and Adds Popular Teleservices to Practice Offerings

With more than 20 million members belonging to just ONE of the many human telemedicine services available, the use of telemedicine has grown significantly in recent years. We’ve also seen telemedicine emerge and gain popularity in small animal veterinary care. So much so, that the AVMA (American Veterinary Medical Association) Practice Advisory Panel released recommendations and guidelines on telemedicine issues in early 2017.

The appeal of telemedicine is easy to grasp. Imagine that you have a sore throat for a week and suspect you need a quick exam and antibiotics, but you don’t have time to make the appointment, miss work, drive 30 minutes to the doctor’s office, wait an extra 20 minutes in the lobby because they’re always late, drive another 20 minutes to the pharmacy, wait for your prescription to be filled, and then drive another 30 minutes back home. All-in-all, you’ve now spent somewhere between 2-4 hours of your precious time, plus co-pays, gas, and time off work. 

Telemedicine is an alternative solution. You contact your physician (not the nurse’s help line) for a telemedicine exam. Typically, the exam includes a phone call or video call (Skype, FaceTime, etc.) to your regular physician with pictures and consultation that results in a proper medical record entry, medication prescription or advice, and a small fee—all with the added benefit of not wasting your time.

TEVA is now offering TELEMEDICINE consultations in lieu of some farm call visits for your convenience, and to ultimately save you TIME and MONEY.

By law, in all cases, we must have an active relationship (VCPR) with you and your horse. (VCPR stands for Veterinarian-Client-Patient Relationship.) This means we have seen your horse within the last several months in order to legally give advice and dispense medications.  

Our veterinarians are responsible for your horse’s health from the moment you reach out to us - whether it is our physical arrival on your farm or responding to a question submitted via email or text. Once we start interacting with you, we become liable, medical records must be created, and documents stored and archived. Although we have informally provided this opportunity in the past, recent regulation changes regarding tele-medicine by our veterinary leadership mandate we formalize this process. Consequently, we will charge for this service to account for veterinarian’s time and expertise as well as the behind-the-scenes administration/documentation processes that occur as a result of an electronic inquiry.  

This telemedicine convenience fee begins at $29 depending on complexity and dialogue. Follow-up questions, texts, or images of the same issue (like follow-up healing wound photos) are unlikely to generate additional charges.

We hope you’ll see this as an opportunity to enhance your horse’s care, adapt to changing technology, your needs as a client, and provide a valuable time and money saving service to you.


Telemedicine Case Examples

The following cases show how telemedicine may be a great option in certain situations. We hope you will see value in this service and understand the legal and regulatory reasons behind needing to formalize this process. 


TELEMEDICINE CASE 1:

From an owner's email to TEVA

“My horse got this cut a couple days ago (see attached picture), didn’t look like needed stitches, that’s why I didn’t call, but now it’s warm and swollen and he’s mildly lame. Do I need a visit, can I get some antibiotics?” [usually a dialogue with the vet begins with the vet about how long, where is the cut, how lame, what has the owner already tried topically, etc.]

Telemedicine medical record entry is made: “Left front forelimb laceration, (photo attached), 3 days old, no oral meds, owner started bute and BlueCoat ointment on their own, now warm, painful, lame. Appears to be a 2” partial thickness horizontal laceration over lateral forearm with moderate soft tissue swelling, mild serous discharge. Recommended to stop BlueCoat and switch to topical triple antibiotic ointment from grocery store, bandage with non-adherent dressing and vet wrap, start oral antibiotics, SMZ/TMS, 14 tabs, orally twice a day for 10 days. Send follow-up picture in 3 days with progress report. Call immediately is swelling persists or gets worse, no riding, limited turn out to small paddock. Owner will pick up oral antibiotics from TEVA office in 2 hours.”

Cost: $29 plus medications dispensed


TELEMEDICINE CASE 2:

Owner sent text/video to TEVA vet's phone

“Doc, take a look at these, my horse Missy is “off” but not lame. Farrier reset shoes 2 days ago, do you need to visit?” [after a few exchanges with the owner…]

Telemedicine medical record entry: “Left hind lameness 2 days after farrier, history of flat feet and soreness after some trims. It could be sole soreness/bruise, abscess developing, or other lameness. Advised owner to give anti-inflammatory for 2 days only (owner already has bute). If a bruise, it will resolve. If an abscess, it will get much worse and requires a visit. If other lameness, it may go away, then come right back, necessitating a vet visit for lameness evaluation. Office to call back in 3 days to check status of Missy.”

Cost: $29


TELEMEDICINE CASE 3:

YouTube link sent directly to TEVA vet's phone

Regarding client potential purchase of a horse. “Hey, Dr Jay, I’m thinking about buying this horse, what do you think?” As a result, our veterinarian will review the video, usually several times, then have a small exchange with the sender asking things like what’s the intended use, how old, what work is it doing, etc.

Telemedicine medical record entry: “Client sent video of prospect. 10-year-old, children’s jumper for daughter, horse appears sound at most gaits, video of poor quality for evaluation, appears short on right hind with right hip hike. Unlikely to meet expectations but formal exam may be warranted.”

Cost: $29


Additional Resources

WHITE PAPER: The American Association of Equine Practitioners (AAEP) Position on Telemedicine

This white paper helps to define telemedicine and give veterinarians guidance of how to proceed in this new arena. Published July 2018.

Read the AAEP White Paper on Telemedicine

From Practice Owner
Dr. Jay Joyce:

“For the betterment of our horses, and recognizing that both access to vets and convenience are important to all of our clients, we are pleased to offer this service. Recent changes to the State’s Veterinary Medical Regulations have mandated that we formalize a program, or stop teleadvising entirely. TEVA chooses to embrace this opportunity and extend convenient telehealth services to our current clientele for a fee,” says Dr. Joyce.

“This is not to replace usual phone calls or texts regarding open cases, quick opinions, clarifications, or progress checks,” he continues. “Telemedicine is intended for minor, new, stand-alone issues like small wounds, hives, minor lameness, snotty nose, or uncomplicated fever.”


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