Chester Diokno Mojica
MD Performs Routine Annual Physical Examination on Insured Consumer by and for
KE Torkelson, M.Sci. – Pathology (2017)
Parent Agency Brand
New Day
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Parent Document
11_GHlth_CCCHC_CDM_17100502_Physical_Report
3.5.4
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Stats About Literacy &
Readability
Core Topic – Elimination List
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Special Topic
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Chosen
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1-Satisfaction
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In Depth
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2-Lab – Blood Carbon Dioxide
Levels
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Honorable Mention
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2-Lab – Blood Glucose Level
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In Depth
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2-Lab – Complete Blood Count
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Brief
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2-Lab - Fecal Occult Blood Test
(FOBT)
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Left Out
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2-Lab – Lipids - Cholesterol
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Brief
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ADDRESSING ASSESSMENTS
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Matrix of Core Topics – Last Reviewed: 20171023-M:
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Special Topic – Elimination List
For the Most Part Concentration on All Special Topics Eliminated
in due Course
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Special Topic
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Chosen
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Christmas Report Card
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Compassion Fatigue
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Digital Appointment
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Under Assessments
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Global Health Fitness (HEDIS)
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Under Assessments
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Metadata & Metadata for
Special Topics
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Was - In Depth
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MSG’s Celery Diet
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Was - Brief
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MSG’s Health Related
Engagements (HREs)
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MSG’s Structural Temporal
Reconciliation (STR)
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Patient Portals
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Was - In Depth
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Record Request
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Scheduling
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Link to Legacy Report
[RETAINED]
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Show and Tell
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Sleep Disorder
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Matrix – Special Topic
Elimination List: Last Updated: 20171020-F:
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The Cut In Due Course
In order to meet our deadline we
have decided to cut out our non-lab and non-assessment Special Topics. Some Special Topic material is embedded with
the lab and assessment sections. We
think the report will be a better read if it is not too long. It should come out around thirty (30) pages.
(MSG – Division 11 – Pathology, 2017)
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Abstract _ Executive Summary
On October 10, 2017 (20171010-TU
@ 130) we visited our Primary Care Physician (PCP) Doctor Chester Diokno Mojica
(CDM) for our annual Physical Examination.
We saw him at his offices in Garden Grove in the Central City Community
Health Center Facility. This
constituted our fifth (5th) annual physical in five (5) years. This year up to this point (20171010-TU) we
counted the following as Health Related Engagements (HREs). Total HREs = 99: In Network HREs = 36: Out
of Network HREs = 59. HREs are similar
to Dosage. We had hoped that our Dosage
could have been decreased this year (2017).
The trend indicates that we still need intensive care.
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Outcomes
By the end of the physical doctor
and we mutually agreed that this year’s physical is a 94.0 % success or an
A. This was our best physical in five
(5) years with Doctor Mojica. He closed
the appointment indicating that we should remain Guarded and not to go “out and
party”. For our appointments we prepare
in advance. We usually have one or more
items to Show and Tell. This time we shared
the results of one of our UC Davis Physics Exams. We indicated that we were getting rid of memories. He said “Why are you getting rid of this
good memory”. Our response is it is
part of our (Torkel Saga) Digitization Project. Doctor indicated that we hit the Blood Glucose Level (BGL) Issue
out of the park!
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Our Results Up Front Method
(ORUFM) - Subjective
In most of our studies we present
the objective material first. More
often than not we are subjectively more critical than the objective findings. This time we present our subjective findings
first because it presents a better picture than our objective sources do
:o). Make note we are evaluating the
whole team of individuals that contributed to our annual physical. For the sake of accountability we assign our
outcome measure to the principal I.e. Doctor Mojica. For the purposes of this report Doctor Mojica may be denoted as
CDM. The consumer is Keith Edward Torkelson,
M.Sci. Around here we like to call him
Buster! MSG is his business. Satisfaction is his passion.
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Subjective Up Front Method (SUFM)
For this report we place our
subjective findings before the objective findings. Below: A table presenting our findings about our physical with
Doctor Chester D Mojica (CDM). We used
MSG’s Quick Score Method (QSM). This
would be an example of a consumer rating Services and Supports. The insurer is Brand New Day – Universal
Care. The contractor for PCP care is
Central City Community Health Center (CCCHC).
The provider is CDM and Team.
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#
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Tool
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Note
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20171013-F
QSM
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20171013-F
Letter
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1
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Virtue and Value
Boy Scouts Style
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2
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C
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2
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Vitals
Online Rate Your Doctor
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Mutual Agreement
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3.7
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A-
(94%)
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3
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Vitals
Derived
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3
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B
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4
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Vitals Plus (MSG)
LiveX Development (Theta)
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B
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5
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Blood Glucose Levels (BGL)
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Doctor Perspective
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4
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A
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6
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Blood Glucose Levels (BGL)
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Consumer Perspective
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4
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A
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7
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Lab Assessment
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3.7
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A-
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8
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Clinical Assessment
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3.7
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A-
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9
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Clerical Assessment
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3.7
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A-
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Total/Items Scored
[Grade Point Average]
{Grade}
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30.8/9
[3.4]
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GPA
{A-}
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Table - Last Update: 20171013-F:
Date of Key Appointment: 20171010-TU: Nature of Appointment: Yearly Routine
Physical Examination By CCCHC PCP and Team.
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What’s Up With The “C”?
Just because your doctor gets to
transact with you does not mean she or he is your friend. One of MSG’s assessments to determine if an
individual has the character to make a good friend is our
Commercial-Off-The-Shelf (COTS) Boy Scout of America Value and Virtue (Law)
Assessment (BSA). At this point Doctor
Mojica makes a better doctor than a friend.
We will share his BSA results a bit latter on.
