Telehealth, spurred by the rise of digital communications technologies, presents both opportunities and challenges for healthcare providers, including veterinarians and their staff. Understanding key definitions is important as you decide whether and how to implement telemedicine in your practice.
Telehealth is the overarching term that encompasses all uses of technology to deliver health information, education or care remotely. Telehealth can be divided into categories based on who is involved in the communication.
For communications between veterinarians and animal owners there are two important categories that are distinguished by whether a Veterinarian-Client-Patient Relationship (VCPR) has been established: telemedicine, which is client-facing, includes the delivery of information specific to a particular patient and is allowable only within the context of an established VCPR; and non-client-facing models that involve delivery of general advice, telemarketing, and advertising.
Telemedicine is a subcategory of telehealth that involves use of a tool to exchange medical information electronically from one site to another to improve a patient's clinical health status. Examples include using Skype or a mobile app to communicate with a client and visually observe the patient for a post-operative follow-up examination and discussion. Telemedicine is a tool of practice, not a separate discipline within the profession. The appropriate application of telemedicine can enhance animal care by facilitating communication, diagnostics, treatments, client education, scheduling, and other tasks. Practitioners must comply with laws and regulations in the state in which they are licensed to practice veterinary medicine. Telemedicine may only be conducted within an existing veterinarian-client-patient relationship, with the exception for advice given in an emergency care situation until a patient can be seen by or transported to a veterinarian.
Teleconsulting is a subcategory of telehealth in which a general practice veterinarian uses telehealth tools to communicate with a veterinary specialist to gain insights and advice on the care of a patient.
Telemonitoring is remote monitoring of patients who are not at the same location as the health care provider. This could range from the use of a portable glucose monitor to a wearable monitoring device that captures the patient's vital signs and other behaviors.
Teleadvice is the provision of any health information, opinion, guidance or recommendation concerning prudent future actions that are not specific to a particular patient's health, illness or injury. This is general advice that is not intended to diagnose, prognose, treat, correct, change, alleviate, or prevent animal disease, illness, pain, deformity, defect, injury, or other physical, dental, or mental conditions. Examples include recommendations made by veterinarians or non-veterinarians via phone, text or online that all pets should receive annual wellness exams as part of a comprehensive preventive care plan, or that animals living in mosquito-infested areas should receive year-long heartworm preventatives.
Teletriage is the safe, appropriate, and timely assessment and management (immediate referral to a veterinarian or not) of animal patients via electronic consultation with their owners. In assessing patient condition electronically, the assessor determines urgency and the need for immediate referral to a veterinarian, based on the owner’s (or responsible party’s) report of history and clinical signs, sometimes supplemented by visual (e.g., photographs, video) information. A diagnosis is not rendered. The essence of teletriage is to make good and safe decisions regarding a patient’s disposition (immediate referral to a veterinarian or not), under conditions of uncertainty and urgency.
E-prescribing or electronic prescribing
E-prescribing, or electronic prescribing, is a digital-based electronic generation, transmission and filling of a medical prescription, taking the place of paper and faxed prescriptions. Requirements for prescriptions can vary from state to state, and also depending whether they involve controlled substances. In general, veterinary prescriptions should be handled in the same way, whether on paper or in a digital format. Veterinarians interested in e-prescribing should check both state and federal requirements.
mHealth or Mobile Health
mHealth, also called mobile health, is a subcategory of telehealth that employs mobile devices. Some mHealth applications and wearables are designed to augment animal health care within veterinarian-client-patient relationships, while others are designed and marketed directly to consumers for their education and animal monitoring without clinical input (no VCPR).
Frequently asked questions (FAQs)