31 Mar Telehealth During COVID-19
We have received a flurry of inquiries regarding Governor Wolf’s executive order that expands the delivery of telehealth during the COVID-19 pandemic. Because veterinary medicine is considered essential and life sustaining, and falls under the “Medicine” category, this has raised some issues pertaining to veterinary telehealth.
First of all, it is important to consider the underlying purpose of the Governor’s action. Of utmost importance is the mitigation of human-to-human contact as we attempt to slow down the transmission of the virus and to conserve supplies. That is why medical professionals, human and veterinary, are being directed to only provide life-sustaining services, or those that would treat illness as well as prevent suffering. Mental and behavioral health service delivery has suffered as a result. The Governor’s order allows these services to continue without face-to-face contact and puts influence on the private medical insurance industry to expand coverage.
Although no Pennsylvania law expressly prohibits the practice of telemedicine, keep in mind that our Pennsylvania Board of Veterinary Medicine and Veterinary Practice Act clearly states that a VCPR (Veterinary-Client-Patient Relationship) is required in order to diagnose, treat and deliver medical services. The necessity of physical exam and an established relationship cannot be overstated. However, we must temper this with human public health and safety, and mitigate interaction with clients.
Therefore, looking at the underlying intent of this executive order, use your best professional judgement when assessing problems that are non-emergencies that can be addressed through telehealth. For companion animal practitioners, some things you may want to consider providing would be the following:
- Prescribing antibiotics for a seasonal acral lick granuloma for an established patient who seems to get one every spring, based on a phone call or picture.
- Dispensing methimazole or levothyroxine for an otherwise healthy patient who has been stable on this dose for years, even though periodic blood work may be due.
For food animal veterinarians, the FDA has provided a statement allowing for temporary non-enforcement of certain requirements of the VCPR to allow for more use of telemedicine. This allows veterinarians to prescribe drugs in an extra-label manner or authorize the use of VFD drugs without direct examination of or making visits to their patients, which will limit human-to-human interaction and potential spread of COVID-19 in the community. For the complete article, click here.
Please keep in mind, this is not an opportunity to stretch the practice act or an opening for out-of-state veterinarians to take advantage of this temporary change. According to the PA Media website, those not licensed to practice veterinary medicine in the state of Pennsylvania would still need to meet certain professional requirements and to formally petition the State Board of Veterinary Medicine for a waiver. For more information, click here.
Thank you for your understanding and sensitivity during these fraught times.