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 dehydrationOutlines critical warning signs in telehealth necessitating immediate action, such as intense shortness of breath, low or declining oxygen levels, chest discomfort, indicators of diabetic ketoacidosis or hyperosmolar hyperglycaemic state, low blood pressure, confusion, and ongoing vomiting or fluid loss.
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 effectsReviews optimal methods for reconciling medications and evaluating adherence in telehealth, incorporating the ask-about approach, checking inhaler and device application, and addressing recent alterations, adverse reactions, and safety matters.
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 accurately measure blood glucose, blood pressure, oxygen saturation, and heart rate at home, covering device preparation, frequent mistakes, problem-solving, and recording outcomes during telehealth consultations.
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 languageDelivers a systematic method for starting a 25-minute telehealth consultation, fostering rapport, verifying identity and consent, establishing a mutual agenda with straightforward language, and allocating time to cover 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 flagsEnhances abilities in video-based observation to detect breathing difficulties, changes in mental state, skin circulation issues, facial and body signals, and environmental hazards, incorporating these into remote triage and decision-making for escalation.
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 triggersDescribes conducting a respiratory history via telehealth, covering symptom onset and progression, provoking factors, sputum and cough details, usual exercise capacity, patterns of COPD or asthma, and spotting acute worsening indicators.
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 organised questioning centred on symptoms for diabetic patients, including signs of high and low blood sugar, glucose trends, medication usage, dietary habits, sickness, and self-care during illness in telehealth environments.
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 availabilityExamines assessing home safety and social factors in telehealth, such as living arrangements, access to medicines and nourishment, transport options, caregiver assistance, and involving social services or community support when required.
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 impactInstructs on remote anxiety evaluation using short screening queries, symptom length and background, safety issues, effects on daily life, and recognising when to refer urgently for mental health or crisis support.
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
