How does TELER work
TELER defines what needs to be done, not how it is done, so it's left to the clinician to decide the best possible course of treatment for their patient. While TELER is concerned with individuals rather than groups, data can be aggregated to produce group data.
Why TELER is better than conventional methodsTELER basically has two functions. The first is to identify the level of the problem, the second function is to track how effective the treatment is. What TELER doesn't do is define what the treatment should be. Once a diagnosis has been made, the clinician will use TELER to assess the current level of the problem. The clinician would look through the TELER library and choose the indicator(s) that specifically relate to the problem and the patient will essentially be tested against these indicators to see what stage they are initially at. This functionality replaces the need to simply ask the patient how they feel on a scale of 1-10. For each subsequent treatment session, the patient will be tested against the same indicators and because each value of the indicator remains constant, the response from the patient will show whether the treatment is working or not. Example: Treating a patient with a shoulder injury Example:
Shoulder - internal rotation while standing
Lvl - Condition
0 - Unable to let arm hang freely by side
1 - Able to let arm hang freely by side
2 - Able to place back of wrist on buttock
3 - Able to place back of wrist on sacrum
4 - Able to place back of wrist on small of back
5 - Able to place back of wrist between shoulder blades So using the indicator in figure 1, the clinician test how much movement the patient has in their shoulder. If they could reach the wrist to their sacrum but not the small of their back then the clinician would note that they are at level 3 prior to receiving any treatment. It is at this point, having run through any number of indicators with the patient that the clinician would then choose the best form of treatment. Using a special TELER form, the clinician will mark down what treatments are going to be used for that session and also state which indicators are being used and level the patient is at before the treatment begins. This is done for each session, and the beauty of a TELER indicator is that in every treatment session the patient is being tested against the exact same conditions so progress, or lack of, can be easily identified. There is also a clearly defined goal to aim for, for the patient to be able to place their wrist between their shoulder blades and once this has been achieved the treatment can end. So why are indicators better than pain scales?
In brief, because each level of an indicator has a clinically valid condition that must be met, and because the exact same criteria are used for each treatment session, the results are clinically valid, statistically valid and above all else, accurate.
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