Telemedicine is defined as the remote diagnosis and treatment of patients by means of telecommunications technology.
Whilst we recognise that telemedicine may offer many potential benefits to cats, caregivers and the veterinary profession, there are also concerns that if used inappropriately it might have a negative impact on cat welfare. We consider it to be a complementary service to physical assessment of the patient.
Types of telemedicine
In-house telemedicine
The telemedicine service is a virtual extension of the current service and the veterinarian, veterinary nurse or vet technician performing it has complete access to the cat’s medical record.
Third party company provided telemedicine
The telemedicine service is run by a third-party company. The veterinarian, veterinary nurse or veterinary technician performing it have no medical history outside of what the owner is providing during the appointment or from previous telemedicine consults with this provider.
Referral telemedicine
The telemedicine service provided is run by a specialist or expert in their field and the consultation occurs with the involvement of the primary care veterinarian.
Potential benefits of and opportunities provided by telemedicine include:
- A triage service to help decide if a physical visit is required.
- A medium through which cat caregivers can engage with the veterinary profession in a relaxed environment where they can focus on each other and not on the cat.
- A useful way to support cats that get very stressed coming into clinic.
- A way to have visual assessment for behavioural consults which can include the cat’s environment and the cat’s behaviour at home.
- A vehicle to give more detail and spend more time on preventative health care, supportive care for chronic conditions and additional behavioural and nutritional advice.
- A useful follow-up for routine post op checks and checks on medication administration for in-house telemedicine.
- A way to provide essential care between physical visits in shelter/charity clinics where a veterinary surgeon is not always physically present on site every day.
- A route for more specialist advice to be offered to cat owners and caregivers in remote locations.
Potential concerns of telemedicine include:
- Difficulty in truly diagnosing and treating patients properly as many diagnostic procedures cannot be performed remotely (amplified because cats mask signs of illness).
- A potential lack of transparency regarding the link between third-party relationships.
- Discounts offered on physical visits may be to a clinic significantly distanced from the home, resulting in unnecessarily long travel times for the cat.
- Potential loss of continuity of care and consistency of advice if a third-party service does not adequately inform the registered clinic with a summary of the consultation.
- Demand for veterinary advice where there are inadequate numbers of vets combined with increasing pet populations, the rise of telemedicine may mean that the needs of the cat are not properly met through a lack of availability of timely physical appointments.
- There may be limitations on what can be prescribed because of different legislation regarding remote prescription of therapeutics in different countries resulting in client dissatisfaction if their expected needs cannot be met by the service provider.
- Diagnosis and treatment options available via in-house telemedicine may differ to that available via third-party providers.
- As in physical practice, there may be variations in service depending on who is staffing the telemedicine, veterinarians or veterinary nurses / technicians, the qualification of the staff managing the telemedicine service needs to be transparent.
- It is important to also know that 2nd opinions cannot be given by telemedicine suppliers.
Our position
We consider telemedicine to be a useful complementary tool but not a replacement of physical visits by the veterinarian. There are benefits of telemedicine which can expand and enhance the role of the veterinary service, but there are also potential concerns. The onus is on telemedicine providers to be transparent about what level of service they offer, who is staffing the calls and what affiliations they have to veterinary clinics and corporations, to ensure that clients do not have undue expectations of the scope of service being offered.