Feature Picture - Honoring Dale
-
Doesn't he just look like the poster child for ECT?
-
Calculated for 20180320
Doctor Denies 2.8 Star Performances
by Omission
-
Blogger Title
Rimal B Bera MD Partners with
Keith Torkelson - Referral and Linkage Part-III (2018)
-
Google Plus Information
Treatment Hacker - Health &
Human Services – Core Competency – Referral and Linkage – Fleshing About – By Keith
E Torkelson MS – UC Davis Pathology – Social Specialist - Treatment Tracker
-
Pre-sell – Housing Advisory Board
(HAB) – Volunteer Work
-
Title - “How is it First Blood”
Outstanding Invoice – Old
Business First
Sunday, November 20, 2016
Rimal B. Bera, MD Evaluated by
Keith E Torkelson MS as a Doctor On-Call - LiveX
-
-
Unreasonable Accommodations & PMADS Pre-Sell
-
Date 11/20/2016 – WorkAbility
& Evaluation Study
-
Abstract – Executive Summary
For this paper we investigate
multiple assessment approaches. This
report is about our partnership with our new and improved Behavioral Health
Doctor AKA Psychiatrist. His name is
Rimal B Bera MD (RBB). As of 2018 RBB
is about sixty (60) years old. At times
we choose his colleague Bum Soo Lee MD to compare him with. We calculated a Stick the Linkage Score
(SLS) for BSL and RBB 59.6% & 36.5% respectively. For RBB we derived a Satisfaction with Material Review Value
(SWMRV) of 45.0%. For RBB we offer up
an Encounter Satisfaction Grade (ESG) of 7.1%.
Our Level of Impression Score (LIS) score for RBB is 38.9%. This translates into a Star Equivalent of
1.9 with 5.0 Stars being best. We saw
BSL from 2012 till 2017. Initially in
2012 we gave him a BHD Management Score of Passing. BSL improved over time. RBB is a “Work in progress”. At this time for an Appropriate Service
Score we give RB Bera a “B” or Above Average.
We are holding back on our Vitals Plus (Theta) V New Approach for a
future report. Overall our Satisfaction
with Linkage Score (SLS) yield 38%.
Thirty-eight (38) percent mutates into 1.9 Star Equivalents. We finish with the objective results we
found that other rated doctor Rimal B Bera online. We found a total of twenty (20) ratings online. Overall others rate doctor Bera (Rate Your
Doctor) with 2.8 Stars out of 5.0 being best.
Some doctors like our Dermatologist and Ophthalmologist highly value
these online impressions whereas others' say they do not matter. Better safe than sorry, Yes!
-
Dedicated To:
We here at MSG dedicate this
report to several individuals whom have influenced us in a positive manner: Let
us begin with Clayton Chau MD (a consumer professional who overcame Clinical
Depression and requires no medication anymore) and Mary Hale MS (our antagonist
in public health). Next would be Gloria
Shanks (our adoptive mom – a Master Mum) and Rochester Cannon (our problematic
roommate for his nightly inspiration).
Of course we include Peter Brain Gabriel (A Man of PEACE a thing Greater
Than Us). Last is Joyce Maxine Brown
(Born 1925) our Family Therapist.
-
[INSERT IMAGES SAMPLE]
-
In Honor Of – In Memory Of…
Charles Anderson, Chad Carlsen,
Josie Gann, Kulle Lippand, Mike McMahon, Mark Barnes, New Old Man John and
obviously Dale…
-
[INSERT IMAGES Pending]
-
Charles Anderson - CEO - A Better Today
No Time 4 Old Men - New Old Man John
-
-
Figures - Objective Results Up
Front (ORUF)
-[PDF] - 2018 Medicare Star Ratings - Brand New Day [NO CACHE]
-
[Brand New Day MSG DISTRIBUTION]
Figure – Rate Your Doctor –
Objective
Calculated for 20180320
-
BND=Brand New Day
Bera=BND Contractor
CMS=Centers for Medicare &
Medicaid Services
-
CMS is not to be confused with
MSG’s Content Management System (AVEY, 2018)
“A content management system
(CMS) is a software application or set of related programs that are used to
create and manage digital content. CMSes are typically used for enterprise
content management (ECM) and web content management (WCM). (Jun 1, 2016)”
-
-
Doctor "D"
-
[INSERT CASA YOUTH SHELTER STATS]
-
Found
We still haven’t found what we
are looking for. We included a scan of
a sample page of Casa Youth Shelter Performance Outcomes Results. We still have not found much more than what
is reported online with regards to rating our new doctor Rimal B Bera MD. So we continue to collect up and report our
baseline results about us and for ourselves.
Getting a new doctor is both an opportunity and danger. It is a once in a lifetime opportunity and
we are taking advantage of it to grow personally and professionally. In psychiatry quality assurance is making
its’ way to the forefront about the progressive reformation of the “Practice”. The older psychiatrists need to prove their
practices in a manner that quantitatively sells their chosen profession to the
next generation. As of this report
there is a deficit about transparency and accountability for Behavioral Health
Doctors (BHDs). Next we present our
Objective Results Up (ORUF) Front material.
-
Objective Up Front (OUF)
Figure - 20180320-TU: Current Summative – For Rimal B Bera,
MD
-
Matrix – Rate Your Doctor – Rimal B Bera, MD for March of
2018
Query Date
|
Service
|
Stars
|
Ratings
|
Trend
|
|
20180310-SAT
|
Healthgrades
|
2
|
4
|
Not Established
|
|
20180319-M
|
Vitals
|
3.3
|
11
|
Not Established
|
|
20180320-TU
|
Webmd
|
2.4
|
5
|
Not Established
|
|
Matrix – Rate Your Doctor – Rimal B Bera, MD for March of
2018
-
Matrix – Rate Your Doctor – Rimal B Bera, MD for April of
2018
20180418-W: Update
Query Date
|
Service
|
Stars
|
Ratings
|
Trend
|
|
20180418-W
|
Healthgrades
|
2
|
4
|
Same
|
|
20180418-W
|
Vitals
|
3.3
|
11
|
Same
|
|
20180418-W
|
Webmd
|
2.4
|
5
|
Same
|
|
Matrix – Rate Your Doctor – Rimal B Bera, MD for April of
2018
-
Example of Collecting Data
Longitudinally
As more and more of us know
collecting longitudinal formative and summative measurements is now more in
vogue that ever. After you collect
three data points for three different Time Stamps one acquires a slight degree
of predictive leverage. For the time
being it looks like doctor Bera is stuck with regards to what his clients’
think of him (Rate Your Doctor). Please
note that we never report our findings, which are generally higher than those
others report, on Healthgrades, Vitals, or WebMD. If we did the Stats would not qualify as objective anymore.
-
20180626-TU: Doctors CV
At the last minute we came across
Rimal B Bera’s Curriculum Vitae or CV online.
Anyway we look at it this is a good find. Doctor’s CV is some odd 41 pages long. A large portion of it addresses presentations. We looked around for measures such as grades
for key courses, MCAT results, and self-assessment scores. We really couldn’t find much in terms of
quantified performance. We think it is
not what you did or do rather than how well you did or are doing at it. We are holding off comparing our CV with his
for our RBB Profile Report.
