Contact

STR
Structured Temporal Reconciliation

STW
Spread The Word

UCF
Urgent Care Facility

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Table – Assessment Theme (Elimination)



Last Reviewed in Context of Teladoc Transaction 20190404-TH:
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Figure – Results Up Front - Teladoc Clinical Notation
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-
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Table – Results Up Front - Vitals-Plus Method – Combined Scores – For Teladoc
Super Summary
Measures of Quality and Satisfaction – Process – COPD Antibiotic Solution
Date of Encounter: 20180918-TU:
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Clinical
Clerical &
Scheduling



Patient Ratings
Service Experience Element
20190321
(TH)
Teladoc
Annie Nguyen
MD
Appt Made
20190321-TH
Teladoc
Phone Srvc Rep
Sample CALC

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Items = 7
7.0/7
100.0%
5.0/5
100.0%
Sum/# Scored
4.5/5
%


Items = 18
17.0/18
94.4%
14.5/17
85.3%
Sum/ # Scored
13.5/15
%


Items = 25 (CALC)
24.0/25
96.0%
19.5/22
88.6%
Sum/# Scored
18.0/20
%

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Star Equivalents
(5.0 Stars is the Best)
4.8
4.4
4.50


With Bonus
IF – THEN Impression
Add 1 to Numerator
Stayed
Stayed
(18+1)/20 * 100 =
95.0%

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Indications of Satisfaction: Actual Data from 20190321-TH: Encounters (Service Rep and Teladoc Annie Nguyen (Female)) – Last Reviewed: 20190403-W:
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Member Satisfaction
On March 27, 2019 Teladoc self-reported a consumer satisfaction rating of 95%.  This would be the equivalent star score of 4.75.  As you see in the matrix above: We concur!
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Metadata > Full Vitals Plus
11_BND_Teladoc_19031401_Notes II
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Table – Chest Health Related Needs - Tablized
20190325-M @ 1100 am Shared with Derek
Follow up per Teladoc MD Instructions
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Need

As of March 29, 2019
(F)
Extended

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Are antibiotics still indicated?

Not Really


Is an inhaler indicated?

Not Really


Need BND help with quit smoking resources

Pending


Chantix [SPELLED]

Not Approved Yet


Patient Assistance

Investigating


Cannot afford Chantix copay

+ / - $220 / Month


Exploring sisters nicotine gum method

Pondering
Says to mix it with regular gum

Invested in an air purifier to address allergy concerns

Partial Success


How is it BND Helper Gibb’s?

We fired him a few years ago
Dread has turned to annoyance

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Last Reviewed: 20190403-W:
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FYI - Costs – Patient Assistance
The cost for Chantix oral tablet (0.5 mg-1 mg) is around $448 for a supply of 53 tablets, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans. Chantix is available as a brand name drug only; a generic version is not yet available.
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20190404-TH: Meeting to Discuss Chantix with BHD
Rimal B Bera MD – Relapse Risk
RBB was not helpful.  Considering smoking is a behavioral issue one would figure your Behavioral Health Doctor (BHD) could lend a hand.  Instead he disappointed me about my medications general.  In other words we have to find a better way with our management of medications including Chantix.
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Leveraging the Cigarette Tax
A couple of year ago now Californian’s passed a cigarette tax.  We just wish the resources were available to smokers such as us to quit smoking.
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20190402-TU @ 0914 am Derek Follow up on Chantix
Derek Refers to BND Grievances
How is it Derek is our Go To Dude (GTD)?
We hooked up with Brand New Day (BND) back in the summer of 2012.  Since that time we have had four (4) BND Health Human Services Helpers (HHSHs).  A few years back we asked our then current helper for help with housing.  He said I don’t have time.  Incidentally, yesterday April 3 (W), 2019 Doctor Bera says he doesn’t have time to help us.  Running in parallel since 2012 was our relationship / partnership with Derek.  Derek overall is the most helpful person for us at BND.  We were looking through our intake paperwork.  It indicates that we can choose our BND helper.  Jessica Reynolds was our next pick yet she has failed to establish rapport.  So basically we don’t have a BND helper.  And we could still use housing help.  In our second report dealing with Teladoc follow up, we will formalize a grievance testimony.
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Timeline – Pre-Teladoc Activity (STR)
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Time Stamp
DOW
Note
Extended

