Comprehensive Telehealth Clinical Competencies for Physicians, Physician Assistants, and Advanced Practice Registered Nurses Training Program

Description

A workflow-based training for safe virtual care, documentation, clinical decision-making, and escalation.

Telehealth and telemedicine are no longer occasional workarounds or technology add-ons. They are now part of routine clinical care across outpatient, specialty, community-based, home-based, school-based, rural, hybrid, and post-discharge settings. For Physicians, Physician Assistants, and Advanced Practice Registered Nurses, the central question is not simply whether virtual care is available, but whether it is clinically appropriate, safe, feasible, accessible, and well documented for the patient and situation at hand.

This 7-hour recorded course provides a practical, workflow-based approach to telemedicine clinical competencies, earning participants the Telemedicine Clinical Competencies Certificate. Rather than asking clinicians to memorize rapidly changing rules, statistics, or payer policies, the course teaches a repeatable decision process for selecting telehealth modalities, verifying requirements, preparing for safe encounters, communicating effectively, assessing patients virtually, identifying limitations, adapting for digital access needs, and knowing when to stop, branch, pause and verify, escalate, or refer for in-person care.

Participants will learn how to apply a Telehealth Clinical Decision Lens that considers clinical purpose, modality, verification requirements, feasibility, assessment limits, risk and escalation, follow-up, safety netting, and documentation. The course addresses telemedicine law and scope-of-practice verification, webside manner, privacy and security during the encounter, start-of-visit safety, virtual physical exam skills, digital access and accessibility considerations, documentation anchors, and common real-world “curveballs” such as patients who are driving, not private, unexpectedly located in another jurisdiction, experiencing connection failure, dominated by a helper or caregiver, unable to communicate without support, using an unsafe callback method, presenting with an inadequate virtual exam, requesting unapproved communication channels, or reporting red-flag symptoms.

The course also includes a set of practical handouts and job aids that learners can use during and after the training: the Telehealth Clinical Decision Lens, Telehealth Verification Runbook, Start-of-Visit Safety Script, Virtual Exam Documentation Pattern, Digital Access and Feasibility Screen, and Curveball Documentation Examples. These tools are designed to help clinicians translate course concepts into repeatable workflows, documentation patterns, and safety decisions across practice settings.

Throughout the training, learners are encouraged to apply virtual care decision-making to realistic clinical scenarios while staying within their profession’s scope of practice, organizational or practice policies, payer requirements, and applicable federal and state rules. The course is educational and does not provide legal advice, patient-specific medical advice, payer-specific billing instruction, or organization-specific protocols. Instead, it gives clinicians a durable framework for delivering safer, more effective, and better-documented telemedicine care.

Included Handouts and Job Aids

Participants receive the following downloadable course tools:

• Telehealth Clinical Decision Lens: A practical workflow for deciding whether telehealth is appropriate, which modality is safest, what must be verified, what can and cannot be assessed, and how the decision should be documented.
• Telehealth Verification Runbook: A checklist for identifying legal, scope, location, privacy, prescribing, payer, credentialing, malpractice, and organizational or practice-policy requirements that may need to be verified.
• Start-of-Visit Safety Script: A model opening routine for verifying identity, driving or unsafe activity, audio/video quality, location, callback, privacy, accessibility needs, participants present, and consent.
• Virtual Exam Documentation Pattern: A guide for documenting virtual exam method, findings, limitations, plan, safety net, and escalation decisions without overstating what was assessed.
• Digital Access and Feasibility Screen: A tool for evaluating whether the patient can safely participate in the chosen telehealth modality today, including technology access, communication readiness, privacy, literacy, language access, disability accommodations, and support needs.
• Curveball Documentation Examples: Model documentation language for common telehealth disruptions using the Risk/Limitation → Mitigation → Plan structure.

