Remote veterinary care has been around for decades, but it has taken a global pandemic to make it (nearly) mandatory for veterinary practices to use the available technologies. In the past, remote veterinary care was difficult because of certain laws and the need to establish a veterinary–client–patient relationship (VCPR) in person. But now telehealth is much easier for vets with temporarily relaxed telemedicine rules due to forced lockdowns across the country. “However, in response to COVID-19, many states (but, unfortunately not all, including California) have amended laws, allowing veterinarians to establish the VCPR by electronic means, as well as permitting a wider use of telemedicine,” comments Shea Cox, DVM, CVPP, CHPV of Pet Hospice.
Vets are already comfortable with basic telehealth services, such as assessing a patient over the phone to determine if they need to be seen or refilling a repeat medication. However, there remains uncertainty among vets in the realm of telehealth, such as how to charge for services and what telehealth may look like moving forward. In this article we address these concerns, as well as some benefits and drawbacks of telehealth for vets, new ways for vets to incorporate telemedicine services into their business model, and how AnimalBiome products can support at home care for patients.
Incorporating Telehealth Services
Your practice may not change too much as you incorporate telehealth services, but undoubtedly your billing will. So how do you charge for services online? Here we provide examples for charging for different types of telehealth services and products, highlighting that your practice can maintain revenue while moving online.
Type of services:
Regular Check-Ins: Schedule affordable, convenient time slots to have a video conference with your clients as an annual check-in. You will see your clients more regularly, and may even become aware of issues before they become serious.
Sell Products: Most pet parents want help with nutrition and diets for their cats and dogs. By selling prescription diets and/or supplements, you can provide your clients with products they can trust as they figure out what works best for their pet.
Programs: Create interactive programs that your clients can enroll in that last any length of time, such as a weight loss regime, a behavioral training curriculum, or a care improvement workshop (e.g., dental hygiene). You can track your patient’s progress and set meaningful goals that clients will enjoy participating in.
On Call Service: Charge your clients for an affordable annual or monthly subscription service that allows them to call as often as they need about issues with their pet. Costs can be adjusted for number of pets, health of pets, age of pets, etc.
Active Monitoring Program: Sell your clients a package that includes relevant products, detailed instructions of use, and support to actively monitor health issues. For example, you can send your client a diabetes monitoring kit, with a glucose monitor, online worksheet to regularly track their pet’s glucose levels, and information on when to get in touch with you.
Telehealth Access: Create annual or lifetime memberships to patient portals, which are a great way for clients to communicate about known conditions that should be monitored, such as post-operative recovery, response to new medication follow up, prescription refill, or hospice care.
AnimalBiome Products Can Help with At-Home Testing
Imbalances in the gut bacterial community have been linked to many serious conditions, including atopic dermatitis, chronic gastrointestinal issues, gum disease, diabetes, and obesity. AnimalBiome’s Gut Restore System includes supplements for cats and dogs that promote a healthy and balanced gut microbiome and two microbiome Gut Health Test kits. Microbiome tests before and after supplementation completion allows you to see how the patient responds to microbiome therapy. We spoke with Dr. Katie Kangas, a veterinarian at Integrative Veterinary Care in San Diego, California, who uses AnimalBiome’s products in her practice. “I have begun widely recommending AnimalBiome's microbiome fecal assay test and FMT protocol for my canine and feline patients,” says Dr. Kangas. A microbiome test can identify imbalances in the gut microbiome, which once addressed, can lead to reduced symptoms, better response to treatment plans, and more informed decisions about customized diets.
The Gut Restore supplements (a fecal transplant in a capsule) may be able to alleviate bacterial imbalances, by introducing healthy gut bacteria in a non-invasive way. In her patients that have taken AnimalBiome’s Gut Restore Supplements, Dr. Kangas has “seen very good success thus far with both dogs and cats improving from symptoms and conditions related to IBD, colitis, gastric reflux, chronic vomiting and diarrhea, allergies, skin problems, and other immune mediated conditions.” These health conditions are very common, but “oftentimes traditional/conventional therapies are not ultimately effective and/or carry significant side effects” says Dr. Kangas, who recommends AnimalBiome’s products for patients presenting with these issues.