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20160415
F
Receive BND Teladoc offer by mail
Free service / resource

2017-2018

Let Teladoc service stand idle


2018

COPD Episode
Incidental Antibiotic Fix (IAF)

20190108
TU
Pre-physical
Blood and Urine

20190114
M
4 Day Allergy Respite
Ruled in allergy

20190205
TU
Review lab
With PCP – CDM
Address allergy
No antibiotic prescribed

20190206
W
Jeff Gibbs Calls
How is it?

20190305
TU
CBC & PA Visit
Submit Fecal
Address left ear problem



Key appointment w PCP (CDM)
No indications for antibiotics?






Last Reviewed: 20190329-F:
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Incidental Antibiotic Fix (IAF)
Since 2012 our Primary Care Physician’s Office (PCPO) at Central City Community Health Center (CCCHC) has never prescribed for us antibiotics.  What occurs is another office such as our Dermatologist prescribes us what we call Incidental Antibiotics.  Last year (2018) when we suffered our annual COPD aggravations our Dentist prescribed us antibiotics.  For the most part the Incidental Antibiotics Fix (IAF) as a minimum turns our sputum mucous from green to cloudy or clear.  More often than not our IAF contributes for substantial annual remediation.
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Timeline – Pre-Teladoc Activity – PCP Care (STR)





Time Stamp
DOW
Note
Extended






20190216
TU
Consider Urgent Care
Too much work – To far away

20190312
TU
Revisit Teladoc Option
Hard to believe it is truly free

20190314
TH
Call then back out (Why?)
Overwhelming
Process & False Hope

20190315
F
Online account setup
Abort due to glitch

20190317
SU
Call Teladoc Service Rep


20190319
TU
Begin Respiratory Health Respite (RHR)
$100/Day – To improve quality of sleep and rejuvenation



Teladoc associated emails


20190320
W
Hospital Bound
(Like “Mike”)
Usual routine to meet up with friend is overly stressful
Good night’s sleep did not remedy






Last Reviewed: 20190329-F:

Figure – “Mike O”
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BND CCCHC Client – FV Hosp Infectious Disease Ward
Our Homeboy - Treated for Flu and Pneumonia
BND Team Smoking Cessation Control Subject
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Table – Teladoc Activity (STR)
Day of Telehealth Visit (Consult) – March 21, 2019 @ 330 pm
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Time Stamp
DOW
Note
Extended






20190321
TH01
Create online account
Failure

20190321
TH02
220 pm Call service Rep
Success

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20190321
TH03
330 pm Phone visit (consult)
Annie Nguyen MD

20190321
TH04
Discuss presenting problems and history
Annie Nguyen MD

20190321
TH05
Proclaimed as our alternate
Visit Urgent Care

20190321
TH06
Doctor prescribes antibiotic course
20190327 – Hindsight “Miracle”

20190321
TH07
Doctor Nguyen’s Assignment
COC
Follow up with Health Team(s)

20190321
TH08
FU Gilbert Drugs
714-636-8230
Kudos to Pharm Teck “Nick”

20190321
TH09
Begin Antibiotic Logging


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Last Reviewed: 20190327-W:
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[INSERT PHOTO OF WAITING ROOM]
Figure – A Teladoc Waiting Room
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Table – Teladoc Follow Up Activity
Doctor Nguyen’s Assignment





Time Stamp
DOW
Note
Extended






20190325
M
Follow up with BND
Met briefly with Derek
He took down our Chantix request

20190322
F
CCR – Continuity of Care Record
Record
Failed to be sent to PCP
Attempt online also fails

20190324
SU
Organize notes
For Team BND
Rule out digital appointment rigor

20190402
TU
Follow up on Chantix request
Derek say to go through BND Grievances
20190325-M
Ran into Mark Allen

20190405-DL
F
Close Teladoc portion
With publication







Last Reviewed: 20190327-W:
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Table – Antibiotic Log – Antibiotic Awareness
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Date Stamp
DOW
Note
SVS
Extended

