We’ve all faced tough times but, for us, some of brightest things to come out of the last 12 months have been the examples of the human ability to innovate and adapt. Faced with the unprecedented global physical shutdown, human ingenuity, creativity and problem solving has led to development of digital solutions to provide virtual alternatives in many areas of life and work. The already rapid pace of the digital revolution received the super-charged boost of necessity as social distancing became a requirement of life.
Prior to the emergence of COVID disrupting our world, we at VetCT had already begun to think how an app connecting vets and specialists could revolutionise the provision of specialist advice to primary care vets. App downloads topped 218 billion globally in 2020 (Statista Research Department, 2021), and people aged between 18 and 44 spend more than 50 percent of their digital time on mobile apps (Galov, 2021). Creating an app-based interface allowing instant, 24/7 connection and a place for data and reports for clinical cases to be organised and shared seemed like to obvious way to improve vet-to-specialist communications.
We have all seen the meteoric rise of vet-to-pet telemedicine in many veterinary practices across the UK. Similar increases have been noted in human healthcare: nearly half of healthcare consumers are now using telehealth in the US according to consultancy firm McKinsey, up from 1 in 10 last year (Stokel-Walker, 2020). Telehealth is here to stay – now is the time to figure out how to do it best and embrace this revolution to better service our profession, our clients and our patients.
Our app sits in the teleconsulting realm. Teleconsulting is the official name for vet-to-specialist remote communication and represents an entirely different branch of the telehealth tree to vet-to-pet telemedicine (AVMA Practice Advisory Panel, 2017). There are very few players exploring the teleconsulting space and it presents a real opportunity to service the need for patients that cannot be physically referred to benefit from specialist advice, all delivered through their local vet and veterinary practice.
Increasing access to specialist support both for veterinary professionals and their clients is what sparked us to create VetCT as a vet-to-specialist teleradiology service back in 2009. Since then, our remit has expanded as technology has improved and demand has increased, and we now provide 24/7 virtual advice covering a range of specialist disciplines.
Specialist care has undergone a revolution of its own in recent decades. When we graduated, the only “referral centres” to speak of were the veterinary teaching establishments in universities and a few large referral hospitals. Fast forward two decades to the current day and private referral hospitals have opened all across the country resulting in unprecedented access to physical referral options. While this expansion in specialist services has enabled far more clients than ever to access this level of care for their pets, many owners are still limited by cost, geography or inability to travel – especially during the pandemic.
Many specialists are time-poor as demand grows along with client expectations. A recent survey we conducted amongst veterinary specialists in the UK revealed that specialists spend, on average, five hours per week giving free advice to vets in first opinion practice, yet half said 25 percent or fewer of these cases result in referral. Half the specialists often or always felt time pressured, 70 percent felt sometimes or always pulled in too many directions, yet over 90 percent wished the first opinion vet had sought specialist advice sooner. So, it’s a catch-22 for specialists, who are under time pressure, yet wanting to help their colleagues in first opinion practice and have these conversations sooner.
For the first opinion vets seeking help, there is a similar picture. A survey conducted amongst first opinion vets showed that on average vets spend 9.5 hours per week seeking additional advice on cases. There are also barriers to simply picking up the phone. Many vets are reluctant to take up a specialist’s time – especially in cases where they know referral is not an option. It is time inefficient playing phone-tag for both parties. For those individuals lacking confidence, or simply wanting the reassurance of a second opinion in complex cases, there can be the barrier of wondering how they’ll be perceived by the specialist, their colleagues and employer, and even by the owner.
How can an app solve these issues? It’s taken a year and a lot of fine tuning and research, but the key areas we have designed the app to address include:
- For vets: instant, reliable access to specialist advice and support, removing any concerns around seeking advice. The ability to upskill and build confidence in different types of cases. CPD points for every specialist interaction
- For practices: less time wasted on seeking additional advice on cases, a more confident team, a new revenue stream for the practice with 78 percent of vets saying they would be able to charge the client for this service. CPD savings
- For specialists: reduced time pressure and more timely referrals. Initial trials have suggested the app might even increase the number of physical referrals. An overall spotlight on the true value of specialist advice
- For pet owners: the ability to have consistent specialist input within their local practice when physical referral is not an option. A clearer understanding of the value of specialist input
- For animals: access to specialist advice, support and care for pets who would not previously have been able to benefit, leading to improved welfare and outcomes. This applies globally – we could reach and support vets working overseas, remotely and in charity settings
The app also brings the opportunity to book small blocks of specialist time and we have already seen interest in bespoke CPD, significant event discussion and clinical audit. Fundamentally, in providing a middle ground of specialist support for cases, we hope to improve the working lives for vets and specialists, while extending the access to specialist care for pets and their owners to improve outcomes.
As with all new developments, there will be successive iterations to build on and fine tune the service we can provide through the app for all parties. We welcome feedback from all stakeholders and really want to get this right for the profession.
Looking to the future, the veterinary profession is on the horizon of increasing use and effectiveness of all forms of telehealth. Like it or not, the past year of COVID has forced an acceleration of this process on all of us. Now is the moment to focus on the positives that these advances can bring and embrace the benefits in terms of managing demands on our time, modernising workflows and delivering better services. Virtual is already reality – let’s make it work for us.
VetCT has recently published two case studies to illustrate the ways in which its teleconsulting services can help veterinary practitioners achieve better clinical outcomes and improve patient and client care, whilst also feeling supported by specialists and increasing their own knowledge base.