Excellent, so let's get started and well we've got a few more people joining us as we get started, so. Thank you very much for you all joining us here today for our two lunch and learn discussion panels on veterinary telehealth. We're very excited to be discussing remote consulting in 2020 and beyond with 10 of our industry's leading experts.
We split today into two separate sessions, each with 5 panellists, and a big thank you to the webinar vet for hosting this webinar, the recording. Will be available for 2 within 24 hours afterwards. We're going to have a short break at 1:30 to allow us to change our panel over for a prompt 1:40 start for the second session.
If you have any problems, please pop them in the chat box. And I'd like to start now with three quick poll questions, and one longer open answer question for the Q&A box, so. Please, pop your answers in the the Q&A box and keep problems in the chat box.
Dawn and Sophie from Webinar Vets are very kindly managing that for us, and my colleague and practise manager Tan from First Vets will be managing the Q and A box. At the end of the session we'll take some questions, and any questions we don't get to, we will follow up directly with afterwards. We know that the past year has been a hugely challenging time for everyone across our profession.
And today we're going to focus on two things. Firstly, we'd like to share and reflect on the learnings from our collective experiences so far. And secondly, we'll look ahead to what the future of Vetmary Telehealth might hold.
These experiences have provided a fantastic foundation on which we can all continue exploring veterinary telehealth. Our first panel is going to focus on the clinical side of telemedicine. And our panellists are Chris Toughnell, Ellie Russell, Eve Hanks, Sarah Caney and Vanessa Nicola.
In a moment, I would like to ask our panellists to introduce themselves by way of the first question, which is directly related to their personal, professional backgrounds. So what is remote consulting? We know that remote consulting has meant something different to everyone over the past year.
So I'd like to start by asking each of our panellists to share what telehealth means to them and what their experiences are, please. Jessica, do you want me to jump in and answer that question while Chris is trying to his, his audio? That's fine.
So, to introduce myself, I, my background is I'm a small animal vet, worked in a variety of different practise settings for sort of over 15 years. But I now kind of have 22 hats, which I guess are, are relevant to what we're gonna be talking about today. I work as part of the BDS training team, particularly in our sort of communication training, just really trying to support and help veterinary professionals to communicate in a way that helps them deliver great care, but also enjoy their work.
And my other hat is that I'm a PhD researcher researching communication and how that affects the safety of the care that we deliver to our patients. So, I think for me, telehealth is really all about how we create a sort of collaborative team approach to bringing all the veterinary professionals and all the veterinary team members, into how we deliver care to patients, but also how we bring, clients into that as well. So, I see it as really an opportunity to build strong relationships between veterinary professionals and clients, so that we can kind of all maximise our, you know, different inputs to deliver the best care and get the best outcomes for, for our patients.
Not hand over to, I don't know whether Eve is gonna, Eva's gonna come in next. I certainly can, Eli, thanks very much. So I'm Eve Hanks, and I've been a vet for 10 years now.
And similar to Ellie, I've had a little bit of a patchy career in the sense that I've also done a PhD, and I work currently, in clinical practise. I work in research and I've got a biotech startup company as an entrepreneur as well. So my clinical background actually encompass all species, including small animal medicine.
And telehealth came into my clinical life about 2 years ago now, so I'm a pre-pandemic physio vet, and generally when this first offered itself as an opportunity to me in terms of work, I was positive about the concept because I think we can all in practise recognise that access to veterinary care was likely to change with improving technology. However, I think for me the extent to which the service was well received was actually quite a surprise. And of course, global pandemic assists in enabling change, but even before lockdown, the eagerness of clients to engage with this was really humbling.
So for me, I would say that telehealth makes for a superb working environment, but it also raises some questions about our current care infrastructure as well. Thanks Eve, Vanessa, would you like to go next? Yes, of course.
So my name is Vanessa. I'm, I'm a small animal vet. I've worked for 20 years in a veterinary hospital environment, and I've got a certificate in ophthalmology, so seeing first opinion and referral cases, really, I'm currently one of the directors of the YD Veterinary centre, and, before the pandemic, I would say we were sort of in the process of Making our hospital a little bit more digitally aware.
So you know, changing our PMS system, using online booking process through Vitoria, and you know, doing sort of modernising our way of delivering a good service to our clients, . We were using a specialist telemedicine service through VDS as a referral system, but we were not offering yet sort of telemedicine to our clients. So it's really the pandemic that threw us into offering video consultation.
Lucky on that that front, and then we started really, delivering a large number of video consultation during the first lockdown. So it's been a steep learning curve in terms of, you know, what type of consultation to triage that way, the, the, the slight issues that we come across, but it's been a very interesting way of, first of all, keeping, keeping some kind of revenue at the beginning, keeping the clients obviously delivering the the service that we wanted to them. Helping the team on the ground who was obviously overworked and overloaded with cases, but actually through that we kind of discovered that there was definitely a future for the video consultations and you know, something that we could definitely learn from and and start using going forward.
