Veterinary TeleMedicine - a kiss of death or the only way forward?

Veterinary TeleMedicine - UPbook

May 12, 2020 11:41:08 PM / by Michael

Free veterinary telemedicine software

Veterinary telemedicine - the topic on the tip of every practice owner's tongue right now as we find ourselves in the throes of a global pandemic! (join the launch of UPbook's Free Veterinary Telemedicine Software!) 

And like it or loathe it, fear it or revere it, detest it or request it, Veterinary TeleMedicine is still the topic everyone is talking about ad nauseum right now, and it raises all sorts of interesting questions that we’d like to address here today...questions like:

What exactly is telemedicine?

Is it right for me? 

Am I already doing it now?

And what happens after the virus passes...will it still be part of the day to day life of my busy veterinary hospital and the new normal of how we practice our profession?

All great things to consider so let’s take a look at how TeleMedicine applies to the veterinary industry - today in the time of COVID-19...and beyond!

We’ll start with the most obvious question…what exactly is TeleMedicine?

Basically veterinary TeleMedicine is the delivery of veterinary services remotely (outside of an in person setting) and using any combination of different communication technologies to facilitate those doctor-client connections.

And obviously when we think of the term TeleMedicine, we tend to conjure up an image of a real time, in person video conference  between the veterinarian and the client...but in reality it is so much more than this and it is probably something you are already practicing every single day!

Let’s dive a little deeper though...

So TeleMedicine can be Asynchronous or Synchronous…

With Asynchronous TeleMedicine, information is sent at one time but received at another (and this would include things like email, voice messages, texting, fax and to a certain degree, chat)...all tools that any dialed in animal hospital is pretty familiar with and using regularly…

But the relative newcomer to the field - thrust into the spotlight and given a heightened position of importance due to COVID-19 - is the field of Synchronous TeleMedicine which  involves a real-time interaction between clients and veterinarians.  Real time could, of course, be a phone call as we are all very used to, but nowadays and more and more often now it could also be a face-to-face video conference between the DVM and the pet owner…

And it's this out of the ordinary approach to service delivery and vet medicine that has gotten everyone wondering: is video conferencing actually right for me, and how on earth would we use it effectively with patients who cannot even talk!

Good questions but unfortunately they are very hard to answer.  Really the only way you can find out if it’s right for you is to hunker down and just try it!  ANd when you do, don’t worry; there are countless resources available on how to increase TeleMedicine workflow, efficacy and appreciation but until you see how you personally react to it, what sort of response your particular clients have, and whether in reality it is a good relationship enhancing and business decision for you - you just cannot know.

The bottom line in my mind - the risk you run by avoiding TeleMedicine, by not utilizing creative ways to extend the flow of revenue, by not having a back up in place in case of shutdown or quarantine, and by being potentially left behind as TeleMedicne takes off and is adopted by others all far outweigh the risks of trying it and finding it is just is not for you!

So if that makes sense, now you need to know what are the next steps for getting it up and running.  There are countless TeleMedicine apps that allow for various functions such as Appointment scheduling, Payment processing and of course Video conferencing, and they range from several hundred dollars a month or more right - so a serious investment - down to a NO COST version like the one our team has created - the FREE UPbook TeleMedicine app - that was designed as a way for us to contribute to the veterinary industry during a time when we all must band together as a supportive community…

But there are lots of options...the important thing is to choose one!

One quick note here that is important to stress in any discussion on TeleMedicine though and that is that although the veterinary industry is not as strict as human medicine and does not yet have a HIPAA counterpart, the communications applications we typically use to connect with friends and family - such as FaceTime or Skype - are generally not deemed appropriate for TeleMedicne as they do not protect patient privacy. 

That’s the to the ‘WHY’. 

Now let’s consider: under what conditions should practices consider using TeleMedicine versus requiring a visit to the clinic?

Well, according to the AVMA the appropriate use of TeleMedicine can enhance animal care by facilitating communication, diagnostics, treatments, client education, scheduling, and other clinical and business related tasks.  This covers a great number of potential presentations that don't require the pet to be in front of you and palpated to have you still be able to deliver high quality medicine, including: a prescription refill request that a client phones in, a client emailing a picture of their pet for a diagnosis or teletriage, or using a video conferencing app for a thorough consultation that includes assessment, diagnosis, and treatment of a pets particular issue…

And as we discussed earlier, chances are you’re already participating in some aspects of telemedicine, and the natural progression - or question you need to ask yourself is: am I ready to now offer virtual clinical services via video to assess, diagnose and treat my patients as well!

So there we have it - the bare basics of Veterinary TeleMedicine with no particular judgement or recommendation attached to it...

