What is veterinary telemedicine?
In order to define telemedicine, we need to first review a few key concepts that are specific for the practice of veterinary telemedicine. The first concept is the Veterinarian-Client-Patient Relationship or VCPR. It’s a legal term that encompasses the basis for veterinary care. A quick synopsis is that all three parties – the veterinarian, the client (or pet owner), and the pet – must be present and willing to participate for treatment to be given. The VCPR is for the protection of all three parties and to establish such a relationship, there are certain conditions that must be satisfied. Most of those conditions fall under the responsibility of the veterinarian, like maintaining medical records and performing an exam. But the client must agree and take an active part in their pet’s care. Of course, the pet is the recipient of love and hopefully cooperates with said care.
Let’s turn to a few more terms that need to be defined. Telehealth is the overarching term that encompasses all uses of technology to deliver health information, education, or care remotely. Telehealth can be divided into categories based on who is involved in the communication and how it’s conducted.
Tele-triage is a subcategory of telehealth that involves the safe, appropriate, and timely assessment of veterinary patients via electronic consultation with their owners. This can take the form of a phone call or even a text message. It can be synchronous, like a real-time live chat service; or asynchronous such as using email for a back-and-forth exchange. This subcategory of telehealth does not require an existing VCPR and can be performed by a variety of veterinary medical professionals (veterinary assistants and veterinary technicians are the most common). However, tele-triage does have limitations. Generally speaking, and for the safety of your pet, individuals performing tele-triage cannot diagnose a disease or condition, provide a prognosis, prescribe any sort of drug (even over-the-counter preparations) or recommend treatment other than basic home care.
Telemedicine is another subcategory of telehealth that requires a veterinarian to have an existing Veterinarian-Client-Patient Relationship or if laws allow, establish such a relationship virtually. Telemedicine is a tool of practice and veterinarians must comply with the laws and regulations in the state in which they are licensed. Thus, true telemedicine isn’t available to pet owners in all states within the United States. However, if State Veterinary Practice Acts have favorable laws, veterinarians practicing telemedicine in those locations can diagnose a disease, give a prognosis (if able to do so), prescribe medications, and recommend treatment. Telemedicine can be practiced over the phone or more effectively through a video interface.
Who provides telemedicine services for my pet?
True veterinary telemedicine services are provided by a licensed veterinarian in the state where you and your pet reside. There are two scenarios we need to consider when answering this question.
- Telemedicine can be undertaken by a veterinarian at the animal hospital where you go for regular veterinary medical care. In this situation, your veterinarian already has a valid and established relationship (VCPR) with you and your pet along with easy access to medical records. Many states allow this type of veterinary telemedicine.
- Telemedicine services can be provided by a veterinarian living in another state but licensed in a state that allows the establishment of a VCPR virtually (or remotely). We refer to this as a centralized telemedicine service. For example, if you and your pet are in the state of New Jersey, the telemedicine veterinarian can live in Colorado must be fully licensed in the state of New Jersey to legally engage in the practice of telemedicine. This model works best if the telemedicine veterinarian is also associated with your pet’s veterinary hospital which facilities knowledge of your pet’s health history and sharing of medical information.
What medical conditions can telemedicine address?
Veterinary telemedicine is a complement to in-hospital pet care, never a replacement. It has inherent limitations that must be considered. First, pet wellness exams cannot be done via telemedicine. Your pet needs to be examined in person at least once every 12 months (more often for puppies/kittens and senior pets). During an annual exam, diagnostic testing is usually done along with administration of vaccines and/or other medications and possibly procedures that may be deemed necessary after a thorough physical exam is performed. Second, telemedicine is not appropriate for emergency situations – if your dog was hit by a car or your cat ate a toxic plant such as day lilies.
Telemedicine appointments are reserved for several common patient situations such as mild diarrhea, sudden onset of limping, sneezing, skin issues, or coughing. Telemedicine is great for nutritional consultations or behavioral issues like noise phobia. Veterinarians practicing telemedicine can assist you with basic pet care like crate training, proper puppy/kitten socialization techniques, grooming etiquette, brushing teeth/oral care, and so much more! Understand that while telemedicine does not provide the opportunity for a detailed diagnostic workup, many minor conditions can be treated symptomatically based on your pet's signs. Telemedicine can also be used for follow-up care or monitoring a pet with a chronic medical condition.
How does telemedicine work?
Telemedicine connects a client (you, the pet owner) with a veterinarian using technology. Using a video interface is more inclusive. While a telemedicine veterinarian does lose a few senses over video, namely touch and smell, and cannot perform a traditional ‘physical’ exam, they can use you, the pet owner, as a surrogate. For example, the telemedicine veterinary may ask you to use your phone camera to show skin, teeth or other areas of interest, or use your sense of touch to feel your pet for things like bumps, swelling or tenderness.
Veterinarians practicing telemedicine must adhere to the same standards of high quality care that an in-hospital veterinarian follows. They will also make your pet’s safety a top priority. There is value in visiting with a licensed medical professional over video and you should expect to pay a fee for that service.
Are there benefits to using telemedicine?
YES! Benefits abound and some may surprise you!
There are benefits for the hardworking veterinary professionals providing care for pets in facilities across the United States! Many animal hospitals are struggling to keep up with demand for their services. Telemedicine can alleviate some of their scheduling pressures, seeing patients with minor medical conditions over video and reserving in-person appointment slots for those patients who absolutely need them.
There are benefits for clients! With telemedicine, a pet owner who is unable to physically go to an animal hospital due to health, weather, transportation or other issues—perhaps a very scared cat who refuses to come out from under the bed—can visit with a veterinarian virtually.
Believe it or not, there are benefits for pets too! Telemedicine veterinarians can see pets at their most relaxed in their home environment. Many pets experience anxiety and stress when going to an animal hospital. For example, getting in a carrier for a cat or even the car ride for an anxious dog can be an ordeal. Then there are the unfamiliar sights and smells outside and certainly inside the hospital. Telemedicine completely removes those fears.
Finally, telemedicine offers benefits for the veterinarians practicing it. Veterinarians spend years in school and more time honing their skills in practice but sometimes the physical demands become overwhelming. Telemedicine allows veterinarians to practice medicine and help pets without the bodily challenges that come with working in an animal hospital.
What if telemedicine can’t solve my pet’s problem?
As mentioned previously, telemedicine does have limitations. Here’s an example. Let’s say your dog suddenly develops a mild limp and you visit with a veterinarian over video. That doctor, with your assistance, will perform a virtual exam and may be able to prescribe medications that provide symptomatic pain relief. However, if the limping continues or gets worse, more steps need to be taken in order to determine the cause. That requires an in-person visit for a physical exam and diagnostic testing such as radiographs.
Because pet safety and well-being are the priority, your pet may still need to be seen by a veterinarian at an animal hospital after the telemedicine appointment. However, the telemedicine veterinarian can certainly do an initial assessment, educate you on what may be going on, provide details on next steps that may be taken at the animal hospital and get your pet started down the right path to recovery.