So it's been a very interesting sort of Period, really, with lots of, of, of lesson learned, but it's, yeah. That's kind of the, the, the main experience. Great, thank you, NASA.
Sarah, would you like to go next? Hi. So, my name's Sarah Kaney.
I'm a UK based, Scottish-based, feline specialist. And, I've had a long standing interest in, remote consulting, which to me, to answer that first question, is basically anything where you're not in the same room as your client that has an impact on pet care. So, actually about 1012 years ago, I started offering telephone referrals to cat owners that wanted specialist advice and support wherever they were based in the world.
And now I tend to do that via Zoom, but, basically, the principles, really are that actually, it's just for me, the, that sort of auditory route is the Is the major route through which the useful data is coming, as I'm sure we'll talk about in the other questions. And I found it a really rewarding experience for me as a clinician, but also very much appreciated by the cat owners, and of course, a huge thing for cat owners, which all of us will also appreciate if we have cats ourselves, is the massive stress associated with taking your cat to the vet, whoever you are. I'm sure you can identify with that if you have a cat yourself.
And it's stressful for the cats, but it is very stressful for the owners. So, I love the idea that remote consulting can can be of sort of multiple benefits to the patients and their carer. Thank you, Sarah.
Chris, how is your? I do, can you hear me now? I hope you can brilliant, sorry about that.
So my name's Chris Tonell, I'm a, equine practitioner from Newbury in Berkshire, but our practise is 50% equine and 50% small animal. I I'm also on the council of RCVS and I'm the council lead for Vivet, which is, the RCVS network for veterinary innovation. As far as I'm concerned, I'm right with Sarah that that that remote consulting is anything that is not done face to face and so essentially it's it it it dates back from the early days when they might have sent you a postcard or a letter or sent a messenger, and then really set.
Off and started going when the telephone became came into common use and and obviously our predecessors were sat on a landline for for a good length of time, but they were definitely remote consulting back then so it's the technology is obviously enhanced and and this pandemic has driven. The, the sort of implementation of the technology ahead, very quickly with video and picture, but I still, I, I, I agree with Sarah that I think that the, the richness of the information is probably mainly auditory at the moment and certainly. For me, what telehealth, teleconsulting, remote consulting means is, is filling in the gaps that in that sort of continuum of care from er the owner's initial concern to hopefully a successful outcome for the animal.
Excellent, thank you, Chris. So from the first poll, we can see that 61% of people, in the audience have been using remote consulting during the past 12 months, and the 39%, so they haven't. So I'd like to ask.
Everyone next, where do you seek further resources and support on remote consulting? There's, there's a few options to choose from. And while people are considering that, I'd like to come to Ellie for the next question first, please.
. The VDS training have had a lot of informal dialogue over the past 12 months with vet teams on, you know, the current challenges that people have been experiencing amongst practise teams. And I think these will resonate with people, in the audience. So firstly, practises have felt overwhelmed.
Secondly, they've felt disconnected from their clients and their clinics. And thirdly, they've struggled with rapid change management and mobilising their teams. We know that from a virtual veterinary care association poll from the US last week, some of the most, the biggest concerns from teams, over there, the biggest, the biggest.
Area would be the regulatory framework, and then also, the, practise team and the client's perspective. So Ellie, I wonder if you could share, how remote consulting can meet some of these challenges and support teams on the ground. Yeah.
So I think, you know, I would echo kind of what Chris and Sarah say that I think sometimes it's how we're thinking about it as something new and different, rather than recognising it as something that's sort of been a part of our practise in different ways for, for sort of a long time. And I think that, you know, the, the pandemic has, has been. The sort of two sides to the coin, I think, in terms of remote consulting, that for some some practises, it's removed some, some things that they'd imagined might be roadblocks that they've discovered, haven't been, and it's enabled them to start integrating different ways of connecting with clients that perhaps they already wanted to, and that's been really successful.
But for others, it's felt like something that, that's been done to them, and that they've had to start remote consulting, in a different way. And certainly, you know, speaking to, vet teams about the challenges of. Consulting, it's quite common for them to have relatively negative experiences of, of, of doing that.
And they're scared that they're going to make a diagnostic error, and that they're kind of gonna get into trouble for that. So I think there's, there's a, a danger that they're, you know, having Made these changes at pace during the pandemic that people have had experiences that they maybe wouldn't have had had they been proactively integrating telehealth and telemedicine as a choice. And, you know, one of the biggest things that we hear a lot is, You know, we don't have time and practise to stop and reflect on how we're working, and we don't have sort of time to make changes.
So I think there's a real challenge there for telemedicine and telehealth to Articulates the benefits for veterinary teams in making these changes in terms of improving workflows, providing different sorts of, of working, different working patterns, but also to provide some support. Important and help to give teams the time, the space to look at it as a proposition and work out how it's going to help make their jobs easier and help make the service for their clients better and the quality of, of care better. So I think there's lots of opportunities, but lots of, of challenges, that, that, you know, that are there.