Desired Outcomes:

• Differentiate among major telehealth modalities, including synchronous video, audio-only, asynchronous care, mobile health, remote patient monitoring, and remote therapeutic monitoring.
• Apply a Telehealth Clinical Decision Lens to evaluate clinical purpose, modality, verification requirements, feasibility, assessment limits, risk, escalation, follow-up, safety netting, and documentation.
• Determine whether telehealth is clinically appropriate for a given patient scenario based on presenting concern, acuity, available data, privacy, communication reliability, digital access, and the need for in-person assessment or emergency escalation.
• Identify legal, regulatory, licensure, scope-of-practice, prescribing, privacy, payer, credentialing, privileging, malpractice, and organizational or practice-policy requirements that may need to be verified before providing telehealth care.
• Use a verification-based approach to address patient location, provider authority, modality restrictions, audio-only considerations, controlled-substance prescribing, reimbursement variables, and documentation requirements.
• Demonstrate telehealth best practices for webside manner, professional presence, communication, privacy, patient engagement, visit opening, visit closing, and clear follow-up instructions.
• Apply a start-of-visit safety routine to verify patient identity, unsafe activity such as driving or operating machinery, audio/video quality, current physical location, safe callback number, privacy, accessibility needs, participants present, and consent per policy.
• Document telehealth encounters using core documentation anchors, including modality, consent per policy, identity verification, patient location when relevant, participants present, privacy or accessibility supports, assessment limitations, clinical rationale, follow-up, safety net, and teach-back.
• Conduct or guide virtual physical exam components using patient-assisted maneuvers, caregiver or telepresenter assistance when appropriate, available peripherals, patient-generated data, images, video observation, and home devices.
• Recognize limitations of remote assessment and determine when to narrow the visit scope, change modality, request additional data, arrange testing, recommend in-person evaluation, or activate urgent or emergency care.
• Assess digital access, accessibility, communication readiness, privacy, health literacy, digital literacy, language needs, disability accommodations, and other feasibility factors that may affect safe participation in telehealth.
• Adapt telehealth workflows to address access barriers, interpreter or caption needs, assistive supports, caregiver or telepresenter involvement, low-bandwidth conditions, unsafe callback methods, unapproved communication channels, and situations where another modality or in-person care may be safer.
• Respond to common telehealth curveballs by choosing whether to continue, stop, branch, pause and verify, or escalate, and by documenting the risk or limitation, mitigation, and plan adjustment clearly.

Format and Access

This is a non-interactive, self-study course. Instruction consists of 7 hours of video instruction and a post-test.

Course Outline

The Telemedicine Clinical Competencies Certificate (TMCC) will become available to participants who complete the full training content (recorded videos), complete and pass a post-test (you may retake it if needed), submit the program evaluation, and claim the certificate of completion.

Module 1: Telehealth Foundations and the Clinical Decision Lens

This module frames telemedicine as an adaptable clinical workflow rather than a simple technology platform. Learners explore foundational concepts, core competency domains, and major virtual care modalities before mastering the Telehealth Clinical Decision Lens — the 8-step framework that anchors clinical decision-making throughout the rest of the course.

Core Topics:

• Virtual Care Foundations: Distinguishing telehealth vs. telemedicine, core terminology, competency domains, and integrating virtual care across diverse settings.
• Modalities & Ecosystems: Comparing synchronous video, asynchronous care, audio-only care, and remote monitoring applications.
• The Telehealth Clinical Decision Lens: An 8-step framework covering purpose, modality selection, safety verification, feasibility, assessment limits, risk escalation, safety netting, and documentation.
• Applied Practice: Evaluating a clinical telemedicine case using the decision lens.

Related Handout: Telehealth Clinical Decision Lens

Module 2: Telehealth Law, Scope of Practice, and Verification Requirements

This module teaches a durable, verification-based approach to telehealth law, regulation, scope of practice, prescribing, privacy, credentialing, and risk management. Rather than memorizing static or temporary rules, learners master the Telehealth Verification Map—a repeatable method for identifying what must be verified across specific patient locations, clinician credentials, modalities, payers, and practice settings.