-
FYI - [PDF] - Curriculum Vitae - Psychiatry & Human
Behavior – UCI (41 Pages)
-
Table - Scores for Engagements with Rimal B Bera MD
Figure – Invoice
Community Partners – Sustained From Referral II Report
PDF] - 2018 Medicare Star Ratings - Brand New Day
Stars Distribution
Casa Youth Shelter Performance Stats
Objective Up Front (OUF)
Matrix – Rate Your Doctor – Rimal B Bera, MD for April of
2018
-
-
-[DIVIDE]-
-
-
Table - Acronyms – Brief (Short-form)
Table – Index - Assessment
Elimination (Considered)
Table - Presenting Problems:
Advance Planning for July Encounter (Appointment #3)
Table - Goals – Associated with
our Bera Partnership
Special Topic – Credit for Work
Done
Table - Bera Centric Projects
(MSG Publication Progress)
Table – Qualities to Close a
Referral-Linkage
Table - Vitals Plus (Theta) V New
Approach
Table – Patient Activation Measure (PAM) Scores for May 21,
2018 (Monday)
Table - Timeline – Summary –
Behavioral Health Doctor (BHD) Referral & Linkage Steps
Table - Referral & Linkage
Themes – Engagement & Appointment Checklist
Table – Compare BHDs - A Quick
Comparison
Table - Advanced Planning
2017-2018 for Referral & Linkage
Table - Rigor Revisited – Time
Spent
Limited Appointment V
Comprehensive Consult (Appointment)
Table – Appointment Date
20180411-W - Progress Notes
Table - Duty Now For The Future –
A Psychiatrist
Table – Challenging Topics
Evaluation – TimeMAX (MSG, 2018)
Table – Doctor Bera’s Special
Interests
Table -
Diagnostics – Buster’s Cognitive Performance
Table - Scores for Engagements with Rimal B Bera MD
Table – History & Fact Finding About Rimal B Bera MD
Table - The Impressionator (MDG, 2018-Beta) - Scoring
Version
Table - Linkage Resource & Material Checklist – Team BERA
Table
- Linkage Material Checklist & Review
Team
MSG – ProSumption Materials - Applied
Table - Schedule for Defining A
ProSumer (Beta-Draft)
Table – Buster’s History - Some
Effective Linkages & Some Not So…
Matrix – Linkage – “Stick the
Linkage” - Quantitative
Comparing Bum Soo Lee (BSL) MD
with Rimal B Bera (RBB) MD
Charter Information
-
-
Table – Acronyms – Last Updated: 20180218-SUN:
Table – A Full and Complete Linkage indicates our presenting problems have been addressed
-
Table - Acronyms – Brief (Short-form)
-
|
|||
AcroCode
|
Meaning
|
||
-
|
|||
#BFF
|
Big Fat Foot
|
||
AIB
|
As Indicated By
|
||
AMB
|
As Measured By
|
||
ASS
|
Appropriate Service Score
|
||
AVEY
|
[MSG CONSTRUCT]
|
||
BHD
|
Behavioral Health Doctor (AKA Psychiatrist)
|
||
BHDC
|
Behavioral Health Doctor in Charge
|
||
BND
|
Brand New Day
|
||
BSA
|
Boy Scouts of America
|
||
BSL
|
Bum Soo Lee - MD
|
||
C/O
|
Care Of
|
||
CAHPS
|
Consumer Assessment of Healthcare Providers and Systems
|
||
CCCHC
|
Central City Community Health Center
|
||
CMS
|
Centers for Medicare & Medicaid Services
|
||
COD
|
Co-Occurring Disorder
|
||
COP
|
Co-Occurring Problem
|
||
CS
|
Customer Service
|
||
CSUF
|
California State University @ Fullerton
|
||
DELL
|
[MSG PLATFORM]
|
||
DX
|
Diagnosis
|
||
ESG
|
Encounter Satisfaction Grade
|
||
GPA
|
Grade Point Average
|
||
GRE
|
Graduate Records Examination
|
||
HEDIS
|
The Healthcare Effectiveness Data and Information Set
|
||
HEL
|
Hearsay Error Level
|
||
HOS
|
Health Outcomes Survey
|
||
HRE
|
[MSG PRODUCT]
Health Related Engagement
|
||
IOHL
|
Institute Of Higher Learning
|
||
LOP
|
Level Of Power
|
||
MOMs
|
Meeting Of the Minds
|
||
NT4OM
|
No Time for Old Men
|
||
PBM
|
Pharmacy Benefit Manager
|
||
PIP
|
Problem In the Past
|
||
QA
|
Quality Assurance
|
||
QL
|
Quantity Limit
|
||
QSM
|
Quick Score Method
|
||
RBB
|
Rimal B Bera - MD
|
||
SARAH
|
[MSG PLATFORM]
|
||
Satisfaction
|
|||
SLS
|
Stick the Linkage Score
|
||
SPC
|
Single Point Contact
|
||
Stars
|
|||
STR
|
Structured Temporal Reconciliation
|
||
SUD
|
Substance Use Disorder
|
||
SWMRV
|
Satisfaction With Material Review Value
|
||
TGTU
|
Things Greater Than Us
|
||
TNTN
|
Too Numerous To Note
|
||
TX
|
Treatment
|
||
UCD
|
University of California @ Davis
|
||
USDA
|
United States Department of Agriculture
|
||
-
|
-
[INSERT SAMPLE ASSESSMENT INDEXING - Due Rigor]
-
[SHARE ALSO WITH DIAGNOSTICS & QUALITY]
Table – Index - Assessment Elimination (Considered) – 1 to M
-
|
||||
Assessment
|
IF - Acro
|
Application
|
||
-
|
||||
***Vitals Plus Theta
|
VPT
|
Profile & QA
|
||
Accountability
|
A-EBR
|
QA
|
||
Axis Five Evaluation
|
A5E
|
Diagnostics
|
||
Bera Assessment Battery
|
BAB
|
|||
Bera Assessment Referral I
Report
|
BAR-I
|
|||
Bera Assessment Referral II
Report
|
BAR-II
|
|||
Bera Assessment Referral III
Report
|
BAR-III
|
|||
Bera Assessment Referral IV
Report
|
BAR-IV
|
|||
Bera Centric Assessments
|
BCA
|
|||
Big 5 Personality
|
B5P
|
Diagnostics
|
||
Scouts of America Virtue
Assessment
|
BSA
|
Profile
|
||
Casa Youth Shelter Performance
Statistics
|
CYS-PS
|
Multiple
|
||
CMS Stars
|
Multiple
|
|||
CMS Stars (Satisfaction)
|
||||
Cohort Variation Tool
|
CVT
|
|||
Curriculum Vitae
|
CV-AMT
|
As a Measurement Tool
|
||
Digital Presence & Penetrator
|
DP&P-IT
|
Profile & QA
|
||
Emotional Stability Evaluation
|
ESE
|
Diagnostics
|
||
Event Quality Assessment
|
EQA
|
|||
Family Support Cluster
|
FSC
|
Treatment
|
||
Health Related Engagement
|
HRE
|
Multiple
|
||
Homework Assignment Log
|
HAL
|
Multiple
|
||
Innovation – MHSA Awareness
|
MHSA-INNA
|
Profile
|
||
-
|
Table - Table - Assessment Elimination (Considered) – 1 to
M: Last Reviewed: 20180622-F:
-
Table – Index - Assessment Elimination (Considered) – N to Z
-
|
||||
Assessment
|
IF - Acro
|
|||
-
|
||||
MD On Call Assessments
|
MDOAC
|
QA
|
||
Mental Status Exam
|
MSE
|
Diagnostics & Plus
|
||
MOM - Presentation Evaluation
|
MOM-PE
|
Profile
|
||
MSG – Stars
|
MSG***
|
QA
|
||
MSG – Vitals Plus
|
MSG-V+
|
QA
|
||
Online Rate Your Doctors
|
ORYD
|
Multiple
|
||
Patient Activation Measure
|
PAM
|
Treatment
|
||
Performance Earned Value
|
PEV
|
QA
|
||
Personality Parity Cluster
|
PPC
|
Diagnostics
|
||
Postsecondary Ed Performance
|
PEP
|
Profile
|
||
Presenting Problems List
|
PPL
|
Multiple
|
||
Professional Quality Of Life
|
Pro-QOL
|
Profile & Treatment
|
||
Promising Practices Workbook
|
PPW
|
|||
Publish Or (Perish) Tracker
|
POT
|
|||
Quality Of Life (Indicator)
|
QOL
|
Treatment
|
||
Rate Your Professor
|
RYP
|
Profile
|
||
Resilience (Youth) Questionnaire
|
YRQ
|
Treatment
|
||
Satisfaction Cluster
|
SFXN
|
Multiple
|
||
Transparency
Experimental Bunny Rabbit
|
T-EBR
|
QA
|
||
-
|
Table - Assessment Elimination (Considered) – N to Z: Last
Reviewed: 20180622-F:
-
-
New Concept – Markers Of Health –
Indicators Of Health
We recently came upon a concept
new to us referred to as Markers Of Health (MOHs). While surfing “The Net” we found that most of the material about
MOHs pertains to physical health such as one’s Body Mass Index (BMI). So as not to confuse with MOHs that are
physical we call the features that make us mentally fit our Indicators Of
Health (IOH). Two IOHs we pride
ourselves for are we prepare for our appointments and we write things
down. Our goal here at Mentalation
Solutions Group (MSG) with our series of Bera related papers (publications) is
to gather a thorough history and collect up some Baseline Values (BVs). At this point, with our third appointment
coming fast we would consider our referral-linkage efforts a success by
awarding us an “A-“.