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Objective – Satisfaction
We take the majority of our
objective data from online rating sites.
The two we use most frequently are Vitals and Healthgrades. For us the numbers are weak indicators until
we can find a total number of votes at or greater than one hundred (100). As you can see below that Doctor Mojica’s
on-line ratings exceed that of the parent plan Brand New Day (BND). This very likely translates that CDM can
step it up and in the process improve the plans CMS Stars Ratings (CSR). Brand New Day’s CSR for 2017 is reported as
3.0 Stars.
Initializing Our Objective
Evaluation of Doctor Chester Diokno Mojica MD
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TimeStamp
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Method
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# Of
Votes
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Rating
5.0 is Best
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Interpretation
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20170319-SU
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Healthgrades
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9
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3.2
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20170521-SU
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Healthgrades
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9
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3.2
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20170319-SU
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Vitals
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9
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3.8
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20170521-SU
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Vitals
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10
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3.9
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20170324-F
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POR
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18
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3.5
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Above Average
Mediocre
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20170521-SU
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POR
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19
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3.6
*
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Showing
Improvement
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20161124-TH
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BND Health Plan CMS Stars
(2017)
Parent Plan
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**
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3.0
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“Work of a satisfactory
standard”
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20171006-F
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Healthgrades
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10
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3.0
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20171006-F
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Vitals
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11
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3.9
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Last Reviewed: 20171023-M: Table
– Stars Data for Doctor Chester Diokno Mojica MD – Objective Assessment Results
– POR = Pooled Objective Results. Cleaned Up: 20171006-F: Updated: 20171006-F:
Updating Frequency
We updated this table about four
(4) times in 2017. In the future we
will probably only update twice per year.
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FYI – Query: “chester mojica
vitals”
Give it a try for
yourselves. Enter “chester mojica
vitals” in the search engine of your choice.
Satisfaction – Brand New Day
Consumer Satisfaction
Matrix – Coding Legend –
Prescribed Satisfaction Assessment
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Code
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Meaning
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Code
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Meaning
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X
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Extraction
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W
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Whole
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Matrix – Coding Legend – BND
Corporate Prescribed Satisfaction Assessment
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Acro
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Instrument
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Target
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Offered by
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KCSS-X
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Kansas City Satisfaction Survey
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Consumer
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BND
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ACSS-X
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Annual Consumer Satisfaction
Survey
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Consumer
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BND
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KCSS-W
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Kansas City Satisfaction Survey
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Consumer
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BND-2013
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ACSS-W
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Annual Consumer Satisfaction
Survey
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Consumer
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BND-2015
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Table – Satisfaction Assessment –
Last Update: 20171020-F
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Prescribed Satisfaction
Assessments
For this report we left out our
findings based on Satisfaction Assessment that we prescribed by the parent
organization or insurer Brand New Day (BND).
These surveys consist of some odd twenty-five (25) questions (Items). Part of the questions deal with treatment
experiences with the plan doctors. BND
changed the format and some of the content between 2013 and 2015. The scoring algorithm we wrote for 2013 does
not fit 2015 or later formats. Because
Satisfaction is an MSG Value (Passion) we will puzzle the prescribed assessment
for a re-purpose. In the past, for
example 2012, Doctor Mojica’s office offered their version of a Satisfaction
Survey. They stopped offering it. This constitutes a step back when a provider
is proving that they are achieving a measureable impact. For us this falls partially under
Technological Needs fix and we will report on it separately under consumer
computing needs.
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Key Dates (KD)
We here at MSG have clocked
several Key Dates (KDs) for 2017. The
KD for this report is 20171010-TU.
20171010-TU also constitutes a Major Milestone. This is the date of our most current and
most successful Physical with Doctor Chester D Mojica.
Satisfaction – Brand New Day Consumer
Satisfaction – Metadata
Satisfaction – Brand New Day
Consumer Satisfaction – Metadata
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Metadata
“Metadata is "data
[information] that provides information about other data". Three distinct types of metadata exist:
descriptive metadata, structural metadata, and administrative metadata”. We here at MSG are really in to metadata
because in Health & Human Services as compared to Computer Programming
(done right) we find it lacking. In
programming the documentation (metadata) can be more voluminous that the
code. Above is just an example of one
means we use to manage and share our metadata about TorkBase (2014 and Before)
and AVEYBase (2015 to Present) two of our databases.
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Applied Patient Portal – My Quest
– Labs
We chose to address the lab work
now because it also constitutes objective data. After the labs we move on to our Special Topics that tend towards
subjectivity (cut out). At the heart of
the new improved Primary Care Physician Movement (PCPM) is the Blood Work Panel
(BWP). Quest calls theirs the
Comprehensive Metabolic Panel or CMP.
Looking at the Quest Patient Portal – MyQuest it looks like the samples
tested are fasting blood and urine by micturition.
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Comprehensive Metabolic Panel
Result: What does it mean?
“A Comprehensive Metabolic Panel
(CMP) is typically ordered as part of a routine health exam; when you are being
monitored for a specific condition or are taking medications that may impact
your kidney or liver.” (Quest, 2017)
Test Name: CMP: Collection Date -
09/14/2017
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Tests in a CMP
“Cholesterol, Total, HDL
Cholesterol, Triglycerides, LDL-Cholesterol, Chol/HDLc Ratio, Non HDL
Cholesterol, Comprehensive Metabolic Panel, Urinalysis, Complete, CBC (Includes
Diff/Plt), Rpr (Monitor) W/Refl Titer, Hemoglobin A1c, Creatinine, Random
Urine, Microalbumin, Random Urine (W/Creatinine), TSH, PSA, Hepatitis A IgM,
Hepatitis B Core Antibody (IgM), Hepatitis C Ab W/Refl To Hcv RNA, Qn, PCR,
Hepatitis B Surface Ag W/Refl Confirm (Refl), HIV 1/2 Antigen/Antibody, Fourth
Generation W/Rfl”
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Comprehensive Metabolic Panel
(CMP) - Current: Annual for 2017
In the list of lab tests above
there are some case errors. When Quest
reports the test in a codified form they YELL or use all uppercase. In converting to mixed cases in order to
make the codes realistic we may have missed a few. Example: W/Rfl just doesn’t look quite right.