Thanks Ellie. Chris, I wonder whether you have er some further thoughts to share on that. Yeah, I I I think that when you concentrate on what the job is that we're trying to get done here, then you can see that the lines are very much blurred between what we can do with remote consulting and what we can do face to face and, and it is, it's this continuum of care and there's an opportunity with remote consulting in all its forms to.
To increase the contact between the veterinary practise and and the client and therefore the animal and and that leads to all sorts of things. It it generally leads to better outcomes for animals because we're able to pick up on problems as they develop or, or. Quicker, and it definitely leads to better satisfaction for those involved with the care because we feel that we're more in touch and and and more able to offer that personalised service we want to offer.
And, and that sort of brings me to one of the points that actually. As with all cases, at the moment we're, we're, we're scratching the surface of what I hope will be possible in the future in terms of that continuity of care through technology, but at the moment most of us are aware that that that continuity is best provided if the people involved are the same people because it. And however much you put onto the computer and however much data you seem to record, it's never quite as good as the human capturing machine of capturing colour and sound and smells and and and all the nuances of of of the consulting consulting room.
So to me it it it fills that gap, but . It, it's hugely, it's made hugely easier if there is remote information, so I, I, I guess there's been a lot of stress on practises that have all their data on servers at the practise base and and it's difficult to access them. We, we've got a cloud based practise management system which has been a huge benefit when we're trying to deal remotely with people because we can access the data very quickly.
But. I, I, I, I think that it's interesting listening to Ellie talk about how uncomfortable some people might feel with it and and threatened maybe by the the concern of of not having enough information. And this is where I think it comes down to the individual professional dealing with with the case.
E each case has its own complexities and and and difficulties, and if there's a minimum database of information that we need. Before we're able to make a clinical decision, we need to feel comfortable as a professional that we've received that minimum database of information and we're not being pushed in to make a decision. And if that means driving, driving us to see the animal physically at the moment, then that's what it means.
But that minimum database can be satisfied. More and more as this technology advances, because as we were talking earlier, when we just had the telephone call and we didn't have video and pictures, we didn't have all the data that we can receive that way. And and as we advance.
Further, that the ability to achieve that minimum database remotely will, will increase. So, so everything's going to evolve, but I do think it's really important that the individual professional is is comfortable with making the decisions that they're being asked to make. Yeah, it's a really good point, and I think it ties into quite nicely where the audience have indicated they look for further support and resources on remote consulting.
So 22%, have said that they'd look to the RCVS, 13% to the BVA, 8% on social media, Facebook, and 5% on LinkedIn. A huge proportion, over 50% say others, so it would be great if you could share in the chat box where else, in the audience you, you look for this support and information. Vanessa, I'd like to understand more about how how veterinary telemedicine is supporting your team in your practise.
Right, so I think there were, you know, several points we could make here. I mean, obviously at the beginning of the lockdown, it supported the practise financially because suddenly we, you know, we were not able to see most of our clients, so it did allow us to carry on, just carry on working. It obviously supported the team on the ground just by having an excellent sort of triage elements to it, .
And you know, while we were obliged to see pretty much anything that wasn't dying through telemedicine, it sort of very quickly became clearer to us which cases were appropriate to do by telemedicine and which cases were less so. And you know, as the pandemic developed further, we kind of adjusted. Constantly that sort of triage element to it and now it emerged a new way of looking for post-COVID and you know what cases actually could be, you know, could be treated perfectly through telemedicine and actually maybe even better than than in a normal consultation, as Sarah was saying.
Another thing it did help us to support our team. When, for example, you know, people had to isolate or, you know, we had one of our vets was pregnant at the beginning of lockdown, so we had to shield. So you know, it did allow these people to carry on working and, you know, maybe not be hit financially so much and then he supported, of course, the receptionist and so on on the ground, just, you know, diverting those calls and those clients towards the telemedicine.
One thing that was very important for us is that the process was automated. So, you know, it was through our online booking system. Clients could just book it.
It was communicating with our PMS, as Chris said, OPMS is a cloud-based system, so you know, everything was facilitated through that, and it was quite important for us that the telemedicine didn't. Add too much work to the team, but it was there to support them, to help them to sort of make them more efficient, really. In terms of the clients, I think right, you know, once they got over the, the first shock of having to pay for a system that they were not familiar with, they also, they also felt that they were getting.
Value for money and you know and and a sort of a good plan with some some alternative to what they couldn't really get what they really wanted at that point. But I think they all felt that we were trying our best to care for the animal really and overall the experience was rather positive for them as well. Brilliant, thank you.
