Lesson 1Red flags that require escalation: severe dyspnea, SpO2 < 90% or significant drop, signs of DKA/HHS, chest pain, altered mental status, hypotension, persistent vomiting or dehydrationIdentifies key clinical warning signs in telehealth needing urgent escalation, such as severe breathlessness, low or dropping oxygen levels, chest pain, DKA or HHS indicators, low blood pressure, confusion, and ongoing vomiting or dehydration.
Severe dyspnea and work of breathing on videoInterpreting low or dropping home SpO2 readingsChest pain, palpitations, and cardiac warning signsIdentifying signs of DKA and HHS remotelyRecognizing hypotension and poor perfusion signsEscalation pathways and emergency instructionsLesson 2Medication reconciliation and adherence assessment: ask-about technique, inhaler use review, recent medication changes or side effectsDetails best approaches for medication review and adherence checks in telehealth, using the ask-about method, checking inhaler and device usage, and clarifying recent changes, side effects, and safety concerns.
Preparing patients for a virtual med list reviewStepwise telehealth medication reconciliationUsing the ask-about technique for adherenceReviewing inhaler and device technique remotelyIdentifying side effects and drug interactionsDocumenting and communicating medication changesLesson 3Gathering home measurements: guided instructions to obtain blood glucose, home BP, pulse oximetry, heart rate, and how to troubleshoot devicesProvides step-by-step coaching for patients to get accurate home readings of blood sugar, blood pressure, oxygen saturation, and heart rate, covering device setup, common mistakes, fixes, and recording in telehealth visits.
Preparing the patient and environment for measurementsStepwise coaching for home blood pressure readingsGuided self-monitoring of blood glucose at homeUsing and interpreting home pulse oximetry safelyAssessing heart rate by device and manual methodsTroubleshooting common home device problemsLesson 4Opening and agenda-setting for a 25-minute visit using simple languageGives a structured way to start a 25-minute telehealth visit, build rapport, verify identity and consent, set a joint agenda in easy language, and handle time while prioritising patient concerns.
Verifying identity, location, and emergency planUsing plain language to explain visit purposeBuilding rapport and psychological safety quicklyEliciting the patient’s main concerns and goalsNegotiating a realistic shared agenda and time useTransitioning from agenda to focused assessmentLesson 5Video observation skills: recognizing respiratory distress signs, altered mental status, skin perfusion, facial cues, environment red flagsDevelops video skills to spot breathing distress, confusion, skin colour changes, facial and body cues, and home hazards, integrating these into remote triage and escalation choices.
Optimizing camera, lighting, and positioningVisual cues of respiratory distress on videoRecognizing altered mental status remotelyAssessing skin color, perfusion, and sweatingReading facial expression and body languageSpotting environmental and safety red flagsLesson 6Respiratory assessment by history: onset, triggers, sputum, cough, baseline exercise tolerance, COPD exacerbation triggersExplains conducting respiratory history via telehealth, covering symptom start and progression, triggers, sputum and cough details, usual exercise capacity, COPD or asthma patterns, and acute flare-up signs.
Clarifying onset, duration, and progression of dyspneaExploring triggers, positions, and relieving factorsCharacterizing cough, sputum, and hemoptysisAssessing baseline and current exercise toleranceIdentifying COPD and asthma exacerbation patternsDetermining need for urgent in-person evaluationLesson 7Symptom-focused questioning for diabetes: hyperglycemia symptoms, patterns, insulin/oral agent use, recent changes in diet or illnessEmphasises structured questioning for diabetes patients on high and low sugar symptoms, patterns, medication use, diet, illness, and sick-day handling in telehealth.
Screening for hyperglycemia and hypoglycemia symptomsExploring home glucose logs and daily patternsReviewing insulin and oral diabetes medication useAssessing diet, activity, and recent illness changesDiscussing sick-day rules and self-managementIdentifying diabetes red flags needing escalationLesson 8Home safety and social determinants: living alone, access to meds/food, transportation, caregiver availabilityGuides assessment of home safety and social factors in telehealth, including living arrangements, access to medicines and food, transport, caregiver help, and involving social services when needed.
Assessing living situation and basic home safetyEvaluating access to medications and refillsScreening for food insecurity and nutrition risksIdentifying transportation and technology barriersAssessing caregiver availability and caregiver strainCoordinating referrals to social and community resourcesLesson 9Assessing anxiety remotely: screening questions, duration, safety concerns, functional impactTeaches remote anxiety assessment with quick screening questions, symptom duration and context, safety issues, daily impact, and escalation for urgent mental health needs.
Building comfort to discuss emotional symptomsUsing brief anxiety screening questionsExploring duration, triggers, and coping effortsAssessing impact on sleep, work, and self-careScreening for safety, self-harm, and substance useCoordinating follow-up and mental health referrals