Core Topics:

• The Verification Framework: Differentiating durable principles from update-sensitive rules, utilizing the Verification Map framework, and navigating federal resources.
• Licensure, Scope, & Clinical Operations: Verifying interstate telemedicine practice rules, state training requirements, controlled-substance prescribing, credentialing by proxy, privileging, and liability/cyber insurance coverage.
• Privacy, HIPAA, & Technology Security: Practice control over platforms and accounts, Business Associate Agreements (BAAs), risk analysis, security safeguards, and remote communication rules.
• Reimbursement & Payer Rules: Navigating Medicare, CMS, private payer requirements, and service vs. payment parity laws.
• Applied Practice: Reviewing verification case examples and documenting workflow or plan adjustments.

Related Handout: Telehealth Verification Runbook

Module 3: Telehealth Best Practices, Webside Manner, and Documentation Anchors

This module focuses on delivering high-quality, patient-centered telemedicine care during routine clinical encounters. Learners examine clinical appropriateness and modality selection, master webside manner and professional environment setup, execute a standardized start-of-visit safety routine, and apply core documentation anchors throughout the encounter.

Core Topics:

• Clinical Appropriateness & Modality Selection: Applying standards of care to evaluate virtual care appropriateness and matching the modality (video, audio-only, asynchronous) to the specific clinical purpose.
• Webside Manner & Professional Presence: Optimizing clinician environment (camera, lighting, framing, background), considerations for employed vs. private-practice clinicians, setting a visit agenda, and applying patient-centered communication techniques over video.
• Start-of-Visit Safety & Privacy: Executing the standardized opening script, conducting start-of-visit safety/location/privacy routines, maintaining encounter security, and managing basic tech troubleshooting.
• Closing Routines & Documentation Anchors: Utilizing a structured closing checklist, delivering clear follow-up instructions, applying core telemedicine documentation anchors, and engaging in mini-practice exercises.

Related Handout: Start-of-Visit Safety Script

Module 4: Virtual Physical Exam Skills and Assessment Limits

This module teaches clinicians how to perform virtual physical exams while recognizing the inherent limits of remote assessment. Learners explore what can be observed, guided, measured, or supported through peripherals and telepresenters. Emphasis is placed on exam safety, identifying red flags, applying the Virtual Exam Sufficiency Check, and accurately documenting clinical findings and assessment limitations.

Core Topics:

• Virtual Exam Techniques & Adaptations: Translating in-person exams to telemedicine settings across body systems, utilizing peripherals, and leveraging common household items/devices.
• Telepresenters & Guided Maneuvers: Collaborating with telepresenters, caregivers, or patients, and maintaining safety during patient-assisted and movement-based exam maneuvers.
• Exam Sufficiency & Stop Rules: Applying the Virtual Exam Sufficiency Check, recognizing red flags and stop rules, and determining whether to continue virtually, request more data, refer in person, or escalate care.
• Documentation & Applied Practice: Applying the Virtual Exam Documentation Pattern (differentiating direct observations from self-reported findings), documenting exam limitations, and completing case scenario practice.

Related Handout: Virtual Exam Documentation Pattern

Module 5: Digital Access, Accessibility, and Telehealth Feasibility

This module frames digital access and accessibility as fundamental clinical safety and feasibility issues. Learners examine how broadband stability, device availability, literacy levels, language access, disability accommodations, and cultural trust impact a patient’s ability to participate in virtual care. Emphasis is placed on using the Digital Access and Feasibility Screen to identify barriers empathetically and adapt modalities when telemedicine is unfeasible.

Core Topics:

• Digital Equity as a Clinical Issue: Examining social determinants of health, drivers of digital health disparities, and the relationship between digital equity and patient safety.
• Accessibility, Literacy, & Inclusion: Addressing hearing, vision, disability accommodations, language access, cultural responsiveness, and variations in general, health, and digital literacy.
• Empathetic Screening & Feasibility: Utilizing the Digital Access and Feasibility Screen, conducting empathetic interviewing, evaluating public location privacy risks, and deploying assistive tools (interpreters, captions, telepresenters).
• Modality Adaptation & Documentation: Adapting care plans or shifting modalities when virtual visits are unfeasible, and documenting access barriers, accommodations, and workflow adjustments.