That said, in closing I want to leave you with a vignette from which you can draw your own changed my mind...we’ll see about yours!

So full disclosure: prior to COVID-19 I personally was not a huge fan of telemedicine and thought to a certain degree it may even be the kiss of death to our industry...we are in a profession with narrow profit margins and one could argue that all of the things that help make us profitable at all have traditionally required an in person visit. 

We want to create lifelong relationships with the pet owners in our community and realize the lifetime value of each client and there's nothing like a face to face interaction to ensure that this happens - a reassuring pat on the owners shoulder when delivering difficult news or a playful rub of the puppies belly are sure fire ways to make sure those lifelong bonds are laid down...

And let’s face it...with a client standing before us in person it is also much easier to sell them that bag of pet food or talk through the merits of a Wellness Package - arguably all things made easier when done face to face…

This was my prevailing view of the merits of TeleMedicine in the Veterinary industry...that is, until a person very close to me shared their experience with Human TeleMedicine that kind of blew my mind and forced me to have a serious shift in perspective!

So here’s the story...about a month ago - in the midst of COVID-19 - a good friend of mine - a busy mom of young kids who was also a professional and works long hours every day -  suspected she had a fairly serious bronchial infection...maybe even pneumonia.  My friend resides in an area that was at that time under strict lockdown so freedom of movement was limited, and even if they could have gone outside she personally concluded that the last place she wanted to be when feeling so physically vulnerable was a doctors waiting room or a hospital - in either case surrounded by a bunch of sick people...

So the only real solution at that time was a TeleMedicine consult - an option my friend was neither fond of nor looking forward to...

For the sake of brevity, here is a run down of her experience in a nutshell:

  • Booking her TeleMedicine consult was effortless and took less than 2 minutes
  • She had a super fast triage with a friendly nurse and in under 4 minutes found herself face-to-face, over video, with a qualified MD...and not a GP but someone who specializes in pulmonary issues
  • The consultation was thorough and encompassing but very efficient and probably lasted only  7 minutes (made all the more efficient because my friend had worked hard to prepare a well thought out summary of her signs, symptoms, impressions, etc. so was herself very prepared)
  • A diagnosis of suspected was given
  • Medication was prescribed and 
  • DELIVERED to her home within the hour!
  • Strict instructions to get back in touch as soon as the course ended to reassess the situation
  • My friend got a phone call from a pharmacist later that day walking her through exactly how to take all 5 of the medications she ended up purchasing
  • The consulting MD sent her an email (probably automated but still reassuring) the next day just checking in so now she has a fast track way to contact them in the case of future problems

Long story short and the final synopsis from a jaded and suspicious patient: the experience was stellar from start to finish, so much so that my friends ultimate take away was that she seriously doubted whether she’d ever be able to go back to the typical way she sought medical services in the past - i.e. a visit to an office or outpatient department.  And she felt strongly enough about this change of heart that she vowed if her own family physician did not offer TeleMedicine in the future she would very likely have to switch to someone who did offer this as an option.

Bottom line, in one interaction my friend went from being vehemently opposed to the whole TeleMedicine model to being a complete TeleMedicine convert and was amazing to behold! For more details check the veterinary telemedicine workflow blog post. 

As an addendum to this story, and some important points to note on the ROI of this remote model:

By the time my friend's bronchitis had cleared several weeks later she had paid for 3 TeleMedicine consultations, purchased 3 courses on antibiotics and multiple other medications, and she did eventually need to go to the hospital for a work up including 3 chest x-rays and a throat swab..and she also donated to a community fund raising campaign!  So from the point of view of the health provider and the financial feasibility of TeleMedicine versus an in person visit, they would likely have made the same amount of money from the patient using this virtual approach - if not more! 

And from my friends perspective, reflecting on the whole experience several weeks later when she was well again, she still vowed she would not have changed one single thing about the process and had absolutely nothing to criticize…for her the ROI was enormous because it saved her most precious commodities - her time and her health by not exposing herself by risk by going to a medical facility during a pandemic in person!

For me as a pet owner I’d love to experience all the convenience of a triage or assessment from the comfort of my own home - not stressing out my pet, not having to find parking, not having to find child care, etc.  I’d be happy to go to the vet but only if I really had to - and this is where TeleMedicine could reign victorious...practices could actually be compensated for the triage/assessment piece AND still have patients come in when needed!

Please note: if you are considering TeleMedicine there are a number of legal issues you will need to clarify in your own particular state, such as where your governor sits in relation to the concept of the Veterinarian-Client-Patient Relationship (VCPR) - please do your own due diligence and research before embarking on any TeleMedicne journey!

Join the launch of UPbook's free telemedicine software for veterinary practices!

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Written by Michael