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MyQuest Notation
“Note: Data displayed only for
results that meet strict identification matching. Historical result view may
vary based on corrected or updated patient demographics. The reference range
displayed may vary due to potential changes in laboratory testing methods.
Please refer to the published reference range on each lab report.” (MyQuest,
2017)
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Aside - Hospital Pathologist
Central Laboratory (HPCL)
One day we may write about our
really hey it is cool happening job as a Clinical Laboratory
Associate/Specialist back about 1990 working with Doctor Harry Inami and Team.
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Patient Portal LiveX
MSG obtained our lab information
and data using Quest Diagnostics’ Patient Portal called MyQuest. My Quest is available to any consumer using
Quest Labs as their lab. As one of our
side endeavors we sell the Patient Portal concept. For example we presented earlier this year to the Orange County
Health Care Agency (OCHCA) Mental Health Services Act (MHSA) Consumer Action
Advisory Committee (CAAC). CAAC has the
role of advising to and for the OCHCA Mental Health Services Act (MHSA)
interest. We assessed as to whether the
CAAC members were satisfied with our presentation. On average they gave us a B-.
We asked our supervisor who was in attendance and in support this day:
What grade do you give us? She said an
A+. She said the CAAC members went from
knowing little or nothing to improving their Patient Portal situational
awareness.
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Linkage by Referral
More often than not consumers
discover their patient portal resources by referral. No one in our BND and CCCHC support teams referred us to
MyQuest. We discovered MyQuest by
ferreting about. Of course we all will
eventually have Patient Portals about our Primary Care provider. CCCHC is behind the curve for implementing a
Patient Portal. There is a chance they
are piggy backing their Meaningful Use requirement on BND’s Cerecons. If you are lucky enough to be served by
Quest Diagnostics give MyQuest a try because it is the highest quality patient
portal we have tested to date. Now let
us get to the lab work! :0)
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FYI - Quest Diagnostics Patient
Login
https://myquest.questdiagnostics.com/web/home
FYI - Tiny Detail - CARBON
DIOXIDE [Example of MyQuest YELLING]
Collection Date - 09/14/2017
Result = 19 mmol/L
Reference = 20-31 (mmol/L)
Addressing Lab Findings -
Slightly Low CO^2
Our latest lab results indicate
that we have slightly low carbon dioxide levels.
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Interpretation
“Low values. Low carbon dioxide
(bicarbonate) levels may be caused by: Hyperventilation, aspirin or alcohol
overdose, diarrhea, dehydration, or severe malnutrition.” In addition low
carbon dioxide may indicate: “Liver or kidney disease, a massive heart attack,
hyperthyroidism, or uncontrolled diabetes.” (Quest, 2017)
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Indicators for Us > Eating
Less Calories > Diarrhea > Dehydration
No Comment Necessary
This is an example of data
presented in text form only. Next we
will present data as graphics for tables, figures and time series graphs.
Lab – Blood Glucose Level
Our Blood Glucose Level (BGL)
results we present in the most detail.
Blood Glucose Level
Collection Date - 09/14/2017
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What we deserve at the Physical
Before looking at the data know
that we were facing Doctor Mojica pointing out a defect that may have led to a
medical intervention rather that a behavioral one. We obtained our results before the exam and saw that he had
ordered a diabetes confirmatory test A1c.
This led us to believe he was readying to make an issue of it. The results below show that our behavioral
fixes including our new and improved Celery Diet worked. For the appointment we thought it
appropriate for CDM to state something like: Wow! I see that! How did you do it? MSG prepared and had on hand our 1-page summary for behavioral
and nutritional changes we made. We
will share it in a Special Report as MSG’s new and improved Celery Diet. Surprisingly Doctor did make a good deal
about the changes we instrumented.
Doctor CDM is moving into pacific waters of Strengths Based Service.
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Avoid the Tiny Details Approach
(ATDA)
Temporarily we are avoiding tiny
details to get into the big picture and finish this report. We did notice that there was a glitch in our
appointment card. They scheduled us for
two pre-physicals and no physical. It
didn’t matter because it was easily corrected.
We were looking forward to a Strengths Based appointment because we
deserved it. Again, some of the
monologue that we wished to hear was: Wow! I see that…How did you do it? We were prepared to give Doctor Mojica as
one (1) page how we did it document.
What we expected was business as usual.
In our past CDM has preferred the choppy seas of a Deficits Based
Approach (DBA). Now let’s address the
blood glucose related lab results: Blood Glucose and A1c.
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Blood Glucose Level (BGL) Results
– Graphic - Time Series or Longitudinal
Collection Date - 09/14/2017
Results 88 mg/dL
65-99 (mg/dL) - Fasting reference
interval
Figure - Blood Glucose Level
(BGL) Results – Graphic - Time Series or Longitudinal
Collection Date - 09/14/2017
Getting It Right
For this year’s Physical what was
it that we got right? One: We saw our
results in advance, which gave us enough time to intervene where
necessary. Two: As usual we fasted. Three: For the first time we drank
absolutely no coffee. The collection
date was at our Pre-physical on 20170914-TU @ 1030am. The actual scheduled Physical Exam was 20171010-TU @130pm. Four: Most importantly we showed up per
schedule. Doctor Mojica (CDM) serves a
population that is hard to get into the office. Some of his cases have trouble waiting for more than ten (10)
minutes before they walk away.
