Don’t fear telehealth: Better tech and a new AAHA certificate are on the way
“A lot of the fear of telehealth is about, ‘How do I make good judgments when I don’t have all the data that I need?’” said Jess Trimble, DVM, chief veterinary officer at Anipanion and one of the contributors to the 2021 AAHA/AVMA Telehealth Guidelines for Small Animal Practice.
“Telemedicine through a screen can be super tricky when all we have is a blurry photo of a dog.”
But Trimble has a strong message for practices that felt forced into using telehealth during the pandemic: The technology has improved, and with some preparation from your team, these platforms can revolutionize how you practice medicine and deliver client services.
AAHA’s chief medical officer, Jessica Vogelsang, DVM, was a contributor to the 2021 guidelines along with Trimble.
When the task force initially met in 2020, she said nobody knew what the future would bring. “If we’d had a crystal ball, it would have been amazing to know just how important these modalities would be when clients couldn't be in the same room as the veterinarian,” Vogelsang said.
In retrospect, she said, “I would have placed more emphasis on how to help clients collect accurate medical data such as photos and videos, and how to effectively and consistently triage.”
Vogelsang and Trimble have seen great adoption of telehealth tools in workflow management, including the incorporation of client text messages, photos, and videos directly into the patient record.
“When people see how technology is removing communication barriers and improving access to patient data, they’re much more open to further exploring what else is possible,” Vogelsang said.
VCPR myths: What is and isn’t allowed
“[There’s still a lot of] confusion about what is and isn’t allowed when you’re using telehealth,” Vogelsang said. “For example, there are no barriers in any state to using telehealth tools in the practice of medicine if you already have a VCPR [veterinary-client-patient relationship], but many people are reluctant to use these tools even when it’s permitted because they’re not sure what the liability is.”
Understanding what’s allowed via telehealth and exactly what interactions require a VCPR also holds people back from bringing on virtual staff, said Trimble.
And that’s a shame, she said, because while there are many practices desperately in need of staff, there is a whole workforce of brilliant, passionate veterinarians and technicians out there who want to work but, for whatever reason (illness/injury, burnout, family obligations, etc.) can’t physically be in a practice.
“We just need to fix this mismatch,” she said. “We have all of these clinics that could use the help, and all of these people who can provide the help, and we’re not helping them meet in the middle.”
She knows that concern about the VCPR and whether a vet or tech is in the same state as a practice is a common concern, but, she said, “Most of the time, that doesn’t matter. These technicians aren’t providing diagnoses or treatments. They’re calling back lab results, providing education, or going over a discharge, right? A VCPR isn’t necessarily required when they’re just providing teleadvice or teletriage.”
When it comes to veterinarians, she said, that work often falls into the realm of teleconsulting, which also doesn’t require a VCPR in many states. “Every state is different,” she said, “but I think a lot of the fears around this are largely unfounded.”
New telehealth platforms and pandemic chaos
Back in 2020, pandemic-related restrictions and precautions led many veterinary practices to look into using telehealth in a more structured way, but that initial excitement didn’t necessarily translate into widespread use.
“These practices thought they needed telehealth in order to survive the pandemic,” Trimble said. “Many practices jumped right in without realizing they’d need to learn new technology and implement change in their processes—which many of them were not prepared to do. After all, they’d adopted telehealth in reaction to a crisis, not because they were actively seeking change.”
“I think we saw a real negativity from the veterinary profession after that, because a lot of them had tried telehealth platforms, and none of [those platforms] were ready for the pandemic,” Trimble said.
Know your use-cases and choose a telehealth “champion”
Now a few years post-pandemic, Trimble sees a lot of practices revisiting telehealth—with a much different approach.
“What I’m loving to see is that these practices are prepared,” Trimble said, adding that the platforms are too.
“[Practices have] thought about this. They know what use-cases they want to use it for. They understand how it’s going to change their workflows. And they’re doing it because they know it’s good for the patients and good for the practice—not just because it’s a forced function for the pandemic.”
Successfully implementing telehealth takes planning and preparation. Every practice has different demographics within their teams and case types, which determines the type of telehealth they can provide, Trimble said.
“The practices that are prepared are coming in with a champion—someone who lives it, breathes it, believes it, understands how to use technology,” she said. “Whether that someone is at the front desk or a veterinarian, it makes all the difference.”
Ideally, though, it’s not just one person pushing the practice into the telehealth realm. “Team involvement is definitely one of the biggest factors for success that I see,” Trimble said. “And the other one is that they’ve actually thought about what workflows would work well for them.”
Whether it’s surgical follow-ups, health certificates, or a virtual front desk, she said, it’s important that they’ve given those business use-cases some thought.
AAHA Guidelines Champion certificates to address telehealth
It can be a lot to think through these use-cases and understand the possibilities of telehealth. The 2021 AAHA/AVMA Telehealth Guidelines for Small Animal Practice provide a framework for where to begin.
Also, AAHA is preparing to launch a new series of Guidelines Champion certificates in 2023 to provide actionable recommendations and skills training around a number of the association’s guidelines. Rather than just reading a PDF, these interactive certificate programs will bring the guidelines to life.
Each certificate will take about two hours to complete and qualify for CE credits. The first one, available now, is the Nutrition Champion certificate, which will be followed by certificates for anesthesia, diabetes, pain management, and—you guessed it—telehealth.
The telehealth certificate is currently being written by Trimble and Vogelsang.
“We are really excited about expanding upon the guidelines and giving learners actionable steps to implement them that improve efficiency and patient care right out of the gate,” Vogelsang said.
From telehealth to telemedicine
For the time being, Trimble’s work is more focused on areas of telehealth that don’t include diagnosis, treatment, and prescriptions—but soon, she said, telemedicine technologies could be tools regularly used by veterinarians to make better medical judgments.
“There’s some really cool AI facial recognition tools for cats that help to say whether they’re in pain, and there are a couple of collars coming out that do full temperature, pulse, and respiration—the give really incredible vital signs and data on these pets,” she said.
“Once we start to have real data from our patients, we can start to make real medical judgments, and then actually provide real telemedicine.” She looks forward to seeing that technology become more prevalent, more affordable, and more readily available to pet owners everywhere.
Between technological advances and the veterinarians entering the workforce who had to go through veterinary school during COVID, Trimble believes the future is on its way.
“I think in the next three to five years, we’re going to see a huge shift,” she said. “The technology will start to catch up, we’ll have more veterinarians who are comfortable with it, and the platforms will be ready to support all those clinics. Everything is going to come together, and my hope is that every single clinic starts to offer it in a meaningful way.”
Kristen Seymour is a freelance writer based in Sarasota, Florida. She's a frequent contributor to many pet-focused publications including HealthyPet Magazine, USA Today's Pet Guide, Vetstreet.com, DailyPaws.com, Happy Paws, and more.
Photo credit: © beavera E+ via Getty Images Plus
Disclaimer: The views expressed, and topics discussed, in any NEWStat column or article are intended to inform, educate, or entertain, and do not represent an official position by the American Animal Hospital Association (AAHA) or its Board of Directors.