Our world is more connected than ever, with technology-enabled globalisation reaching into almost every aspect of our lives, including our work. Connection can be a powerful driver to democratisation of care by providing more options to access veterinary advice and support beyond the boundaries of time and location. However, time, confusion, scepticism and even concern can prove barriers to exploring and embracing the tech behind connectivity solutions in veterinary practice.
So, how can we look at technology – with a small “t” – to encourage the adoption of innovations in practice that can help to join up clinical care to improve patient outcomes? And how can technology provide vital solutions to some of the challenges we face as a profession?
What is connected care?
Connected care is a term coined in US human medicine, coordinating clinical care using technology to gather patient data and utilise electronic communication between patients and care providers, as well as between clinicians themselves. There are three key goals of connected care:
- Quality care: leveraging expert advice
- Patient-centred care: customised to the individual patient
- Preventive care: improving outcomes by enabling earlier and greater patient engagement
Connecting care from pet owner to vet, within the veterinary team, and between vets and specialists opens the door to improved early access veterinary care, more efficient workflows, improved owner engagement and compliance, patient data gathering and greater access to specialist advice. But do we really need tech for connected care?
Connecting care from pet owner to vet, within the veterinary team, and between vets and specialists opens the door to improved early access veterinary care, more efficient workflows, improved owner engagement and compliance, patient data gathering and greater access to specialist advice
Overcoming barriers to embracing innovation
“Necessity is the mother of invention” or so the saying goes. As veterinary medicine grows in complexity, the need to leverage patient data and up-to-date knowledge to optimise individualised care also grows. We live in times with invention, innovation and even disruption around every corner – often coming from “intrapreneurs” within the veterinary industry – to meet the challenge of providing veterinary care in the modern age.
However, despite the emergence of many technological solutions there can be reluctance to change working practices. This leads us to ask, what are the barriers to embracing innovations? Is it a lack of time and resources to research and implement? Is it because there is no perceived need to change the way we do things? Or is there an inherent mistrust of new technology – is it just technology for technology’s sake? Have you found it’s done more harm than good – expending time rather than saving it?
Start with why
Easy wins to boost patient care and practice morale is to start small. A good way to find tech that can really benefit your practice is to start with “why?”
Simon Sinek’s great opening question for self-examination in life decisions also provides a great starting point for decision making when adopting tech in practice (Sinek, 2009). What problem(s) are you trying to solve? What outcome(s) do you want? What does success in adopting the technology look like?
Let’s take teleradiology as an example: the remote reporting of diagnostic imaging by radiology specialists. Which of the following benefits of remote reporting of your diagnostic images are most important for you, your team and your patients?
- Easing workflows by saving time in diagnostic image interpretation for your team
- Quality and reliability of diagnostic reports
- Connecting your team and practice to specialist radiologists, providing diagnostic confidence and peace of mind
- Improving patient outcomes by enabling more pets to benefit from expert imaging interpretation
- Education – building imaging interpretation knowledge and understanding on your cases in practice
- Enabling in-house use of advanced imaging modalities (eg CT, MRI) by having a remote radiologist report on the images
- Boosting recruitment and retention through more advanced in-house diagnostic capability and work-up of more interesting cases
- Providing an additional revenue stream
- Increasing services offered to clients and client loyalty
Once you’re clear on your “why”, you are better equipped to find a service that meets your needs and expectations. You could also ask different providers about their “why” for creating their product or service to see if there is resonance between what you value and their solution; why did they create a teleradiology service? What matters most to them in developing and running the service? How do they think the service will benefit the team and patient care? If there is alignment you can be confident of a much higher probability that the technology will prove a successful outcome based on your expectations.
Indeed, as Sinek (2009) puts it, “people don’t buy what you do; they buy why you do it. And what you do simply proves what you believe.”
Technology with a small “t”
Change can be hard, and often the biggest barrier to adopting tech is the need for change management. Indeed, practices change their PMS software on average every seven years, not because they are satisfied with the existing system, but due to the not inconsiderable effort of researching and implementing a new system that may well improve workflows and overall efficiency.