Hemoglobin A1c
Collection Date - 09/14/2017
Results 5.3 (% of total Hgb)
Reference <5.7 (% of total Hgb)
Purpose - For screening for the
presence of diabetes:
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% Of Total Hgb
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Indicates
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Note
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<5.7%
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Consistent with the absence of
Diabetes
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We are here now
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5.7-6.4%
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Consistent with increased risk
for diabetes (Pre-diabetes)
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Four months ago we were here
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> Or = 6.5%
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Consistent with diabetes
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Table Created: 20171019-TH:
Hemoglobin A1c Reference Ranges Per MyQuest 2017
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Interpretation - Hemoglobin A1c
(MyQuest, 2017)
“This assay result is consistent
with a decreased risk of diabetes. According
to American Diabetes Association (ADA) guidelines, hemoglobin A1c <7.0%
represents optimal control in non-pregnant diabetic patients. Different metrics
may apply to specific patient populations.
Standards of Medical Care in Diabetes (ADA).
Doctor’s Prescription – “Keep up
the good work (CDM, 2017)”.
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What we got and paid for?
The appointment of interest is:
20171010-TU @130pm – Physical with Doctor Mojica (CDM). As we mentioned earlier, this is our fifth
(5th) and best physical yet with CDM.
He did mention our Wow! I see that …you tackled the Blood Glucose Level
issue. He pointed our far more
strengths that deficits. Hats off to
Doctor Mojica he’s navigated through the Panama Canal :o)
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Lab – White Blood Cells (CBC and
WBC)
Now we move ahead to examine our
Complete Blood Count (CBC). We first
regularly (1 per month or even more frequent) had a Complete Blood Count (CBC)
back in 2006. This lab test is a big
time topic in a context other that our Physical. CBCs and how they are important for us have been and will be
addressed in other MSG papers. For now,
over time our White Blood Cell (WBC) Count (WBCC) has fluctuated up and
down. Most of the time we face results
measuring that our WBC Count is elevated.
Since 2007 no doctor has ever been able to satisfactorily explain what
is going on. For us an elevated WBCC is
protective. That aside we feel the
highest correlation is between our dental health and lab fluctuation. Doctor Mojica recently associated our
elevated WBC’s with a toe injury.
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[INSERT TOE INJURY]
Image - Toe Injury That Doctor Associated with Elevated White Blood Cell Count
20171019-TH: My Quest Update
Figure - Lab – White Blood Cells
(CBC and WBC) – Period: 20170123-20171004
No Comment Necessary
This is an example of data
presented in time series graph form (Line Graph) or longitudinally. We address this data in separate reports
under CBCs and the CBC Registry (For Clozapine). See the area below 6.0 now that would be a serious problem for
us.
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Lab – Lipid Panel
Here we will give you the Full Monty of data presentations:
Text, lab report, level one and drill down to longitudinal results. They each have some value.
20171021-SAT: Applied: Date of Service: 20170307
For Date of Service 03/07/2017 we
had our Lipid Panel run. We are high
(H) on Cholesterol, Total and LDL-Cholesterol.
For managing our elevated Cholesterol Doctor had put us on Med-A. There was a gap in getting Med-A
refilled. Without it our Cholesterol
went back up to were the report below shows.
To get a look at these results we discovered and signed in with
MyQuest. We were looking for a report
that indicated we actually had been controlled using Med-A. Thus we were looking for a 2015 report. This is how we found out the MyQuest only
supports 2017 results and onwards. For
the 2015 report we got to use Quest’s manual method. They provided us with what we were looking for Free-Of-Fee (FOF). We here at MSG like FOF or pro bono. Pro bono might be described as denoting work
undertaken without charge, especially legal work for a client with a low
income.
Three Different Formats - Name the Formats
Lab Report
Graphic Organizer
Time Series (Longitudinal) – Line Graph
Figure – Lab Report Format
We just checked and this format
is not available online using MyQuest.
It would be the format if Quest were to send a paper report to the
doctor or you as consumer (client). For
long reports this is the best format.
This format has been in use at least since the 1980s.
20170914 – Lipid Panel Update
Collection Date - 09/14/2017
Aside: ASK-Ahnika
Brief promotion for our ASK
Ahnika Idea. We have a niece Ahnika
that is a PhD and MD. We think that one
day she may start an ASK Ahnika Service.
When we ask her Health & Human Services (HHS) questions she boggles
us. By increasing her encounter rate
through her ASK Ahnika Services she might begin to better serve us her at
MSG. We tried to associate us as her
paraprofessional yet to no avail. That
means we have still failed to sell our service.
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Lab - Last format: Time Series or
Longitudinal
Nate: Actually Time Series is a
better name for what many are calling Longitudinal.
Lipid Panel Update
Collection Date - 09/14/2017
Result – 148mg/dL
Reference - <200mg/dL
Figure - Time Series Line Graph – Longitudinal
Format – Cholesterol Update
Lab Topic - PSA, TOTAL – Is
It Sexist?
There are far more results to
Metabolic and Urine Panels. Yet
considering that most are unremarkable we will close with our Prostate-Specific
Antigen or PSA results. PSA is a test
for Prostate-Specific Antigen. As you
can see below our results are favorable.
We work hard on our Prostate health.
It is good to see it is paying off.
We are rather amazed the CDM selected the PSA method to track the health
of our prostate.
Collection Date - 09/14/2017
Result = 0.9
Reference = < OR = 4.0
(ng/mL)
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FYI - Prostate-Specific Antigen
“The total PSA value from this
assay system is standardized against the WHO standard. The test result will be
approximately 20% lower when compared to the equimolar-standardized total PSA (Beckman
Coulter). Comparison of serial PSA results should be interpreted with this fact
in mind. This test was performed using
the Siemens chemiluminescent method. Values obtained from different assay
methods cannot be used interchangeably. PSA levels, regardless of value, should
not be interpreted as absolute evidence of the presence or absence of disease.”