-
Minimalistic Approach
We hope that in the next
appointment we can Stick The Linkage (STL) enough to earn a summative grade of
“A”. We really wish we had a Health
& Human Services professor to run this report by before publishing it. It took time to grow our relationship with
our last Behavioral Health Doctor (BHD) Bum Soo Lee MD (BSL). We hope to grow an effective and productive
relationship with our new BHD Rimal B Bera (RBB). Even though he has only demonstrated a minimalistic approach we
still have high expectations for him and our futures. Eventually his quality assurance issues (deficits) will have to
be addressed. We here at MSG would help
him with that if he asked.
-
Team Bera – Jeff Gibbs Harassment
Our insurance is Universal Care –
Brand New Day. Anyone who works for or
with Doctor Bera is Team Bera. Team
Bera includes Doctor Bera, his clinical staff, his clerical staff, his Brand
New Day Helpers, and even us though we go unrecognized. One of his BND associates is Jeff Gibbs (a
helper). Jeff Gibbs was our helper
(life coach, case manager, etc.) yet when he refused to help us with our housing
issues we informally fired him. When we
see him we feel dread. On Tuesday’s BND
offers free pizza at lunch. Even if it
is convenient for us to participate we avoid it so as not to run across
Gibbs. On May 16, 2018 we decided to
get some writing done while we observed the BND site operation. We overheard Jeff Gibbs addressing medication
issues with a client. We said to
ourselves good at least he can help someone!
He disappeared away from our visual field for about 15 minutes. Then he pops around the corner, apparently
sees us, and starts groping his crotch for us to react. Let it be said that this paragraph is our
reaction to the Alleged Sexual Harassment (ASH) perpetrated by Jeff Gibb on
20180516 about Noontime.
-
Health Related Engagements (HREs,
MSG, 2018)
We here at MSG track what we call
are our Health Related Engagements.
About ten (10) years ago a colleague (Tony Delgado) with the county
(OCHCA) addressed what he calls “Dosage”.
The numerical value for our Health Related Engagements equal Tony’s
dosage. He stated at the time that
there was a positive correlation between Dosage and favorable outcomes. Thus far, for 2018 (June 25, 2018) we have
participated in a total of sixty (60) HREs.
We have participated with all our required HRE appointments. Twenty-nine of the HREs in which we
participated were in the Brand New Day Network (BNDN). In general even if we have two appointments
in one day we score only one HRE.
-
New - Patient Activation Measure
(PAM)
We recently came a across an
assessment instrument called the Patient Activation Measure or PAM. “The Patient Activation Measure (PAM) is a
commercial product which assesses an individual's knowledge, skill, and
confidence for managing one's health and healthcare.” It is a rather wimpy measure yet we scored (20180521) ourselves. The results yielded that we are 100%
activated. Don’t take that wrong it is
not like we are manic activated or hypo-manic activated we are just a patient
that enjoys working hard on our and others’ cases.
-
Table - Presenting Problems: Advance Planning for July
Encounter (Appointment #3) – Updated: May 16, 2018 (Wednesday)
-
|
||||
Issue
|
Fix or Solution
Status
|
|||
-
|
||||
1-Need Open-ended Referral to JHF
|
We come a long way if we trust him enough to ask!
|
|||
Clozapine Management
Clozapine Contingency
|
Looks good doctor still on probation till the end of 2018
|
|||
Direct Submission of Homework (Reports)
|
Only if he solicits submissions
The Solicitation Dilemma
|
|||
Emotional Stability
|
Improving
|
|||
Housing
|
Still on the top three of
issues for us
|
|||
Malingering Roommate
|
Disappointing yet tolerable
|
|||
Minded Medication Methods
(Triple M)
|
We have matured our methods – Report pending
|
|||
Need Referral to New Therapist
|
Only if he asks
|
|||
Psychiatrist Performance Statistics
|
Second and third party no First Party Stats made available
to us
|
|||
Sleep
|
Goes hand in hand with housing and minded medication
|
|||
Therapist Likely to Pass Away
|
Our family therapist is now 93 year old we are in the
process of closing our partnership (5 years)
|
|||
-
|
Table – A Full and Complete Linkage indicates our presenting problems have been addressed
-
JHF=John Henry Foundation
Doctor Bera associates with a
local service called the John Henry Foundation. If we can get up the courage we want him to give us an open-ended
referral to the John Henry Foundation.
In case of emergency we would rather sleep there that at the
hospital. We discussed this referral
with Doctor Bera’s partner in crime Kami at our #52 HRE (The Meeting Of the
Minds). I think his name is Andrew
Kami, he said he could not help us.
-
Full and Complete Linkage
Obviously it is very likely we
are going to link up. For one reason,
we don’t have any viable alternatives.
Considering there are only about four doctors at the site convenient to us
we are lucky to have been approved to see Doctor Bera. We hope to make the most of it. We hope he doesn’t experiment on us as much
as some of his predecessors did.
