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 dehydrationDefines clinical red flags in telehealth that require escalation, including severe dyspnea, low or falling oxygen saturation, chest pain, signs of DKA or HHS, hypotension, altered mental status, and persistent 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 effectsCovers best practices for medication reconciliation and adherence assessment in telehealth, including the ask-about technique, reviewing inhaler and device use, clarifying recent changes, side effects, and safety issues.
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 devicesCovers stepwise guidance for coaching patients to obtain accurate home readings for blood glucose, blood pressure, pulse oximetry, and heart rate, including device setup, common user errors, troubleshooting, and documenting results 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 languageProvides a structured approach to opening a 25-minute telehealth visit, building rapport, confirming identity and consent, setting a shared agenda in simple language, and managing time while addressing patient priorities.
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 flagsBuilds video observation skills to recognize respiratory distress, altered mental status, skin perfusion changes, facial and body language cues, and environmental red flags, and to integrate these findings into remote triage and escalation decisions.
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 triggersDetails how to conduct a respiratory history by telehealth, including onset and course of symptoms, triggers, sputum and cough characteristics, baseline exercise tolerance, COPD or asthma patterns, and identifying signs of acute exacerbation.
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 illnessFocuses on structured, symptom-focused questioning for patients with diabetes, including hyperglycemia and hypoglycemia symptoms, glucose patterns, medication use, diet, illness, and sick-day management in the telehealth setting.
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 availabilityExplores how to assess home safety and social determinants during telehealth visits, including living situation, access to medications and food, transportation, caregiver support, and when to involve social work or community resources.
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 how to assess anxiety remotely using brief screening questions, duration and context of symptoms, safety concerns, functional impact, and when to escalate for urgent mental health or crisis evaluation.
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
