Employee Health Services

TCMA administration and staff will work collaboratively with your organization to evaluate the current wellness programs offered. Collaboratively, we will determine the adequacy of a new program, should it be required.

An HRA should provide patients with identified risks and realistic plans for improvement, this will include:

• Health Risk Assessment Overview
• Personal care and safety
• Weight management modification including diet
• Lifestyle behaviors modification
• Assessment of readiness to change
• Ergonomic and musculoskeletal disorders review
• Women’s health & disease prevention
• Family health history
• Heart health
• Diabetes
• Blood pressure
• Cancer screening
• Stress management evaluation and counseling
• Lipid trending and behavior modification
• Creation of a personal action plan
• Generate an overall wellness report

TCMA’s philosophy is that wellness coaching should be designed individually for each employee and provided by the onsite clinical personnel, on a one to one basis. TCMA’s HRA tool, in conjunction with our EMR, identifies and measures a comprehensive array of health risk factors:

• Obesity, diet, and BMI
• Lifestyle behaviors
• Musculoskeletal disorders
• Family health history
• Cardiovascular health
• Diabetes
• Blood pressure
• Cancer
• Stress
• Cholesterol/Lipid Panel
• Generates an overall wellness report upon completion
• Provides patients with identified risks and realistic plans for improvement

Urgent issues revealed from lab tests, radiographic exams, other tests, or HRA results will be immediately brought to the attention of our providers, and we will immediately contact the employee in question. The results for non-urgent, routine labs will be brought to the attention of the employee within 72 hours from initial visit. We provide a variety of education such as:

• One-on-One format
• Large body of employee gatherings suitable for lectures
• Health fairs (Several times a year)
• Monthly Wellness Newsletter
• Online wellness library through the TCMA website

Our HRA assessment is available both on and off line.

TCMA provides counselling and medical management with a goal of harm reduction.

TCMA staff customarily track and trend patients weight at each patient visit. This information is used to help tailor an appropriate program with support from our staff. We can help facilitate a weight loss challenge across the organization.

Our staff lead groups of employees on community sponsored wellness walks/runs and actively participate in health prevention & promotion events with community groups. We collaborate with stakeholder groups with an annual health fair and provide trending from year to year.

Behavioural health can be done by direct referral, either in person or via telemedicine with our staff psychologist, if needed.

Lifestyle coaching is best delivered when patients are onsite with our clinical team, ideally in a 1:1 setting, enabling us to specifically tailor the coaching to the employee (our patient) needs. As we identify high-risk patients via clinical visits, we will ask them to participate in the HRA wellness process. We especially need to be successful in gaining a high rate of participation with this population––the Client’s goal will be 100% participation of its high-risk [cost] individuals. During our treatment of acute injuries, other wellness and healthcare issues will be addressed with patients. This time will be used to initiate the HRA process if the employee has not yet completed it. Additionally, the provider will discuss any other abnormal health findings, and encourage the patient’s use of the health clinic for screening and maintenance of a healthy personal and work lifestyle. Such an example might be identifying a patient’s blood pressure to be elevated on the visit, they will be encouraged to return for evaluation of hypertension and other healthcare issues associated with it. Provider interventions include changes, when necessary, in the medical management of any given patient and require ongoing monitoring and participation. This will include one on one personal coaching and goal setting.

If the City has an HRA fund, it can be added based on the patient progress and participation in the health and wellness program.

TCMA has a Wellness Library that has nutrition, health, procedure education and much more. The Wellness Library is user-friendly and extremely helpful.

Currently, TCMA wellness initiatives include:

• Glucose monitoring
• Blood pressure monitoring
• BMI (weight management)
• Lipid screening and management
• Smoking cessation
• Diet and exercise counseling and programs

Patients can walk in the employee health clinic for assistance, at any time, for questions and interpretation of their HRA. The HRA can be discussed at any phase with an employee through our telemedicine system. No on-site visit required, making it extremely convenient for the employee. For those employees that do not have access to the internet, they are welcome to come and use the computers/tablets at the clinic. Additionally, through our outreach program the providers visiting the departments will have tablets with them should any employee need them to fill out their HRA. As we identify high risk patients via clinical visits, we will ask them to participate in the HRA wellness process. We especially need to be successful in gaining a high rate of participation with this population––the City’s employee health clinic goal is 100% participation.

