Veterinary Practice magazine spoke to co-founders of Vet AI, Paul Hallett, Sarah Warren and Robert Dawson, about the development of the new pet health app, Joii. Launching in April 2019, the app is designed to give pet owners access to vets without having to visit a practice. The app will be a cost-effective means to allow the many pets in the UK that are not registered with a vet professional to receive advice and care. The team plans to introduce artificial intelligence to detect and predict conditions in pets and envisions positive changes to the work/life balance of veterinary professionals.
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How will the app work?
RD The app will give owners access to free veterinary advice in the form of a triage process that’s been written by our own veterinary team in conjunction with vets from pharmaceutical companies. The triage process will tell them whether they need to go and see a vet, whether it’s a problem that they don’t really need to worry about, just keep an eye on, or if it’s something that we can deal with in the form of a remote veterinary consult. If our triage process advises a remote consultation when the pet has a problem that requires a visit to a veterinary practice, they will not be charged for the remote consult.
SW We’re focusing on dermatology at launch; we know that’s beautifully aligned with remote consultation, because it’s such a visual disease. When we were designing the app and the triage process, we collaborated with some European veterinary specialists and took part in a feasibility study. It proved that remote consultation for dermatology cases was just as accurate in providing differential diagnoses as it is in clinic.
What are the main aims for the app?
RD The idea behind the app is to try and bridge that gap between Google and veterinary practice; almost everyone goes to the internet to try to find out what a problem is first, unless it’s an absolute emergency. We’re trying to engage people with the veterinary profession at the earliest possible stage.
PH We’re finding that more and more people are avoiding the vets because of price. And that ultimately is an animal welfare issue. We feel that by providing this service, we’ll have an impact on animal welfare.
RD The bigger picture is that we’re going to be recording the data we get from people entering problems into the app and from the veterinary consultations in a structured way. It will give us insights into pet diseases and health that haven’t been available before. Our ultimate goal is to have a system where we can increasingly predict disease and inform owners on how to prevent the disease rather than waiting for it to come along. If the triage is free for the client, how is the app financed?
PH We will sell products and do tele-consults straight away. But the bigger picture is to work with the large pharmaceutical companies and help them reduce spends on drug trials and improve medication – things like that. I think we’ll be able to leverage our data when it becomes significant enough.
How much will it cost a client for a remote consultation?
RD It would cost about £20.
How does the app sit in terms of veterinary regulations and the definition of “under his or her care”?
RD We’re working really closely with the RCVS, who are going through a process of reviewing the guidelines of remote prescribing. If we can set out a framework which controls it from an early stage, we can make sure that pet owners and vets are protected. The potential for somebody to come in from a larger business outside the veterinary profession and do something similar in an unethical way is considerable. And I think the Royal College are very aware of that. We would like it to come under the Practice Standards Scheme; if they want to, we will help set up the guidelines around it to make sure that there are clinical notes that can be inspected, that we’re adhering to prescribing policies around antibiotic resistance and other areas and we can show that, where appropriate, we’re sending people into practice.
Do you think you will be able to prescribe in future?
RD Yes; it’s just a question of when, really, and what product ranges. I don’t think remote prescribing would be suitable for any potentially abusable drugs. But I think it certainly would be for parasiticides, for instance, and for things like anti-inflammatories for arthritis, and antibiotics, although there could be some restrictions on the amount of antibiotics that we prescribe.
Will you be working with insurers?
RD We probably will work with an insurer, or several. For them, I think the most exciting thing about what we’re doing is potentially identifying predictive and preventative care plans. It could make insurance much more affordable.
Which areas of practice do you think it will work well for, and where do you think it could never work remotely?
RD [It will work for] low risk conditions, I think. Management of long-term cases is another area, even if at some point you have to have a work-up in practice. Things that aren’t suitable include: anything that’s an emergency; seizuring animals; a vomiting dog where you need to palpate the abdomen. Some things: operations, X-rays, ultrasound scans, will never be available as a remote consult. I think, over time, practices are going to deal with the high-level stuff, and more of the less urgent things will be dealt with remotely.
SW And behaviour is really suitable for remote consultation. We’re planning to work with a behaviourist and provide behavioural consultations. Are you expecting to have a relationship with practices whereby if the vet diagnoses a condition that is easy to manage, they will direct the client to the app?
RD First, we want to demonstrate that we’re creating a significant amount of traffic into practices: that we’re identifying problems that maybe people wouldn’t have identified had they not had the remote consult. We would like to partner with local practices; we wouldn’t charge them for sending cases in, but would like to have a relationship where we can exchange clinical notes freely. Potentially, if the owner prefers to carry on managing something remotely, they have that option to do that with us. We see ourselves developing a network of partner practices over the country.
Would your veterinary staff be working full time?
SW We’ll be employing a small number of full-time vets at launch, and then taking on a pool of vets that can come on board quickly, who will want to work with us part-time and combine that with their job in practice. It’s the same for nurses. We’re planning on taking on three nurses at launch: two full-time, and one part-time. We’ve had a hugely enthusiastic uptake from vets who want to improve their work/life balance.
What are your longer-term goals?
RD We are committed to pet healthcare and our goal long term is to go outside of the UK. The UK has got very good veterinary provision anyway. And pets, on the whole, are looked after well here. In some parts of the developing world, people have the same relationships between pets and owners, but without access to the veterinary care. We’re going to be able to make it really affordable with the app once the AI develops and is completely available to anybody with a mobile phone. Hopefully it will transform the lives of pets in large parts of the world.