Sarah, did you want to add anything there? I think maybe I won't add anything for this question just because my setup and and my involvement with telemedicine has been very much, you know, as my sole business, so I, I don't have the team element to deal with, which but yeah, I definitely agree with the comments that have been made in in terms of some of the things we're going to talk about later as well, and the, the whole idea of, I think this was forced on the profession because of the The government and therefore, as I think it was Vanessa was saying, you know, that lots of cases that you wouldn't choose to do telemedicine, you had to initially, unless they were dying. And that's maybe put people off, the concept of telemedicine, but really, it is something that I think is a profession, it's, it's, it's good for us to embrace, and, I'll stop there for now.
Eve, did you have anything to add in terms of telemedicine supporting teams on the ground? Yeah, I think, I think, I absolutely agree, particularly with with what Chris was saying as well, and it's interesting to hear Ellie's thoughts on it and what she's had fed back to her. So I think that the telehealth is, of course, complimentary to physical veterinary work.
It's not some silver bullet solution, although everyone kind of hoped it would be through. Pandemic, you know, neither are perfect, and, and I think that both physical vet and video vet work is evolving currently. So, you know, we're just working in a normal business environment, trying to identify the market needs and then work within that structure.
And I think that there is a clear and there was a clear market gap for this telemedicine. And as we've seen, and I think that the thing for me, that I've learned, I suppose from being physical vet and then transferring to the video vet side, is that I assumed the business model was the owners recognised ill health, and then sought some veterinary attention with some external input from Facebook readers, friends, etc. But actually, It's much more that the owners struggle to assess their pets, and I have not fully realised the extent to which that occurred, so they find it difficult to assess disease severity, difficult to triage, how do they identify deterioration or where can they go for practical advice, you know, to improve these clinical outcomes.
And I think that we as an industry were missing that until now. So I think we have to accept the challenge to address that aspect of care, and I think that telehealth can help practise teams because, as Chris has said there, we're talking about improved client bonding, which is always important, but also it will allow the effective targeting of clinical resources if it's used correctly. So it's not extra work, it should.
The, I suppose, it's one of the key ways that you can create an agile practise environment going forward so that you can deal with challenges. So, so I think I, I, it's been an eye opener for me. Brilliant, thank you.
So I'd like to ask the audience one more poll question. Overall, what's your perspective on remote consulting? Has it been positive so far, negative or, or neutral?
So whilst we're. Getting those answers in, let's move to the next question, and Eve, I'd like to come to you first on this. Let's discuss particular use cases, cos this is an area that we're all learning about, a lot.
We've all experienced that there are cases that can be handled remotely whilst there are those that can't. So it'd be great if you could each share a case example of providing remotely, healthcare remotely in your experience. So I think that I have favourite consoles that come through and I've done several 1000 video consoles now, so I've got quite a good flavour as to to what is presented on the platforms, and I think that for me, by far the best is the no ill health console.
So the things that clients are not always asking us in the physical vet situation, so we are asked these questions, but I think we experience within a vet consult the tip of the iceberg, and that there's much more of the new ill health questions out there. So we're looking and thinking about things like feeding and nutrition, exercise moderation, and running with your dog, for example. Behavioural issues, changes around puppies growing up, sexual maturity, maybe minimising stress with home moves, these sorts of things that are super rewarding to work positively with clients, you know, where you work along with your clients, and you can really lean into this preventive healthcare using the video platform and and be part of the overall education.
So the other important aspect actually of these consults that make them much more fun, is that you've got 10 minutes of uninterrupted time. So you're not double booked and there's no emergencies waiting for you. You can actually just discuss this with the client.
So that, that's definitely for me is one, and I think the other, the other, one that's really useful on the video platform as well is the clients who have Googled symptoms to the point of despair. They're always a good. As well to debunk some myths and just possibly put them back on the right track.
So, I think that clients really appreciate the veterinary input, and it's not necessarily, yes, we can treat diarrhoea, yes, we can treat first opinion skin, and, you know, we can discuss broken teeth, of course, we could talk about the specifics, but I think the generalisations of what we, what we address is slightly different from what you see within our physical practise. Thanks Eve, who else would like to share a case, case example? Again, if, if you want, I, I just think of, you know, as I said, our opinion of what cases should be seen through video has really evolved over the last year.
But, you know, we, we clearly discovered things that we, we didn't think at the beginning and and I feel certainly those consoles that benefit the most of telemex now the one where you know you have a long discussion ahead of you, you actually want the owner's full attention. And you know, before, when they are in the room, they are distracted by the pet who might be stressed, who might be panting or God knows what, and, and you're not actually delivering. And, you know, or they're not taking in the message that you're trying to put through.
So, you know, it might be those AOP cases that, you know, you need to explain a lot of things to, it might be the, you know, we see a lot of brachycephalic in the hospital and it might be those pre-OA consultation where you know you do want the owner to understand the risks and the element of the postoperative care and things like that. It could also be the puppy and kitten. You know, consultation where you want to discuss your sort of plans and your options and the different sort of preventative care that they need to give them and really when the puppy is sort of in between you and the owner, there's there's very little attention to what you are saying.
