ABSTRACT The objective of the proposed research is to develop a patient safety learning laboratory that will identify prominent patient safety issues associated with telehealth (synchronous video and phone visits), with a focus on patients with chronic conditions, and design, develop, implement, and evaluate novel safety solutions. The Safe and Equitable Telehealth for Chronic Conditions (SafE-T C2) learning laboratory addresses numerous Agency for Healthcare Research and Quality priorities and will focus on improving safety, quality, and value of healthcare. The laboratory will address chronic conditions, health equity and vulnerable populations, and primary care. At the foundation of the learning laboratory is a socio-technical system engineering framework that considers multiple factors that may contribute to patient safety issues including technology, people, processes, and policies. Aim 1 is the problem analysis phase and a multipronged approach will be used to identify telehealth related patient safety issues. Aim 2 is the solution design and development phase. In this phase a diverse set of stakeholders, including industry partners, will co-design and develop safety solutions. Aim 3 is the implementation and evaluation phase. Developed solutions will be implemented in different outpatient clinics across multiple healthcare systems and process measures and outcome measures will be used to determine effectiveness of the solutions in addressing the intended patient safety issues. The research effort is a unique collaboration between MedStar Health, Stanford Health Care, and Intermountain Healthcare. This project utilizes the extensive expertise of the diverse research team which includes system engineers and human factors experts, health equity researchers, clinicians and operational leaders, data scientists and clinical application developers, as well as implementation scientists. The laboratory also includes industry partners, a health equity advisory team, a health equity community advisory board, and a patient and family advisory board that will inform all aspects of the project. Contributions from this research will include identification of prominent safety issues, development and implementation of safety solutions that can be scaled across different healthcare facilities, and new knowledge of which safety solutions are most effective to improving telehealth safety. Our rigorous dissemination plan includes communication of results to policymakers and advocacy groups, clinical leaders and other organizations that serve to improve clinical practice, as well as academic audiences. Results will be available within 4-6 months of project start and we will disseminate our findings throughout the course of the proposed four-year project.