Telemedicine and How it Works
What is telemedicine?
Telemedicine is defined as the act of practicing medicine at a distance.
Any time that a veterinarian diagnoses a condition, recommends a particular treatment, or provides a prescription without the patient in the hospital for an in-person physical examination, that veterinarian is practicing telemedicine.
"Telemedicine can be offered in a number of different ways."
Telemedicine can be offered in a number of different ways. Telephone calls, text messaging, online chat, email consultations, and visits conducted through videoconferencing programs are all examples of telemedicine.
Is telemedicine performed by my regular veterinarian or by a telemedicine veterinarian?
Historically, telemedicine for pets could be performed only within the context of an existing Veterinarian-Client-Patient Relationship (VCPR). This meant that veterinarians could only offer telemedicine services to existing clients and to patients who had been previously seen for a physical examination.
Given the current COVID-19 pandemic however, veterinarians are being asked to limit in-person contact with their clients. This has led some federal and local governments to relax the legal requirements surrounding telemedicine, making this service available to a wider range of pet owners.
Some veterinary hospitals offer their own telemedicine services. These services may use veterinarians that work within the veterinary hospital or veterinarians contracted from an outside service. The advantage to this arrangement is that these veterinarians typically have access to your pet’s medical record. This means the veterinarian will be familiar with your pet’s medical history and also that your telemedicine visit will be documented in your pet’s medical record.
"Some veterinary hospitals offer their own telemedicine services."
If your veterinarian does not offer telemedicine services however, there are providers that work directly with pet owners. Depending on the laws in your area, you may be able to receive care from these telemedicine providers.
What issues can telemedicine address?
Telemedicine is not appropriate for every concern. A dog that has been hit by a car or has a large bleeding wound, for example, needs to be seen in-person and hospitalized for diagnostics and treatment.
A number of common veterinary complaints can be addressed via telemedicine. Chronic recurrent issues, such as flea allergies and behavior problems can often be addressed through telemedicine. Minor concerns, such as a recent acute (sudden) onset of mild limping or a recent onset of mild diarrhea, may also be good candidates for telemedicine. Although telemedicine does not provide the opportunity for a detailed medical workup, many common conditions can be treated symptomatically (treatment recommendations based only on the pet's symptoms and clinical signs) through telemedicine.
Telemedicine can also be used for follow-up care or monitoring on existing patients. Post-surgical rechecks and scheduled follow-up visits for pets with chronic medical concerns can typically be conducted through telemedicine. If your pet is due for an annual examination but does not need any vaccines, a telemedicine visit may be all that is needed to allow you to refill your pet’s flea/tick and heartworm prevention.
Telemedicine may also be used for prescription refills for current patients and for palliative care.
How can a veterinarian diagnose my pet’s problem without a physical in-person examination?
In a typical veterinary visit, your veterinarian gathers information about your pet via two methods: the medical history and the physical examination.
The medical history can easily be obtained in a telemedicine visit, just as it would be during an in-person visit. Understanding what you are seeing at home, when these signs started, whether signs have worsened or improved since their initial onset, and other facts about your pet’s history can significantly narrow down the list of possible diagnoses. In many cases, the medical history is just as important as the physical examination.
The physical examination is more limited in a telemedicine appointment, compared to an in-person visit. Your veterinarian may ask for images or videos of particular areas of concern. If your dog is limping, your veterinarian may ask for a video of your dog walking and running. If your dog has a mass, the veterinarian may ask to see the mass, either in a photo, or via live video. Your veterinarian may also ask you to check specific items on your pet. For example, your veterinarian may explain to you how to check your pet’s heart rate and then ask you to do so. Your veterinarian may ask you to lift your pet’s lip to check the color of your pet’s gums.
While it is impossible to perform a complete, comprehensive examination during a telemedicine appointment, in many cases your veterinarian can gather enough information to arrive at a reasonable presumptive diagnosis and start treatment. Your veterinarian may recommend things that you can do for your pet at home or may prescribe medications to treat your pet’s condition.
In what other circumstances is telemedicine beneficial?
Telemedicine is particularly useful (and necessary) in situations where pet owners cannot physically bring their pet to a veterinary hospital. In remote communities, pet owners typically do not have the option to take their pet to a veterinarian when the pet becomes ill or injured. Veterinarians may need to make their best presumptive diagnosis and create a treatment plan based on the information gathered in the telemedicine appointment combined with their experience.
What if my pet’s problem cannot be treated via telemedicine?
Your veterinarian may determine, based on the telemedicine appointment, that your pet requires in-person care. Your veterinarian may not have been able to collect enough information to make a complete and accurate diagnosis and further diagnostic tests may be required to determine the cause of your pet's problem. For example, your veterinarian may only be able to provide symptomatic relief to a pet that is experiencing pain, but in order to determine the root cause of the pain and treat it, bloodwork, radiographs, ultrasound, or other diagnostic tests may be required. Preliminary advice may still be given via telemedicine in order to provide your pet with immediate relief and prevent more serious consequences.
Your veterinarian can help you determine when and where your pet should be seen and may be able to give you an idea of what to expect during the in-person veterinary visit.
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