As the COVID-19 vaccine is slowly distributed and life is slowly getting back to normal, you’re still dedicated to providing the best medical care that you can for your patients. Curbside clinic service has become more and more popular with veterinary services, patients, and clients. Telehealth in veterinary practice has become a hot topic among veterinarians just as much as in human healthcare.
Telehealth is the blanket term for any health information, care, and/or education provided remotely with the help of technology. Telemedicine is a subcategory of telehealth. Telemedicine refers to the use of technology to exchange a patient’s health information – for example, a Skype call between a general practice veterinarian and client/patient.
Prior to the COVID-19 pandemic, telehealth was slowly becoming more available and usable by veterinarians and human health care providers. The COVID-19 pandemic fast-tracked the rise of telemedicine. However, that does not mean telehealth services have advanced without controversy.
Veterinary Telehealth Already Standard Practice
Telehealth can be an amazingly helpful tool. For example, teleconsultations – when general practice veterinarians consult with veterinary specialists – and teletriage – electronic assessment and management of patients to determine how quickly a patient needs to see a veterinarian – are methods nearly all vets practice. These approaches to veterinary medicine allow clinicians to provide timely and efficient veterinary care.
Teleconsultations can allow veterinarians hundreds of miles apart to collaborate to provide the best patient care. A patient’s attending veterinarian can share pertinent information with the specialist as well as allowing the specialist to provide the patient’s vet with advice on how to move forward with treatment.
Telemonitoring allows veterinary professionals to remotely observe information about their patients, such as blood pressure or glucose levels.
Teletriage helps pet owners who just need to know, “Do I need to bring my pet in for this?” Sometimes, prescription refills or minor abrasions can be easily dealt with at home with a phone call rather than in the veterinary clinic. While this allows vets additional time to see emergency patients, it also saves time and stress for the patients and their owners.
While telehealth in veterinary practice is extremely helpful, there are concerns. Virtual visits essentially eliminate physical examinations. This is difficult for a vet whose patients can’t say, “I ate a tennis ball yesterday” or “I ate chocolate last night”.
Also, the physical exam is important for finding other problems that may not have been noted by the animal owner or may not be visible on a visual assessment. Some examples include a mass noted by palpation or a heart murmur noted on auscultation. As a result, a virtual visit may lead to a hospital visit anyways or possibly a missed diagnosis.
American Veterinary Medical Association on the Use of Telehealth in Veterinary Practice
The AVMA recommends the use of telehealth to the public with an existing Veterinarian-Client-Patient Relationship (VCPR). It makes possible exceptions for teletriage, especially in poisoning and emergency cases. The AVMA approves of veterinary telehealth between practitioners and the use of apps and other electronic means of communication.
Veterinarian Telehealth Laws by State
According to TeleVet, 44 states require an established VCPR in order to practice telehealth. You can start your relationship virtually in:
- Alaska
- Connecticut
- Delaware
- Washington, DC
- Michigan
- Oklahoma
- Virginia
In 38 states, only one veterinarian may establish VCPR with a patient after an in-person examination. In Illinois and seven other states, VCPR must be established in-person, but applies to all vets at a single veterinary practice. Also, a vet in Illinois must have an Illinois veterinary license in order to treat patients in Illinois (unless a Veterinarian-Client-Patient Relationship has previously been established).
The most telehealth-friendly state for relief veterinarians is Virginia. There, you do not need to start the relationship in-person, and the relationship is with the veterinary practice, not the specific doctor. For relief vets, this means you can treat patients virtually with no legal concerns.
Confusion in Florida
This is definitely a controversial topic, with vets weighing in on both sides. Florida suspended their restrictions on the practice of telemedicine (restrictions listed in the Practice Act Chapter 474), which became a matter of confusion and debate among veterinarians. The Florida Veterinary Medical Association did release a points of clarification section on their website to more completely explain what this telehealth suspension does and does not do.
For example, the order does not suspend the VCPR requirement (which requires a physical exam) for the practice of veterinary medicine in Florida. Veterinary telemedicine can be used to provide a diagnosis or treatment recommendations (this includes dispensing medications and authorizing prescriptions) for Existing Patients. Veterinary Telemedicine cannot be used to diagnose or treat a “New Patient”.
More recently, The Florida Senate has a bill- CS/HB911: Medical Treatment of Animals under debate. Here’s the introduction to the bill:
This bill provides exception to who may immunize or treat animals for certain diseases; authorizes use of veterinary telemedicine; prohibits prescription of controlled substances; provides exceptions; revises grounds for disciplinary action against veterinarian; provides that supervising veterinarian assumes responsibility for person working at his or her discretion or under his or her supervision; provides exception to certain vaccination requirements; authorizes employees of animal control authorities to administer rabies vaccinations under certain circumstances”
CS/HB911
There are several changes, including to telemedicine, included in this bill. If passed, it may change the way not only telemedicine is practiced in the state, but many other aspects of the practice of veterinary medicine, which has caused many veterinarians to voice concern.
As we all know, telehealth is a combination of pros and cons. Ultimately, the degree of use and practice of telemedicine are outlined by each state’s legislation and determined by each veterinary practice and individual vet . As we continue to move further into the 21st century, telehealth and veterinary science will inevitably evolve, and we will continue to evolve with it.
Have any thoughts on the matter? Tell us your opinion on Telemedicine, Telehealth and your state’s guidelines in the comments below.