Telehealth and the VCPR

​The importance of having an established Veterinarian-Client-Patient Relationship in place whenever practicing veterinary medicine, whether in person or remotely through telemedicine, cannot be overstated. The AVMA Model Veterinary Practice Act, which many governmental bodies use as a guide when establishing or revising laws governing veterinary practice, includes a definition of the VCPR as follows:

A VCPR is present when all of the following requirements are met:

  •    The veterinarian has assumed the responsibility for making clinical judgments regarding the health of the patient, and the client has agreed to follow the veterinarians' instructions.

  •    The veterinarian has sufficient knowledge of the patient to initiate at least a general or preliminary diagnosis of the patient’s medical condition. This means the veterinarian is personally acquainted with the keeping and care of the patient by virtue of a timely examination of the patient by the veterinarian, or medically appropriate and timely visits by the veterinarian to the operation where the patient is managed.

  •    The veterinarian is readily available for follow-up evaluation or has arranged for the following: veterinary emergency coverage, and continuing care and treatment.

  •    The veterinarian provides oversight of treatment, compliance and outcome.

  •    Patient records are maintained.

Many states have adopted this definition of the VCPR, or a very similar one, as a component of their state veterinary practice act. In addition, federal law requires a VCPR for extralabel drug use in animals and issuing a Veterinary Feed Directive.

Given current technological capabilities, available research, and the existing state and federal regulatory landscape, veterinary telemedicine should only be conducted within an existing VCPR. An exception may be made for advice given in an emergency situation until a patient can be seen by a veterinarian. How a state defines the VCPR, the congruence of that state VCPR with the federal VCPR, and whether or not a VCPR exists in a given situation based on those definitions, must be guiding principles in deciding what services can be offered.

"A Veterinarian-Client-Patient Relationship cannot be established solely by telephonic or other electronic means."
– AVMA Model Veterinary Practice Act

Within an established VCPR – A variety of telehealth and telemedicine service models are available to veterinarians and veterinary hospitals. Client-facing telemedicine services may include use of tools that allow the veterinarian to remotely gather all essential veterinary medical information from the animal owner or other caretaker; access the patient’s medical records; and conduct a virtual exam of the patient through real-time video or by attached pictures.

Without an established VCPR – The veterinarian may provide general telehealth advice but must specifically stay clear of diagnosing, prognosing or treating patients. Any advice given should remain in general terms, not specific to an individual animal, diagnosis or treatment. Non-client electronic communications should be in the non-clinical realms of general advice, mHealth, web content, and other generalized messaging.

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