Dr. Kangas states, “The AnimalBiome system and products are very easy to incorporate into telemedicine practice. Pet owners can submit/send their pet's stool sample and the consultation discussions about the results can be done via telemedicine or phone. The recommended FMT capsules and other products used to support the protocols can be ordered (by the pet owner or the veterinarian) and mailed straight to the pet's family.”
A majority of dogs have some degree of periodontitis by the age of three, highlighting that oral hygiene is an area many pet parents need help with. The oral microbiome plays an important role in immune system function and overall health. The newest product offered by AnimalBiome, DoggyBiome’s Oral Health System, includes two (before and after) microbiome-based Oral Health Test kits and a prebiotic powder water supplement that promotes beneficial bacteria and decreases the overgrowth of inflammation-causing bacteria—the root cause of gum disease. The oral microbiome test can determine bacterial imbalances in the mouth to help you make informed decisions about your patient’s oral hygiene care and if supplements improve oral health.
AnimalBiome offers a wide range of products for at-home testing, with 95% of customers getting microbiome test results in 2 weeks or less. Testing and supplement administration of all AnimalBiome products take place in the home and all results can be accessed online.
Will TeleHealth Stay?
Many veterinary practices have evolved to incorporate telehealth during the COVID-19 pandemic, but will they continue to do so moving forward? There are certainly limitations and concerns, as many believe that a lack of in-person examination reduces the standard of care and quality of the VCPR. Privacy and the management of cyber security infringements add an additional headache to telemedicine, of which no online business is immune to. Federal and state laws may make telemedicine tricky moving forward, such as prescribing medicine or still seeing a long-term patient that has moved out of state. Perhaps the biggest drawback of telemedicine is ease of use; there are many clients and vets that may struggle with accessing and adapting to new technology.
There are many benefits to using telehealth, both for the patient and for convenience to the client and vet. Many people have concerns about bringing their pets into the vet for non-emergencies or preventative wellness care, as evidenced by a study that found 52% of cat owners avoid annual visits. Dr. Cox believes that convenience may be a key factor to this statistic because, “Having to get your pet into a carrier, drive across town or sit in traffic, take time off work, and wait in a lobby –– for an average of 16 minutes of face time with your vet –– are all unnecessary barriers to care.”
Dr. Kangas echos a similar sentiment in her veterinary practice, noting that, “Many of our clients are very appreciative of the telemedicine option. It saves them travel time, pet stress, their own stress, and often allows a more focused conversation (with less distractions) between the doctor and the client/pet owner.” Telehealth allows patients to receive veterinary care from the comfort of home without the aforementioned barriers, suggesting that practices may see an increase in clients with the introduction of telehealth options.
In addition to convenience, telehealth platforms may make it easier for clients to provide more detailed and accurate information compared to in-person visits. With telemedicine, clients can create a well documented progression of an issue in a variety of media types (time-stamped notes, photos, videos, etc) which can be invaluable for making informed decisions about a patient’s care. Furthermore, “Telemedicine also makes it very easy for clients to show you exactly what they're doing at home for their pets- with foods, supplements or medications - without them having to pack everything in a bag to bring and display,” highlights Dr. Kangas, who uses telemedicine in her veterinary practice. Lastly, using telehealth for non-urgent visits not only frees up clinic appointments for the patients that need to be seen the most, but also allows for maximum flexibility.
That said, telemedicine will never completely replace in-person visits. “I can’t stress enough that telemedicine is just one tool of many in our patient care toolbox,” says Dr. Cox. “It is an excellent way to manage patients and keep the lines of communication open with clients in between scheduled visits. It is an adjunct to patient care.”
The world was dependent on computers even before it was rocked by a global pandemic, which accelerated the trend to the inevitable, widespread use of veterinary telemedicine. It is here to stay, and there are many platforms available to vets to make the transition as easy as possible. Dr. Cox urges fellow veterinarians to keep talking about telemedicine, stating “If we continue to work together, we can create best practices that will help us move seamlessly into a model of care that allows veterinarians to deliver exceptional and personalized patient-client centered care, both in-person and virtually.” AnimalBiome’s products are also available to make at-home testing easily part of your in-person and virtual practice, which can help you make informed decisions and promote steps to support healthy microbiomes in your patients.
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