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January 2024
Telehealth After COVID
Virtual care offers huge benefits for your patients, clients, staff, and bottom line. These include increased workflow efficiency, improved work-life balance, better and more thorough care for patients, and added convenience value for clients. It is no surprise that the lynchpin of well-implemented virtual care begins and ends with veterinary technicians, assistants, and care coordinators.
Why Some Technicians Believe It’s More Relevant Than Ever
By Hannah Lau, DVM
Welcome to our official “post-COVID” era of veterinary medicine—at least, the world is forging ahead and adjusting to the new normal. Most businesses have opened their doors to the public and said farewell to curbside-only services. However, there are skills we learned during the thick of the pandemic that can—and should—be brought along with our ever-evolving practices.
Telemedicine and virtual care have been a strong part of our industry for decades, but it enjoyed new attention during 2020 as a solution to new stressors, including social distancing, intense demand, and smaller veterinary teams. If you were an adopter of virtual care during the height of COVID, you may now be facing a choice: to phase out virtual services and “go back to normal,” or to continue to offer them to clients. Or perhaps you weren’t able to implement virtual services in 2020 but are interested in doing so now in pursuit of the many benefits they can offer.
There is a reason that virtual care has persisted for decades even outside of the media spotlight: It offers huge benefits for your patients, clients, staff, and bottom line. These include increased workflow efficiency, improved work-life balance, better and more thorough care for patients, and added convenience value for clients. And, to no one’s surprise, the lynchpin of well-implemented virtual care begins and ends with veterinary technicians, assistants, and care coordinators.
“It’s time that we realize there are alternative options of care that we can utilize to help our patients, clients, and clinics. Telemedicine can be a wonderful adjunct service to a well-rounded patient care plan.”
—Jessie O’Connell, CVT, full-time virtual care technician
New Twist on an Old Method
Regardless of headlines, telehealth and virtual care are nothing new. The veterinary field has been using virtual care extensively and skillfully for decades, especially by hospice vets, large animal practitioners, specialists, and general practitioners. What has changed and perhaps garnered new attention (and for some, anxiety) are the technological modalities available.
Traditionally, virtual care has been done largely over the telephone and through email. It is well within the scope of general practice to manage patients over the phone, especially in cases of chronic disease where small treatment adjustments are constantly being made. Email has taken up the telephone’s mantle in many ways, but it can be just as slow, frustrating, and time consuming. Usually, these types of communications require even more time afterward to document conversations in the medical record. More modern modalities include video chat, texting, and instant messaging or online chat. These can be offered through online browsers and smartphone apps and can be integrated into your practice management system to cut down on time spent updating medical records.
These modalities can include charge-based interactions to account for staff time and experience. Suddenly, hours spent at your desk after the office closes (or at home on your laptop finishing records on your day off) can be reduced and compensated for. If, as a veterinarian, you can confidently say that you have never provided care or treatment advice without the pet in the room with you, it is likely that technicians and assistants are providing that care to your clients. It happens almost every time a client reaches out for assistance, and it happens a lot more when the schedule is full or the doctors are busy. Care is generally not outright refused when the office is already pushed to the limits; instead, it is adjusted and molded to fit the needs of the situation.
What About the Physical Exam?
The elephant in the room when discussing virtual care is always the physical exam. It is easy to suggest that virtual care ignores, downplays, or even denies the need for the physical exam. However, this is an inaccurate simplification. The physical exam is a modality—one of our most valuable diagnostic tools. It can be thought of similarly to a radiograph, ultrasound, blood panel, or cytology. It is special in that it can provide a wealth of information in a short time with only the skill of a veterinarian, even without special equipment or costly supplies.
“At a time when in-clinic DVMs are stressed due to staff shortages, DVM shortages, and long hours, telehealth can ease the burden.”
—Kaye Lovatt, CVT
However, similar to any other diagnostic modality, it still has access barriers for clients and patients. These include transportation, cost, availability of an onsite veterinarian, and usually a technician or assistant to help hold the pet. The physical exam also requires either a calm and cooperative or a premedicated or sedated patient. Denying all medical care without a physical exam can be compared to denying all medical care without diagnostic bloodwork.
