Why should veterinary practices continue telehealth offerings
Out of necessity, veterinary teams engineered creative solutions on the fly to continue meeting the needs of their patients during the pandemic. It certainly helped that the FDA suspended certain areas of enforcement around veterinarian-client-patient relationship guidelines to facilitate veterinary usage of telemedicine.
According to survey results published in the Journal of the American Veterinary Medical Association in June 2021 (n = 550), however, many practices report they are likely to quit using synchronous video-based telemedicine entirely or use it much less/somewhat less frequently going forward. They might want to reconsider.
"Telemedicine is an added service. It will never replace the in-person exam, but it adds a whole dimension to care that expands the full evaluation and eases access," says Sally J. Foote, DVM, CABC-IAABC, who started doing behavior consults via video chat in 2013. Since selling her brick-and-mortar practice in 2018, Foote has worked entirely online.
"If veterinary medicine practices don't lead this, we will lose this," she says, making comparisons to what happened with online pharmacies, where outside entities introduced online options that disrupted traditional in-hospital dispensing and grabbed significant market share before veterinary practices responded with online pharmacy fulfillment of their own.
Telehealth > telemedicine
Though virtual appointments using real-time, two-way video garnered much of the attention, telehealth for pets is much more than telemedicine. It encompasses several types of communication and uses:
- Teletriage/teleadvice (using phone, email, texts, or other client portal communication tools)
- Teleconsulting (with clients and specialists)
- Telemonitoring (wearables with apps and other tracking or reporting options)
- E-prescribing and online stores for medications, foods, and other pet supplies
- Telemedicine, which requires an established Veterinary Client Patient Relationship (VCPR) and may be limited or regulated differently by states
By focusing on communication first, West Towne Veterinary Center set itself up to handle — and thrive — when the pandemic hit. The practice implemented a cloud-based client engagement platform at the beginning of the fourth quarter of 2019 and then added a new phone system in January 2020.
Cheyene Canales, West Towne's practice manager/bookkeeper explains that with these two changes in place, "We were set up prior to the pandemic with two-way texting, auto reminders, online scheduling, digital fax, [and] client caller ID, among other features. Now those programs are not exactly what I would call telehealth platforms, but they did provide us with a better idea of how to clearly communicate with our clients in a variety of ways. So once the pandemic happened in March, we were able to very quickly adapt to it."
Telehealth for pets resources
AVMA and AAHA released "Telehealth Guidelines for Small-Animal Practice" in 2021. The guidelines provide a seven-step plan for how to integrate, monetize, and market telehealth for pets.
The Veterinary Virtual Care Association offers several virtual care guides such as legal and ethical considerations and client consent forms. The organization also provides free access to various telehealth webinars, including one called "The Case for Telemedicine Beyond COVID-19."
You'll also find a Veterinary Telemedicine Community on Facebook where you can ask questions and connect with others working through the logistics and practical applications.
Triage is one way to start telehealth services. Such companies may offer 24/7 triage help to clients via phone, live chat, or videoconference.
"Every practice is different, and I would recommend those considering adding or expanding telehealth services incorporate it whatever way works best for them and their patients. It doesn't matter if you have a dozen different telehealth tools. It matters how well you use them."
Six reasons to continue telehealth for pets
Though it started as a stop-gap measure for uncertain times, consider these reasons to continue offering telehealth for pets even though you no longer "have to."
- Convenience. In many cases, veterinary teams provide telehealth for pets asynchronously, which leverages everyone's time to the fullest.
- Access. In-person appointments can pose challenges to clients with disabilities, strict work hours, small children in the home/child care issues, fearful or car-sick pets, etc.
- Bonds. Offering more points and methods of contact with clients helps veterinary teams build stronger client connections. Clients who feel more engaged are more likely to follow veterinary recommendations, leading to better patient outcomes.
- Efficiency. Not every situation needs to be handled face to face, taking a chunk out of your already jammed schedule. Imagine being able to see only the patients who truly need hands-on assessment and being able to satisfy other needs in a new way.
- Balance. Through both better efficiencies and the option to leverage remote work, veterinary teams increase their ability to establish better life balance.
- Satisfaction. Telemedicine for pets leverages and elevates veterinary technicians and creates new avenues for practitioners — offering growth opportunities for those who feel burned out with the limits, pace, and demands of traditional hands-on daily practice.
When asked about telehealth services, veterinary client Laura Tsuk says, "I love them! At least for most situations." In 2020, she received telehealth hospice care for her elderly dog, Fez, in his final months and post-op (blockage) rechecks for her younger dog, Raz.
Those are both good examples of where to start, along with things like rechecks for chronic conditions. Think about situations in which it's easier on the patient and family not having to trek to see you in person and all the stress that entails for them. Plus, consider which scenarios create greater efficiencies for practitioners and the team by leveraging telehealth services.
Foote explains that you can avoid feeling overwhelmed by choosing one type of appointment to move entirely to telehealth, without giving clients the choice to pick in-person visits for those services. For example, senior pets can get checked for pain, gait, and general functioning at home.
"We have to see them in the home to see the flooring, how they live their day. You get so much more info in 10 minutes on a video chat than anything on a physical exam in office."
When you're comfortable with the tech and the process, you can expand to other types of appointments, such as dermatology rechecks, behavior or nutrition consults, lameness evaluations, and even same-day vomiting or diarrhea evaluations to determine which ones need at-home care advice and which ones require immediate on-site exams and interventions.
Optimize your workflow with telehealth
If you don't want to do telehealth yourself, Foote recommends developing a referral relationship with a telehealth provider or hiring remote staff to supplement services offered on-site to keep clients in your orbit. "Veterinary medicine has to let go and embrace the remote worker," she says. "We have plenty of burned-out vet techs and vets who would like to work this way."
Many in the veterinary industry believe telehealth for pets should continue as a resource for clients that also aids professionals grappling with staff shortages, exhaustion, and increasing demand.
Veterinary telehealth gives existing clients the connections and access they've come to expect, but in a new form. It gives potential new clients an extra reason to choose you by providing greater flexibility, more points of service to help new families bond with the entire team, and cutting-edge care delivery that uses tech to extend the quality of care offered.
Thanks to client communication efforts that reveal each family's preferences for contact, West Towne's team used that intel to optimize their daily schedules.
Canales says, "This allowed staff to see more appointments in a day without feeling overwhelmed or drained. A 60-minute slot on our schedule previously would only fit a single in-house exam. Now using these new tools, we could fit two to four video calls in that same time. Using this simple trick throughout the pandemic, we've been able to support our original client base, attract new clients, maintain an average increase of 25 percent per month (even with cutting approximately 15 hours off our workweek), and doing it all with one of the smallest teams we've ever had. Every practice is different, and I would recommend that those considering adding or expanding telehealth services just incorporate it whatever way works best for them and their patients. It doesn't matter if you have a dozen different telehealth tools. It matters how well you use them."