Change can be hard, and often the biggest barrier to adopting tech is the need for change management
Where the prefix “tele” may be off-putting to some thanks to its connotations of a degree of separation from patient to vet, in truth it is the greatest connector. The root form of the word “tele” means “bridging the gap” – boosting connection and access, and removing geographical and financial barriers to care.
Part of the problem lies in the confusion around terminology (Box 1).
|Telehealth: the overarching term that encompasses all uses of technology to deliver health information, education or care remotely|
Telemedicine: a subcategory of telehealth that involves exchange of medical information electronically from one site to another to improve a patient’s clinical health status
Tele-triage: the initial assessment and management of animal patients via electronic consultation with their owners
Teleconsulting: subcategory of telehealth in which a general practitioner uses telehealth tools to communicate with a veterinary specialist to gain insights and advice on the care of a patient (note this is different to human medicine, where teleconsulting can also mean doctor to patient remote interaction)
Teleradiology: the remote reading and reporting of diagnostic imaging (including X-ray, CT, MRI, fluoroscopy, nuclear medicine, etc) by radiology specialists
Telemonitoring: remote monitoring of patients who are not at the same location as the healthcare provider
Teleadvice: the provision of any health information, opinion, guidance or recommendation concerning prudent future actions that are not specific to a particular patient’s health, illness or injury
mHealth or mobile health: a subcategory of telehealth that employs mobile devices
Teleconsulting, for example, is one term that is often confused – it is the connection of veterinary professionals, ie general practitioners to specialists, providing a portal for accessing expert advice on case management. In contrast to inefficient phone-tag or email exchanges, modern teleconsulting platforms provide a secure portal for transfer of patient information where clinical queries and specialist advice is documented and accessed through desktop platforms and apps. Flexible options for accessing teleconsulting advice enable timely advice to be exchanged in a way that suits the case and the clinicians – for example, through live-guided procedures, instant telephone advice, written reports or quick queries answered through messaging services.
Connecting pets in primary care practice to specialists through such services enables more animals to benefit from specialist care, while supporting the veterinary team to manage their cases in confidence, supported by expert input. For the specialist, it also provides organisation of clinical information and data in a secure platform, giving them the information they need to be able to provide the best advice.
There is also the possibility of multi-specialist input, effectively opening the door to a virtual hospital of specialist support with coordinated case discussions to provide the most holistic and practical advice for each individual patient. Within the clinic, the whole practice team can view teleconsulting interactions, improving continuity of care and case-based learning.
It’s easy to see how utilising a virtual platform to enable such powerful interactions with real people is a great way to build technology into practice for the benefit of the team and the patients.
The future of connected care
We’re unlikely to see the day when automated robots are routinely employed to squeeze anal glands or examine ear canals. However, tech-enabled remote guidance is something that is already happening in medicine and industry, especially in training. VetCT performed a smart glasses trial, with a remote specialist giving live feedback to vets wearing the device in practice. As this technology develops, the scope for remote-guided examination and procedures is enormous.
Beginning to explore tech now will ease the integration of such tools into clinical practice as they arise. Change will become necessity; in the same way internet search tools are now a part of daily life, AI tools will increasingly form part of daily practice…
AI will also feature much more heavily, and beginning to explore tech now will ease the integration of such tools into clinical practice as they arise. Change will become necessity; in the same way internet search tools are now a part of daily life, AI tools will increasingly form part of daily practice in everything from data collection to dictation, client interaction and diagnostics.
Technology can be the most truly connecting force. In many ways, technology and teleservices are widening access to veterinary advice, reaching more people and animals. And yet, we are all too aware of the risks of relying heavily on tech thanks to the fallout from COVID lockdowns with loss of social capital, erosion of culture and rise in loneliness. Where does the balance between tech as an enabler and inhibitor lie? We can begin to answer this for ourselves, our practices and our clients and patients by finding the solutions that answer our “why” and connect us together to provide joined-up, high-quality and more efficient care.
Embracing technology to join the dots of clinical care is a good way to begin future-proofing our practices and profession as technology development accelerates. The true power of technology is to connect people and pets more efficiently, empowering teams to deliver great care while safeguarding and benefitting animal welfare. Technology will prove vital to keeping people at the centre of patient care.