Provider interventions include changes when necessary in the medical management of any given patient and require ongoing monitoring and participation. This will include one on one personal coaching and goal setting. Our patient education includes influencing emotions and attitudes and is aimed at correcting destructive personal behaviors. Lab results are populated automatically into the HRA and shared with patients via phone, mail, or at a personal appointment. Interventions will be discussed and implemented. Educational flyers and pamphlets will be given to patients at appointments, sent out to patients, and can be used as paycheck stuffers. Safety and health tips will be routinely posted on the medical clinic’s website. Education will be based on the most prevalent ICD-10 diagnoses codes so we can identify and customize educational tools that will specifically target the needs of your employees.

Our staffing model provides us time to take care of walk in and urgent care complaints. Patients are first assessed by the medical provider. A plan of care is decided on collaboratively with the patient, based on need. Depending on the condition and defined goals, a timeline for follow up is decided on the initial visit. If the patient feels he or she needs to be seen sooner at any point they can call for additional appointments. The plan for the patient is clearly documented in the EHR for reference by the entire Healthcare Team.

TCMAi providers and clinics are readily able to deal with chronic disease issues including but not limited to:

• Obesity
• Diabetes
• Heart disease
• Hypertension
• Lipid disorders
• Chronic obstructive pulmonary disease
• Asthma

Of particular interest to many employers is the rapid increase in the incidence of diabetes.  This is quickly rising to the top of the causative list of the most expensive claims in the world of healthcare.  

TCMAi is ready to Thwart this progression with the utilization of modern day technology, including digital and SIM card equipped glucometers, and close monitoring of hemoglobin A1c’s. for all of our clients’ employers who suffer from diabetes.

A decision to refer is based on the patients needs and the perception of the clinic provider. The patient will be included in the decision making process. We always try to refer inside the City’s insurance network of providers.

Vaccinations and immunizations are provided such as,

• Hepatitis B Series
• Meningococcal
• Herpes Zoster
• Influenza
• Pneumococcal
• Tetanus
• Tetanus, Diphtheria, Pertussis,
• Allergy shots could be provided after consultation with an allergist.

TCMA electronic medical records system is Agastha. It is a secure, HIPPAA compliant web based EMR system. It is a robust product used throughout all TCMA managed locations which includes a secure patient portal. To meet compliance for safeguarding patient information, access is limited to authorized patient care providers and the patient themselves, the employer would not have access to the personal health records information. Our EMR systems provider, performs internal audits consistent with federal guidelines. Also, our internal IT department audits user security in real time and quarterly.

We are able to integrate with your insurance provider to report hypothetical claims through our EMR.

This policy applies to all users of TCMA’s electronic communication and information systems (IT). This includes but is not limited to:

• Employees
• Contractors
• Physicians
• Staff
• Representatives of vendors and business partners

Unless otherwise indicated the policy applies to the use of any information technologies including but not limited to:

• Workstations
• Servers
• Software applications
• Clinical systems
• Email, instant messaging, file transfers, utilities, and blogs
• Shared database files and data storage files
• Connection to external networks
• Internet web sites
• Use of external e-mail (e.g. G-Mail)
• Chat rooms
• Social network sites (Facebook, etc.)

We have an excellent telemedicine system providing communication between mid-level providers and physicians as well as, physician to physician interactions. Furthermore, we use telemedicine when appropriate to communicate directly with patients regarding lab results, counselling and HRA results

If care is required outside of normal operating hours, patients can call our after-hours answering service, with a qualified medical provider available for consultation. If it is determined at that time that the condition is such that there is immediate need for care, arrangements will be made for the most appropriate, cost effective alternative site. If a patient has a true emergency, then they should call “911” for help or go to a hospital emergency department.

When appropriate consultation is made for collaborative care with those providers inside the city’s network.

Patient care follow-up is determined at the end of a visit. It can be:

• A return visit
• telemedicine consultation
• follow up phone call

Our scheduling routine allows for walk in care at all times.

Lab services are provided on site. There are no extra fees for drawing the labs, the costs of the labs are passed through with no additional mark up. The following is a sample list of some of the labs that we routinely draw, less utilized studies can also be performed on a case by case basis.