Senior vets working in telemedicine are calling for more involvement and transparency to ensure the profession is represented in a more balanced way.
Vets at Joii Pet Care, which offers video calls with RCVS-registered vets and vet nurses, have put their names forward to the British Veterinary Association (BVA)’s working group for the RCVS under care review. They have also offered to share data on pet healthcare outcomes with organisations such as Vet Compass and Small Animal Veterinary Surveillance Network (SAVSNET) so that information about all aspects of veterinary care is visible and balanced.
In addition, Dr Adele Williams, BVSc, MRCVS, DipECEIM, PhD, a vet at Joii Pet Care and an examination marker for the equine veterinary course at Liverpool University, has designed a telemedicine degree module aimed at embedding good practice and educating those wanting to pursue telemedicine in their career. Joii Pet Care is also seeking in-person veterinary practice partners to formally refer animals, as stipulated by the new RCVS under care review mandate; although the vet team always signpost clients to their local vet practices (without bias) where a physical examination is needed.
Dr Williams said: “We, along with other telemedicine firms, are seeing many positive examples daily from the work we do to care for pets and their owners. We are doing all we can to deliver a high level of care, safely, and this is in large part not being taken into account or represented at higher levels of the profession even though telemedicine makes up a growing proportion of the industry. We are also doing all we can to proactively engage with the industry on this topic, and I know others are too. This all needs to be addressed if we are to adapt to the increased demand for services, cost of living crisis and changing owner expectations.
“Ourselves and our peers are willing and very capable to be part of the discussions about the future of pet healthcare. Currently, there is little representation of telemedicine at a senior level and very minimal profession-wide data; this is exacerbating the sharing of misinformation and instilling fear that I worry is circulating in parts of the industry.”
The profession did adapt during the COVID-19 lockdowns, which showcased the strength and viability of telemedicine. A study showed that nearly one in three veterinarians relied on telemedicine to meet social distancing guidelines and examine pets safely. Another study showed that telehealth appointments were more convenient and more comfortable for pets, with 56 percent of pet owners saying telemedicine options would increase their number of visits.
During the pandemic, Joii Pet Care itself undertook remote prescribing, which has since been removed across the profession pending the RCVS under care review. This is despite results of a clinical audit published in Veterinary Evidence demonstrating that no harm was done as a result of prescribing remotely and without physical examination of pets.
The study showed that overall prescribing rates were low and that the antimicrobial prescribing rate was lower than that reported in physical practice, and was 99 percent first line antibiotics, a large proportion of which were topical.
It also revealed that there were a low number of adverse events, all of which were self-limiting issues of the same nature of adverse events commonly encountered in physical practice. Joii Pet Care also recently reviewed the management of canine acute diarrhoea and found that 75 percent were able to be managed to resolution without referral into physical practice, and without the need for antibiotics.
Dr Williams added that she’d like to see industry-wide surveys of the telemedicine topics published which are responded to by the whole industry. “In my view, telemedicine really can have a positive influence on the profession. It provides more options for owners to access care earlier and alleviates some of the pressures facing practices who can then concentrate on the more complex procedures. But all surveys I’ve seen to date seem to favour in-practice respondents. It’s time we asked the whole of the industry – educators, practitioners – what they want and why. All we are asking for is for a place at the table to debate this issue. There also needs to be recognition that change does need to happen for the good of animal welfare and working conditions of vets in the UK.
“I believe as a profession we should be taking this opportunity to produce good practice guidance around telemedicine and remote prescribing to ensure animal health and welfare is protected. We should harness the usefulness of telemedicine and use it to help tackle current issues we are facing.
“It is also important to recognise that, in general, vets do not wish for harm to come to their patients, regardless of their proximity to their patient, and can be trusted to act professionally and with caution when taking an animal under their care without physical examination.
“Telemedicine should be seen as a useful part of veterinary medicine, it will never replace the need for physical veterinary practice, and shouldnt be a threat but an aide to solving the current issues facing the profession. We should aim to produce guidelines tailored to this way of adapting to pet health care needs in a modern veterinary profession and train vets to do so.”
Joii Pet Care is calling for better representation of telemedicine experts on advisory boards and working groups making decision for the profession, data from all telemedicine firms to be collated across the UK and included in profession-wide statistics, alongside the statistics for veterinary practices, and enhanced and consistent telemedicine education and industry-wide guidelines.