-





20190320
W
Hopeless
“Blood in mucous”



20190320
W-ON

3.5
Waking up worse than when I went to bed

20190321
TH
330pm
Teladoc Phone Consult

Annie Nguyen MD
DX as Infection
PX Antibiotic

20190321
TH
Day 1 of 7



20190322
F


Hope room will be Peaceful enough to have restorative sleep

20190322
F-ON
Slight Fever
5.0


20190323
SAT
Shave

Photograph control infections on right cheek

20190323
SA-ON

4.6


­20190324
SU
Purchase ($100.00)

Air filter / ionizer system

20190324
SU-ON

4.7


20190325
M
Plan FU with BND Derek

Discuss Chantix & Continuing Antibiotics
Want plans in place for continuity of care

20190326
TU
Day 6 of 7



20190327
W
Final – Day 7 of 7

Mucous persists yet it’s clear

20190327
W-ON

4.8
Full night rejuvenating sleep
Air filter appears helpful

20190328
TH
Begin close Teladoc I

Migrate effort to HRA Report

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Last Reviewed: 20190327-W:
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Performance Challenge
Off course we have a way to gauge the COPD gray area.  We will outline are chest health performance areas and share them either in Teladoc II and or Health Risk Assessment.
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Table – First String Cast of Characters – Centered About COPD (2019)
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Character

Clerical &
E_Clerical
Clinical
Note

-





01 - CDM
Chester D Mojica MD

X
X
Our mistaken belief persisted

02 - Teladoc

X
X








03A - Derek C

X
X
20190325-M
Addressed Chantix


03B – Derek C

X

20190402-TU
Referred away

04 – Rimal B Bera MD

X

X
20190403-W
Didn’t like Derek’s Idea

05 – BND Corporate

X
X
20190402-M
Derek suggests going the Grievance







Last Reviewed: 20190403-W:
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Table – Second String Cast of Characters – Centered About COPD (2019)
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Character

Clerical &
E_Clerical
Clinical
Note







06 - Jeff Gibbs

X

20190325-M
Avoided

07 - Jessica R

X

20190325-M
She listened in with Derek

08 – Team Martha



Benign

09 - Corporate Ali E

X

Consideration

10 – Chester Mojica


X
Would have to make a special appointment
Chance of disappointment too high

11 - Teladoc

X
X
They would say we did not follow up with prescribed after care

-





12 - Urgent Care

X
X
Next on our list to test out

13 - Emergency Room


X
Would like to avoid hospital at all costs

-





Last Reviewed: 20190403-W:
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Figure – Family Inspiration – Ordinal Sister #3
Special Topic - Situational Awareness
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Theme – Teladoc - Continuity of Care – Via Email
CCR (Continuity of Care Report]
-
Teladoc Crmail crmail@teladoc.com
Cc: Resolution Team (RT)

Mar 21 at 3:44 PM (TH)

Hello,
We were notified that the completed visit information you requested to be sent to your PCP was unfortunately unsuccessful.  This is more than likely due to a missing or invalid fax number on file for your PCP.  The good news is you have some options available to you 24 hours a day:

You can
Log into your Teladoc member portal to update your PCP’s contact information and resubmit your request.  Print your visit information through the member portal by accessing your visit history and send to your PCP in the method of your choosing.  Or Call us at 888-423-9173 and speak to a representative to assist you in updating and resubmitting the request.

We apologize for the delay and look forward to serving you soon.

Member Support
P: 1.888.423.9173


Facebook | Twitter | LinkedIn

CONFIDENTIALITY NOTICE: This E-Mail Message, including any Attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information or otherwise be protected by law.  Any unauthorized review, use, disclosure or distribution is prohibited.  If you are not the intended recipient, please contact the sender by reply E-Mail and destroy all copies of the original message.
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Table - Issue Type Elimination List (In Scope of Teladoc)
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Issue

Chance
Note


-





UTIs

No
Candidate for Teladoc


Strep Throat

Briefly



Pink Eye

No



Sinus Infection

Possible



Cold/Flu

Possible
Would use OTCs
Have been vaccinated for Flu


Ear Infection

Possible
Would use antibiotic ear drops if necessary


Rash

No



Medication Refill

NA



Bronchitis

Yes



Asthma

Possible
Could be associated with food allergies


-





and more!


