Vet Nurse Telemedicine Flowchart: Asynch
Vet Nurse Telemedicine Flowchart: Hybrid with Curbside
Front Desk Phone Guide
On October 14, 2020, during National Veterinary Technician week, the Animal Policy Group sponsored a conversation on The Bridge Club, so the VVCA could engage with the profession on how Veterinary Technicians/Nurses can and should be part of the virtual care ecosystem.
This post is a follow-up Q&A with Nicole Rogers, Vice President of Operations at whiskerDocs and Mark Cushing, Co-Founder of VVCA and Managing Partner/Founder of the Animal Policy Group.
Q: Nicole, can we talk about what can and can’t be done by Veterinary Technicians/Nurses in each of the segments of virtual care?
A: Let’s first talk about those segment definitions again. Virtual care is an entire ecosystem of care, really, which includes upfront triage utilizing technology to capture medical history, current medications and current presenting health concerns (teletriage), comprehensive education delivered telephonically or electronically (telehealth), and the use of technology tools to aid the remote diagnosis and treatment of conditions (telemedicine).
There are few limits to what virtual care can offer. At whiskerDocs, we are always exploring new ways to expand the reach to pet owners and to build the trust and the bond between pet owner and veterinarian. Virtual care is never intended to replace in-person care, which is important to mention. We can break it down a bit further and look at what the states require for management of care. Diagnoses require a diagnostic test – which may be possibly virtually in the future. Empirical treatment with prescriptions can explored assuming there has been a virtual consultation to establish the ever-critical VCPR.
Q: Nicole, is there a firm line in the sand?
A: It stops at the VCPR – without it, no medications can be legally prescribed. This is where we believe putting a veterinary technician/nurse at the front of every telehealth appointment matters – let them help the veterinarian establish the VCPR and then funnel to appropriate care, based on the specifics of the case.
Q: Nicole, it sounds like whiskerDocs is truly driven by Veterinary Technicians/Nurses, right?
A: Yes. Veterinary technicians/nurses are the forefront of everything we do – from handling our inbound calls, chats, and emails to developing our protocols. They are chronically under-utilized in practice across the board, as many of you can attest to, and we are able to leverage their expertise in a way that allows for more efficient case management for the veterinarians (both in brick and mortar practice and telemedicine), better care for the pets, and even a warmer experience for the pet owners.
Q: Nicole, how can Veterinary Technicians/Nurses get more involved in virtual care, if they are interested?
A: They can speak to their practice owners and veterinarians about establishing in-clinic protocols to help funnel a patient’s pre-appointment or even request a third-party telehealth service to be at the front of each call. In many places, they are already handling follow up calls, delivering lab results, etc.
Q: Mark, can you remind us what a Veterinary Practice Act is and why it’s important to this conversation about Veterinary Technician/Nurse utilization?
A: Each state has a Veterinary Practice Act, passed by its legislature, spelling out the requirements to be licensed as a veterinarian and veterinary technician/nurse, facility requirements, basic rules governing veterinarians and veterinary technicians/nurses, and disciplinary procedures. States vary widely on how specific or general the practice acts are concerning veterinary technicians/nurses. However, all practice acts relate only to the medical side of veterinary practices, not the broader universe of pet care or animal care. Practice acts routinely prevent veterinary technicians/nurses from doing 3 things: (1) perform surgery, (2) prescribe medications, and (3) provide a diagnosis or prognosis for an animal. That’s all, so virtually everything else connected with caring for a pet (for example, nutrition, behavior and more) is wide open for a veterinary technician/nurse to share her expertise with and guide a client.
Q: Mark, what can, and can’t a Veterinary Technician/Nurse do while utilizing virtual care tools under supervision?
A: Veterinary practice acts spell out 3 categories of supervision of a veterinary technician/nurse by a veterinarian, and the practice privileges for veterinary technicians/nurses in each case. Immediate supervision means the veterinarian must be in the room with the veterinary technician/nurse, so this covers more serious, life-threatening procedures. Direct supervision requires the veterinarian to be on the premises but not in the room with the veterinary technician/nurse. Indirect supervision means that the veterinarian must be able to be accessed electronically (typically by phone) but does not have to be on the premises with the veterinary technician/nurse. So, veterinary technicians/nurses may perform telemedicine services as it pertains to indirect supervision, provided they are able to reach the veterinarian electronically. Of course, as discussed above, all of the pet care services and advice by a veterinary technician/nurse may be performed regardless of where the veterinarian is located.