(MyQuest, 2017)
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FYI - PSA Measures and Protection
“Prostate-specific antigen, or
PSA, is a protein produced by cells of the prostate gland. The PSA test
measures the level of PSA in a man's blood. For this test, a blood sample is
sent to a laboratory for analysis. The results are usually reported as
nanograms of PSA per milliliter (ng/mL) of blood.” (MyQuest, 2017)
-
Leveraging Lab Results
The three providers that may help
us collect the record(s) we need are: Brand New Day (BND), Quest Diagnostics
and Central City Community Health Center (CCCHC). Respectively the consumer portals for these are named: (BND) Cerecons,
(Quest Diagnostics) MyQuest, and CCCHC don’t have a portal at this time. The next results from our physical we need
are not available on Cerecons and our not warehoused by MyQuest. We need to get them from CCCHC.
-
Query “central city community
health center records request form”
20171019-TH: We searched online
for a Records Request Form (RRF) on the CCCHC site. We could not find one so we called CCCHC the clinic. They asked us to come in person to fill one
out. CCCHC is sort of behind the curve
as far as what they offer online. Next
we want to know our Spirometry and Hearing Test results. We also accessed the parent agency Brand New
Day’s (BND’s) Patient Portal. Neither
our Spirometry nor our Hearing Test results were reported on the BND Patient
Portal.
-
Action Item - New and Improved –
Informed Decision Making (AI-01)
In order to make promising and
better-informed decisions we are going to request records from Central City
Community Health Center (CCCHC). We
want records from two recent visits: 20170914-TH & 20171010-TU.
-
Formal Paper Record Request
Process (FPRRP)
Just above we addressed the
Record Request Process (RRP) as an Action Item. In our legacy reports we used to commit to many Action
Items. In this report we will keep our
Action Item (AI) commitments to less than five (5).
-
Assessment Segue
Now, let us dispose of the
remaining Assessments.
Assessments (MSG, 2017) – MSG
Assessment Elimination List
|
-
|
|
|
|
Acro
|
Instrument
|
Target
|
Offered by
|
|
|
-
|
|
|
|
BSA
|
Boy Scouts of America
|
Consumer & Provider
|
Consumer
|
|
HFA
|
HEDIS Fitness Assessment
|
Consumer
|
Consumer
|
|
ProQOL
|
Professional Quality Of Life
(Burnout & Compassion
Fatigue)
|
Consumer & Provider
|
Consumer
|
|
RYD
|
Rate Your Doctor (Online)
Series
|
Provider - Objective
|
Consumer
|
|
SAT
|
Satisfaction & Satisfaction
Suggestion
|
Provider
|
|
|
VOA
|
Vitals Online Assessment – KD
|
Provider
|
Vitals
|
|
VAP
|
Vitals Assessment Plus – KD
|
Provider
|
Consumer
|
|
|
|
|
|
|
Table – MSG Assessment
Elimination List – Last Update: 20171020-F
MSG Assessments - Separatism As
Measured By (AMB) - ProQOL
We addressed the Rate Your
Doctors assessments such as Vitals earlier on.
We decided to leave out the Pro-QOL with one note. The ProQOL assessment reflects some provider
consumer separatism. In general
consumers are offered Quality Of Life (QOL) assessments much different from the
ProQOL. The ProQOL is designed to
measure the Quality Of Life for a Professional. This implies that consumers aren’t not worthy to share the
qualities that make life rewarding as a Professional would be gifted. As we stated earlier CCCHC (CMD) discontinued
the Satisfaction Survey that they offered at Physical time. That leaves for discussion our BSA and HFA
evaluation tools. First let us look at
the BSA findings.
-
Quality Of Life (QOL)
|
|
|
|
|
Acro
|
Instrument
|
Target
|
Offered by
|
|
|
|
|
|
|
ProQOL
|
Professional Quality Of Life
(Burnout & Compassion
Fatigue)
|
Consumer & Provider
|
Consumer
|
|
|
|
|
|
|
Table – Quality Of Life (QOL)
Assessment – Last Update: 20171020-F – Results Fractionated Out.
Assessment – Boy Scout Model –
Virtues and Values
Metadata > Assess_Virtues_BSA_14112901_Register
V2017
-
Boy Scouts of America (BSA)
Results Here (Lived Experience)
We guess at age eleven (11) or in
1970 our principal Mr. Torkelson began indoctrination into the Boy Scouts of
America. Because his role models were
either Eagle bound or had achieved the rand of Eagle Mr. Torkelson set his
sights on achieving the rank Eagle. Our
records show he was awarded the Rank of Eagle Scout in 1974. Part of the Eagle process is one
demonstrates knowledge in depth about the BSA Law. You also commit to practice the BSA Scout Law to the best of your
ability in all affairs. MSG’s BSA
instrument is derived from the Standardized Scout Law.
FYI - Scout Law (BSA Assessment –
Brief Version)
-
“A Scout is trustworthy, loyal,
helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean,
and reverent. The Scout Law has 12 points. Each is a goal for every Scout.”
Mutable (Adjective)
Mutable might be defined as
liable to change. If you are mindful of
the Laws in all your activities you can sustain or improve your performance
about the Law.
Metadata – Sampling - Boy Scouts
Assessment (BSA)
Figure – A Sample of BSA Related
Metadata: Last Reviewed: 20171022-SUN
-
Addressing Friend or Fantasy
One of the assessments for
Character and Personality that we here at MSG are familiar with is the basic
version of the Boy Scout Law (BSA). We
often apply it to see if we have a good friend or a good friend in the making. Basically most if not all of our contacts
within “Central City” (CCCHC) do not qualify as Good Friends. Next we have some BSA related data points.
