Pet-Specific Care for the Veterinary Team. Группа авторов

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      29 29 Schelkun, S.R. (2014). Lessons from aviation safety: “plan your operation – and operate your plan!”. Patient Saf. Surg. 8: 38.

      30 30 Clay‐Williams, R. and Colligan, L. (2015). Back to basics: checklists in aviation and healthcare. BMJ Qual. Saf. 24: 428–431.

      31 31 Levy, M.M., Pronovost, P.J., Dellinger, R.P. et al. (2004). Sepsis change bundles: converting guidelines into meaningful change in behavior and clinical outcome. Crit. Care Med. 32: S595–S597.

      32 32 Lingard, L., Regehr, G., Orser, B. et al. (2008). Evaluation of a preoperative checklist and team briefing among surgeons, nurses, and anesthesiologists to reduce failures in communication. Arch. Surg. 143: 12–17; discussion 18.

      33 33 de Vries, E.N., Prins, H.A., Crolla, R.M. et al. (2010). Effect of a comprehensive surgical safety system on patient outcomes. N. Engl. J. Med. 363: 1928–1937.

      34 34 Sivathasan, N., Rakowski, K.R., Robertson, B.F. et al. (2010). The World Health Organization's 'Surgical Safety Checklist': should evidence‐based initiatives be enforced in hospital policy? JRSM Short Rep. 1: 40.

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Recommended Reading

      1 Gawande, A. (2010). The Checklist Manifesto: How to Get Things Right. New York: Metropolitan Books.

      2 Oxtoby, C., Ferguson, E., White, K. et al. (2015). We need to talk about error: causes and types of error in veterinary practice. Vet. Rec. 177 (17): 438.

2.5 Virtual Care (Telehealth)

       Lowell Ackerman, DVM, DACVD, MBA, MPA, CVA, MRCVS

       Global Consultant, Author, and Lecturer, MA, USAr

BASICS

      2.5.1 Summary

      Today's consumers want their healthcare on their own schedules, and at their own convenience. Since most have smart devices, they typically have access to online messaging, images, and even video, and are used to these devices playing a central role in their lives.

      Telehealth (or virtual care or connected care or even healthcare on demand) is the umbrella term used for healthcare consulting delivered remotely, and can be subdivided based on the parties involved in the consultation.

      Veterinarians providing telehealth must comply with all laws and regulations associated with their license to practice veterinary medicine. The standard of care is the same regardless of whether telemedicine or in‐hospital care is provided.

      Telehealth has the potential to enhance animal care and the delivery of veterinary services, and regulations are evolving accordingly.

      2.5.2 Terms Defined

      Electronic Prescribing (E‐Prescribing): The use of digital electronic prescriptions rather than providing a printed prescription or faxing a prescription.

      Mobile Health (mHealth): Subclassification of telehealth in which mobile applications (apps) and wearables are used to provide healthcare information for pets.

      Teleadvice: Subclassification of telehealth in which only general advice is provided that is not specific to a particular patient's situation.

      Teleconsulting: Subclassification of telehealth in which the consulting takes place between a primary care veterinarian and a specialist.

      Telehealth: Broad term to describe healthcare consulting delivered remotely. Sometimes referred to as virtual care or connected care.

      Telemedicine: Telehealth delivered between a veterinarian and an animal‐owning client, under the auspices of a veterinary–client–patient relationship (VCPR).

      Telemonitoring: A form of telehealth in which patients are monitored remotely.

      Teletriage: Subclassification of telehealth in which assessment is made remotely regarding the need for urgent veterinary visitation. Teletriage does not include rendering any diagnosis, just advising regarding the potential urgency of the situation based on the information provided.

      Veterinarian‐Client‐Patient Relationship: A legal relationship between veterinarian and animal owner in which the veterinarian has assumed responsibility for making clinical judgments and the clients has agreed to follow the veterinarian's instructions, the veterinarian has sufficient knowledge of the patient to make such judgments, continuing care is provided or available, the veterinarian provides oversight of treatment, compliance and outcome, and patient records are maintained.

MAIN CONCEPTS

      Telemedicine has had a place in veterinary medicine for decades, and yet changes in technology, and advances in human medicine, have changed the landscape in recent years. Regulatory changes, however, have not always kept pace.

      Human medicine functions on a different