Roark Larson App Blog (2)


Editor’s Note: Welcome to 2016 and a new year of fresh voices at the Dr. Andy Roark website! We’re kicking off the month with a look ahead at technology trends in veterinary medicine- the sort of thing most of us are used to being about five years behind on in our clinics. Does it have to be this way? Can we be more proactive about using these new tools in our practices? Today, Dr. Eli Larson explores the pros and cons of a new communication app in our brave new world.


Veterinarians are lagging behind with communication 


The days of calling and leaving a message are long gone, but veterinarians just haven’t gotten the hint. Two-way asynchronous communication is extremely common — e-mail, blogging, and text messaging are examples  — now the preferred means of communication in human medicine between patients and healthcare providers.


Unfortunately, veterinarians are lagging behind our human counterparts in client engagement. This form of communication will soon become expected amongst veterinary clients, so we need to not only understand what is available, but embrace this form of client engagement… before someone else does it for us.


There are common self-inflicted roadblocks many clinicians face when considering asynchronous communication, whether via a practice’s app, patient portal, or e-mail. Clinicians are concerned that the inbox will suck up their time, encourage unrealistic client expectations, fill up with frivolous questions, and act as an undue (non-compensated) burden. However, our clients want – and expect – this style of communication, so we need to find a way to provide it in a way that works for everyone involved.


The futuristic opportunity for veterinarians on mobile apps


A newer concept I ran across at the AVMA conference in Boston is a standalone app that allows licensed veterinarians to join a pool of clinicians and offer advice about pets to clients via an “e-mail” type interface. It also allows for chatting in real time. Basically, it allows veterinarians to fill a service void that clients want while still getting compensated for their time.



Here’s how it works. A licensed veterinarian signs up by taking a photograph of their driver’s license and veterinary license. Once approved, you create your profile by uploading a photo of yourself, selecting a specialty and species, and creating a short introduction along with a biography. The client base is nationwide, so your portfolio is necessary in order to generate clients.


Once set up, you get to choose when you’re available for e-mails or chatting. You also select a set price for their time. Now, I have not used the messaging function (I am rarely just “available”) but I have used the mail function. When a client decides to ask for my advice (and spends the money to do so), a push notification shows up on my phone. From there, I am able to view the question, some basic patient information, and decide if I am willing to accept this message or decline it.


Here’s what happened when I chatted with pet owners via an app


I chose to create my replies on my computer using a full size keyboard and then transfer them to my phone via Dropbox, but the app also offers a desktop portal. I send my response and, as long as the client accepts it, I get paid. The client also creates a “review” of their experience, for which I receive reputation points. The more advice I give, the more reputation points I get, the higher I’m ranked, and the more likely I am to be selected by clients looking for advice. Now I just sit back and wait for the cash to roll in, right?


Not quite.


American Pit Bull Terrier puppy isolated on whiteI have been active for about three months now and have had a grand total of 13 takers. At $4 per message, that comes to a whopping $52. Of that, the app gets 30% (hosting, facilitating, overhead, liability coverage, etc.) leaving me a total earnings of $36.40. When my total earnings hit $20, the app will directly deposit into my bank account. I’m not exactly going to quit my day job.




The great thing is, this app has the ability to fulfill a service that pet parents are looking for. If their local vets won’t offer this type of communication, they can find someone that will. And there are many benefits to veterinarians who wish to participate; however, there are also some concerns to consider (Table).


The good: An app like this allows an individual veterinarian to build their own brand name and help pet owners at their convenience through a unique telemedicine solution.


The bad: As with any new technology or paradigm shift, it can be difficult to predict negative outcomes. At the AVMA in Boston, the people behind the app told me that they received both encouragement and vitriol from veterinarians. In fact, the AVMA has created a committee to form guidelines regarding telemedicine, presumably to identify how much information can be given remotely without establishing a proper patient/client/doctor relationship.


Regardless of your opinion, it is clear that this style of communication is in demand. If your clinic is not offering some form of asynchronous communication – email, text, chatting, etc. –, your clients will seek advice elsewhere. I will continue to participate for now, but it’s worth noting that I feel like I am experienced enough in both communication and medicine that I can offer plenty of helpful advice without opening myself up to liability or their pets to harm.


Is veterinary telemedicine… legal?


Any veterinarian engaging in telemedicine like this must remember that it is unprofessional (not to mention potentially illegal) to prescribe or diagnose without a proper client/patient/doctor relationship.


To that end, I try to offer “specifically vague” advice. I specifically recommend clients visit their veterinarian to investigate problems more thoroughly and identify whether any medication would be appropriate. I may non-specifically mention classes of drugs that might be appropriate for a possible disease process while listing my common rule-outs to consider. I think this is a communication art form that you’d need to be comfortable with in order to prevent exposing yourself ethically, morally, and/or legally.



Telemedicine: benefits and concerns


Telemedicine through asynchronous communication is one of many new modalities that veterinarians can use to help pets. Applications like this make it convenient and easy for both the doctor and the client. I foresee an explosion in veterinary healthcare IT opportunities for the forward-thinking veterinarian; keeping an eye on the latest apps that facilitate this is a great way to stay on the cutting edge.


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Dr. Eli Larson is a 2004 graduate from Michigan State University College of Veterinary Medicine. Since that time he has been working as a companion animal clinician in Michigan and Wisconsin. Most recently he completed a Masters Degree in Medical Informatics hoping to use technology for improving the lives of doctors, clients, and patients.