Telemedicine

Learn how to implement veterinary telemedicine in your practice!

March 19, 2020

What is telemedicine?

Telemedicine is a subcategory of telehealth that involves use of a tool to exchange medical information electronically from one site to another to improve a patient’s clinical health status. Examples include using Skype or a mobile app to communicate with a client and visually observe the patient for a post-operative follow-up examination and discussion. Telemedicine is a tool of practice, not a separate discipline within the profession. The appropriate application of telemedicine can enhance animal care by facilitating communication, diagnostics, treatments, client education, scheduling, and other tasks.  Telemedicine, while fairly new as a service offering in veterinary medicine, has been used in human healthcare for more than 25 years. Some of the initial situations where veterinarians have utilized telemedicine services within an existing VCPR include: general wellness care, after-hours care, post-surgical care, hospice care, and to facilitate access to veterinary care.

CLICK HERE for important questions and answers to implement telemedicine in your practice!

Veterinary Telemedicine Lecture – March 2018

What is the definition of a VCPR in Indiana law?

Indiana code 25-38.1-1-14.5 defines “Veterinarian-client-patient relationship” as follows:

“Veterinarian-client-patient relationship” means a relationship between a veterinarian and client that meets the following conditions:

  • The veterinarian has assumed the responsibility for making clinical judgments regarding the health of the animal and the need for medical treatment, and the client has agreed to follow the veterinarian’s instructions.
  • The veterinarian has sufficient knowledge of the animal to initiate a diagnosis of the medical condition of the animal. The veterinarian has recently seen and is personally acquainted with the keeping and care of the animal by either of the following:
  • An examination of the animal.
  • By recently seeing and being personally acquainted with the keeping and care of representative animals and associated husbandry practices by making medically appropriate and timely visits to the premises where the animal is kept.
  • The veterinarian is readily available or has arranged for emergency coverage for follow-up evaluation if there is an adverse reaction or failure of the treatment regimen.
  • When appropriate, the veterinarian has arranged for continuing care with another licensed veterinarian who has access to the animal’s medical record.

If the VCPR already exists, what are my options with telehealth for healthcare delivery?

If a valid veterinarian-client-patient relationship exists, veterinary telemedicine could be an acceptable means to have a follow up examination or a valid means of one veterinarian consulting with another concerning the care of a patient with whom a valid veterinarian-client-patient relationship exists.

Do telemedicine service providers require separate liability insurance coverage?

In most instances there are no special requirements for liability insurance when it comes to offering telemedicine services. Veterinarians are expected to provide the same level of care whether veterinary services are offered in person or through telemedicine. However, we recommend that you ask your professional liability carrier for a recommendation.

What services can be provided through telemedicine?

Any service is possible with telemedicine as long as a VCPR is in place, and the attending veterinarian is comfortable assessing the patient remotely and feels able to exercise good clinical judgment to assist the patient.

What digital methods are considered viable and legal telemedicine tools?

Telemedicine service providers make it easy for you to conduct high-quality telemedicine consultation and also handle payments with the client. Most service providers pay the doctors a portion of the service fee and keep a portion to cover their costs of providing the technology. Each provider has unique terms and fees, so be sure to inquire about this directly with the providers to see which ones best meet your needs.

Sample listing of veterinary connected care companies – Learn More

What are “good practice guidelines” for doing telemedicine that are generally accepted principles?  (i.e., is there a national association that backs these guidelines…. AVMA, AAVSB?) 

AVMA Guidelines for the use of telehealth in veterinary practice – click here

AVMA resources and information – click here

Veterinary Virtual Care Association – click here

Guiding Principles of Telehealth

 

  1. Telehealth is an innovative and practical tool with vast potential to serve existing clients and attract new pet owners into the pet healthcare system.
  2. Telemedicine tools will become an integral part of veterinary medicine with the potential to grow the economic footprint for veterinarians.
  3. Expanded telemedicine use should be encouraged as supporting technology and telemedicine practice standards are developed.
  4. Veterinary medicine can learn from the 25 years of experience and applications for telemedicine in human healthcare.
  5. The Veterinarian-Client-Patient Relationship (VCPR) is fundamental to veterinary practices. Its shape and rules must evolve as practices, technologies, and consumer expectations evolve.
  6. Veterinarians are equipped to decide when they have enough information to diagnose or prescribe. The current VCPR regulations do not allow veterinarians to exercise their professional medical judgment when that information is received electronically.

(Some information in this document is taken from the American Veterinary Medical Association and the Veterinary Innovation Council.) 

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