Observations on benefits, pitfalls & options for vet practices
This area has been evolving over recent years but has come to the fore starkly during Covid-19 lockdown. The RCVS has relaxed its guidelines on remote prescribing during lockdown. Should this inform future practice? If so, what precautions should be taken to make it work and to minimise the risk?
Even after lockdown has been lifted, this topic will not go away. The use of telemedicine is fairly widespread already in the US, which may teach us some things to emulate and others to avoid.
Telemedicine can be particularly useful for things like:
● Post-operative follow-up
● Routine prescription check-up (flea, worm etc.)
● Triage for non-urgent concerns
● Long term care monitoring
● History taking
● Dietary issues
Some benefits include:
● Improved client compliance when it comes to paying for remote advice
● More efficient use of veterinary professional’s time
● Flexibility & quality of life for veterinary surgeons on maternity/partial retirement
● Allows you to view the animal in their natural environment rather than under stress
● Increased availability of consultations without the physical space requirements
● On call appointments can be triaged to determine which need to be seen out of
hours
● Easier for less mobile clients or pets, and improved flexibility for those that work
However as with any new tool, there are pitfalls and areas of concern. It is so important to remember that telemedicine will not replace the need for in house consulting. Rather, it should be used alongside to help streamline your caseload and maximise efficiency.
One major source of concern surrounding veterinary telemedicine is a lack of clarity on where one stands with regards to insurance and RCVS support.
When prescribing POM-V medication, you need to be able to demonstrate that you have enough information. If, following your consultation, you feel you require more information, request that the client drops the patient off at the practice for further diagnostics. The RCVS has written in their article the requirements for remote prescribing, and so this should be used to guide your decisions. The BSAVA has published a useful triage tool here https://www.bsava.com/TriageTool
Unfortunately there are no convenient hard and fast rules but let’s be honest, when are there ever in veterinary medicine?
Options for practices wanting to adopt some form of remote consulting
There are ways of doing this on a shoe-string. There are various providers of videoconferencing solutions, such as Zoom, there are payment gateways such as PayPal and there are scheduling tools like Eventbrite. So some practices are pulling together their own solutions. However, each one needs to be integrated with invoices and practice communications and then maintained – adding to the long list of expertise needed by the practice.
However, for a joined up approach that allows you to concentrate on vet
consultations rather than IT, it is easier to go with a package that combines all three in a way that can carry your branding and allow you to continue your high standard of professionalism. When you start to factor staff time into your costs, this may well prove more cost effective in the long run.
There are several companies starting to offer telemedicine solutions to vet practices. Some have gone even further and are employing vets and offering a pre-practice triage service. This raises questions of care/practice cost/control, etc. A good solution appears to be using a specialist software provider that only provides the platform, enabling the practice to remain in the driving seat. There are a growing number of specialist software houses providing practice focused solutions for telemedicine. Some require long term contracts, some are integrated within one or other practice management software system. A few are operating as ‘Software As A
Service’ with practices only billed a commission on online transactions made using the tool. The largest three providers globally appear to be:
● http://www.linkyvet.com/en/
● http://www.teletails.com/
● https://ohsvirtualvetcare.com
There are also smaller providers springing up all over the world including Sheffield-based www.VetConsult.online which is focused on customisation to suit independent practices.