-
Assessment – Standard Boy Scouts’
of America (BSA) – Scout Law
Metadata > Assess_Virtues_BSA_14112901_Register V2017
MSG and Buster Rates Others (Proofed By AVEY)
|
|
|
|
|
TimeStamp
|
Role
|
Result (%)
|
MSG on…
|
|
|
|
|
|
|
20170916-SAT
|
PCP
|
57.5
|
CDM
|
|
20171010-TU
|
PCP
|
70.0
|
CDM
|
|
|
|
|
|
|
20150321-SAT
|
Family Therapist
|
70.8
|
JMB
|
|
20161001-SAT
|
Family Therapist
|
80.0
|
JMB
|
|
|
|
|
|
|
2013-Retro
|
General Control
|
85.0
|
KM
|
|
20170916-SAT
|
Supervisor
|
85.8
|
KM
|
|
20161001-SAT
|
Supervisor
|
90.0
|
KM
|
|
|
|
|
|
|
Last Updated: 20171018-W:
Applying the Boy Scout Law (BSA) Assessment: Brief Version.
FAQ – Is it helpful for your
doctor(s) have the qualities of a good friend?
FAQ – What is up with the Metadata?
Assessment – HEDIS
The Healthcare Effectiveness Data
and Information Set = HEDIS
-
Checklist
In the Physical process the fewer
surprises the better. Back 2012 we
found in order to cope with the drama associated with a CDM Deficits Based
Physical we created a checklist.
Eventually we backed our checklist with a HEDIS Criterion. The HEDIS Criterion is not numerical in
nature. We began developing a scored
reflection of HEDIS. HEDIS is complex
in given year. HEDIS may be revised
from year-to-year. For the time being
we stick with 2010 HEDIS the one we discovered first.
-
HEDIS & HEDIS Extended -
Assessment Development
Again, we here at MSG developed
our HEDIS tool in order to cope with Doctor Mojica concentrating on our
deficits. Even when we request our
records from our Physical we expect that as usual the labs and other findings
will not be quantified for application as outcome measures for us. This year our HEDIS Fitness Assessment Score
is 100%. We still have one serious
physical health risk factor. We smoke
cigarettes. The reason our smoking does
not drive our fitness score down this year is because our COPD status is Stage
Two (2) of Four (4).
-
[INSERT COPD IMAGES X 2] - FYI
Metadata - HEDIS
Figure – HEDIS Findings In Our
(TorkBase) Database (Metadata)
-
Assessment – HEDIS
Metadata > Assess_HEDIS_Base_17082901_Re-Develop
HEDIS 2010 Measures – 21-Item
Using the HEDIS 2010 as a template we created our HEDIS
Driven Fitness Assessment (HDFA). It is
a twenty-one-item tool. It is nowhere
as refined as it could be yet it does suffice to offer a ballpark figure. Presented in the table below are our HDFA
results for three (3) TimeStamps.
-
|
|
|
|
|
|
HEDIS - HDFA
|
Date Score
Day of Week
|
20161208
TH
|
20170902
SA
|
20171006
F
|
|
|
|
|
|
|
|
Section A
|
7 Items MAX
Score (Items Scored)
|
6.0 (7)
|
7.0 (7)
|
7.0 (7)
|
|
Section B
|
14 Items MAX
Score (Items Scored)
|
10.0 (10)
|
11.0 (11)
|
12.0 (12)
|
|
|
|
|
|
|
|
|
Fraction
Total Score/Items Scored
|
16.0/17
|
18.0/18
|
19.0/19
|
|
|
HEDIS Fitness Score (HFS) =
|
71.4%???
Correction
94.1%
|
100%
|
100%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Results for HDFA = HEDIS Driven
Fitness Assessment – Last Reviewed: 20171020-F:
-
Error Checking
On 20171006-F all scores were
recalculated – Errors detected were found in our favor. 20161208-TH was 71.4%: Is 94.1% on
20171020-F: We here at MSG have small
3% error rates in calculating. At some
point we are going to dig up all of our HDFA calculations and proof them again.
-
100% Justification
Once again, a reason we scored
one-hundred (100) percent is that for the HEDIS items that apply to us the one
that held us back in 2016 (Cholesterol) is under control. In addition our Risk Factors for COPD are
not impinging to full detriment (yet).
-
FYI - 20171022-SUN: HEDIS
“The Healthcare Effectiveness
Data and Information Set (HEDIS) is a tool used by more than 90 percent of
America's health plans to measure performance on important dimensions of care
and service. Altogether, HEDIS consists of 81 measures across 5 domains of
care.”
-
Evaluation - Primary Care
Physician (PCP) Comparative History and Quality
-
|
|
|
|
|
PCP (Doctor)
|
Friend or Foe
|
Association
|
Sample or Solution
|
|
-
|
|
|
|
|
Gee
|
Friend
|
Kaiser
|
Urinary Track Infection UTI
|
|
Hanley
|
Friend and Mentor
|
Independent
|
Repaired avulsed left thumb
|
|
Biorkman
|
Friend
|
Bristol Park
|
Jungle Rot on both feet
|
|
Mojica
|
Antagonist
|
CCCHC
|
Cholesterol Drama
|
|
Clark – UCD
|
Foe
|
UC Regents
|
FAILURE to Help
|
|
-
|
|
|
|
|
Last Reviewed: 20171019-TH: Comparing PCP’s and doctors that practice or
have practices family medicine.
