Veterinary telemedicine (VTM) is not currently provided for in any code or professional standard issued by the Veterinary Surgeons Board of South Australia (VSBSA). However, VTM may be a helpful tool to minimise the risk of exposure to COVID-19.
Veterinary surgeons providing veterinary treatment in South Australia must use their professional judgement to decide whether using VTM is appropriate and necessary in particular circumstances relating to COVID-19.
The VSBSA recommends that use of VTM during the COVID-19 pandemic be limited to the following:
VTM should only be conducted by a veterinary surgeon in order to diagnose a disease, injury or condition, prescribe medication or otherwise treat an animal within an existing Veterinary Surgeon-Client-Patient Relationship (VCPR), with the exception of advice given in an emergency until the patient can be seen by a veterinary surgeon
The veterinary surgeon should assume responsibility for making medical judgements and ensure that he or she has sufficient knowledge of the patient to make at least a differential or preliminary diagnosis of the disease, illness or condition
The veterinary surgeon should be readily available for follow-up evaluation, or have arranged for veterinary emergency coverage and continuing care and treatment of the patient
The veterinary surgeon should provide oversight of treatment, owner compliance and outcome
The veterinary surgeon should document the patient's continuing care and treatment in the medical record
The veterinary surgeon should obtain and document the owner's informed consent for the use of VTM
In the absence of a VCPR, any advice provided by the veterinary surgeon to a client through electronic means should be general and not specific to a patient, diagnosis or treatment
In light of the risk COVID-19 poses, if it becomes widespread in South Australia, it may be appropriate for veterinary surgeons to use VTM to authorise repeat medicines where they can reasonably judge it appropriate and safe to do so using patient histories and/or recent visits to the premises even without having seen the animal recently. Whilst this departs from the clear standard set out in the Code of Professional Conduct for Veterinary Surgeons, it may be justified during the COVID-19 pandemic to protect veterinary surgeons, their staff, and the wider public.
Risk assessment and professional judgement by the veterinary surgeon in determining whether VTM is appropriate and necessary for each case is vital. When making decisions of this kind, the key questions to consider are:
Have I considered all available information and am I satisfied that the information is reliable?
Have I received and documented sufficient information to establish identification and ownership of the animal?
Do I have evidence to support treatment of the patient?
Is immediate action necessary and in the interests of animal welfare?
Can I delay treatment until a physical examination is possible?
Can I refer the animal/owner to another veterinary practice/ veterinary surgeon?
Has the client provided informed consent?
What are the risks (including consideration of the nature and quantity of any drugs being prescribed)?
What are the benefits?
How, and how often, will I follow up with the owner to monitor the animal's progress?
In my professional opinion, is my decision reasonable and would it be considered reasonable by a group of my peers in all the circumstances?