Telemedicine: Gaining Steam Within the Veterinary Profession

Photo Credit: Flicker CC license, littlebiglens, goldensAlthough the practice of telemedicine has been around for quite some time, only recently has this technology been embraced by the veterinary profession. In July of this year, the American Veterinary Medical Association (AVMA) provided a game changer by providing unanimous endorsement for the practice of telemedicine.

What exactly is telemedicine?

Telemedicine is a form of “remote consultation,” meaning the doctor and patient are not in the same location. Telemedicine is a means of providing evaluation and treatment recommendations via either telephone (verbal or text messaging) or electronic means (email, Skype). Here are a few examples of how telemedicine might work.

Your dog has torn a toenail and is limping. You describe the situation to your veterinarian via email and include a photo of the torn nail. Your vet advises you on cleaning the site, restricting your dog’s activity, and watching for things such as an infected appearance or persistent limping that would warrant an office visit.

You send a text message to your veterinarian letting her know that you switched brands of cat food a week ago and your kitty has vomited once daily for the past three days. She seems completely normal otherwise. Your veterinarian responds requesting that you discontinue the new food and resume feeding the previous brand. If the vomiting doesn’t disappear within a couple of days or any other symptoms develop, bring your kitty in for an exam.

Your dog has just returned home from a foray in the neighborhood and has a gash on his head. You’re wondering whether or not stitches are necessary. You snap a photo of the wound and text it to your veterinary hospital with the question, “Are stitches needed?” The response is, “Yes, please bring your dog in for stitches and don’t feed anything between now and then in case anesthesia is needed.”

Veterinarian-client-patient relationship

A critical component of telemedicine within the veterinary profession is prior establishment of a veterinarian-client-patient relationship (VCPR). What this means is that the veterinarian providing the telemedicine service (or another veterinarian within the practice) has already met the animal in person, performed an examination, and established a medical record.

The only situations in which telemedicine is condoned without prior establishment of a VCPR are poison control centers calls. In such cases, advice is rendered without any prior hands-on evaluation of the animal.

Advantages and Disadvantages

Telemedicine exchanges between veterinarians have been happening for years. For example, a general practitioner might email x-rays or an electrocardiogram tracing to a specialist for interpretation. Telemedicine exchanges between veterinarians or veterinary staff members and their clients offer several potential advantages some of which include:

  • Convenience of timing: an email or text message exchange doesn’t rely on both parties being available at the same time
  • Avoidance of unnecessary office visits (thereby avoiding unnecessary expense for client and stress for patient)
  • Easy exchange of educational materials
  • Potential to readily assuage client’s worries and concerns
  • A convenient way to deliver a progress report on how a patient is doing

Telemedicine is also fraught with disadvantages including:

  • Potential to miss something of significance because of lack of “hands on” evaluation
  • Mistakes can be made because of lack of a “hands on” evaluation
  • Potential challenges in record keeping (transcribing emails and texts into medical records)
  • Inability to adequately perceive and address client’s emotional needs
  • Clients hoping to avoid office visits may abuse the system

If you are interested in learning more about veterinary telemedicine, take a look at the Final Report on Telemedicine authored by the AVMA Practice Advisory Panel. Be forewarned, it is not light reading- you may want to have a cup of coffee in hand!

Is telemedicine available through your veterinary practice?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
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Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

 

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