Like allergy


-





Last Reviewed: 20190402-TU:
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Quality Sharing - Paying it Forward
Link to “Spread The Word” (STW) - External Quality Review (EQR)
Figure – Teladoc Solicitation
-
-
Table - Spreading The Word Promise
-




Route

Status
Detail

-




Blogger

Brand New Day Blog


BND - Direct

Shared with Derek C


BND Corporate – Use Complaint form to thank

Derek recommendation
Use Grievance Process

By Report (BR)

Grievance


FB




Single Point Contact (SPC) Derek C

20190325-M


Word of Mouth

PRN


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Last Reviewed: 20190402-TU:
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Case Note: 20190322_0700 - “Greetings and happy ItSaFriday!
Yesterday I gave a service called Teladoc a try.  It is covered free of charge by my health plan Brand New Day (BND).  It is designed as an alternative to Urgent Care or the Emergency Room.  Via telephone we consulted with Teladoc doctor Annie Nguyen for 10 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 (STW)”.  For this transaction we score doctor Nguyen 5 Stars with 5 Stars being best.  KET
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FYI - Teladoc Homepage
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Introduction - Antibiotic History
Beginning at about age 3 I remember my mother once a year came down with an ear nose and throat (ENT) issues.  See would self-medicate with Over-The-Counter (OTC) remedies until her symptoms became unbearable.  Our family doctor was John Hanley.  Dr. Hanley was a General Practitioner that doubled as a surgeon.  When mom reached her tipping point she would go to Doctor Hanley and he would patch her up.  Nearly every year my mother was prescribed a course of antibiotics.  She never developed a verified case of antibiotic resistance.  If doctor Hanley deemed antibiotics necessary he would give you an IM injection right in the office to give you a good start in the fight.
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As A Kid
We grew up in a family of eight (8): Two parents and six (6) kids.  When we think back everyone had their health moments.  Yet, the three males had some fairly severe health crises.  When it came to Ear Nose and Throat (ENT) we being the youngest had it rather bad.  If it were not for doctor making good judgement calls by prescribing penicillin we would not recover from our annual ENT crisis.  If it were not for antibiotics in the first place we would have very likely died young. 
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COPD 2018 Winter
As we had mentioned earlier we had a bout with COPD or ENT early in 2018.  By chance we invested in Dental Implants.  Part of the process dictated pre-operative antibiotics.  This course of antibiotics corresponded to recovery our aerobic competencies.  Our current episode for which Teladoc helped us with began in November 2018.
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Table - 20190321-TH @330 pm Phone Visit Consult - Results
 -




Item

Addressed
During

 -




Doctor’s Name

Annie Nguyen (F)


Argument for Antibiotic Fix

PASS


Onset Nov 2018

Chronic Cough


Addressed as cold

Yes


Addressed as allergy

Yes


Mucous on & off green

Yes


20190321-TH Current Mucous pink color

May be blood


Extreme Fatigue




Sore Throat

No
Waxed and waned

Interfering with Sleep

Yes


Elevated Neutrophils (See lab)

Yes


Waking up sicker than when going to bed

No


Left ear blockage

No


Impetigo Indicator

No
Photos of cheeks

Sore glands in neck

No


On Respite for Health

Yes


OTCs Tried (Listed)

Yes
3 month cost >$150

Household symptom density

Yes


Time Spent

20 minutes


Diagnosis

Infection (Respiratory)


 -





Last Reviewed: 20190402-TU:
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Discussion
Lived History and Satisfaction with Teladoc
Back in 2016 we received promotional material from our healthcare provider Brand New Day (BND).  It addressed a free service paid for by BND called Teladoc.  We set the material aside because we did not trust the information.  The cusp of 2018-2019 has been particularly hard on us with regard to respiratory challenges.  We had discussed it on a least one occasion with our Primary Care Physician (PCP).  We also had a mistaken belief that our body could beat the “The Bugs” on its’ own.  We live in a house inundated with coughing and hacking.  We also were made to feel we deserve our sickness because with smoke.  On a day we were generating green mucous our PCP failed to examine it.  We were planning on visiting a BND approved Urgent Care Facility (UCF).  Our roommate coughs and hacks at night.  After he kept us awake from 10pm – 6am we added intense fatigue to our problems.  It was time to take leave in the form of a respite.  Unlike usual when on respite, we wake up feeling better that when we went to bed this was not the case.  So we appealed to Teladoc.  We knew we needed antibiotics.  After a ten minute exchange of information our Teladoc doctor, Annie Nguyen, prescribed us our much needed antibiotics.  Today is March 28, 2019, yesterday we finished the last of our antibiotics. 
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Sample - OTCs Tried
Since November 2018 when our COPD symptoms intensified we have suffered.  We had several mistaken beliefs.  Just one was that the Over-The-Counter (OTC) remedies would bring us back to a better level of health.  In four or so months we spent more than $150.00.  A partial list of OTCs we used is: Theraflu Nighttime, Non-alcoholic cough syrup - Alka Seltzer – Benadryl - Cough and Congestion tablets Congestion gel tabs - B Vitamins and Codeine.
-
About Our House and Room – Teladoc Rescue