Any practitioner would prefer to operate with as much data as possible, and we are free to recommend the diagnostics we wish, but the reality is less convenient. Not everyone is able to elect bloodwork for their pet for a myriad of reasons, and this is not a good reason to deny a consultation. Continuing with our bloodwork metaphor, there are some situations in which diagnostics are more indispensable than others. It may not be advisable to treat a sick diabetic patient empirically without bloodwork, but it may make more sense to treat a skin infection without bloodwork.
Of course, “medical care” does not have to mean prescriptions if the provider does not feel it is the correct course of action. It can mean education, husbandry adjustments, decision support, and more. At times, medications without diagnostics are justified with proper education, such as for pain management, quality of life improvement, or financial constraints. Ultimately, whether the situation has reasonable treatment options available with or without diagnostic data should be up to the determination of the veterinarian. Allowing for robust telemedicine options does not negate the importance of a physical exam, but it does allow the owner to receive appropriate medical care that meets them where they are.
As huge players in the workflow of virtual care, the perspectives of veterinary technicians and client coordinators are fundamentally important. I asked three veterinary professionals to weigh in with their thoughts on virtual care and its importance.
“Virtual care teams are essential to a high-volume clinic. With the number of pets far outweighing the amount of staff in clinic, a virtual team can provide relief to the in-clinic team to help with burnout and overall call volume so better patient/client care is provided face to face,” said Meagan Cross, virtual care coordinator at Bond Vet. “I came from an in-clinic ER and specialty hospital with no virtual team. The amount of times the phones rang in the lobby was insane, and it definitely took away from the clients’ overall experience of waiting up front to be helped until I got off the phone.”
It is never too late to start strengthening your virtual care offerings. This can be as simple as offering text messaging services to your clients with the help of your practice management software.
Jessie O’Connell, CVT, a full-time virtual care technician, said, “Barriers to accessing care have become increasingly more obvious in the past three years. It’s time that we realize there are alternative options of care that we can utilize to help our patients, clients, and clinics. Telemedicine can be a wonderful adjunct service to a well-rounded patient care plan.”
The Politics of TelehealthIt is a time of reckoning for state veterinary boards regarding virtual care and veterinary-client-patient relationship laws. Regulations vary from state to state, but trends are moving in favor of virtual care. The most recent freedoms for veterinary telehealth were established in Arizona and California. This progress is in response to the strong historical success of virtual care in human medicine, veterinary virtual care experiencing huge client demand, support from rescues and humane societies, and the key role of virtual care in improving access to care for patients in need. If you feel virtual care (including phone calls and email) continues to be important to your practice, reach out to your state representatives to let them know that you can be trusted to make strong decisions for your patients in every situation. |
Kaye Lovatt, CVT, noted, “Veterinary telehealth is definitely advantageous to pet parents. At a time when in-clinic DVMs are stressed due to staff shortages, DVM shortages, and long hours, telehealth can ease the burden. After-hours/evening telehealth can also ease the high workload ER facilities are subjected to overnight. When a pet parent arrives home from work and finds their pet has an anal gland abscess, sore ear, or diarrhea, there ought to be options for medical care other than having to visit the ER. Veterinary telehealth can, and does, fill this void.”
Dial In Your Telehealth Game
When considering your own practice, it is never too late to start strengthening your virtual care offerings. This can be as simple as offering text messaging services to your clients with the help of your practice management software. It can be as complex as offering 20-minute video calls for cases that you feel are a good fit for virtual care, such as long-term cases, incision rechecks, or behavioral consults, and then scheduling in-clinic care as indicated.
Once this aspect of your practice gets off the ground, consider booking a half day from home to accomplish these tasks. Of course, no practitioner should do anything they’re uncomfortable with. The expansion of virtual telemedicine guidelines per state is in the pursuit of practitioners having the freedom to practice medicine as they see fit. It is vital to be empowered to offer virtual care when it is viable and to recommend in-person care when it is needed. As always, veterinary medicine remains a practice. Just as we adjust our treatment plans with progressing data, so must we adjust how providing care looks with progressing technology and client needs.
Ultimately, society and technology continuously change with each decade. It is up to us to adapt to new techniques and implement them in ways that benefit our patients. Providing a good spectrum of care requires we step out of the “gold standard or nothing” mentality and begin meeting clients where they are. Market demand will continue to influence the industry, and veterinarians have a unique opportunity now to lead the charge with high-quality care.
Photo credits: nensuria/E+ via Getty Images, sturti/E+ via Getty Images, Liudmila Chernetska/iStock via Getty Images Plus, Courtney Hale/E+ via Getty Images