Over the last few years, there has been increasing provision of veterinary telemedicine consultations, with multiple companies now offering such a service. An online survey of veterinarians in the U.S. found that the percentage of respondents (n=93) who reported their practice offered telehealth services increased from 12% before the pandemic to 38% between March 15 and June 15, 2020.1 The implementation of these services has provided a whole new sector of veterinary employment, and in most cases one that suits those who would rather work flexibly and from their own home, addressing some of the stressors facing the profession. With increasing pet ownership and practice workload, telemedicine is likely to play an increasingly crucial role in the future of veterinary practice, but the importance of integrating it alongside in-person visits and developing technologies to maximize its advantages cannot be understated.
Telemedicine will never replace the face-to-face consultation completely—nor does it intend to—but with advancements of technology it is likely to find a successful way into our profession as long as we can clearly recognize where it can be a success and where it will fall short. In human health care, where telemedicine is frequently offered, there is a larger body of evidence surrounding its use. Approximately 15% of physicians use telemedicine, with more use seen in larger practices or in non-metropolitan areas.2 Telemedicine has been credited with improving access to care for those in rural communities or those who face barriers due to transportation or a shortage of local providers. Despite the obvious limitation of being a “hands-free” consultation and examination, telemedicine has been shown to provide a reliable means of assessing patients in certain circumstances. However, current evidence relating to the use of telemedicine in veterinary practice is more limited, and for our profession to follow in the footsteps of human health care, we will have to find evidence for its success and reasons for its failure.
In an effort to improve our objective understanding of telemedicine, a recent study explored veterinarian, veterinary nurse, and cat owner experiences of telemedicine consultations during the COVID-19 pandemic.3 An aim of the study was to gather opinions of whether and how telemedicine should be offered by veterinary practices for feline patients in the future. One advantage frequently described by owners and veterinarians alike resulting from this questionnaire-based study was the perceived reduction in stress for the cat compared with a face-to-face consultation; additionally, no vets were bitten in the process! Convenience, cost, flexibility, and reduced pressure were also common perceived advantages. Common disadvantages inevitably included the inability to perform a complete clinical examination, followed by concerns about misdiagnosis and/or delayed diagnosis, communication difficulties, and technical difficulties.
Such studies are revealing that as our comfort and understanding of telemedicine grow, its role is one that should be integrated into our more routine in-person approach, with there being some scenarios for which it is better suited than others. Postoperative checks, repeat prescription consultations, monitoring of diabetic patients, and nutritional counseling have all been suggested as potentially appropriate situations for veterinary telemedicine.4 As an example, a randomized investigation of postoperative checkups on dogs following routine neutering found that owners in the virtual group noted that their appointment took less time and their dogs were less stressed than if they had to travel to the clinic, with no dogs in this group suffering a complication requiring a subsequent visit to the clinic.5
Further research could focus on examining the success of telemedicine consultations for specific scenarios to identify where this could provide a useful, and potentially more efficient, alternative to in-person consultations. The more evidence we have, the more trust and success we may have in finding a role for telemedicine in our daily routines—and one that unburdens our currently overextended profession.
References
1Dubin RJ, Angliss G, Eng C, et al. Veterinarians’ perceptions of COVID-19 pandemic-related influences on veterinary telehealth and on pet owners’ attitudes toward cats and dogs. JAVMA. 2021;259(10):1140-1147.
2Kane CK, Gillis K. The use of telemedicine by physicians: still the exception rather than the rule. Health Aff. 2018;37(12):1923-1930.
3Caney SMA, Robinson NJ, Gunn-Moore DA, Dean RS. Veterinary surgeons’, veterinary nurses’ and owners’ experiences of feline telemedicine consultations during the 2020 COVID-19 pandemic. Vet Rec. 2022:e1738. doi: 10.1002/vetr.1738. Epub ahead of print.
4Bishop GT, Rishniw M, Kogan LR. Small animal general practice veterinarians’ use and perceptions of synchronous video-based telemedicine in North America during the COVID-19 pandemic. JAVMA. 2021;258(12):1372-1377.
5Bishop GT, Evans BA, Kyle KL, Kogan LR. Owner satisfaction with use of videoconferencing for recheck examinations following routine surgical sterilization in dogs. JAVMA. 2018;253(9):1151-1157.