-
Nature of Our Effort(s)
Why spend so much time reporting
about this year’s physical? For one to
get our numbers normalized was a huge achievement. And two we have been generating and silo-ing a good deal of data
that may help others get the most out of their physicals. Last we are proud with put our Blood Glucose
Levels we put in order and under control by behavioral rather than
pharmacologic means.
-
Selling Satisfaction (A Passion)
After vetting hundreds of
assessments we have decided to specialize in Satisfaction Assessment half time
(0.5 FTE). We just created our new hey
it is really cool and happening Resume.
We may get to graduate in the OCHCA across to a different ladder.
-
Physical – CDM (Process over
Patient)
When we began seeing Doctor
Mojica back in 2012 he tended to practice process over patient. He told this on a couple of occasions: “This
is how we do it around here”. This
fifth physical (2017) is the first time that we felt he was beginning to
practice patient over practice. Indeed
Doctor Mojica is evolving in real time.
-
Assessments - Omitted
|
|
|
|
|
AcroCode
|
Instrument
|
Target
|
Offered by
|
|
|
|
|
|
|
HRA
|
Health Risk Assessment
|
Consumer
|
CCCHC
|
|
PHQ-9
|
Personal Health Questionnaire
(9-Item)
|
Consumer
|
CCCHC
|
|
QOL
|
Quality Of Life
|
Consumer
|
BND
|
|
SHA
|
Staying Health Assessment
|
Consumer
|
CCCHC
|
|
SFXN
|
Satisfaction
|
Consumer
|
CCCHC-V
|
|
|
-
|
|
|
|
Last Reviewed: 20171019-TH:
Prescribed Assessment Pod for Report for a Physical.
-
Prescribed Assessments
Beginning in the summer of 2012
and yearly until the present a CCCHC Physical included written
Assessments. We call these Prescribed
Assessments because the BND/CCCHC Axis asks you to complete them. For 2017 The Axis dropped all of them. Therefore we will withhold our findings and
discussion associated with said omitted Assessments. One note about Prescribed Assessments and Solicitation: If BND or
CCCHC does not solicit for a particular Assessment they are very likely not to
take into consideration the results.
Actually this applies across a broad range of Health and Human Services
Agencies.
-
Brand New Day Extracted –
Satisfaction
We discussed BND Satisfaction
Assessments such as the KCSS and ACSS on the corporate level earlier. We decided to leave our findings and
discussion about those as well.
-
Summary and Takeaways – Loose
Ends
Doctor Chester D Mojica (CDM) and
Team
Even though this report has been
focused on Doctor Mojica’s part in delivering a Pre-physical and Physical we
also compliment his team as well at their efforts. We would like to thank our Pre-physical nurse for her excellent
bedside manner. Using our Quick Score
Method (QSM) we give her 5.0 Stars with 5.0 Stars being best. We still don’t know her name because she
does not brandish a visible Identification.
-
Presenting Problem(s) – Progress
Note
We have fewer problems this year
(2017) as compared we 2013-2016. What
follows are our problems that linger: Sleep Disorder, Attention Deficit
Disorder, Cigarette Smoking, trying to link with a new Behavioral Health doctor
of our choosing, and we are always at risk of homelessness.
Promotion – MyQuest - Manual
Request Form
Secured by Quest Diagnostics ©
2000-2017 Quest Diagnostics Incorporated. All rights reserved.
Satisfaction Inventory – A Legacy
in and Passion about Satisfaction
It was in 2007 that we came
across our first satisfaction survey in the context of Health and Human
Services (HHS). It was offered in the
waiting room of the Orange County Health Care Agency’s (OCHCA) Costa Mesa
Clinic. Although the format was not
ideal it introduced us to the concept of mutable Satisfaction. In addition, the OCHCA Assessment addresses
domains of living and Satisfaction such as Legal Status and Housing.
FYI - Mutable
Mutable might be defined as
liable to change.
Close
Last in this report (study) we
share some links to our in scope legacy publications and an image gallery to
deal with lose ends and miscellaneous discoveries.
20171022-SUN: MSG and Associates
Legacy Links Associated with BND
& CDM & CCCHC
Developing Objectivity –
Strengths Legacy
Triple xxx TheDAG - Digital
Appointment - Development | AnimaCules
http://ktork46.blogspot.com/2015/02/triple-xxx-dag-digital-appointment.html
Triple xxx TheDAG - Digital
Appointment - Development. Technological Needs in Human Services.
#IridiumRecords. Posted 9th February 2015 by Keith Torkelson.
