Veterinary telemedicine

“Telemedicine can be broadly defined as the use of telecommunications technologies to provide medical information and services” (1). Modern telemedicine applications originate with the transfer of electrocardiograms in Europe at the beginning of the 20th century. Not long after, consultations by radio were used to assist patients on ships and in remote places. In North America, a wave of programs including transmission of radiographic images began in the 1950s. NASA’s need to have the capacity to remotely provide medical assistance to astronauts spurred developments in the USA. Later, telemedicine was seen as a partial answer to shortages of family doctors and specialists, especially in remote areas. Telemedicine is also seen as providing efficient and convenient access for busy working people.

As newer technology is developed, the cost of the technology goes down, but pressure on hospital infrastructure continues to increase, as does the prevalence of chronic medical conditions, thereby making telemedicine increasing more attractive for providers and patients. A system that started as a simple transfer of images has blossomed into a complex array of technologies that form electronic medical networks to provide remotely assisted surgery, diagnostic or therapeutic consultations, case management and education.

In Canada, a number of private companies provide access to telemedicine for humans. Typically, clients pay a consultation fee, or purchase a subscription. One company CEO noted that over half of the diagnoses that are made do not require in-person hands-on access and suggested that telemedicine is a partial answer to the problem of long wait times, as well as a time-saver for some patients (2). You pay for rapid and convenient access to a doctor who can provide advice, order prescriptions, and treat certain conditions (3). One advertisement promises instant connection to a doctor from your phone, tablet, or computer at any time. The patient opens the app, describes her/his symptoms and requests to see a doctor. You are connected to a doctor, with whom you consult by text, audio, or video. The doctor can make a diagnosis and, if necessary, provide prescriptions.

Veterinary telemedicine is following along the same path as human telemedicine but has challenges associated with the inability of patients to describe their ailment. Regulatory bodies such as the College of Veterinarians of Ontario (CVO) have been quick to lay out the framework within which veterinarians can engage in this form of veterinary practice. The CVO regulations support developments in telemedicine for animals, but insist on a veterinarian-client-patient relationship (VCPR). In many cases a physical examination is considered essential for a proper diagnosis and drugs cannot be prescribed based on telemedicine alone.

There are now several opportunities for clients to access telehealth services for their pets in Canada and the US. Ontario Veterinary TeleHealth Services started in 2016 and claims to be the first in this field in Canada. Led by Dr. Garth Graham in Guelph, Ontario, this company has established digital communication platforms that allow veterinarians to connect with pet owners to provide consultation on health issues. The business started as a simple one in which pet owners could call a 1-800 number and reach Dr. Graham who would listen to the owner’s description and offer advice (4).

Healthy Pets started more recently but garnered considerable publicity through an episode of the television show Dragon’s Den, on which Emma Harris, CEO of the company, received a $500 000 boost from Arlene Dickinson’s venture capital fund (5). Healthy Pets has a video platform and a network of veterinarians who are able to assess clinical signs and offer advice but are not permitted to diagnose or prescribe. Pet owners may opt for single 15-minute sessions or they may pay a monthly subscription. Veterinarians in the network pay $50/month and earn $20 per consultation. The value of the service is that it guides clients to the appropriate level of intervention and does so in a convenient and inexpensive manner.

Healthy Pets is similar to US companies, such as Whisker Docs, which offers a 24/7 pet helpline via phone, e-mail, or live chat. They charge $39.99 for a call-in or live chat and $4.99 for e-mail. Annual subscription is $129.99; monthly subscription is $16.99. An interesting expansion involves an arrangement with Embrace Pet Insurance, whereby pet owners with this company’s insurance have free access to Whisker Docs services.

Telemedicine for farm animals is somewhat different. Some rural farm animal practices are using smartphones and iPads in combination with FaceTime and Skype to gather and share patient information in order to get a head start on decision-making and to provide assistance to inexperienced colleagues in activities such as surgery. Also, researchers are investigating systems to monitor farm animal health at a distance. Challenges include cost-effectiveness, robustness and accuracy of equipment, effectiveness in predicting health status, and information security.

There appears to be a bright future for telemedicine for animals. It expands access to veterinary health care, provides an inexpensive triage service, provides payment for veterinary consultation, and is particularly effective in situations such as follow-up after an office or hospital visit or for inspection of surgical sites or mobility.