So we felt that those those consultations when clients are relaxed at home with a cup of tea, you know, you're much more likely to actually get, you know, the message and the importance and therefore a sort of better care ultimately for the pets at that point. So that was a very interesting sort of point that we learned and we certainly will use in the future. Thank you, Vanessa.
Sarah, I know that you had a case you wanted to share. Well, I definitely echo what Vanessa's just said as well. I, I think my, my key, point to note was really, again, it's the discussion with the owner.
Anything where a discussion with the owner, is, going to be beneficial is, really a good case for these sort of remote consults, I believe. And to add some extra, examples to to Vanessa's, I would say chronic health conditions, so chronic chronic kidney disease, your arthritic cat, for example, where you want to monitor their progress. But it perhaps is not necessary on every occasion for the animal to come in.
Perhaps you want to find out have they successfully transitioned their cat to a new diet? How is the medication going? All those sorts of discussions can be very well managed remotely, and for some conditions where stress is a factor in the disease.
Your cat with idiopathic cystitis, for example. It's, you know, potentially a contraindicated to bring that animal into the clinic, but you obviously want to still understand how their case management is going and input and change it. So I think that can work very well.
From a, early diagnosis perspective as well. I would say you're what you might discuss during your booster appointment for your older cat would lend itself very well to a remote consultation. And I would love to see nurses utilised more widely for these where you go through a checklist of health, ask about the cat's mobility, its cognitive function.
And provide a lot of behaviour, advice and support, just perfect ones for doing this sort of consultation. It's not to say that that's the end of the story. Often, you might be saying, we'd like a urine sample from the cat, or we do think this cat needs to have its blood pressure checked.
But you're doing a lot of the components of the assessment in a way that is less stressful for the client and the clinician, much more productive, and the discussions and the question answering and the explanation. And can just work so, so much better, I think. Chris, did you want to go next?
Yes, I'm delighted to. The the in in in equine practise I think it's it's maybe been a little bit different. I mean certainly you could look at cases that all get an element of remote consulting because as I said to you, that continuity.
Of care and and and the telephone conversations between appointments and maybe the the sharing of videos and and pictures between appointments. But inevitably I I think the cases that come to mind that have been most amenable to. Remote consulting, solely have been mainly the ones that are manifest themselves topically, so skin problems or or wounds, and wounds particularly I think in equine where the the over external severity of the wound doesn't always .
Reflect its its severity in terms of the outcome for the animal. So small wounds near joints obviously can be devastating in terms of the animal's future, whereas large wounds on the trunk are not that concerning. And also being able to differentiate between wounds to the.
Client looked very severe because they might involve quite a large area of excoriation but no full thickness skin injury and the ones that look less severe but we might be more concerned about. So it's added a huge amount in wounds and wound triage throughout the pandemic and before so. Excellent, that's a great example, thank you, Chris.
Ellie, did you want to add anything? Yeah, I think just, just sort of two points, really. One, you know, interesting to listen to, you know, Vanessa and talking about, you know, your client sat at home with a cup of tea in a relaxed environment and how much more likely it is that communication is going to be successful.
And I think that we, we underestimate potentially the, the experience for clients of being in the physical building because it's our normal environment for us. And it's quite easy to not imagine, the stress that may have been involved for them in, in getting there through the traffic and being late to pick up the kids from school, and, you know, the cats peed in the basket or, and so I think, you know, it, it, it's really interesting to think about how we can. Make things easier for ourselves by putting us in a situation where we're more likely to win, where our clients in an environment that it makes it easier for communication to be successful.
But I think another, sort of question for everybody, and I, you know, I don't know what the answer is here, but there are obviously, you know, such a range of different types of consultations, and I think it's all about what we as vets expect to be able to achieve in a consult and what our owners expect us to be able to achieve. And It, you know, it's a quite simple workflow solution to have a vet sat in a consulting room all day, and they take whatever type of appointment comes in. And clearly, you know, listening to everything that that we've been sharing, there are some that would be much more appropriately directed towards a, a remote consult or even asynchronous communication via, you know, exchanging photos or, or, text chat.
But how do practises manage that more complex workflow arrangement of syphoning the appointments that need to come in for a physical exam, the appointments that potentially could maximise your nurses, just as Sarah's saying. It's, it's, it's difficult to make that kind of happen. So I think that's, you know, there needs to be some support there to help maximise the opportunities that are, that are there.
Thank you, Ellie. OK, let's move on to our next question. From the poll that we did on people's personal experiences, 60% say they've had a positive experience with remote consulting.
37% said a neutral perspective, and 3% say they have a negative perspective on remote consulting. So let's look ahead at some tips. If we consider the consultation journey from the vets and the owner's perspective, the pre-preparation, the consultation itself and the post-consultation journey, can I ask each of the panellists to share their top tip for getting the most out of our remote consulting and the roles potentially that each team member can play.
Who would like to start with that one? I can start if you want. I think what's, what's quite important as always is to manage the owner's expectation.