We live in a home for dying old men.  A total number of ten (10) adults sleep in our house: Nine males and one female.  This “Cold” season has been particularly hard on the majority of us.  One person was hospitalized with a diagnosis of Flu and Pneumonia.  Even though he (Homeboy) was released (and neglected) he still months later coughing.  At dinner time we are exposed to some odd eight more adult males that come over to eat with us.  These walk ins exhibit few if any COPD like symptoms.  There is a chance that bacteria and or viruses linger in our house.  There are also allergens in our room.  We ruled in allergy while on medical respite.  In other words our allergy symptoms improved while away over the course of three days.  The person who sleeps above has poor hygiene.  Skin flakes particularly from his scalp rain down upon us.  Recently we bought an air purifier for about $100.00 to use at night.  We have noticed an improvement.  Yet nothing has helped us as much as the antibiotics prescribed by Doctor Annie Nguyen via the Teladoc Telehealth service.
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Matrix – Objective - Insider Scoring of Teladoc
-





Category

Teladoc
Score
(5 Best)
CCCHC
Clinical
2019
Predicted
Note (CCCHC)

-





Work-Life Balance

3.2
3.5
NEI

Pay & Benefits

3.5
3.5
We wonder about this

Job Security & Advancement

2.7
3.0
Secure for Martha, CDM and a couple others
Little advancement demonstrated

Management

2.7
3.5
Probably would not like working with them

Culture

2.9
3.5
Gradually improving since 2012

-







15.0/5
17.0/5








A Job Value Score =

3.0 SEs
3.4 SEs
The CCCHC score is very near the insurers CMS Stars scores for 2019







Last Reviewed: 20190403-W:
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Objective - Working at Teladoc Health: 58 Reviews | Indeed.com

-
Summary About Image Matters
Pre-visit Image Criteria and Limit (5)
Upload Image Option
-
Four Images
Lab Work
Mike O’s Germs
Color of Mucous
A Teladoc Waiting Room

[INSERT IMAGES]
A Teladoc Build Slideshow – A Digital Appointment
-
-
Figure – CBC Results
-
-
Figure – Our Cohort Exposure - On Taking Home the Germs [DITTO]
-
-
Figure – Sputum (Mucous) with Possible Blood
-
-
Includes Color after 5 days treatment
-
Figure - Teladoc Waiting Room [DITTO]
Health Respite
-

-
-
Appendix
A-Table – Teladoc Performance Statistics As Reported By (ARB) Teladoc
20190327-W: Teladoc Stats



20190327-W: Teladoc Stats
Who are the doctors?

Promotions
World Wafers
-

-
One Health
-

-
One Health Initiative - One World One Medicine One Health
Mission Statement
“Recognizing that human health (including mental health via the human-animal bond phenomenon), animal health, and ecosystem health are inextricably linked, One Health seeks to promote, improve, and defend the health and well-being of all species by enhancing cooperation and collaboration between physicians, veterinarians, other scientific health and environmental professionals and by promoting strengths in leadership and management to achieve these goals.”
-
Images At The End
-






-
The End
-30-






-

1 comment:

  1. I started on COPD Herbal treatment from Ultimate Life Clinic, the treatment worked incredibly for my lungs condition. I used the herbal treatment for almost 4 months, it reversed my COPD. My severe shortness of breath, dry cough, chest tightness gradually disappeared. Reach Ultimate Life Clinic via their website www.ultimatelifeclinic.com. I can breath much better and It feels comfortable!

    ReplyDelete