-
[PRINT FOR JULY 2018
APPOINTMENT]
Table - Goals – Associated with
our Bera Partnership
-
|
||||
Goal (SMART)
|
Current – Status
20180622-F
|
|||
-
|
||||
1-Routine Stuff
|
Get it perfect
|
|||
2-Health Outcomes Survey (HOS)
|
Review Highlights
|
|||
3-Get an opened ended referral
to JHF approved by Doctor Bera (Ditto)
|
||||
-
|
||||
Break into The Google Top Ten
(20180509-W in the 20s)
|
Actually a challenging “Hack”
opportunity
|
|||
Charter “The Doctor Bera
Program”
Standalone Blog
|
Decided to hold off
|
|||
Condition Specific
|
Sleep
|
|||
Continue Profiling (Profile
Report)
|
||||
General “Better Than Ever”
|
Our promise for the Brand New
Day Program
|
|||
Help Him with his Quality
Assurance Program (QAP)
|
Dedicated Report Pending
|
|||
Improve his Consumer Rated
Direct Stars Scores
|
Will be very challenging
|
|||
Open Share of Development
|
Possibly when we Trust him
(AVEY)
|
|||
Recall Invoicing
|
Might Print it and bring it to
his attention
|
|||
Revisit BND Stars
|
||||
Sell him our Housing Advisory
Board (HAB) concept
|
AEB – He Joins
|
|||
Sell him on Steinberg
Programming Language
|
Unlikely – Shows little
interest
|
|||
Unreasonable Compensation
Method (UCM)
|
||||
Workbook Method (Promising
Practice)
|
Some of these page lay the
foundation for an effective workbook
|
|||
-
|
Table - Goals – Associated with
our Bera Partnership - AEB=As Evidenced By – Last Reviewed: 20180627-W:
-
Objectives – How to Get There?
SMART=
“Why not think of a small goal
you want to set right now, personal or professional. To make your goal
S.M.A.R.T., it needs to conform to the following criteria: Specific,
Measurable, Attainable, Relevant and Timely.”
-
How is it we profile?
04_Net_Profile_14121501_TheMRH
The first record we have in our
database labeled “Profile” pertains to the Orange County Health Care Agency
(OCHCA) employee Mary Hale. We began
profiling her December 15, 2014.
Previously our profiles usually fell under “Biographies”. Our profiles tend to be more critical that
do our Biographies. Profiling empowers
us a bit here at MSG. Metadata: 2014
records are archived in our Tork Reconstruction Company or TRC-Base. Currently we are running AVEY-Base-2018.
-
-
Vignette - Here Is The News! –
Clozapine Risk & Contingency
As we write this paragraph it is
June 26, 2018. We will carry this
paragraph through multiple publications because we find it important. There is an issue with our principle
medication, Clozapine, for which we have no tangible fix. Today while at the clinic for our routine
Complete Blood Count (CBC) work we overheard another consumer, Sam I Am,
sharing in the waiting room. Sam
reports that after being rather stable on Brand-name Clozaril (Generic
Clozapine) for over twenty (20) years his CBC lab values converted. In other words he is now suffering low
numbers of White Blood Cells (WBCs). Most
likely it is his Neutrophils of the WBC family that are low. This is termed Neutropenia. Bad news!
Neutropenia indicates that you cannot be prescribed Clozaril (Clozapine)
anymore. We will leave the “doctor” anonymous. In response “doctor” stops Sam I Am’s
Clozaril cold turkey while he waits for a second lab to confirm the problem. Sam reports he has not been sleeping because
Clozaril is essential for a full restful night of sleep. When we left him about 11am we wished him
luck because the lab and his Clozaril disposition are pending. Sam is quite bright when it comes to how
much he has learned as a Behavioral Health Consumer (BHC). He said that a relative said why not reduce
the Clozaril rather than take it away cold turkey. Further his relative advices that on a reduced dose he might get
the benefit of sleep and get his WBC number(s) up again. For us, also on Clozapine, we have worried
quite a bit about a life without Clozapine.
Actually in 2012 we suffered catastrophic losses and Clozapine was in
the scenario. As Sam puts it Clozaril
was a real game changer for him. We
agree, for us Clozapine has been a game changer. In the next paper we will address what we call our Clozapine
Contingencies. This one should be
printed and shared with Medical students in their Pharmacology Course because
good “fixes” are pending.
-
-
-
Guess Who? - Not Sam I Am's
-
Special Topic – Credit for Work
Done
List of Links - A Sampling of
Bera Related Prior Reports
-
Brand New Day - Blog
Referral and Linkage Part-II – Keith Torkelson Partners with
Rimal B Bera (2018)
-
Clozapine - Blog
Referral and Linkage Part-II –
Keith Torkelson Partners with Rimal B Bera (2018) – For The Common Good & Clozapine
Management - Monday, April 2, 2018
-
The Torkel Saga - Blog
Rimal B. Bera, MD Evaluated by
Keith E Torkelson MS as a Doctor On-Call (2016)
Initialize a Relationship with
Doctor - Results Up Front
[NOTE – HAS OVERDUE INVOICE]
-
Profiling and Evaluating Doctor
Rimal B Bera as a Replacement Doctor (2016)
By Keith Torkelson Master of
Comparative Pathology (UCD) LiveX = Lived Experience
-
Brand New Day HMO: Keith Edward
Torkelson – Treatment Preferences (2017)
Dec 14, 2017 - Behavioral Health
Medication - Treatment Preferences by Keith E Torkelson M.S. for Doctor Rimal B
Bera Advanced Directives - You visited this page on 3/4/18.
-
Brand New Day HMO: Referral and
Linkage Part-I – Keith Torkelson Partners with Rimal B Bera MD (2018).
Blogger Title. Referral and
Linkage Part-I – Health & Human Services – Core Competency – Referral and
Linkage – Objectivity and Strengths – By Keith E Torkelson MS – UC Davis
Pathology.
-
[SHARE Also IN PROFILE AND QA]
Table - Bera Centric Projects
(MSG Publication Progress)
-
|
|||||
Project
|
Year
Published
|
Note
|
|||
-
|
|||||
Research Replacement Doctor
|
2016
|
||||
Evaluate Potentials
|
2016
|
||||
Progress About Clozapine
Treatment Preferences
|
2017
|
Medication Management
Driven by “must have” time
tested medication - Clozapine
|
|||
Research Study
Advance Planning
|
2017
|
||||
Shopping (MDSearch)
|
2017
|
||||
Referral I
|
2018
|
||||
Referral II
|
2018
|
||||
Referral III
|
[2018]
|
On Deck
|
|||
Referral IV & Close Linkage
|
|||||
Table - Bera Centric Projects
(MSG Planned Publications)
-
Centricity and Solicitation
(Solicitation Paradox)
If an encounter is not about you than
it is safe to say it is about them. It
is about the minimal effort required to get one’s bill paid. Doctor Bera did
not sanction this report. Nor does he
send you home with any Intel based client homework. This is our homework. We
are prepared to discuss much of it in our last Referral-Linkage
appointment. Once again we repeat, if a
professional or administrator did not solicit a piece of work they lack the
resources to consider it. One of our
skills as a ProSumer is trying to figure out what the doctor needs using what
minimal information that they provide to us.
