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 needing escalation, including severe shortness of breath, low or dropping oxygen saturation, chest pain, signs of DKA or HHS, low blood pressure, changed mental state, 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 effectsCovers best practices for medication reconciliation and adherence check in telehealth, including the ask-about method, 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 step-by-step guidance for coaching patients to get accurate home readings for blood glucose, blood pressure, pulse oximetry, and heart rate, including device setup, common user mistakes, troubleshooting, and recording 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 way to start 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 spot respiratory distress, changed mental state, skin perfusion changes, facial and body language signs, and environmental red flags, and to blend 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 triggersDetails how to do a respiratory history by telehealth, including start and course of symptoms, triggers, sputum and cough features, baseline exercise tolerance, COPD or asthma patterns, and spotting signs of acute worsening.
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-centred questioning for diabetes patients, including high and low blood sugar symptoms, glucose 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 availabilityExplores how to check home safety and social factors during telehealth visits, including living situation, access to medications and food, transport, 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 from afar using short screening questions, duration and context of symptoms, safety worries, functional effects, and when to escalate for urgent mental health or crisis check.
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
