Telehealth Training Manuals and Guidelines -- trusted by medical professionals since 1985

Telehealth Guidelines (2017)

Age-based, 5-Level Triage Guidelines are available on Amazon now

COURSE DESCRIPTION:  This CE course explains the 5-level triage process of telephone triage, as well as how to correctly operate  Telehealth Guidelines.  Telephone triage or telehealth guidelines are decision support tools, in paper or in software format, utilized by clinicians performing telephone triage. These “expert systems” provide decision support for the interview and assessment process.


Woman-with-headsetUser’s Guide   Transparent:  Define the decision support theory underlying the protocol design.  Standard  Operating Procedure: Utilize a problem solving methodology.  Uses a Nursing Risk Diagnosis (or “Working Diagnosis”) approach. Also included:  A  link to 10  real life case studies (2005) 60 minutes.

Research and Clinical Decision Making Research on nurse decisionmaking by Patel and other experts (1995) supports the overall approach and design of these telehealth guidelines.  In addition to the use of the nursing process and nursing risk assessment, Sheila Wheeler believes that pattern recognition, rules of thumb and context are key tools to assess and estimate symptom urgency.

Ms. Wheeler and her 20+ member team built these features into the format design and system components (clinical training, standards and documentation form — available in the Telehealth Clinical  Training Manual).

These guidelines were designed to mimic how the brain naturally solves problems in “real world” situations. Because patient histories are often complex and symptom presentations ill-structured, novel, variable and/or unique, a telehealth system must be able to address these challenges  — flexible, attuned to symptom nuances and subtleties while providing firm support for decision making.

Whether telehealth or telephone triage, all clinical call center facilities performing this service should have in place a system (“an interdependent group of items forming a whole and serving a common purpose”).   Telephone triage and even telehealth is filled with uncertainty, requiring fail-safes and well-integrated components.   This system has both. Thus, the designers of these guidelines intend them to be used by clinicians with substantive decision making experience.


“This book is one of the only books I know of that has pertinent positives and negatives for common chief complaints. I’m a medical student, and I’ve been looking for a book like this for a while. I don’t know anything about nursing protocols, but I will say that it has been a very useful book for coming up with relevant lines of questioning while taking an H and P.  Each chapter is a chief complaint, and the pertinent positives are arranged from most severe/emergent to least. It doesn’t have any confusing flow charts, unlike most other triage books. And, more importantly, it gives you the possible diagnosis for each pertinent positive finding, which a lot of triage books don’t do. I think it’s brilliant.” –  Celsio Gonzalez (link)

 Adult,  School Age or Infant-Child telephone triage guidelines, Link to 10 Case studies. 

Age-based Guidelines are available on Amazon now

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