Updated on April 19, 2020
With intensifying concern around COVID-19, use of telemedicine has become an important way to protect and monitor the health of veterinary patients and veterinary teams. Using telemedicine can help prevent the spread of COVID-19, because it allows veterinary patients to be appropriately triaged and monitored with only those veterinary patients that really need to be seen making the trip to the clinic along with their owners. The AVMA has resources to support your use of telemedicine at avma.org/Telemedicine. While a variety of communication tools are available for use to conduct telemedicine visits, the AVMA has also compiled a list of providers to assist (please understand that offerings are evolving as the COVID-19 crisis unfolds; we are doing our best to provide current information, but changes may occur).
VCPR requirements around the use of telemedicine
Guidance around telemedicine may be different in different states, particularly as states adjust to respond to the COVID-19 crisis. In the midst of this emergency, some states—not all—have applied regulatory discretion to temporarily not require an in-person examination to establish a VCPR. The AVMA is aware that emergency provisions and/or direction have been adopted by many states. Please consult the AVMA’s state orders spreadsheet and confirm with your state veterinary medical association and state board of veterinary medicine for the most current information.
At the federal level, FDA has issued guidance, for immediate implementation, that temporarily suspends enforcement of certain aspects of the federal VCPR requirements that apply to extralabel use of drugs and issuing of veterinary feed directives ([VFD]; 21 CFR 530 and 21 CFR 558.6). The guidance acknowledges individual state VCPR requirements that may exist, acknowledges current federal VCPR requirements related to in-person animal examinations/premise visits, and indicates suspension of requirements outlined in guidance are temporary measures during the COVID-19 outbreak.
Controlled substances and telemedicine
Following the declaration of a public health emergency by the Secretary of Health and Human Services (DHHS) on January 31, the Drug Enforcement Administration (DEA) worked with DHHS to allow DEA-registered practitioners to begin issuing prescriptions for controlled substances to patients that were not the subject of an in-person medical evaluation.
DEA-registered practitioners, which—by definition—includes veterinarians, have been advised that they may issue controlled substance prescriptions via telemedicine for the duration of the emergency declaration (i.e., this is a temporary exception) if the following conditions are met:
- Prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice.
- The telemedicine communication is conducted using an audio-visual, real-time, two-way interactive communication system.
- The practitioner is acting in accordance with applicable federal and state law.
The latter is important because state veterinary practice acts and state pharmacy laws continue to apply. Please consult your state veterinary medical board and state board of pharmacy for additional information regarding your ability to use telemedicine for prescribing controlled substances.