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advanced practice nursing, nurse practitioners, nursing education, telehealth competencies, telemedicine



  1. Rutledge, Carolyn M. PhD, APRN, FNP-BC
  2. O'Rourke, Jennifer PhD, APRN
  3. Mason, Anne M. DNP, APRN, PMHNP-BC
  4. Chike-Harris, Katherine DNP, APRN, CPNP-PC, NE
  5. Behnke, Lyn DNP, APRN, FNP-BC
  6. Melhado, Lolita PhD, APRN, FNP-BC, ACHPN
  7. Downes, Loureen PhD, APRN, FNP-BC
  8. Gustin, Tina DNP, APRN


Background: Telehealth is a rapidly growing health care delivery modality with advanced practice nurses as key providers. This growth has occurred without critical consideration of provider training. Training requires the development of competencies situated within a framework.


Problem: Standardized telehealth competencies for advanced practice nursing are missing. The purpose of this article is to describe the development of telehealth competencies for education and practice.


Approach: Using the Four P's of Telehealth framework (planning, preparing, providing, and performance evaluation), a modified Delphi technique was used to identify, develop, and evaluate telehealth competencies.


Outcomes: Competencies were arranged around telehealth domains, expected activities, and outcomes. Effective use of the competencies to guide curriculum development, practice, and future research related to telehealth was identified.


Conclusions: Providing education with competencies aligned to the Four P's Telehealth framework will provide learners with tools to assume leadership roles in all phases of telehealth implementation, delivery, and refinement.