So, you know, what we found is, suddenly during the pandemic, we were taking prepayment for the video consultation just to avoid, I mean, obviously those slots were precious, so we, we didn't want them to go unattended. And so it was quite important for, you know, if the reception team was warning the client not to worry that, you know, if the pet needed to be seen, he would of course be seen. So there was obviously that element to try to again come into a situation where we bond with the clients, we make them realise that, you know, they are getting value for money.
Another tip would be obviously the triage we've talked about, and that's very important, but equally I think the triage of what type of vets you choose to do the the the video consultation, and certainly what we found . You know, those, those people that have a negative experience might be the ones that don't particularly enjoy the contact with clients and the long discussions, and I think that's something to respect is, you know, maybe. To to have those vets who actually really enjoy talking to clients and taking the time and going into details about things, you know, maybe those are the ones that you need to sort of select to do the video consultation, and they can actually be a good support of, you know, when you've got this long block of consultation and you clearly don't have time to go into the Details and actually maybe referring that client at that point to say, right, you know, this requires a long discussion.
I'm going to book you a video consultation so you can have the time to discuss it, you know, quietly with with one of my colleagues or myself. So I think that's something that would be very useful and then obviously . The last tip, for, for the vets that maybe were worried about making a mistake or or not having examined the animal or having dispensed something, you know, and and being worried about because that's what we do.
Maybe the tip was to make sure they gave a clear plan to the owner, you know, if this is not working, if you're worried, if, in two days it's not better or whatever, then we will see you and again managing the expectation because at that point you might. Not be 100% sure of what what is happening and you know what what the pet is experiencing. So I think that was also my my main advice.
It was to just make sure that there was an alternative and something they could fall back into to just reassure themselves and and and the clients. Thank you, Vanessa. Sarah, did you have a top tip that you wanted to share with us?
Well, clearly, I'm seeing referral cases, so my top tips might not always be achievable, but undoubtedly for me, I think the best outcome comes from some element of preparation. If I were in a first opinion clinic, I think it's a huge advantage if you know more than perhaps just one buzzword about what the consult that lies ahead of you might be. And there perhaps is an opportunity to even before that consult collect some either basic Information, whether that's the sort of health questionnaire that I mentioned that I, I do use in my sort of real life clinics as well as online sessions where you can just very quickly get a sort of yes, no, not sure answer to sort of general health questions and identify the specific concern.
Because quite often, and again, this is a luxury I know not all of you might have with your clinical work, but often when I get that sort of pre-information, there are instant questions that I know are going to be really important to ask. And some of those questions might require the owner to do something in advance of the appointment. For example, it might be, could you possibly video your cat doing this behaviour that you've described?
Or take a photo of this, or, it could be, you know, could you measure your cat's water consumption or, you know, all sorts of things which are very doable by an owner and very clinically helpful. But if you can have them at the time of the consult or before the consult, ideally, then it's, of course, going to make your job easier in terms of, getting that more reliable, correct assessment and deciding what further steps are needed. So I think if any of that is possible, that, that does help.
And then really, as I agree totally with what Vanessa was saying on every other respect, and, and if you can follow up with some sort of written report, depending on the case complexity. But again, for me, that's really Hugely important because they, they do tend to be quite long discussions that are summarising. But I think it's for the clients to understand what those next steps are, when to worry, when to contact.
And of course, we just want our clients to contact us with any questions and issues. We just don't want there to be any hesitation and for them to come back to us. So I think those, those be my main tips, which I accept might might not all be achievable for every clinic.
Thank you, Sarah. Eve, would you like to share your top tip for remote consulting? Yeah, I, I think it, it's probably just moving on from what Sarah and Vanessa have said, so I think, I think they're absolutely correct.
The important thing if you're going to put this into practise yourself is not to underestimate the time that's needed to make this really useful because I think you are still under pressure to structure a consult correct. It's not, it's not less of a consult, it's just a different consult. So you need to fully understand the client's questions, you need to examine the patient, and I think the other thing as well, for me that that was quite important to learn is that the clients are not getting in touch remotely through a service such as the one I work on.
To avoid going to the physical vet, that's actually not the question. So we have to not start with that assumption, and, you know, they're asking for guidance, and I think that that they want to have clear action points and as Sarah said, providing a written report and having the time to do that after a consult really helps with feedback from owners. And they also want to know things like how specifically to observe a patient and when to seek further attention and where they can go with questions.
So I think a written summary along with with the time to do it and You can literally get excellent customer service because again, you're concentrating just on this client, so it's welcoming, it's friendly, it's relaxed, you can see your patient at home, there's no stress. So the whole thing can be super useful and I think just don't underestimate the time that you need to, to prepare and then provide a follow-up report for your clients. Yeah, great point, thank you, Eve.
Ellie, did you have anything else to add, one of your top tips? Yeah, I guess not from, from my perspective, not so much a top tip about how to do a remote consult, but top tips for practicess thinking about should we and how would we integrate this. And I think my two top tips would first be talk to your clients.
