In the interest of protecting the health, safety and welfare of the public, the Oklahoma State Board of Veterinary Medical Examiners (Board) at its regularly scheduled public meeting on October 5, 2018, approved issuing this position statement regarding Telemedicine/Telehealth. It is the position of the Board that veterinarians should use the following guidelines regarding the use of Telemedicine/Telehealth in their veterinary practices. (American Association of Veterinary State Boards, AAVSB)
A veterinarian using telehealth technologies must take appropriate steps to establish the VCPR and conduct all appropriate evaluations and history of the patient consistent with traditional standards of care for the particular patient presentation. As such, some situations and patient presentations are appropriate for the utilization of telehealth technologies as a component of, or in lieu of, hands-on medical care, while others are not.
Pursuant to Title 59 O.S. §698.2 (13) “Veterinarian-client-patient relationship” means when: a. the licensed veterinarian has assumed the responsibility for making medical judgments regarding the health of an animal or animals and the need for medical treatment, and the client, owner or other caretaker has agreed to follow the instructions of the licensed veterinarian; and b. there is sufficient knowledge of the animal or animals by the licensed veterinarian to initiate at least a general or preliminary diagnosis of the medical condition of the animal or animals in that: 1. the licensed veterinarian has recently seen or is personally acquainted with the keeping and care of the animal or animals, or 2. the licensed veterinarian has made medically necessary and timely visits to the premises where the animal or animals are kept or both, and c. the licensed veterinarian is readily available for follow-up in case of adverse reactions or failure of the regimen of therapy, or has arranged for emergency medical coverage, and d. the licensed veterinarian’s actions would conform to applicable federal law and regulations;
Telehealth is a reasonable option for patients who lack regular access to veterinary care. It also enhances opportunities to access emergency or specialty veterinary expertise in geographic areas where no other options are available.
The veterinarian accepts that he or she cannot prescribe drugs when practicing via telehealth alone, unless the veterinarian has sufficient knowledge of the animal or group of animals by virtue of a history and inquiry, and either physical examination or medically appropriate and timely visits to the premises where the animal or group of animals is kept.
Appropriate medical records must be maintained in a secure and confidential manner. The medical record should include, but not be limited to, if applicable, copies of all patient related electronic communications, including prescriptions, laboratory and test results, evaluations and consultations, and instructions obtained or produced in connection with the utilization of telehealth technologies.
An animal owner should be able to seek, with relative ease, follow-up care or information from the veterinarian (or veterinarian's designee) who conducts an encounter using telehealth technologies. The veterinarian must ensure that the client is aware of the veterinarian's identity, location, licensure status, and the privacy and security issues involved in accessing veterinary care via telehealth technologies. Evidence documenting appropriate animal owner consent for the use of telehealth technologies must be obtained and maintained.
A veterinarian must be licensed, or under the jurisdiction of, the veterinary board of the jurisdiction where the patient is located. The practice of medicine occurs where the patient is located at the time telehealth technologies are used. Veterinarians who treat or prescribe through online services sites are practicing veterinary medicine and must possess appropriate licensure in all jurisdictions where patients receive care.
Consultation is not considered telehealth and means when a licensed veterinarian received advice in person, telephonically, electronically, or by any other method of communication from a veterinarian licensed in this or any other jurisdiction or other person whose expertise, in the opinion of the licensed veterinarian, would benefit a patient. The licensed veterinarian receiving consultation maintains the veterinarian-client-patient-relationship.
These guidelines should not be construed to alter the scope of practice of any veterinarian or veterinary technician or authorize the delivery of veterinary medical services in a setting or in a manner that is not otherwise authorized by law. These guidelines support a consistent standard of care and veterinarians and veterinary technicians must review and understand the laws, regulations, and policies of each jurisdiction where they practice. The veterinarian must employ sound professional judgment to determine whether using telehealth is suitable each time veterinary services are provided and only furnish medical advice or treatment via telemedicine when it is medically appropriate.
This Position Statement is issued as of the 5th day of October 2018, by unanimous approval of the Board members.
Oklahoma State Board of Veterinary Medical Examiners
Clint J. Gardner, DVM, Board President