COVID-19, Telemedicine and Veterinary Nurses

Telemedicine or telehealth – what does it mean, how has it been used, and what is the role of the veterinary nurse?

According the American Veterinary Medical Association (AVMA), telehealth is the “overarching term that encompasses all uses of technology to deliver health information, education, or care remotely”.¹ Telemedicine differs from telehealth as it is a subcategory involving the use of electronic means to exchange medical information in an attempt to improve a patient’s clinical health status. It is important to distinguish between the two and remember that telemedicine is a tool for use in the hospital; it is not a distinct field within veterinary medicine.

Utilizing telemedicine appropriately may improve the care of veterinary patients through the facilitation of communication, diagnostics, treatments, client education, scheduling, etc. Veterinarians and veterinary team members must adhere to the laws and regulations in the state in which they are licensed to practice veterinary medicine. Telemedicine must be conducted within an existing veterinarian-client-patient relationship (VCPR) – this is a key point to which the entire veterinary team, must follow.  The only exception is surrounding an emergency – advice given in an emergency situation – until that patient is seen or transported to a veterinarian.

The American Association of Veterinary State Boards (AAVSB) developed guidelines which provide balance between enabling access to veterinary care while ensuring patient safety.³ This document provides guidance for regulating the use of telehealth technologies in the practice of veterinary medicine by veterinarians and credentialed veterinary technicians.

Telemedicine has been used in human medicine for 25+ years. Using telemedicine to provide veterinary medical services is relatively new but was beginning to increase in use (e.g., general wellness care, after-hours care, post-surgical care, hospice care) prior to the COVID-19 pandemic. However, since the pandemic reached North America the use of telemedicine and telehealth has increased exponentially in both human and veterinary medicine.²

As concerns intensify surrounding COVID-19 and many pet owners under stay at home orders, use of telemedicine has become an important way to protect and monitor the health of veterinary patients and veterinary teams. The use of telemedicine can help prevent the spread of COVID-19, since it allows veterinary patients to be appropriately triaged and monitored. The result: those veterinary patients and pet owners which really need to be seen are making the trip to the clinic.

Credentialed veterinary technicians are critical in telemedicine patient care, just as they are with in-person patient care. Veterinary nurses involved in telemedicine are providing care and following the veterinarian’s orders in accordance with the established VCPR.

Exactly how are credentialed veterinary technicians involved in telemedicine? Something as simple as a follow up email or text to a client is considered telemedicine. Veterinary nurses play a large role in follow up with clients. The veterinary nurse gets information from the client, assesses the pet on video, and reports this information to the veterinarian as well as documenting it in the medical record.

Other areas in telemedicine with which veterinary nurses are working collaboratively with the veterinarian and pet owner are:

• Follow-up
• Q & A
• History taking
• Behavioral issues
• Nutrition discussions
• Hospice care
• Triage
• Environmental concerns
• Long-term care monitoring

The role of credentialed veterinary technicians in telemedicine during the COVID-19 pandemic is amplified, given the reasons mentioned earlier.

Due to the pandemic, the Federal Drug Administration (FDA) has issued guidance regarding the telemedicine requirements in veterinary medicine.⁴ As the pandemic continues to unfold, federal and state guidance is changing. All veterinary team members should be knowledgeable about the latest updates regarding COVID-19 and the FDA’s recommendations. Please visit: avma.org/Coronavirus, cdc.gov, FDA.gov, as well as the state veterinary medical boards for the most up to date information.

The potential benefits of virtual ‘visits’ are clear, especially today. With many veterinary hospitals trying to provide veterinary care to patients at a time when many pet owners are following stay at home directives, telemedicine is one answer. The net effect is reduced human exposure and contributing to flattening the curve.

We are all in this together!