-
Nov 5, 2016 - Keith E Torkelson
(MS) External Review Officer Findings About Central City Community Health
Center Garden Grove Staff and Scheduling Central City Community
Saturday, November 5, 2016
#Central City Community Health
Center #Counter Staff #Scheduling
Co-authored By Buster D Right 4
Complaint Management
http://the-torkel-saga-2059.blogspot.com/2016/11/central-city-community-health-center.html
Deadline – November 6, 2016
(SUN): Met by 1630 PST
-
Brand New Day HMO - Blog Charter
by Keith Torkelson & Team AVEY
20171019-TH: Keith Torkelson – 17
Views – Chartered - 5/27/17
http://brandnewdayhmo.blogspot.com/2017/05/brand-new-day-hmo-blog-charter-by-keith.html
Chester Diokno Mojica MD –
Strengths By Keith Edward Torkelson, M.Sci. With MSG for 2-20171019-TH: BND_HMO
- Keith Torkelson – 28 Views – Chartered - 5/29/17
http://brandnewdayhmo.blogspot.com/2017/05/chester-diokno-mojica-md-strengths-by.html
-
COPD - What Can We Say - We are at Risk
[INSERT LINK TO COPD UPDATE]
We Here @ MSG Like Cows
We think this is the Up Dog Position (UDP)
Milk is part of our Celery Diet
Cholesterol Results - Obtained by Consumer Using Patient Portal MyQuest
White Blood Cell Count Results - Obtained by Consumer Using Patient Portal MyQuest
Satisfaction and More Satisfaction
This is an example from the Health and Human Services Agency powerhouse NCQA
Show and Tell Feature of Our Appointments
For Our Physical Doctor Reviewed this Physics Exam Page in Hard Copy Form
-
MS Word 2000 Pro - Readability Stats for This Paper (Publication)
2017 Key Event - Retina Detachment Reversal Surgery
Ready as Part of Our Digital Appointment APP (Beta)
White Blood Cell Count Results - Obtained by Consumer Using Patient Portal MyQuest
Glucose Results - Obtained by Consumer Using Patient Portal MyQuest
Lipid Panel Results - Obtained by Consumer Using Patient Portal MyQuest
Waiting for Yoga to Start
24 Hour Fitness
Monitor Facing and Easy to Read by Consumer
In Network Ophthalmologist Exam Room
Celery Diet
Ratio Carbohydrate - Lipid - Protein (CLP) Favorable
Reduce All Sodas - With or Without Sugar
Celery Central
Monitor Facing Consumer and Easy to Read by Consumer
Example Kelly Paper
Celery Diet Indicator - Weight Improvement
Health Risk Assessment (Annual)
HRA Skipped this Year (HRA)
Celery Diet - Reward - BLT w Mayo
Brand New Day Provides for Free 24 Fitness Membership
This is our yoga room just before class
Example of Technology Used for Recovery
In Network Dermatologist Exam Room
We left out details about our Celery Diet
Here is an indicator about our results
We finally get to get rid of our big person pants
Example of Technology Used for Recovery
24 Hour Fitness - Fountain Valley - California - USA
That is our principle there at yoga (AVEY)
Brand New Provides for Free 24 Hour Fitness Membership
This was our card to our yoga teacher setting boundaries for ourselves because we do not wish to mess up the therapeutic value of our relationship
-
Brand New Day Provides for Free 24 Fitness Membership
This is our yoga teacher Kamara
We would like to see Central City Community Health Center (CCCHC) invest in Free Wifi for Their Consumers (Patients)
Example here free Wifi at Fountain Bowl
Right now we are publishing this at Starbuck's
They have Wifi for a cup of coffee ($1.95)
Arterial Oxygen Saturation Measurement Taken By Consumer
Doctor did Update our File that We Were Still Walking
Subject - Technology for Recover
SmartPhone - Actual Data for Keith (Buster)
Free Wifi @ Del Taco for Consumers - CCCHC Lacks Free Wifi
Image - Consumer (Patient) Computing Resources
CCCHC Lacks (Free) Wifi - Example Here Free Wifi at Walmart
Image - We Skipped Over Recent Retinal Detachment Event a Key Event for 2017
-
Appendix - Metadata for Special
Topics
|
-
|
|
|
|
|
Special Topic
|
|
Special Topic Metadata
|
|
|
-
|
|
|
|
|
1-Satisfaction
|
|
[PARTIAL]
|
|
|
2-Blood Carbon Dioxide Levels
|
|
|
|
|
2-Blood Glucose Level (BGL)
|
|
SCR_Lister_17092201_Energy
Study
TTS_Digital_Appointment_17072006_F2F
4 Energy
|
|
|
2-Complete Blood Count (CBC)
|
|
|
|
|
2-Fecal Occult Blood Test
(FOBT)
|
|
|
|
|
2-Lipids
|
|
Assess_ConMan_Lipids_17030501_Develop
Records_Portal_MyQuest_Lipids_17040403_Round-02
|
|
|
|
|
|
|
|
Christmas Report Card (CRC)
|
|
|
|
|
Compassion Fatigue
|
|
Assess_ProQOL_16031203_Results
V2017
|
|
|
Digital Appointment
|
|
TTS_Digital_Appointment_17093003_F2F
4 Physical
|
|
|
Global Health Fitness
|
|
11_RENHEW_Exercise_16031204_Counts
V2017
Assess_HEDIS_HDFA_16120801_Results
V2017
|
|
|
MSG’s Celery Diet
|
|
|
|
|
MSG’s Health Related
Engagements (HREs)
|
|
2016022801 HREs Step-03 V2017
|
|
|
MSG’s Structural Temporal
Reconciliation (STR)
|
|
[SEE BELOW]
|
|
|
Patient Portals
|
|
08_Records_Portal_MyQuest_17030802_Account
Records_Portal_MyQuest_Lipids_17040403_Round-02
|
|
|
Record Request
|
|
Provider_CCCHC_Records_Request_17091403_Process
|
|
|
Scheduling
|
|
[SEE BELOW]
|
|
|
Show and Tell
|
|
Prosumer Prosuming with
Prosumption
|
|
|
Sleep Disorder
|
|
|
|
|
|
|
|
|
Matrix - Special Topic – Metadata
for Special Topics: Last Updated: 20171020-F:
-
Appendix – Legacy Links
Assess_VITALS_17031902_CDM_Strengths
Below are links to
two legacy reports that we have published for Doctor Mojica. As you could see in the second one we made
an effort to focus on his strengths (Strengths Based Principle).
Legacy Publications
-
Brand New Day HMO - Blog Charter
by Keith Torkelson & Team AVEY
20171019-TH: Keith Torkelson – 17
Views – Chartered - 5/27/17
Chester Diokno Mojica MD –
Strengths By Keith Edward Torkelson, M.Sci. With MSG for 2-20171019-TH: BND_HMO
- Keith Torkelson – 28 Views – Chartered - 5/29/17
And…That is All She meaning me AVEY…Wrote…
#30 > #IridiumRecords > #AVEY > #Buster
Our Pressed Flower From the Coed
Our Pressed Flower From the Coed
