Here to stay: Why telemedicine is integral to the future of veterinary medicine

sonyachny / stock.adobe.com

To adhere to the social-distancing guidelines brought on by the coronavirus disease 2019 (COVID-19) pandemic, many veterinary hospitals have been relying on technology and innovation to preserve their standard of patient and client care. According to telehealth expert Aaron Smiley, DVM, chief of staff at 2 Indiana veterinary hospitals and immediate past president of the Indiana Veterinary Medical Association, the initial allure of telemedicine for promoting COVID-19 safety protocols has evolved into a discussion about how veterinary medicine will be offered in the future. During a recent Fetch dvm360® virtual conference, Smiley outlined the benefits of telemedicine and offered tips for converting to paid virtual care.

“Telemedicine has been integral in the veterinary sector for more than a century. Increased public awareness and use of telemedicine is allowing us to monetize the professional service that we have offered for so long,” he said, adding that telemedicine has always been deeply integrated into veterinary medicine and veterinarians are very good at it. “We have stayed in close communication with our clients and that has allowed us to become very effective in offering telemedicine.”

Why telemedicine?

When Smiley converted from free to paid telemedicine 5 years ago, he feared it would be unpopular among clients. Fortunately, he received the opposite response. “I’ve come to find out [that clients] love the service and are more than willing to pay for it,” he said. Here’s why.

Better customer service

Telemedicine offers excellent customer service by providing easy and convenient communication with the doctor. Telemedicine offers clients who are strapped for time the option to send photos, videos, or texts with medical questions that can be assessed appropriately and answered by a professional. For example, Smiley explains that for routine spay and neuter appointments a client can send a short video of the incision if there is a question about how the suture line is healing. Telemedicine provides a lot of peace of mind because clients have the ability to reach out to the medical team and get advice on next steps.

Still, Smiley acknowledges the importance of physical medicine: “Telemedicine will never replace in-clinic care, but telemedicine married with physical exams improves the level of care drastically,” he said.

Asynchronous telemedicine

Many veterinary professionals don’t appreciate the distinction between asynchronous and synchronous telemedicine. Synchronous telemedicine is often used by human medical professionals, largely due to the demands of insurance reimbursement, and entails live video calls between the doctor and the patient.

In veterinary medicine, getting the patient to show clinical signs during a scheduled phone appointment can prove challenging, ultimately restricting the level and standard of care provided. Asynchronous telemedicine, on the other hand, allows the client to send text messages, pictures, or videos when it is convenient for them. The doctor in turn can review the messages and videos and respond at their convenience. This provides a lot of schedule flexibility for owner and veterinarian it also revives the patient from having to “perform” on demand.

“[Asynchronous telemedicine] is preferred by doctors and clients and, although I can’t communicate with patients, I like to think it’s preferred by them too,” said Smiley.

Monitoring and diagnosis

Smiley identified several conditions in companion animals that can be diagnosed successfully via telemedicine, such as uncomplicated diarrhea or vomiting (the patient is bright and alert, mucous membranes are pink and moist, and the owner has a history of feeding food they aren’t supposed to), uncomplicated otitis (a video with the flash on typically allows good visualization of the vertical ear canal), and flea infestations (a picture of caudal dorsal alopecia or a video of a flea crawling on a dog are hallmark signs). He suggests creating a list of diseases that you currently diagnose remotely as a guide to know what cases would be best to diagnose via telemedicine. “Each veterinarian will have a different list of diseases that they feel comfortable diagnosing remotely and the best guide is past clinical experience,” Smiley said.

Some of the conditions that are easily monitored via telemedicine are diabetes, seizures, arthritis, heart failure, allergies, and deep pyoderma.

Converting your practice

Implementing a new routine takes time and can initially slow down a clinic’s efficiency before speeding it up. Smiley provided advice for making a smooth transition. First, he recommends using telemedicine technology that has the ability to connect the client to the entire medical team at the same time. Using asynchronous exchanges between receptionist, technician, and veterinarian provides clarity for team members and can be more efficient than having the veterinarian return calls or relay verbal instructions back and forth.

Next, ensure that the technology notifies clients when the doctor or staff is unavailable for telemedicine consults. This is crucial because it lets the client know how to proceed remotely when a team member is away.

Finally, understand how the technology incorporates the virtual exam into medical records. Telemedicine technology does not have to be fully integrated with your medical record software, according to Smiley, but it does need to provide you with an easy way to preserve telemedicine records within your in-clinic records.

What to consider before making the switch

Overall, Smiley says his experience has been a positive one and urges other veterinary practices to give it a go. But before converting to paid virtual care, he advises awareness of 2 roadblocks: clinic workflow and the conversion from free to paid telemedicine.

“Paid telemedicine requires new clinical routines, and even the slightest change in routine can be disorienting,” Smiley said. “Because most of us already offer free telemedicine, it is worth the short-term pain of transitioning to paid telemedicine for the reward of better customer service and better patient care—and a reduced risk for burnout.”