Using Veterinary Telemedicine (VTM) in the time of Covid-19
Blog by Professor Jacky Reid BVMS PhD DVA DipECVAA MRCA MRCVS, MD of NewMetrica
Veterinary professionals all over the world have continued working throughout global lockdowns to provide essential care for companion animals. While adhering to strict social distancing requirements, they have successfully adopted teletriage and telemedicine practices to allow them to work effectively and remotely.
Going forward, I am confident that the use of technology in treating companion animals will increasingly become the “new normal”. Reducing client contact and using technology wherever possible to triage clients is fast, efficient and is developing in tandem with similar practices in human medicine.
As countries begin to ease out of lockdown, the use of telemedicine will also contribute to limiting the chances of a second wave of COVID-19, by allowing veterinary patients to be remotely assessed and monitored. As good things come of bad, the current situation has already accelerated the pressure to develop new and better solutions.
For some, especially cat owners, a trip to the vet can be extremely stressful for both animal and owner. Historically those living in rural communities may also have found trips to the vet challenging, but the use of telemedicine can alleviate these pressures. Through increasingly smart technology, vets can support owners in the comfort and safety of their own home.
Increasing understanding of telemedicine
A recent study, which examined the use of veterinary services in the United States, indicated that the availability of telemedicine was not ranked highly by dog and cat owners as a factor in selecting veterinary care. This was however concluded pre-COVID-19. (Bir et al, 2020).
Since then, veterinary practices have had no choice but to optimize procedures for telemedicine. The pandemic has necessitated finding new solutions in the care of companion animals, whose role has never been more important to owners in self-isolation.
Several online, on-demand consultants report significant increases in companion animal owners using video-on-demand veterinary services. There has also been an uptake in app users, respectively, between February and March, due to social distancing guidelines and lockdowns across the UK (Walters, 2020).
How NewMetrica products can help
NewMetrica’s online, health-related quality of life (HRQL) measurement tool (VetMetrica) provides a useful addition to the suite of tools a practice can use to monitor animal patients.
VetMetrica has been developed, using best practice in human healthcare measurement, to assess the HRQL of both cats and dogs. In human healthcare, HRQL measures are used to determine how the patient feels about his/her treatment and is considered very important. VetMetrica HRQL products are specifically designed to measure how an animal “feels” about its circumstances from its individual perspective and provides both the owner and the vet with a measure of health & wellbeing, specifically targeting the impact of any chronic disease including chronic pain.
The tool features a short, owner-based questionnaire designed and validated for completion in the pet’s home environment. An owner can regularly complete the questionnaire in less than 5minutes, helping to improve a virtual consultation by providing longitudinal measurements since the previous “visit” with the patient.
The questionnaire is designed such that owners can not leave blank questions, and they receive reminders to answer their questionnaires at intervals set by the clinician, which has been shown to greatly improve uptake & compliance.
Andy Armitage of Greenside Veterinary Practice in UK, who specialises in regenerative medicine, said that using VetMetrica over a period of 18 months, “Revolutionised how I monitor patients and collect data to assess treatment responses, specifically when monitoring patient responses to new procedures, treatments and optimising protocols.
“VetMetrica’s real time monitoring allows for early identification of problems, leading to quicker intervention. The results can be also used to monitor responses to treatment and help guide owners’ decisions ”. You can read the full testimony from Andy HERE.
Supporting continuance of clinical trials
In addition to its use in veterinary practice, NewMetrica’s HRQL tools offer similar gains in a research environment, as CROs and pharmaceutical companies aim to continue trials in the face of the pandemic.
A recent report (McDermott et al., 2020) emphasised the importance to human clinical trials of outcomes that can be collected remotely during the COVID-19 pandemic, suggesting that their use should be continued in future clinical trials and that those previously collected in person, such as questionnaires, should be converted to remote administration.
VetMetrica is already commonly used as a remote outcome measure in veterinary clinical trials, where the results have been promising. You can learn more about his HERE.
These are all concepts brought into sharp focus by the onset of the current pandemic. If you wish to discuss how validated NewMetrica products can assist your practice or clinical trial, please contact michael.maltby@newmetrica.com
Definitions:
Teletriage: Patient triage by phone or use of technology prior to diagnosis or treatment
Veterinary Telemedicine (VTM): veterinary telemedicine is the use of technology such as phone, email, or video conferencing to provide veterinary care including diagnosis and treatment without being physically present with the animal or owner.
