Virtual reality

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Businessman having video conference.Online consultations have great potential to improve patient care and some Australian practices are already offering an online service for their customers. Sue Nelson finds out what are the potential benefits for more conventional practices

The Internet has become far more than a marketing tool—for many veterinarians, it is where real-time consultations actually take place. Better camera technology and increased broadband speeds have made online consultations not only viable, but in many cases more convenient than
face-to-face appointments.

For some vets, online consultations are borne of necessity, helping them overcome the tyranny of distance. Dr Susanna Samuelsson lived in remote Arnhem Land for 10 years and owned the vet practice there for six. “We would often see people from within the communities—nurses, teachers and police who needed vet care for their pets—so we started Skype consulting with good results,” she says. When she moved from the town, she continued to provide the service.

For other vets, online consultations are a way of educating clients and increasing goodwill. Dr Liz Chmurycz decided to offer an online consultation service to bring people’s awareness back to the existence of vets as the experts in the field.

Dr Chmurycz says that she has encountered a lot of misinformation on the internet around animal health. “People were asking their breeder, their friend’s second cousin who did a week vet nursing in year 10, or someone who has simply owned many animals-. They felt like these must be the experts.

“Asking a vet is usually a last resort for many pet owners. I think that is sad. I set up online vet consults to encourage people to think of vets first, not last or never,” she says.

Dr Samuelsson’s remote online practice has grown considerably. For pet owners in these areas, the access to online consultations for non-life-threatening ailments is invaluable. “Quite often the owner’s pet will have an ailment such as itchy skin or arthritis that isn’t so pressing that the dog needs to be chartered out on a plane to the nearest town. We can give them help via the internet,” she says. “We can send out medications or email prescriptions for them to fill at the chemist. Sometimes, people are unsure of how severe the problem is and want advice on whether their pet needs to be transported. It is mostly peace of mind.”

“I set up online vet consults to encourage people to think of vets first, not last or never.” Dr Liz Chmurycz, Russell Vale Animal Clinic veterinarian who also runs an online consultation service

Both Drs Chmurycz and Samuelsson have also found there’s an overseas market for online consultations. Dr Chmurycz helps pet owners in the Philippines and Egypt. “A lot are ex-pats who have adopted a pet but can’t access local vet care,” Dr Samuelsson says. “We recently had a lady who was working in rural Mexico and had a dog with a skin condition. She tried to take it to the vet and they washed the dog in washing powder and painted it in ‘blue stuff’. Her Spanish wasn’t very good so she didn’t know what it was. But we were able to help her via the internet. Other clients have come from India, Austria, Mozambique.”

But assessing and diagnosing animals remotely has its challenges. “The important thing to remember is that a consultation online is totally different to the face-to-face consult in a vet hospital,” says Dr Chmurycz. “We do not have the luxury of ‘tone’ or asking lots of questions to get clarification of the problem. We do not have the essential part—physical examination of the pet, which is crucial for correct assessment.”

“Obviously, helping people via Skype is never the same as touching and listening to the animal,” Dr Samuelsson says. “The owners are very understanding of this and are just grateful for help.

Owner education is the key to a successful online practice. Dr Samuelsson uses a number of ‘how to’ videos that help the owners gather information for her, such as feeling for a pulse or heart beat, taking temperatures and, for the brave, how to put a needle in a lump, to identify whether it’s an abscess or something that needs a biopsy.

A number of sophisticated smartphone apps can help pet owners to record information about their pets ailments. “There is a smartphone device that will attach as a stethoscope,” she says. “This records the sound of the chest and can then be emailed to me. It’s a great investment for someone who has a dog with a heart condition.”

Of course, the better the technology, the better the ability to diagnose accurately. Arlo home security camera technology, recently introduced in Australia, promises to make online consultations easier from the patient end.

Arlo uses high definition lenses, night vision and motion sensing, allowing users to monitor their pets in real time while they are away from home. “Just set up the camera in out-of-reach areas where your pets have access throughout the day,” says Brad Little, vice-president and managing director of Netgear Australia/New Zealand, the company that produces Arlo.

“If pet owners feel there is something of concern—a foreign object that was eaten, food or water not being consumed throughout the day, or if there are behavioural concerns captured in the footage—the owner can alert their vet and share the video.

Arlo home security cameras can be used to monitor pets.
Arlo home security cameras can be used to monitor pets.

“Sometimes these instances are missed and unnecessary time is lost in diagnosing the issue. In some cases, this can be critical to the survival of the animal. Having access to live online footage allows your vet to see any patterns in behaviour, evidence of injury, or can trigger ideas for further explorations as they undertake a physical exam.”

The question of what to charge for online consultations is vexed. It depends on the level of service you can provide, and what you’re trying to achieve in offering the service. “We absolutely and unashamedly charge the same consult fee as we do in hospital,” says Dr Samuelsson.“It is not easy to be able to give good practical advice and pick up subtle problems visually via the internet. We need to provide good support to our clients with hand-outs and videos so we know that there has been a good understanding of what they need to do. Also, we do not want to discourage people from using a vet service in a clinic by providing a cheap alternative.”

Dr Chmurycz doesn’t charge for her online consultations; she sees them as a goodwill service. The difference is that she doesn’t offer remote diagnosis. She has very specific rules about the advice she can offer but the same principles apply. “Owners want to feel connected to a vet so we need to make it easy for them. Many pet owners take advantage of that, and are thankful to know that we are there.”

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