-
Table - Bera Centric Projects
(MSG Planned Publications 2018-2019)
Project
|
Year
Published
|
Note
|
|||
Profile & Assessment
|
|||||
Standalone Blog
|
|||||
Quality Assurance I (QA)
|
|||||
Diagnostics I
|
|||||
Diagnostics II
|
|||||
Growth I
|
|||||
Performance Earned Value Manual
(PEVM)
|
|||||
Treatment I
|
|||||
Treatment II
|
|||||
Quality Assurance II (QA)
|
|||||
Maintenance V Thrive
|
|||||
Sell His Successes
|
|||||
Rework PRN
|
|||||
-
|
Table - Bera Centric Projects
(MSG Planned Publications) – Last Reviewed: 20180626-TU:
-
Table – Timeline - Bera Centric
Projects (MSG Publication Progress)
-
|
||||
Time Stamp
|
Key Event
|
Satisfied
|
||
-
|
||||
20171024-TU
|
Base Referral (R&L)
|
|||
20180103-W
|
Linkage 1 (Referral Part I)
|
First Appointment
|
||
20180411-W
|
Linkage 2 (Referral Part II)
|
Second Appointment
|
||
20180509-W
|
Charter Bera Standalone
|
Probably with keep with
HEALTHMAN
|
||
20180718-W
|
Linkage 3 (Referral Part III)
|
Third Appointment
Expect
Basic – Satisfied
Comprehensive - Unlikely
|
||
20180718-W
|
Graduate from Linkage Phase
|
|||
-
|
Table - Bera Centric Projects
(MSG Planned Publications)
-
Time Spent [SHARE Also IN PROFILE
REPORT - FE]
For our second appointment Doctor
Bera spent so little time with us that everything he says is important else he
would not have taken the time to say it.
He spent seven (7) minutes out of the fifteen we had grown accustomed
to. He is in the office on Wednesdays
from 1pm to “Fivish”. For the day in question we were his first
appointment. As he was rushing us away
he said: “They gave about sixteen
clients today and you are the easiest”.
Let’s do the math. Four hours
allocated for a total of sixteen (16) clients.
We get fifteen (15) minutes per office call. Maybe it is not a good thing to be an “Easy” client.
-
-
Table - Vitals Plus (Theta) V New
Approach
Close Out Referral (Linked) –
Qualities
Planned for June 30, 2018 (Date
of Meeting of the Minds – No Show)
-
|
|||||
Feature
|
Note
|
||||
-
|
|||||
1-Trust
|
Low-Moderate
|
||||
Acceptance (2.8 Star Doctor)
|
With an average doctor
|
||||
Expectations
|
We now had to lower our
expectations
|
||||
Final Vitals Plus
|
Save over for Profile Report
|
||||
Follow Through
|
Will not share with him unless
he asks
|
||||
Notes at his Lecture (MOMs)
|
No Show
|
||||
Perfection
|
Doctor denies imperfection by
omission
|
||||
Quality Assurance Program (QAP)
|
Gathering the lay of the land
|
||||
Rapport
|
It’s OK
|
||||
Resource Value
|
Low to Moderate
|
||||
Surrender
|
In the end it looks like we
didn’t get a high performer doctor
|
||||
This Report
|
Is about the fifth we have
written addressing a thorough history
|
||||
Tolerance
|
We expect little change
|
||||
-
|
Table – Accepting what we
purchased – Dr. Rimal B Bera MD
-
All Arrows Point to Average
Based on what others have said
(objective findings) and our observations unfortunately we contracted with a
mediocre Behavioral Health Doctor (BHD) AKA psychiatrist. We have this sense of disappointment. Yet, we are quite hopeful he will improve
over the next fifteen (15) years.
-
Special Topic - New Concept for
Us - Patient Activation Measure (PAM)
Here is the Patient Activation
Measure (PAM) we addressed earlier. We
self-scored ourselves on May 21, 2018 (Monday). We consider this a “wimpy” measure because in this carnation it
only addresses four (4) elements.
Anything less than fifteen elements (items) we here at MSG consider a
screening tool. We have provided our
results along with notes in a table after the figure below.
-
-
Figure – PAM Graphic
-
FYI - [PDF] PAM 10 Questionnaire - Kaiser Permanente
-
Table – Patient Activation Measure (PAM) Scores for May 21,
2018 (Monday)
-
|
|||||
Level
|
Meaning
|
Note
|
|||
-
|
|||||
1
|
Disengaged and overwhelmed
|
Never disengaged
Often overwhelmed
|
|||
2
|
Becoming aware, but still struggling
|
2000-2010
|
|||
3
|
Taking action
|
High frequency for taking action
|
|||
4
|
Maintaining behaviors and pushing further
|
Maintain gains 2017
2018 Hopes of pushing further with RBB
|
|||
-
|
Table – Patient Activation
Measure (PAM) Notes – Date Scored: 20180521-M – We self-scored ourselves with a
PAM-2018 – We Achieved a score of 100% - This report is an example of us
“Taking Action”
-
-
Metadata Sample
Assess_Patient_Activation_Measure_PAM_18052001_Tool
-
-
Pre-Sell for the "TriMAN"
-
Activation V Intensity V Dosage
It is not very often that we
score 100% on assessments. Our PAM
Score indicates we are activated. A
better way to capture what we do as a consumer is the frequency and intensity
for our medical treatments. This we
call dosage. The sum of all engagements
that may improve our health we call Health Related Engagements (HRE, MSG,
2018). “The Patient Activation Measure
(PAM) is a commercial product which assesses an individual's knowledge, skill,
and confidence for managing one's health and healthcare.” Conservatively, for 2018 we give ourselves
an “A” grade about activation (PAM) as defined above.
-
Table - Timeline – Summary –
Behavioral Health Doctor (BHD) Referral & Linkage Steps
-
|
||||
Step
|
Key Event
|
Sample
|
||
-
|
||||
01
|
Five (5) Years After
|
2012-2017
|
||
02
|
Retirement Notion – Bum Soo Lee
MD
|
2017 Summer
|
||
03
|
Prepare for Pre-sell
Appointment
|
|||
04
|
Key Appointment (Referral)
|
20171024-TU
|
||
05
|
QC Documentation (MSG)
|
|||
06
|
Psych Nurse Makes Key
Appointment
|
|||
07
|
Date of Key Appointment
(Linkage)
|
20180103-W
|
||
08
|
Address Treatment Preferences
(Absolute Essential Needs)
|
|||
09
|
Maintain Methods
|
|||
10
|
Improve Methods
|
|||
11
|
Special Materials & Methods
associated with New MDs Interests
|
|||
12
|
Publish Referral Report
|
|||
13
|
Linkage Appointment II
|
20180411-W
|
||
14
|
Publish Diagnostics Report
|
|||
15
|
Follow Up Reports PRN
|
|||
16
|
Re-publish Selections
|
|||
17
|
Publish Referral and Linkage
III (DL)
|
20180729-F
|
||
-
|
Table – Steps about referral and
linkage – Last Reviewed: 20180330-F:
-
Aside – Just for Fun – Photos
Keith & The Boss
Online Picture of my Buster
(AVEY)
-
Online Image Doctor Bera – The
Boss
-
Table - Referral & Linkage
Themes – Engagement & Appointment Checklist
-
|
||||
Item
|
Theme
|
Note
|
||
-
|
||||
01
|
Advance Planning &
ProSumption
|
|||
Appropriate Service Grade
|
||||
Assist with Risk Management
|
||||
Avoid Under-service
|
Unlikely
|
|||
05
|
Baseline Assessment Battery
|
|||
Closing Out the Referral
|
See Qualities
|
|||
Documentation The Leino MD
Method
|
||||
Doctors Purpose
|
||||
External Quality Review (CC
MDs)
Quality Assurance
|
||||
10
|
Investigate Clozapine
Contingencies
|
|||
Met Un-met Needs
|
||||
Need & Situational
Awareness
|
||||
Paper Driven Collaboration
|
||||
Perfection About Med Management
|
||||
15
|
PMADS - In Scope Project
|
|||
Problem Solving Resource Value
|
||||
Sell Housing Advisory Board
Mission & Vision
|
||||
18
|
Volunteer Re-development
|
|||
-
|
Table – Appointment Checklist –
Early Intervention – Last Reviewed 20180330-F:
-
Not As Promising As...
