Rapid Advances in Technology
It is hard to believe that once upon a time, veterinary clinics used software only for patient records and appointment management. But as veterinary software offerings proliferated over the last 30 years, most veterinary clinics are turning to software for things a veterinarian in 1985 would never have imagined.
The rate of change is accelerating again as many clinics shift to accommodate remote service options amidst the COVID-19 pandemic. At PetDesk, for instance, we’ve seen an astonishing 300% increase recently in our customers’ usage of Two-Way Messaging–a useful tool to communicate with and provide services to clients while they’re outside the clinic.
In just a few weeks, veterinary practice owners began seeking technology solutions to fill the widening gap in care brought on by stay-at-home orders and physical distancing guidelines. “Telemedicine” is the new buzzword in the industry, attractively simple-sounding. However, between states and practices — and even within practices — there are differences of opinion. Whether you’re confused about telemedicine, or you’ve implemented it and want to learn more, this blog post will help prime you for how to think about telemedicine at your practice.
What is Telemedicine?
One person may say that telemedicine is when you conduct a digital appointment using video. Others may say that you have been practicing telemedicine all along: using phones to conduct surgery followup calls, consult clients on whether they need to bring their pet in for an appointment, etc. Luckily, the industry is beginning to better define this term.
Telehealth is using technology to communicate health information that does not include in-person interaction. If that sounds broad, it is; the term can be understood better by breaking out two of its most common types: teletriage and telemedicine.
- Teletriage is a subcategory of telehealth and usually includes obtaining information to assess the urgency of a problem or general advice, not including a diagnosis.
- Telemedicine is when you use technology to do anything legally designated as “medicine,” like diagnosing, treating, or prescribing.
The AVMA has a useful resource to help you learn more about these distinctions. AAHA has also generated a valuable document discussing Virtual Care, Telehealth, and Telemedicine and their use cases within a clinic setting.
How Does VCPR Fit Into This?
If you’re unfamiliar with the acronym, VCPR stands for Veterinarian-Client-Patient Relationship. It is a legal and medical term carefully defined by state boards. To practice telemedicine–meaning that you are doing something that can be legally designated as medicine, remotely–VCPR is required. Because state boards control VCPR’s definition, it’s important to understand your own governing body’s rules. Here is the FDA’s list of VCPR definitions by state.
Many states have been temporarily updating their telemedicine and VCPR policies in response to COVID-19, and you can look up your state on AAVSB’s website to see what has changed.
The bottom line is that if (1) you have a legal VCPR and (2) your clinical judgment tells you that the case is appropriate, you may perform telemedicine.
What Do I Need?
After you’ve established an understanding of the legal definition of VCPR as it applies to your practice, you can begin the harder work of defining your business’ needs.
PetDesk customers can utilize our Virtual Care tools that are directly integrated into our platform. Some clinics are using Zoom and their existing software’s scheduling and payment capabilities to try it out. Others are changing their entire communication platforms. It all depends on the practice.
Here is a list of initial questions to help you define your needs:
- Is this a COVID-19 operational change, or do I want telemedicine to continue after the pandemic has passed?
- Do I maintain a storefront location? If so, what appointments do I see there?
- Are any of my staff remote, and which ones? Can my staff support remote clients and pets?
- What is our current policy on new clients, and how will that impact my ability to meet legal qualifications for VCPR?
- What is my practice’s current protocol – from check in to check out – for seeing appointments?
- What kinds of changes do I need to our existing protocol to facilitate telemedicine?
- How can I continue to deliver my clients a top-notch care experience?
- What is the best telemedicine financial model for my practice? Should we use telemedicine as an extension of on-site services OR standalone services with different pricing structure?
As with many business decisions, you’re going to face questions involving trade-offs. And that is doubly true when you’re defining needs where there is scant information around best practices. Resist “all-or-nothing” needs and stay flexible as much as possible.
Here is a nonexhaustive list of tools clinics are adding as they need it during the pandemic:
1. Asynchronous Communication Methods
a. Text messaging to coordinate curbside pick up and drop off
b. Pictures sent by the client to help you advise on a tick problem
c. Videos sent by the client to help you assess the severity of a limp
d. PDFs and other documents sent by the clinic to facilitate estimate delivery
2. Phone Call Consultation for surgery followup
3. Live Video Consultations for a complicated sick pet exam or a particularly concerned owner
Considering Different Tools
Abraham Lincoln once said, “Give me six hours to chop down a tree and I will spend the first four sharpening the ax.” How and whether you deliver care remotely is a big decision and undertaking, and you need to sharpen your vision with time and consideration. So take a deep breath, and trust the business needs you’ve identified. Before you make your first call to a software vendor, make sure you have the following in mind:
Remember the Client
If you change your technology to deliver care remotely, your clients’ experience will also change. Telemedicine has the potential to elevate and empower your staff and clients to have more opportunities to drive positive outcomes for the patient and client. That is what you’re aiming for.
But changing client experience can be risky, and you may not even notice the effects right away. It’s easy to recognize a negative review, but it’s hard to detect the slow leak of clients moving to competitors without telling you. As you consider vendors, always start with your clients’ experience. If you have concerns, consider implementing the tool for specific activities first – like surgery follow-ups – that your staff and your clients are accustomed to doing remotely. Once you feel comfortable with that process, you can introduce more activities.
Know What You Already Have
Create a list of any software you currently have that impacts clients. What does each software do, and how do your clients interact with it, if at all? For many clinics, dedicated telemedicine software often overlaps with existing communication software. Make sure you consider the replaceability of what you have. What parts can you (and your clients) live without, what parts would need to be replaced, and what parts are irreplaceable, for cost or other reasons? Do not be surprised if you already have a lot of the tools you need to practice telemedicine.
Choose the Right Partner
It can be confusing to encounter all these brand names for the first time. As many veterinary clinics can attest, selecting software is as much about the company behind the tool as it is about the tool itself. You should ask yourself: How important is support and ongoing training to you? Does the company I’m considering have a track record of responding to customer requests? What do their current customers say?
Get Out There
You’re not alone. The entire industry is working together to understand telemedicine. Industry leaders are discussing best practices, veterinary practice owners are adopting it at their own unique practices, and clients are having their expectations altered in light of the various changes to their day-to-day life.
Join the Veterinary Telemedicine Community on Facebook to connect with other veterinary professionals asking the same questions and for access to excellent resources during this time.