Introductions First, I would like to ask each of you to introduce yourself, state your role in caring for NH residents, and briefly tell us why you were interested in participating in this focus group study. Experience caring for residents requiring further ED evaluation Think back to a recent experience you had with an NH resident who became ill and required a transfer to the ED. Take a few moments to silently reflect on what that experience was like and how it unfolded. Now, I’d like to go around and ask each of you to describe what happened in that recent experience. I think we should have enough time for each of you to talk for about 3–5 min or so. Probes Please describe what the communication with the family was like during that time? How was the family engaged in the decision about the possible care transition? Was it before or after the decision to transfer had been made? Please describe how the resident’s goals of care were considered in the care transition? Telehealth opportunities Now, I would like to show you a short video demonstration of a telehealth consultation. Telehealth is the use of digital technologies to deliver care and health education by connecting users in different locations. This video shows a visit between an NH resident, daughter, nurse, and primary care provider. It is from 4 years ago. Now, we have many more health technologies at our disposal. But the video will hopefully give you an idea of how telehealth could potentially be used in the NH context. Now that you have watched the video, let me tell you about the new potential features and capabilities that could be used (hand out list). Perceptions of telehealth technology in practice  Based on the video and list of potential features, I would like you to tell us how you might have used the technology in the situation you described earlier and how the technology might have changed that experience. Probes Are there people you might have connected with using telehealth? Who? When? (ED, family, goals of care, etc.) Are there certain telehealth features you might have used? Now, please take a moment to put your initials at the top of the paper and then circle those features and capabilities that would most enhance your care of NH residents requiring a possible ED evaluation. Feel free to write any notes for us on the paper. Perceived barriers and incentives to implementing telehealth technology Now I would like to ask you, could you see yourselves using this kind of technology in the future? Probes What would make you more likely to use this technology? What would make you less likely to use this technology? What are the challenges you feel we will face with implementation? What are some strategies to overcome those challenges? What might encourage other providers to use this technology?

Note. NH = nursing home; ED = emergency department.