So, understand. Your clients and what they want and what benefits they would see in this, to really, you know, make sure you're meeting their needs, but also drive what you, what you do, so that you know that you're, you're sort of meeting their needs. And then talk to your team.
So I think, you know, picking up on some of the points that Vanessa made. It, we're all different. We all enjoy different aspects of the job, and some people may really, really enjoy the opportunity to have those longer relationship building, discussion based type consults.
Other people would really like to just be in. Surgery all day. So, talk to your team about how they see it working for them, and then maximise your individual team members, you know, preferences and abilities to really integrate it into sort of what you do.
Great, thank you, Ellie. And Chris, did you have any top tips to share? Well, I'm, I'm gonna be as quick as I can because I'm, I'm effectively just going to enhance the ones that have already been made, mainly around summaries, I think it's really important to get your key messages across and I think a follow up, message of some sort because clients in whichever way we're consulting have some poor recall, and if you want good compliance, you, you need those messages to get across.
And and and and Eve's made a. Really good point. I think providing what I've tried to provide videos that people can assess their animal and gain some of that minimum database that we require so that they've got some information beforehand to to really give us the information we want.
But it's worth thinking a little bit about that minimum database I was talking about earlier and how I think that will be enhanced in the future and I know we're coming to that later. But with with wearable devices and possibly more importantly, implantable devices, hopefully we'll start to get objective information remotely, which will really enhance our ability to make clinical decisions without actually seeing the animal. And, and I can see that being a vast value in species like, like the cat, which is always going to be better assessed in its home environment than than in the clinic.
Absolutely. Thank you, Chris, and I'm conscious of time, so I'd like to remind the audience that as we draw to a close, if you have any questions for our panellists, please do pop them in the queue and A box. I'd like to now move towards the future and looking ahead in our, in our crystal ball.
. Do you think that this remote consulting is going to change? Are we going to see changes in care standards, how pets are insured perhaps? Are we going to see any changes at the end of the COVID pandemic, or are we going to see other changes?
Chris, would you like to start with this for us? Well, I, I, I mean, I think the, the pandemic in, in so much use of, of technology has driven innovation forward about 5 to 10 years, and so, we, we've adopted and, and enhanced some of the stuff that we had there already. We haven't really come up with anything dramatically new, but we're using what we've got and, and we've made it better, which is great.
And I can't see that we're going to go back from that and that I, I think that that those gaps, as I said in between physical examinations will be filled now with, with, with enhanced ways of doing things. Obviously I've just touched on areas that I hope will further enhance our ability to do the job remotely and . Really, as I said, it's getting back to the job to be done really, which is as quick as possible a good outcome for the animal.
And, and we've got a raft of tools available to us to achieve that outcome and I I think that this is just one area which adds to that that that raft of tools and and enables us to keep that. With the client and the animal for the period of time that it takes from, as I say, initial client concern and I think we all wish it would be from the animal getting sick, but of course the client's got to notice it, but from initial client concern to to to a good outcome. So yeah I I think the, the future is, is, is gonna see things getting better and what I hope.
It will also do is enable some people that aren't currently engaged clinically but have been in the past, a huge wealth of of experience that we've got out there to get engaged again because it'll enable them to. Engage at times that are more convenient for them, but not even just times that are more convenient in a way that's more convenient, certainly in, in a family environment, the ability to be able to deliver care without leaving the house is a is a huge advantage. So .
I think things are gonna continue to progress. Excellent, thank you, Chris. Eve, would you like to share your thoughts on this for the future of remote consulting?
Yes, absolutely, I love Chrissy's enthusiasm for the future of remote consulting, so, and I share it actually. So for me, I'm not going to open this can of worms remote prescribing, but you know, very much in, in my opinion, that's something that will play its part in in remote remote consulting as we move forward. But I think there's bigger changes in that, you know, there is flexible working.
Of course, team morale, staff retention, all of these things will also be important, and I think that remote diagnostics are going to be super important in the next 10ish years. So, that will change the face of veterinary medicine and human medicine, and, as someone who works in biotech, it's not very far away at all. So remote diagnostics will be really interesting.
When we add this into the new blended approach to clinical care. And I think that it makes veterinary services easier for clients. It makes it easier to access them, whether you live in a remote area or you have a difficult patient or a complex case, it doesn't matter.
I think easier access to care results in healthier animals overall. So, so I think there's lots of changes coming. I'm looking forward to it.
Great, thank you, Eve. And Ellie, would you like to share your thoughts for the future? Yeah, I think really just to, to sort of echo what, what, what even, and Chris has said there, that I think it's this real opportunity to provide different ways of working that could have a really big impact on, you know, retention and people's experience of, of how they work and, and the enjoyment that they get out of that, which is a real, real sort of opportunity.
