Position Statements

Telemedicine

August 6, 2021

Telemedicine and its application to veterinary medicine is a highly dynamic area that is continually evolving. The Canadian Veterinary Medical Association (CVMA) will endeavor to keep this document current, however readers are advised to contact relevant provincial or territorial regulatory bodies for the latest information on policies and regulations within their jurisdictions.

Background

1. The definition of telemedicine accepted by the CVMA and the Canadian Council of Veterinary Registrars (CCVR) is: “Telemedicine is the provision of specific veterinary medical advice and veterinary treatment of an animal(s) based on the remote diagnosis of disease and injury by means of telecommunications technology where no physical examination of the animal(s) by the veterinarian takes place. It does not include consultation between veterinarians where colleagues in different physical locations consult remotely with each other, or the provision of general, non-specific, advice.” (1)
2. Telemedicine is a tool that complements the delivery of in-clinic or on-site veterinary medicine in order to expand a veterinarian’s ability to provide care to animals. It cannot completely replace many important aspects of “hands-on” practice including physical examination, conducting certain diagnostic tests, administering treatments, among others. While telemedicine can help provide veterinary services to clients unable to visit a veterinary clinic due to factors such as remote location, illness, transportation issues, anxious animals, or family situations, among others, it cannot and should not be a long-term or permanent substitute for in-clinic or on-site veterinary medicine.
3. There are multiple ways that veterinarians can offer telemedicine including, but not limited to, telephone, email (text, videos, pictures), live video streaming, online communication platforms (e.g. Microsoft Teams, Zoom), and specialized telemedicine applications.
4. A valid veterinary-client-patient relationship (VCPR) is required before a veterinarian practising in Canada can engage in telemedicine. Each provincial or territorial regulatory (licensing) body in Canada defines the parameters around the establishment of the VCPR within their jurisdiction. Some jurisdictions permit the initial VCPR to be established virtually while other jurisdictions require the initial VCPR to be established through an in-person visit. (2)
5. Terminology that can be encountered with respect to the applications of telecommunications technology in veterinary medicine include:
   • Telehealth: a global overarching term that includes all uses of technology aimed to deliver health information or education via remote means. Telemedicine is a branch of telehealth where a valid VCPR exists.
   • Teleconsultation: a consultation using telecommunication that takes place between a consulting veterinarian and an attending veterinarian who is seeking advice. An example of this is discussing a medical case with a specialist such as a radiologist, pathologist, internist, or another colleague. Teleconsulting is not telemedicine, and the attending veterinarian is responsible for all information gathered using teleconsultation.
   • Teletriage: providing of general medical information by a veterinarian or veterinary clinic staff member (such as licensed veterinary technicians) that is not intended to specifically diagnose or treat an animal. It is information given to facilitate prudent care, such as the need for yearly examinations, screening of certain diseases, and recommending that pets see a veterinarian as soon as possible. Teletriage is regulated by provincial or territorial regulatory bodies. (2)
6. Prospective clients of telemedicine should be aware that veterinarians providing telemedicine services may not necessarily be licensed to practice in a client’s province or territory. Such situations can result in challenges should a complaint arise. In the case of a complaint against a veterinarian licensed in a Canadian provinces and territory, regulatory bodies can work together to address the matter. However, clients should be cautioned that if the veterinarian is not licensed by a Canadian regulatory body, lodging a complaint may not be possible or productive. In addition, standards of training and practice standards for veterinarians who are licensed outside of Canada may not be at the same level as those found in Canada, thereby potentially putting clients’ animals at risk.
7. Not all jurisdictions in Canada permit veterinarians to prescribe and dispense medications through telemedicine alone.
8. Prospective clients of veterinary telemedicine should refer to provincial or territorial regulations concerning telemedicine. A list of provincial regulatory bodies can be found on the CVMA website. (2)

References

1. Canadian Council of Veterinary Registrars (2020). National Policy Statement on Telemedicine. (unpublished) Personal communication.
2. Canadian Veterinary Medical Association. Canadian Regulatory Bodies. https://www.canadianveterinarians.net/resources/regulatory-bodies. Last accessed April 2021.