Table – Compare BHDs - A Quick
Comparison
-
|
|||||
MD
|
ASS
|
HEL
|
Note (Outcome)
Association - Correlation
|
||
-
|
|||||
Dobos
|
A
|
Outstanding
|
Kaiser – Performance Driven
Consumer-Driven
|
||
Bum Soo Lee
|
B
|
Satisfactory
|
Close Call (2012)
|
||
RB Bera
|
B
|
Satisfactory
|
|||
RP Singh
|
B+
|
Satisfactory
|
Catastrophic Loss
|
||
H DeSilva
|
C
|
Satisfactory
|
|||
D Chandler
|
C
|
Unsatisfactory
|
Catastrophic Loss
|
||
Daniels
|
F
|
Unsatisfactory
|
Catastrophic Loss
|
||
A Inglis
(OCHCA)
|
A-
|
Outstanding
|
Taught Charting and Record
Keeping
|
||
-
|
Table – Rate Your Behavioral
Health Doctor – Psychiatrist – Completely Subjective - ASS=Appropriate Service
Score - HEL=Hearsay Error Level
-
APD MD "The Educator"
Addressed in Profile II
-
Table - Advanced Planning
2017-2018 for Referral & Linkage
Linkage with New Behavioral
Health Doctor (BHD)
Researching & Planning Stages
-
|
||||
##
|
Phase
|
Note
|
||
-
|
||||
01
|
Cycle Change
|
Routine Tuesdays to Wednesdays
to meet Doctors Needs
|
||
02
|
Realignment
|
MSG’s 28 Day Cycle - Plus
|
||
03
|
Secure Referral
|
20171024-TU
|
||
04
|
Interlude Planning
|
Profiling and Assessing New
Doctor
|
||
05
|
Digital Appointment
|
|||
06
|
Post Treatment Preferences
|
|||
07
|
Day Before
|
Select Five In Scope Documents
to Share
|
||
08
|
20180103-W Day Of
|
RBB 1st Appointment
|
||
09
|
Error Preparation
|
Covered by Nurse
|
||
10
|
Next Appointment
|
20180411-W
|
||
11
|
Day of Record Request
|
Medication Vigilance
|
||
12
|
Prep Complaint in Advance
|
Didn’t need it
|
||
-
|
Table – Stages of Referral – Last
Reviewed: 20180330-F:
-
Table - Rigor Revisited – Time
Spent
Limited Appointment V
Comprehensive Consult (Appointment)
-
|
|||||
Things Provided
|
Limited –
Brief
|
Note when addressed
Comprehensive
|
|||
-
|
|||||
1-Satisfaction Survey
|
|||||
2-Prescriptions
(Hand and/or Electronic)
|
X
|
||||
3-Treatment Plan
|
X
|
||||
Baseline Report
|
|||||
Do you have anything to show me
or turn in?
|
|||||
Medication History
|
|||||
Performance Earned Value (PEV)
– Strengths and Successes
|
|||||
Respite Evaluation
|
|||||
PEI – Determine Causation
|
|||||
Sample Statistics
CC Casa Youth Shelter
|
|||||
Treatment Preference Form
|
|||||
What to Expect
|
|||||
Working Knowledge of Most
Significant Other (MSO)
|
|||||
-
|
Table – Expectations by Type of
Appointment – Rimal B Bera – Appointment 2 – Referral & Linkage – Last
Updated: 20180507-M:
-
Quote
-
-
Table – Appointment Date
20180411-W - Progress Notes
Encounter Summary - Roughly
Temporal - Linkage 2 of 3
-
|
|||||
Practice Feature
|
Doctor
|
Consumer (Us)
|
|||
-
|
|||||
Greetings at door
|
Fulfilled
|
||||
We state
|
“Lucky Office!”
|
||||
Tests our Recall 20180103-W
|
Pass
|
||||
Work – Volunteer
|
Unimpressed with what we do
|
Housing Advisory Board
|
|||
How is your health?
|
Addressed Sleep
|
||||
Digital Appointment
Sleep Video
|
Watched about 2 seconds of 1
minute
|
||||
Determination - Clozapine
|
Addressed savings
|
||||
Clozapine
|
Precision Issue
|
||||
Lithium
|
Pass
|
||||
Lorazepam
|
Renewal Issue
|
||||
Time Spent
|
7 Minutes
|
||||
Bera States
|
“I’m facing a big caseload
today”
|
||||
Bera States
|
“You are my easiest”
|
||||
Next appointment
|
20180718-W
|
||||
Parting Statement
|
“See you at the Meeting of the
Minds”
|
||||
Pharmacy Change
|
States I have to hand deliver
the Lorazepam prescription
|
Nick our go to guy at Gilbert
Pharmacy implies that Bera is wrong
|
|||
Vitals Plus Full
|
[PENDING]
|
||||
Notice Nurse Bethany
|
She looked Happy
|
||||
-
|
Table – Behavioral Health Doctor
(BHD) Features of Practice – Last Updated: 20180502-W:
-
Table - Duty Now For The Future –
A Psychiatrist
-
|
|||||
Duty
|
BSL 2012
|
BSL 2017
|
RBB 2018
|
||
-
|
|||||
Evaluation
|
OK
|
OK
|
To Brief
|
||
Diagnosis
|
OK
|
OK
|
Better
|
||
Treatment
|
Issue
|
Better
|
Sustained
|
||
Analyze Health Status
|
OK
|
Good
|
Too Brief
|
||
Necessary Treatment
|
OK
|
OK
|
OK
|
||
Admit to Hospital
|
PASS
|
PASS
|
PASS (*)
|
||
Test Ordered
|
OK
|
OK
|
OK
|
||
Prescribe Medication
|
OK
|
OK
|
A Few Bumps
|
||
Recommend Therapy
|
No
|
No
|
No
|
||
Regular Discussion(s)
|
Yes
|
Yes
|
Unlikely
|
||
Diagnose Disorder
|
OK
|
OK
|
Better
|
||
Response to Treatment
|
Good
|
Good
|
Good
|
||
-
|
|||||
BHD Management Score =
|
PASS
|
Improved
|
Work in progress
|
||
Table – Wellness Planning – Date Scored: 20180624-SUN:
-
Table – Challenging Topics
Evaluation – TimeMAX (MSG, 2018)
-
|
||||
Topic
|
Note
2018 to Date
|
Detail
|
||
-
|
||||
There is an issue or behavior
you haven't revealed to them
|
Accountability &
Transparency
|
Profiling & Publishing
about him
|
||
They have said something that
has upset you
|
Rushed us
|
|||
You are unsure if you are
making progress
|
Unlikely
|
|||
You are having difficulty with
payments
|
We would like him to make good
on the outstanding invoice
|
|||
You feel they're not getting
something
|
Not until he indicates he has
been reviewing our reports
|
|||
They're doing something that
you find disconcerting
|
Medication management and
conflict of interest issues
|
|||
-
|
Table – Introducing TimeMAX
(ProSumption, MSG, 2018)
-
Outstanding Invoice
Rimal B. Bera, MD Evaluated by
Keith E Torkelson MS as a Doctor On ...
Nov 20, 2016 - Rimal B. Bera, MD
Evaluated by Keith E Torkelson MS as a Doctor On-Call .... Off the cuff Doctor
Bera looks as promising as Doctor Dobos (Our ...
