The pervasiveness of smartphones, webcams and the internet has made face-to-face communication from remote locations commonplace, if not mundane. Even, to some degree, when the other face is sporting a white lab coat.
In human health, telemedicine has not only gained traction, it’s breaking speed records. According to one estimate, global use of telemedicine services is estimated to balloon to 7 million patients in 2018, up from 350,000 in 2013.
Which raises the question, can virtual veterinarians be far behind?
Human Medicine Leads the Way
It’s easy to see the benefits of telemedicine, or the use of electronic media to exchange medical information, between one doctor consulting with another or between a doctor and a patient in a different location.
Whether done in real time via teleconferencing or at the doctor’s convenience, such as with email, telemedicine can save time and money, improve patient care, boost client satisfaction and even reduce environmental pollutants by limiting car travel, according to a recent study by the University of California–Davis School of Medicine.
Although human telemedicine services are often limited to simple health conditions such as colds, sniffles and rashes, doctors are also finding it useful for monitoring patients with chronic conditions such as heart and lung disease and diabetes. In fact, the Federal Communications Commission estimates that remote patient monitoring of chronic conditions could save the United States $197 billion over 25 years.
Although more than half of the states in the U.S. require health plans to cover telemedicine services, this number will likely grow as states work out details such as how caregivers are reimbursed for these services.
Pets Can’t Tell Where It Hurts
One major difference between human and veterinary medicine is that patients of the furry kind can’t talk. Which is why a hands-on physical exam can be more critical in veterinary medicine for determining the right diagnosis and treatment, and why telemedicine can be controversial. Without a physical exam, can veterinary patients be assured a certain level of quality care? And if something should go wrong, who is liable?
That’s why the Practice Advisory Panel of the American Veterinary Medical Association (AVMA) recommends that telemedicine should only be conducted within a Veterinary Client Patient Relationship (VCPR), part of which requires that the veterinarian has physically examined the patient and has an existing relationship with the owner. According to the Advisory Panel, “Without a VCPR, telemedicine should not be practiced, and any advice given should remain in general terms, not specific to an individual animal, diagnosis, treatment, etc.”
A Case in Point
In 2013, a Texas veterinarian who billed himself as “the Internet Vet” had his veterinary license suspended for answering pet owner questions online without physically examining the patient. He later sued the state board for violating his First Amendment rights of free speech. A higher court sided with the board, claiming that requiring a physical exam of the animal did not violate his rights of free speech.
To make matters more complicated, the laws governing practice of veterinary medicine, including the use of telemedicine, vary from one state to the next. So even though a number of online services appear to offer 24/7 access to veterinarians — often free of charge — what these veterinarians can actually offer may be very limited.
Not a Replacement for Veterinary Visits
That said, the AVMA does encourage veterinarians to use electronic communications to better serve patients and owners with whom they do have a valid VCPR. Today, it appears most veterinarians use telemedicine to follow up on a patient with an existing condition. They also monitor chronic health conditions remotely via pet wearables that help track parameters such as heart rate and blood pressure or digital reporting of at-home glucose testing for diabetic patients.
At the same time, there are those in veterinary medicine who feel that electronic and digital capabilities are such that it may be possible to perform a “virtual exam” and argue that telemedicine could help serve the 40 to 50 percent of pet owners who do not visit a veterinarian regularly.
One thing’s for sure: With human medicine finding ways to make telemedicine work, and the growing demand for digital convenience, it’s probably only a matter of time before more veterinary services are just a click away.