Ready or Not, Here We Are! Shea Cox, DVM, Is Ready for Whatever the Future Might Bring

Over the years, Shea Cox, DVM, has formed unique insights and strong opinions about what practitioners and the profession must do to take virtual care mainstream. Here, she shares her 2020 story and thoughts on what’s next, come what may, for veterinarians and virtual care.

There is no doubt that telehealth is our future.

Interview by Constance Hardesty, MSc

Shea Cox, DVM, is the founder of PetHospice, which offers both in-home and virtual hospice and palliative care consults. Over the years, she’s formed unique insights and strong opinions about what practitioners and the profession must do to take virtual care mainstream. Here, she shares her 2020 story and thoughts on what’s next, come what may, for veterinarians and virtual care.

Trends: You were an early adopter and have been an active innovator in telehealth for three years. Tell us about what motivated you to get started.

Shea Cox: My aha moment for expanding into telehealth services came when I attended the inaugural Veterinary Innovation Summit at Texas A&M in 2017.

As a hospice and end-of-life practice, we offer three-hour hospice consultations. We recognized early on in our business that 70% of our hospice consults were nonmedical, which lent itself to creating our technician-driven Quality of Life Assessment appointment.

At the summit, I recognized that telehealth was the perfect delivery model for our 90-minute Quality of Life Assessments, and that this modality could allow us to grow services beyond our current geographic boundaries. Telehealth has been instrumental in allowing us to reach clients nationwide; it has allowed us to provide families the time and end-of-life support needed while becoming a partner in care with the primary care veterinarian or specialist.

Trends: You’ve also been outspoken about regulatory obstacles that prevent veterinarians from taking full advantage of virtual care. How did you fare in California during the COVID-19 lockdowns?

SC: Unfortunately, the California Veterinary Medical Board responded to the crisis by stating that telemedicine could only be used for pre-existing conditions. My colleague Jessica Vogelsang, DVM, and I became active at the state level, helping to pass waivers temporarily amending the pre-existing condition clause.

Putting up barriers to healthcare is the opposite of what should be done to protect pets and people, but at least we were able to work with the veterinary medical board to loosen these restrictions.

Trends: What did you learn from the COVID-19 crisis about your own telehealth program? Did the crisis expose any areas in need of improvement?

SC: Only on the legislative side!

Trends: Good on you! Well, did the crisis expose any strengths you had taken for granted or hadn’t really given yourself credit for?

SC: Our “special strength” was the fact that we had already baked telehealth into our model of care. And because we already had the technology in place, and a team that was used to supplementing the delivery of care virtually, we were able to continue our services without disruption.

Trends: Did anything take you by surprise?

SC: The number of veterinarians from other states that began reaching out, asking to join our virtual team. Many of our consultations are nonmedical, focused around quality-of-life and end-of-life issues, for which a VCPR [veterinarian-client-patient relationship] is not needed. Expanding our virtual team allowed us to meet the growing demand for our services and eased the workload that was being placed on our California team.

Trends: Telehealth has sustained your practice through good times and bad. What do you know for sure?

SC: For practices considering the addition or expansion of telehealth services, it is important to lead with the practice and client, not the technology.

It is important to keep in mind that the goal for telehealth is bigger than simply “replacing a visit with technology.” Instead, telehealth is used to improve efficiency, to leverage and augment the care we already provide. Telehealth does not fragment care; it cements long-term relationships.

Trends: Veterinary practices jumped into telehealth during the COVID-19 crisis. Now that they’ve taken the leap, what’s next?

SC: Virtual care will continue beyond COVID-19, especially as pet owners become accustomed to the improved convenience and accessibility that telehealth offers.

Be proactive with implementing telehealth now and don’t stop innovating just because the world reopens. Telehealth is a long-term investment, and the best way to succeed in this “new” future is to set yourself up for success while in the present.

We should continue to be flexible in thinking and agile in action. There is no doubt that telehealth is our future.

Trends: Going forward, one key concern is safeguarding the health of staff, clients, and patients—and everyone they come into contact with. How can telehealth help maintain a safe work environment?

SC: Telehealth has been a lifeline for veterinary practices. Implementing virtual care where appropriate has reduced staff exposure by enabling social distancing, preserved personal protective equipment, and minimized the impact of patient surges on facilities such as emergency hospitals.

At-risk staff have been able to continue to practice from home, using telehealth as an alternative to in-clinic care. Telehealth has allowed veterinary patients to receive timely assessment and treatment recommendations, appropriate follow-up care, and a reduced likelihood of adverse events as a result of delayed assessment and treatment (or worse yet, from owners turning to Dr. Google).

Trends: As we move into autumn, we’re all keeping our fingers crossed. How should practices prepare to take advantage of telehealth in the event of another local shutdown—or not?

SC: While it’s difficult to anticipate what lies ahead for veterinary telehealth in a post-COVID-19 world, we should be prepared for the continued use of telehealth because it’s here to stay.

While the need for safety during a pandemic has increased our usage of telehealth, it is through these same experiences that veterinarians, who previously felt in-person care was the only way to effectively help patients, have quickly realized how beneficial telehealth can be. Many are ready to adopt telehealth as a permanent part of their patient care, not just a stopgap or interim measure during COVID.

Creativity, adaptability, and resilience are key characteristics of our profession. They will serve us well as we move through the next evolution of veterinary medicine

Constance Hardesty, MSc, is a freelance writer based in Colorado. She is former editor in chief of AAHA.

Photo credits: Photo courtesy of Shea Cox

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