References
Bir, C., Ortez, M., Olynk Widmar, N. J., Wolf, C. A., Hansen, C., & Ouedraogo, F. B. (2020). Familiarity and Use of Veterinary Services by US Resident Dog and Cat Owners. Animals, 10(3), 483.
BSAVA & RCVS Joint statements, 2020
McDermott MM, Newman AB. Preserving Clinical Trial Integrity During the Coronavirus Pandemic. JAMA. 2020;323(21):2135–2136.
Waters, A. Telemedicine services thrive during Covid-19. (2020) The Veterinary Record, London Vol. 186, Iss. 12.
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“I have been using VetMetrica for over 18 months now and have found it has revolutionised how I monitor patients and collect data to assess treatment responses. I have been using regenerative medicine to treat dogs and cats for over five years for a number of degenerative conditions such as osteoarthritis. As this treatment is new, I wanted to monitor responses to treatment to help develop protocols and best practice. I have been able to use some of this data to publish my results to promote awareness and efficacy of this novel treatment option. Initially, I was using owner questionnaires such as the canine brief pain index (CBPI), Liverpool osteoarthritis in dogs (LOAD) and the Helsinki chronic pain index along with measuring quantitative data and veterinary assessments. I soon found that these paper based questionnaires had their limitations. Commonly people were not able to answer all the questions or felt unqualified to do so. Incomplete questionnaires were useless and could not be used and getting owners to complete the forms and return them was a logistical nightmare. This resulted in missed data points and many cases did not continue to fill in the questionnaires after treatment. A lot of my time was spent chasing up these clients. My veterinary assessments and quantitative data were showing massive improvements but in many cases, I did not have sufficient validated owner reported treatment outcomes to compare with my findings. The power of my findings were therefore affected as my trials were not placebo controlled and double blinded, something that is very difficult to achieve in a clinical practice. I tried different questionnaires to see if I could get a better response rate from the owners but all had the same issues.
When I first heard about VetMetrica, I thought it may be the answer to my problems with owner reported outcomes. I found the team at NewMetrica very approachable and encouraging. Professor Jacky Reid gave me lots of advice on how VetMetrica could be set up and used in clinical practice and how its design would assist in complete questionnaires being returned and how the data could be analysed. VetMetrica had many advantages over the other questionnaires that I have used and it had been validated for osteoarthritis in dogs. It was very easy to set up and NewMetrica trained one of my colleagues to use the tools which was intuitive and easy to follow. The online questionnaire was appealing and its design made it impossible to leave a question unanswered so we no longer received partly completed questionnaires. All the data was instantly uploaded to give a health related quality of life score and this was easily graphed to track changes in various domains over time. This gave me great owner reported outcome measures for my data collection at the same time as I was collecting the veterinary assessments and quantitative data. I could view this data during my consultation and discuss with the owner how the dog was getting on in the home environment. Due to the owner email reminders, compliance was greatly improved and the software flagged any questionnaires that were due to be completed but that had not been. We could then chase these up with a quick phone call reminder and in most cases this was sufficient to ensure completion. I now have hundreds of animals enrolled on VetMetrica and this is providing a great window into the animals quality of life and how it feels in its home environment. This has enable me to better care for these patients and also collect good quality validated data for future publications. I cannot recommend VetMetrica enough and it has applications in clinicial practice as well as a research tool. Its real time monitoring allows for early identification of problems leading to quicker intervention and the results can be used to help guide owners decisions and monitor responses to treatment.” – Andy Armitage, Greenside Vet Practice

“I found that a computer based scale run by Newmetrica… the same great people who gave us the Glasgow Pain Scales… is a wonderful way to get reliable quality of life scores. You can find it here at http://www.newmetrica.com/vetmetrica-hrql/. It generates a non-biased decision using a computer algorithum. Answers are weighted differently so it is harder for the caregiver to subconsciously manipulate the outcome. And they cannot go back and change their answers like they can on paper form” Dr Mike Petty

“Firstly I want to congratulate you and your team on the important work you are doing in the field of pain assessment and in particular the NewMetrica HRQL tool which I think is a real game changer!” – Leon Warne.