-
Table – Doctor Bera’s Special
Interests
Advertised 3 – Procedures as
Indicated at Intake
-
|
|||
Procedure
|
ProSumer
Buster D Right
|
Sold to us by RBB
|
|
-
|
|||
Family Psychotherapy
|
Ready
|
No
|
|
Psychiatric Evaluation – Brief
Not Paper Driven
|
Ready
|
Favorable update to Diagnosis
|
|
Psychiatric Evaluation –
Extended
30 Minutes
|
Ready
|
Not Done
|
|
Psychotherapy and
Psychophysiological Therapy (incl. Biofeedback)
|
No
|
No
|
|
-
|
Table – Procedures @ Linkage
(Intake) – Consumer Keith Torkelson AKA Buster – BHD Rimal B Bera: Last
Reviewed: 20180625-M:
-
Level of Allegiance and Support –
Aside Disappointing
20180308-TH: Update – Bera’s
Position - 20180625-M: Review
We are almost over the 2018
Clozapine Determination issue were an auditor insisted changing our
prescription to save some odd $60 per month.
Recalling: It looks like our new Behavioral Health Doctor (BHD) Rimal B
Bera (RBB) will not [did not] support us with our Clozapine and preferred
treatment. What RBB is implying is that
our previous BHDs in managing Clozapine are wrong. The chronological order for our Clozapine related BHDs is: Singh,
Inglis, Vu, Daniels (Made an error), and Bum Soo Lee. Actually it turned out to be an exercise in flexibility.
-
20180309-F: Dear Dr. Bera –
20180625-M: A Follow Up
It looks like in the letter that
you do not agree with the chain of Psychiatrists that came before you. It took more than ten years to get our
primary psychotropic medication “Right”.
Incidentally, we did not submit an appeal. It looks like in the letter you deny us of what we need without
proposing and viable alternative. If
you would have asked us in our initial Medication Management Appointment
(January 3, 2018) we were ready to discuss our medications with you. Follow up: In the end this problem with our
Clozapine was fixed. We determined that
our Clozapine could be cut into divided doses.
I was a bit annoying that RBB did not support us through this affair.
Syncope Side Effect – Minded
Medication (MSG) – A Reminder
Syncope is listed as a side
effect for Clozapine (CLOZARIL).
Syncope might be described as a temporary loss of consciousness caused
by a fall in blood pressure. Clozapine
associated Syncope increases our risk for a fall. We determined that “Dividing” our Clozapine doses reduces our
risk of falling. This is the reason we
prefer the 50mg tablets titrated up to 200mg each night. In addition our titration method tests our
Mindful Medication Model (MSG, Triple M, 2018). One day we will get around to publishing our findings about
Triple M. Triple M promotes optimism
and self-efficacy. As Dr. David Dobos
(Kaiser) stated: “Sometimes the patient knows best”.
-
Clozapine Dependence – A Reminder
Ever since 2006 we have been highly dependent on Clozapine
a generic for Clozaril [SPELLED].
Clozapine is not to be confused with Klonopin [SPELLED]. At times the pharmacy may think we are
addicted to Clozapine. We are at our
worst when someone or something is interfering with our daily flow for this our
Drug Of Choice (DOC). For some reason
we cannot sleep without Clozapine. If
we do not sleep our risk for harm gets progressively worse until we have to get
admitted to the Behavioral Health Ward (BHW) to be protected until we get
Clozapine induced sleep. A gap in what
we call the Monthly Clozapine Cycle (MCC) or 28-day Clozapine Maintenance Cycle
(28-CMC) can incur substantial costs even death. Clozapine has a side-effect - drowsiness. For us this means Sleep!
-
Status Life-threatening – A
Reminder
One again a chain of causality can link issues with our
Clozapine to life-threatening situations.
The last time we were at danger for accidental death was 2012. One of the reasons we were safe from
2013-2017 was because our Clozapine pipeline was kept intact. Problems with Clozapine will always
plausibly put us at risk by acerbating our dependency on Clozapine VIS-À-VIS
breaking our Continuity Of Care (COC).
Table -
Diagnostics – Buster’s Cognitive Performance
Our Part Correlations
to GPA – Plus – Balanced Score Card
Will be addressed
with Profile & QA Reports
-
|
|||||
IOHL
|
Estimated
GPA
|
Endeavor
|
|||
-
|
|||||
Orange Coast College
|
4.0
|
UC Reentry Prep
|
|||
UCD Undergraduate
|
3.5
|
Birds as Food Animals
|
|||
UCD Graduate
|
3.5
|
Eradicate Salmonella in Avian
food Chain
|
|||
UCD Veterinary
|
3.5
|
Veterinary Medicine & Human
Health
|
|||
Saddleback College
|
4.0
|
CSUF Reentry Prep
|
|||
CSUF
|
4.0
|
Secondary Teacher Education –
Science
|
|||
Cypress College
|
4.0
|
Health & Human Services
|
|||
-
|
|||||
Graduate Records Examination
(GRE) - Math
|
800/800 = 99th
Percentile
Standard Exam for UCD School of
Veterinary Medicine
|
||||
USDA – Slaughter Inspector Exam
|
PASS
|
Hired (1996)
Retired as a GS-5
|
|||
-
|
|||||
3.6 to 3.8
|
Approximate
Overall Academic Performance
Range
|
||||
-
|
Table – Buster’s Cognition &
Academic Performance – Last Reviewed: 20180624-SUN: (AVEY): IOHL=Institution Of
Higher Learning: Estimated GPA (Except the 4.0s are 4.0s)
-
Yeah - That's Buster Back @ Davis
-
Solicitation Dilemma - Update
20180625-M: Updated Solicitation
Dilemma
For HOS and Bera Reports
We here at MSG have been writing
reports about the psychosocial aspect in Health & Human Services since
2009. We find that if an Agency or
individual does not solicit our findings they lack the resources to consider
them in depth. Our current unsolicited
report addresses our lived experience with our referral and linkage to our new
(and improved) Behavioral Health Doctor.
His name is Rimal B Bera MD. One
of the reasons we here at MSG continue to publish unsolicited reports is that they
help us appreciate where we are and how far we have come for setting things
Right. For us blogging has proven a
better route than direct submissions.
Two examples of documents that Doctor Bera did not solicit yet we will
have on hand for discussion are our: Current Health Outcome Survey (HOS) and a
brief of our Treatment Preferences. The
last time we tried to sell the Treatment Preference approach it was with Doctor
Bum Soo Lee. He indicated that he did
not think it would fly particularly in an inpatient setting.
-
[AN UNSOLICITED LEGACY DOCUMENT]
-
Brand New Day HMO: Thursday,
December 14, 2017
Keith Edward Torkelson –
Treatment Preferences – Behavioral Health Medication - Positions Mental Health
Treatment Preferences for Keith Edward Torkelson M.S.
-
Matrix – Scoring Multiple Engagements (A Time Series) with
Your Behavioral Health Doctor – Last Reviewed: 20180625-M: Q*M=Quick Star
Method. – 5.0 Stars is the Best
-
Table – History & Fact Finding About Rimal B Bera MD
Table - Positions and Promises @ Meeting Of the Minds
Conferences
The Impressionator (MSG, 2018)
The table that follows is the
prototype version of what we call our Impressionator in honor of Dr. Heinz
Doofenshmirtz. What we are looking for
in a BHD is a BHD we can trust to build and sustain our Medication Safety Net
(MSN-MSG-Beta). We have shared on
multiple occasions our treatment preferences gleaned from over twenty years of
lived experience. Metadata =
Mhlth_Tx_Pref_ByandFor_KET_14090116 V2018.