Related Handout: Digital Access and Feasibility Screen

Module 6: Telehealth Curveball Management

As the course’s capstone application module, this training translates earlier core concepts into real-world crisis and disruption management. Learners navigate real-time challenges—such as unsafe patient environments, connectivity drops, caregiver dominance, privacy breaches, and emergent red-flag symptoms—using a structured decision-making framework and a 3-part documentation pattern.

Core Topics:

• The Decision & Documentation Framework: Applying the core decision structure (stop, branch, pause/verify, escalate) and the 3-step documentation pattern (Risk/Limitation → Mitigation → Plan Adjustment).
• Safety, Privacy, & Communication Disruptions: Managing real-world challenges including unsafe participation (e.g., driving), compromised privacy, dominant caregivers, unapproved communication channels, and emergent accessibility/interpreter needs.
• Technological, Location, & Clinical Disruptions: Resolving connectivity failures, dropped calls, unsafe callback protocols, unexpected patient locations, inadequate virtual assessments, and acute red-flag symptoms.
• Applied Practice & Clinical Reflection: Engaging in scenario-based decision practice, conducting clinical-setting reflections, and completing the final curveball management self-check.

Related Handout: Curveball Documentation Examples

Course Details

This program was launched August 1, 2026 and expires on July 31, 2029.

The Telemedicine Clinical Competencies Certificate (TMCC) will become available to participants who complete the full training content (recorded videos), complete and pass a post-test (you may retake it if needed), submit the program evaluation, and claim the certificate of completion.

Availability: 

From the time of registration, you have six months to access the coursework.

Who Should Attend: 

This course is intended for Physicians, Physician Assistants, and Advanced Practice Registered Nurses. The content is applicable to clinicians who are providing telemedicine services.

Teaching Methods: 

This is a non-interactive, self-study course. Teaching methods for this course include recorded lectures, videos, a post-test, and a course evaluation.

How to Attend: 

Course access and completion instructions.

Instructors and Disclosures

Instructors

  Katherine Chike-Harris, PhD, DNP, APRN, CNE, FAANP, FAAN

Dr. Katherine Chike-Harris is a distinguished nursing leader, educator, scholar, and clinician at the forefront of digital healthcare integration and pediatric medicine.

Serving as the Director of Telehealth Education and an Associate Professor at the Medical University of South Carolina (MUSC) College of Nursing, Dr. Chike-Harris leads national efforts in embedding telehealth instruction into nursing curricula.

Her academic leadership is directly informed by her active clinical practice. As a school-based telehealth provider, she delivers vital care to rural and underserved pediatric populations across South Carolina, expertly managing both acute and chronic pediatric conditions to bridge critical access gaps in healthcare.

As a national subject matter expert on virtual health delivery, Dr. Chike-Harris has extensively shaped the field's academic and policy landscape. She has authored 5 book chapters and 18 peer-reviewed articles addressing core telehealth nurse practitioner competencies, policy, virtual physical exam methodologies, and clinical best practices. To further empower nurse educators, she co-developed the C-TIER website, creating a hub of specialized telehealth educational resources for nursing faculty.

In recognition of her groundbreaking impact on telehealth education and pediatric healthcare, Dr. Chike-Harris has earned prestigious dual honors as a Fellow of the American Academy of Nursing (FAAN) and a Fellow of the American Association of Nurse Practitioners (FAANP).

 Raymond Barrett, CEO, LMHC

Raymond Barrett is the founder and CEO of the Telehealth Certification Institute, LLC (TCI). A licensed mental health counselor (LMHC), Ray is an innovator and leader in the field of telemental health. He’s an expert telehealth trainer, a respected speaker, and a trusted consultant.

Ray’s inspiration for TCI came from his clients that started asking him to conduct their therapy sessions over the phone. Ray had discovered a knowledge gap in mental health training. He wanted to fill that void with comprehensive and practical training in telemental health - so Ray created that training for himself and fellow clinicians. 

