Embracing Telehealth in Equine Medicine
Has a client texted you a picture of a horse’s cut leg and you responded with care instructions? Then you’ve participated in telemedicine! Cristobal Navas de Solis, LV, PhD, MS, Dipl. ACVIM, is a large animal internist at the University of Pennsylvania’s New Bolton Center Veterinary Hospital, which offers telemedicine services. At the 2021 Veterinary Meeting and Expo (VMX), held in Orlando—but also accessible virtually—Navas aimed to “demystify” the controversial topic of telehealth in equine medicine.

Starting with a poll of the audience, Navas de Solis established that:

  • 50% of attendees (primarily equine veterinarians) joined the session with the opinion that telemedicine is a “good idea”;
  • 40% viewed it as a “bad idea”; and
  • The remaining 10% were undecided.

Reservations about telemedicine stem from concerns regarding quality of patient care, Navas de Solis said. Skepticism stems from concern over low-quality medicine resulting from lost information or missing details caused by the inability to physically examine the patient.

Legal and logistical obstacles cause additional deterrents. Forty-seven U.S. states mandate that a practitioner and animal owner can’t establish a veterinarian-client-patient (VCP) relationship solely by electronic/telephonic means. Navas de Solis recommended checking the Veterinary Virtual Care Association website for state-specific guidelines, including special COVID-19 provisions. Beyond these barriers, some practices might find setting up the technology necessary to offer telemedicine effectively is time-consuming, Navas de Solis said.

Additionally, practice managers share the concern that having a veterinarian available “at one’s fingertips” will reduce veterinary practices’ in-person caseload, with fewer farm calls and fewer animals shipping into hospitals, decreasing revenue.

With the limitations and risks outlined, what are the benefits of telemedicine in equine practice, and do they outweigh the costs? “Yes,” Navas de Solis said. “Even though all of these concerns are valid.” But he doesn’t see telemedicine as an attempt to replace traditional medicine. “It’s not an entity in and of itself,” he said. “Rather, it’s a tool like any other. If the tool allows me to have better medical outcomes, I’ll take it!”

And research shows it very well might improve veterinary care. A survey of telemedicine-equipped veterinarians identified the following benefits:

  • Increased reassurance by facilitating access to second opinions. “Having access to specialists is very morale-boosting,” Navas de Solis said. “Consults sometimes just confirm that we are doing the right thing. Other times, they change treatment protocols for the better.”
  • Same-day specialist consultation without travel. This can save horses’ lives in rural, underserved areas.
  • Educational and mentorship opportunities for veterinarians worldwide.
  • New opportunities. In his discussion, Navas de Solis used the example of a practitioner who conducted an ultrasound examination while screensharing with a specialist, who provided real-time guidance. The feasibility of this setup is backed by a 2019 study in which the users deemed tele-ultrasonography “useful” in 100% of cases, either because it improved ultrasound skills, provided reassurance to veterinarians, and/or improved case management.

“Telemedicine isn’t anything new,” Navas de Solis concluded. “It’s been going strong for 140 years, ever since people started communicating remotely with telegrams and letters,” he said. “The only difference is, now, we have easier, faster, better, cheaper, and more widely available technology. It is up to the veterinary profession to figure out pros, cons, limitations, indications, contraindications and decide the best way to use these sharper tools.”