NAVC KEYNOTE COMMENTARY • These pet owners probably use smartphones and other electronic tools to manage much of their lives, including personal medical care. However, 48 states forbid a veterinarian from attempting to engage an owner through electronic tools, or vice versa, without a VCPR in place. • Once again, the pet’s health care goes unattended since the pet owner already has decided against visiting the clinic. The result? The VCPR serves as a wall , rather than a door into the world of veterinary health care. Does this make sense? IF WE WANT IT, WE CAN HAVE IT All we need to do is follow the lead already set in place by human telemedicine and learn from their lessons. It really is that simple. State veterinary medical boards can walk across their state capitols and consult sister state medical boards. The AAVSB can reach out to its sister FSMB and the ATA. These organizations have worked through the issues and created templates we can adapt with relatively little effort. The veterinary profession in each state may partner with its state veterinary board, and nationally with the AAVSB, to initiate task forces and implement appropriate regulations in relatively short order, if we want to . It’s not a matter of complexity, but of interest or willpower. I can hear skeptics howling that it’s not that easy. It actually could be—we don’t have to start from scratch—but, of course, there will be work involved (and some need for lawyer/lobbyist services). And the argument we often hear—that veterinary medicine is different because pets cannot speak for themselves—does not hold water since a large share of human health care involves pediatric patients who cannot articulate their conditions or symptoms. Forty-seven states now allow a human doctor–patient relationship to be created through telemedicine. You can be assured that virtually every state resisted this when the process started decades ago, but experience, shared learning, and consumer familiarity with electronic technologies and devices changed people’s minds and opened up state medical HUMAN MEDICINE LEADS THE WAY If you’ve read this far, then you’re scratching your head, wondering how many lobbyists or lawyers (favorite professions of this author) are required to fix the problem. However, I’m pleased to say very few, thanks to human medicine. Lawyers and lobbyists, with doctors, have been busy for 2 decades in human health care arenas, working through the exact issues facing veterinary telemedicine: • Doctor–client relationship: Can this be formed via telemedicine? Yes , in 47 states. • Multi-state licensure: Can state boards still require the treating doctor to be licensed where the patient resides? Yes , although some states are more flexible. • Online prescriptions: Is a doctor–client relationship still a requirement? Yes . • Informed consent: Can state boards require that a client consent to being served through telemedicine? Yes , although some states do not require this. • Privacy/security: Can state boards require that telemedicine adhere to the same requirements as in-person examinations and treatment? Yes . • Standards of care: Are they the same for telemedicine as for in-person examinations and treatment? Yes . Supplemented by FSMB and ATA resources, the states have learned from each other and, subsequently, all 50 have developed some level of telemedicine laws and regulations. Most important, human health care treats telemedicine as a staple of health care delivery. State of Telemedicine In human medicine , Texas, Alabama, and Arkansas are the most conservative states, with limited telemedicine privileges. In veterinary medicine , Connecticut, Alaska, and D.C. have no VCPR rules and may be more flexible with regard to telemedicine privileges, but telemedicine is not being actively practiced in any state beyond consultations between veterinarians. continued on page 116 JANUARY/FEBRUARY 2017 ■ TVPJOURNAL.COM 111
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