Table 3.
Competency Themes Relating to the Delivery of Telehealth Consultations
| Delivery of telehealth consultations |
|---|
| Clinical reasoning |
| Check whether a telehealth consultation is an appropriate medium based upon the service-user’s health condition30–32 |
| Know how to assess during a telehealth consultation whether in-person is required instead20,30,33–37 |
| Know how to support service-users who have not previously used remote technologies38,39 |
| Know whether telehealth is an appropriate medium to communicate updates to service-users22,40 |
| Know how to select or adapt suitable resources for telehealth22 |
| Communication |
| General communication |
| Know how to develop a contingency plan in case of technical failures and communicate this with the service-user23,33 |
| Know how to work with the service-user to develop a communication plan during, and outside of, telehealth consultations as needed41 |
| Preconsultation communication |
| Ensure there is a plan to resolve the issue of becoming disconnected with the service-user21 |
| Explain the implications and limitations of telehealth versus in-person to the service-user when offering a telehealth service31,42 |
| Know how to navigate failed communications, such as miscommunication, equipment failure, or service-user’s loss of faith in the telehealth service42 |
| Make the service-user aware of their rights and responsibilities when receiving a telehealth consultation, including their right to refuse telehealth43 |
| Prepare the client for the telehealth consultation by providing relevant and explicit information about the timing, technology, and instructions33 |
| During consultation communication |
| Be proactive in ensuring the client understands the telehealth services being offered and understanding their service preferences41,44–46 |
| Know how to address nonverbal cues when using telehealth23,21,35,38,41,47,48 |
| Know how to effectively communicate via telephone as needed for a telehealth consultation27,22,20,49 |
| Know how to effectively teach the service-user the basics of technology used for the telehealth consultation38,50 |
| Know how to explicitly introduce yourself and check the client’s identity33,40 |
| Know how to proactively and thoughtfully engage with the client using telehealth29,20,34,37,39–41,44,49–51 |
| Post-consultation communication |
| Document any changes to assessments that were adapted for telehealth36,45 |
| Effectively using technology |
| Ensure you are familiar with the technology and systems used for telehealth for smooth running of the consultation and any troubleshooting31,32,35,45,52–54 |
| Know how to collaborate effectively with service-users using relevant digital technologies37,50 |
| Know how to test and troubleshoot your digital equipment and the service-users’ equipment33,41,47 |
| Understand how your speech may be distorted through communication technologies41 |
| Person-centered care |
| Be aware of how inadequate acceptance of telehealth by the service-user may negatively affect the validity and reliability of any remote assessments47 |
| Ensure that the service-user provides informed consent on their digital data management, and any recording or sharing of any of their telehealth consultation30,33,36,40,54 |
| Explicitly check that the service-user provides informed consent to receiving a telehealth consultation as acceptable31,33,36 |
| Ensure that a therapeutic alliance is established and maintained throughout telehealth consultation22 |
| Practice-based assessment and intervention knowledge, behaviour, and skills (KBSs) |
| Know how to choose the most appropriate technology for specific telehealth consultation contexts24,31,32,36–39,45,50,55 |
| Privacy, security, and safety |
| Check that it is safe to conduct any telehealth assessments33,36,42,51 |
| Provide explicit information on how the service-user’s digital data is managed, and how their privacy and confidentiality will be protected23,22,33,39,41,53,54,56,57 |
| Provide information about any other persons that will be at any of the planned telehealth consultations30,33,34,36,41 |
| Understand the terms and conditions of any software used in telehealth consultation to ensure data is kept confidential54 |
| Professionalism |
| Have a professional environment and reduce clutter and other distractions from the background22,21,36 |
| Keep updated on tax-related information for telehealth services33 |
| Understand how to ensure the safety of service-users when engaging in telehealth33,36 |
| Understand the limits of own competence when translating in-person service to telehealth32,35,37,53 |
| Setting up the technical environment |
| Be aware of how sound and background noise can be measured accurately via telehealth compared to in-person41 |
| Know how to efficiently set up technologies in preparation for any telehealth consultation32 |
| Know how to regularly test your technology to ensure that it works appropriately and safely23,38,42 |