For 2018 we hope first record impressions with our Baseline For Impression
Scale (BL4IS). Once again the
practitioner at center stage is Rimal B Bera, MD (RBB).
-
Table - The Impressionator (MDG, 2018-Beta) - Scoring
Version
1.0
|
||||||
0.5
|
||||||
0.5
|
||||||
0.5
|
||||||
0.5
|
||||||
1.0
|
||||||
0.5
|
||||||
0.5
|
||||||
0.0
|
||||||
0.0
|
||||||
0.0
|
||||||
0.0
|
||||||
Table – Impressions - Data Collected
at Initial Encounter: 20180103-W: Last Reviewed: 20180330-F: Original CALCS Had
Errors Thus Revised: PIP-Problem In Past
-
-
Encounter Material
Review List – Last Reviewed: 20180624-SUN:
Table
- Linkage Material Checklist & Review
Team
MSG – ProSumption Materials - Applied
-
|
|||||
#
|
Component
|
Addressed
20180103-W
|
Satisfied (X)
|
||
-
|
|||||
01
|
Encounter Form
|
Yes
|
No
|
||
02
|
Treatment Preferences
|
So-So
|
No
|
||
03
|
Complaint Form - Initialized
|
N/A
|
Yes
|
||
04
|
OCHCA TAC Work
|
Yes
|
No
|
||
05
|
OCHCA Assessment Inventory
|
Yes
|
No
|
||
06
|
Diagnosis Score Sheet
|
No
|
No
|
||
07
|
Linkage Checklist
|
Yes
|
So-So
|
||
08
|
Binder = PROGRAM - ProSumer
|
Yes
|
Yes
|
||
09
|
OCHCA Hierarchy
|
Yes
|
Yes
|
||
10
|
Cycle Change Announcement
|
Yes (Oral)
|
Yes
|
||
11
|
Health Outcomes Survey (CMS-HOS)
|
N/A
|
|||
-
|
|||||
CALC
|
4.5/10
|
||||
Satisfaction With Material Review Value
(SWMRV) =
|
45.0%
|
||||
-
|
-
Indications He
Cares What We Said
During our last
appointment we think RBB listened to us.
He had to get enough to complete his progress notes. We take notes and if we were to go over what
he said and we said he probably would not recall. All a BND contracted BHD has to do is get the prescriptions
correct and record whatever it takes for them to get paid. If they could do it without seeing the
client they probably would. When we
first began seeing BHD’s our session was 50 minutes, then it went down to a
half hour, next we were seeing doctor BSL for fifteen to twenty minutes. Our last appointment with RBB was about
seven minutes long.
-
Health Outcomes
Survey (CMS)
Our annual Health
Outcomes Survey (HOS) for 2018 from CMS is on deck right now we would like
Doctor Bera to ask us: Do you have any assessments on deck that pertain to me
and our partnership. Actually what we
expect is to focus on getting the prescriptions correct. We still have high expectations for such a
gifted doctor. Health Outcomes doesn’t
that sound like something a doctor would be interested, informed and
knowledgeable about. Depending on the
assessment frequency, up to ½ of his clients have been asked to grade and
submit their HOS-2018s.
-
Table – Sample Activities of a ProSumer: Last Reviewed:
20180624-SUN: AIB=As Indicated By: BHD=Behavioral Health Doctor
-
Table – Activities of a ProSumer – Sample: Last Reviewed:
20180624-SUN: AIB=As Indicated By: BHD=Behavioral Health Doctor
Table – Charter Information for
this Report – Last Updated: 20180626-TU:
Table - Schedule for Defining A
ProSumer (Beta-Draft) – 1 to M
-
|
|||
Meaningful Engagement
|
Example
|
||
-
|
|||
Assessment driven
|
|||
Assessment(s) Ready for Review
|
Health Outcome Survey (HOS-2018)
|
||
Advocacy
|
OCHCA - Housing Advisory Board
|
||
Apply Steinberg Programming
Language
|
May be expecting too much
|
||
Calibrate Self with Normal People
|
We are going to use RBB as our test
subject
|
||
Define Deliverables
|
Reports Published FY 2018
About 1/3 done
|
||
Expect Life Long Learner and
Teachable
|
Learning is measured by assessment
We would be eager to look over his
assessment results
|
||
Familiar With Wellness Planning
|
SMART Criteria
|
||
Health Related Engagement (HRE)
Approach
|
An MSG Product
A Currency for MSG
|
||
HOW – Honest – Open-minded -
Willing
|
Omission may be dishonest
|
||
Investigate Doctors performance in
relationship to BND performance
|
CMS Stars Scoring
MSGs BHD Battery
|
||
-
|
-
Table – Developing ProSumption Using Health Related
Engagements (HREs) – N-Z
Meaningful Engagement
|
Example
|
||
Partnership Approach
|
MSG with Clayton Chau MD
|
||
Performance Driven
|
AIB – Physical Performance
|
||
Preparing in Advance
|
Upgrade the BSL Approach
|
||
Promote Client Access to Computer
Resources
|
|||
Promote E-Assessment
|
Very Important
|
||
Publish or Perish
|
We have some 200 publications since
2012
|
||
Deliver on ProSumption
|
[THIS]
|
||
Promote Revolution about
Psychiatrists (BHDs)
|
“The Experimental BHD Project”
|
||
Promote Satisfaction Assessments
|
Huge room for improvement
[ADDRESSED IN BERA QA]
|
||
Quality Assurance
|
Standalone Report (QA)
|
||
Teach to the Test
|
Innovation about Accountability
|
||
Team Approach
|
[UNLIKELY]
|
||
Transparency Profiling about
Success in Practice
|
As of 20180330-F we can’t find much
Online
|
||
Treating Family Time Seriously
|
Doctor Bera indicated in 2017 an
interest about Family Engagement
|
||
-
|
Cut Short Due to Size
-
[PLACE HOLDER INTO PART IIIB OF
IV]
-
Charter Information
-
|
|||
Specification
|
Note
|
Extended
|
|
-
|
|||
Title (Brief)
|
Behavioral Health Referral
|
Part-IIIB
|
|
Blog(s)
|
Clozapine RX
|
Consider AnimaCules
& HEALTHMAN
|
|
Core Assignment
|
Referral & Linkage
|
Testimony & History
Establish Baselines
|
|
Discipline
|
Health & Human Services
|
Paraprofessional Health Worker
|
|
Inspired By
|
Bum Soo Lee MD
|
||
Dedicated To
|
Kathleen Murray
|
Clayton Chau MD & Mary Hale
MS
|
|
Number of Pages
|
About 50
|
||
Number of Images
|
About 20
|
||
Principle Author
|
Keith E Torkelson
AKA Buster D Right
|
MS – UC Davis
Pathology
Specialty Social
|
|
Editor
|
AVEY
|
||
Driven By
|
DELL
|
SARAH
|
|
Date Published
|
June 29, 2018
|
||
Links to MSG Legacy
Publications
|
About 7
|
“A ProSumer Report”
|
|
Blog-publishing Service
|
Blogger
|
||
-
|
-
FYI
We project worth may decline
Mentalation Solutions Group
Tork Reconstruction Company
-
Promoting PMADS
-
For Doctor Bera
-
Spearheading The John Henry Foundation
-
Doctor Bera's Side Job
-
Baseline Appearance - Keith Torkelson AKA Buster :o)
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