Since 2014, TCI has delivered comprehensive telehealth training and consultation to a global network of more than 40,000 healthcare organizations and professionals. TCI now offers over 180 specialized courses, a vast array of telehealth resources, and ongoing free continuing education opportunities for telehealth providers. Among the most sought-after courses offered by TCI is the Telemental Health Training Certificate (THTC Certificate) program. 

Ray played a significant role in developing the initial curriculum for the Board Certified Telemental Health credential (BC-TMH) for the Center for Credentialing and Education (CCE). He reviewed every training module. He helped draft content, including questions for exams. He even wrote and developed the initial draft of one of the training modules: Telemental Health Settings and Coordination of Care.

The American Telemedicine Association (ATA) - the most respected organization for telehealth - recently overhauled its guidelines. Ray was on the writing committee that developed Best Practices in Synchronous Videoconferencing-Based Telemental Health in March 2022. 

In 2019, Ray participated in a task force for developing a clinical rating process for mobile apps designed to help treat depression.  The recommendations were presented to ATA.

The Commission on Accreditation of Rehabilitation Facilities (CARF) is an independent, nonprofit organization that provides accreditation services worldwide at the request of health and human service providers. As part of the International Standards Advisory Committee (ISAC), Ray helped establish CARF’s standards for virtual services.

Ray also is a frequent speaker and consultant for professional organizations. He has presented for over 20 organizations since 2015. 

Disclosure of Financial Relationships:

UVA Health Continuing Education as a Joint Accreditation Provider adhere to the ACCME Standards for Integrity and Independence in Accredited Continuing Education, as well as Commonwealth of Virginia statutes, University of Virginia policies and procedures, and associated federal and private regulations and guidelines.

All individuals involved in the development and delivery of content for an accredited CE activity are required to disclose relevant financial relationships with ineligible companies occurring within the past 24 months (such as grants or research support, employee, consultant, stock holder, member of speakers bureau, etc.).  UVA Health Continuing Education employs appropriate mechanisms to resolve potential conflicts of interest and ensure the educational design reflects content validity, scientific rigor and balance for participants.  Questions about specific strategies can be directed to UVA Health Continuing Education at This email address is being protected from spambots. You need JavaScript enabled to view it..

Disclosure of discussion of non-FDA approved uses for pharmaceutical products and/or medical devices

As a Joint Accreditation provider, UVA Health Continuing Education requires that all faculty presenters identify and disclose any off-label or experimental uses for pharmaceutical and medical device products. It is recommended that each clinician fully review all the available data on new products or procedures prior to clinical use.

Disclaimer Information:

CE activities accredited by UVA Health Continuing Education are offered solely for educational purposes and do not constitute any form of certification of competency. Learners should always consult additional sources of information and exercise their best professional judgment before making clinical decisions of any kind. Learners are not authorized to copy, modify, reproduce, re-publish, sub-license, sell, upload, broadcast, post, transmit or distribute any of the course materials.

No one in a position to control content has disclosed any financial relationships. 

Accredited Education

Credit Hours: 

7 hours of participation (consistent with the designated number of AMA PRA Category 1 Credit(s)^TM or ANCC contact hours)

ACCREDITATION AND DESIGNATION STATEMENT:

In support of improving patient care, UVA Health Continuing Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physicians
UVA Health Continuing Education designates this live activity for a maximum of 7 AMA PRA Category 1 Credits.^TM Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurses
UVA Health Continuing Education awards up to 7 contact hour(s) for nurses who participate in this educational activity and complete the post activity evaluation.
Hours of Participation
UVA Health Continuing Education awards 7 hours of participation (consistent with the designated number of AMA PRA Category 1 Credit(s)^TM or ANCC contact hours) to a participant who successfully completes this educational activity. UVA Health Continuing Education maintains a record of participation for six (6) years.

This is a non-interactive, self-study course.

Agreement

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