Navigating the Legal and Ethical Landscape of Veterinary Telemedicine
- Dr. Zeke Zekoff
- May 1
- 2 min read
The Veterinary Virtual Care Association (VVCA) emphasizes the importance of clarity from state boards regarding the legal and ethical considerations of providing virtual veterinary care.
Key Legal and Ethical Considerations
Veterinarians engaging in telemedicine must adhere to the specific rules and regulations of their state, territory, or country. This includes compliance with the:
Veterinary practice act
Pharmacy act
Licensure and credentialing requirements
Record retention guidelines
Client confidentiality obligations
Relevant federal laws and regulations from bodies like the FDA, USDA, DEA, and OSHA
Veterinarian-Client-Patient Relationship (VCPR)
A clear definition of the VCPR is crucial for providing consistent guidance to veterinarians. When a physical exam is required, questions arise such as:
Does it need to be a "personally acquainted" exam, or can it be done by another vet, nurse, or technician within the practice?
Can a "physical" exam be conducted virtually?
How recent does the physical exam need to be to maintain a valid VCPR?
Does the exam need to be related to the specific condition being addressed in the telemedicine consult?
Standards of Care and Teleadvice vs. Telemedicine
State boards and veterinary experts need to develop clear standards of care for virtual care. It's also important to differentiate between "teleadvice/teletriage" and telemedicine.
Operational Considerations
Staff using virtual care should be properly trained.
Practices should ensure adequate staffing for telemedicine services.
Opportunities for appropriate telemedicine use should be identified, including preventative care, hospice care, client education, teletriage, care for underserved areas, and monitoring isolated patients.
Guidelines are needed for recommending in-person visits when telemedicine is unsuitable.
Licensing and Record Keeping
Clear rules are needed for establishing the VCPR and determining where a veterinarian must be licensed to provide telemedicine services.
Continuing education requirements specific to telemedicine should be established.
The need for licensure exemptions for veterinarians consulting from other jurisdictions to benefit an animal should be addressed.
Policies for integrating telemedicine platforms with data collection and monetization should ensure confidentiality, data security, and retrievability.
Medical records must include all patient-related electronic communications, past care records, and signed informed consent forms.
Practices must have written policies and procedures for documentation, maintenance, and transmission of telemedicine records, addressing privacy, personnel roles, hours of operation, permitted transactions, required patient information, archiving, and quality oversight.
Veterinarians should be aware of how their data is used, especially by third-party vendors, and can use anonymized data for various purposes.
Insurance and Client Communication
Malpractice insurance should cover telemedicine services.
Risks associated with virtual care platform vendors should be assessed, including data security and insurance protection.
Malpractice insurance may not cover practitioners treating patients in states where they aren't licensed.
Client communication should be timely and professional.
Client consent forms must include details about the client, patient, practitioner, telemedicine introduction, record keeping, liability clauses, client rights, privacy, ongoing care plans, and complaint procedures.
Prescribing
Veterinarians must determine state-specific requirements for in-person exams before prescribing via telemedicine.
All prescriptions issued through telemedicine must comply with jurisdictional and federal laws and standards of care.
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