I think also, I think we've, we as a profession have got the potential to Play a bigger role in helping to bring our clients to that discussion in a way that means they're more prepared to be able to make shared decision making that, that sort of really matters to them. So I think filling in some of those gaps in terms of providing information, providing, sort of more preventative healthcare. So I think it's, you know, that's, that's kind of where it will grow that bit of, of that connection with clients.
Brilliant, thank you. Sarah, would you like to share your thoughts for the future on remote consulting? Thank you.
I, I'd just like to, you know, echo, everyone else in that I, I do think it's really important that we embrace it as a profession. Not in any way as a replacement for the consultation, quite clearly, as we've all said, but really as just an alternative way that we can be in contact with our carers that can just be highly effective in terms of communications in particular. And even without those, the sort of wearables and devices that I know are going to come.
Soon and very much help us, even without that, I think there's just so much we can do to help our carers and therefore help the pets. And so I really hope that all clinics will have like a sort of telemedicine streams into their consult diaries, for, you know, those post-op checks, perhaps the diet transitions, the medication challenges, the Chronic healthcare, the preventative healthcare. There's so many consults that could be really effectively, at least partly delivered there.
And then rather than like, yes, struggling over handling your puppy while someone tells you about the importance of vaccination, worming, etc. You can actually have that, you know, proper experience, delivered effectively via whatever platform or telephone, that you're using. Thank you, Sarah.
Chris, did you, sorry, have your hand up there. Apologise if I hadn't seen that before. No, no, not at all, Jessica, it was just, just to add one further thought in which was that I call it who's holding the baby, and I think it's really important that when the veterinary profession have taken on to assist someone with the care of their animal, that we ensure that we know.
Who's holding the baby, who's taking responsibility, and we've passed the passed that responsibility between ourselves really well and we and we've we've developed over the years a really healthy and and good way of doing that between. First opinion providers, general practise vets and and referral services, and I think it's really important that we give a lot of thought on how we do it if, if there's remote services being provided and and physical services and they're not being provided by the same provider that we make sure that we, we continue to take that responsibility and hand people carefully over because if we leave. Clients with that responsibility or we don't make it very easy for them, then I think we're we're we're letting our clients and animals down and and ourselves ultimately.
Thank you, Chris. And Vanessa, did you want to add something there? Yes, so I mean, I think I've, you know, I've mentioned what I felt were were appropriate cases to carry on seeing by video consultation in the future.
So I just want to agree with Chris very much that You know, even though the future is very bright, it does bring challenges, and suddenly when there are multiple providers of telemedicine for the same pets, you know, whether they might be through the insurance, whether they might be through their first opinion practise, whether they ask opinion to other people, we will have to be very careful about. You know, what do we do with that information, proper clinical records, you know, sharing of information and so on. And so one thing that we the consultation in a sort of traditional way of a face to face the clinical note and not to multiply too much the sort of ways that we're going to communicate with that clients because ultimately we are responsible for keeping the clinical notes of.
You know, GDPR and all sorts of other things. So, you know, even though we were very excited about, about it, I think we, we have to be conscious of the challenges that come with it. And certainly, you know, for example, loving the clients being able to contact you by so many ways can sometimes be very challenging in terms of communication, and I'm sure Ellie would agree with me that we just have to be very careful as not to have, you know, email, text, and books and chat and things that ultimate.
You know, increasing the communication might lead to miscommunication, and so, you know, keeping the consultation element and the sort of face to face and the sort of professional care and responsibility is, is very important throughout. So that's that's one of the things we, you know, we're very careful about. Yeah, absolutely.
Thank you for sharing that point, Vanessa. So I'm aware that we've we've run to time. There's a number of great questions in the Q&A box, which some of them I think will apply more to the second panel.
So we'll carry those forward. There was one that particularly caught my eye from Ivan Lo. Eager.
Does anyone have any views from the clients themselves? The clients are something we haven't really touched on, their perspective of, of remote consulting, today. We've covered a lot of ground.
Would anyone like to comment on some feedback that they've had from owners on remote consulting? Sarah, would you like to just, yeah, unmute myself. So, yes, I actually have, I ran a couple of surveys, last year on telemedicine, one for vets and nurses and one for owners.
And I'm I'm analysing the results at the moment, so I can't be absolutely definitive in terms of the feedback. But I think the, it was something like 85, 90% of owners participating in the survey that said they would like remote consultations to be available after the pandemic, were that, you know, supported by the RCVS, etc. So undoubtedly, they were enthusiastic from that perspective.
Although certainly they did experience, you know, mixed, I guess mixed experiences from the people who participated as you would expect. So some had, some negative experiences of delayed diagnosis from their perspective, misdiagnosis, which, similarly were concerns raised in the vet survey as well, but, you know, clinicians doing telehealth consults, certainly worried about that. But, as I say, the bottom line was that actually for cat owners, this is only cats I'm talking about, they did really value the, the opportunity to talk, without disrupting their cat's life, putting it in a carrier, taking it to the vets.
And they did feel it was something that should be, continue to be available to them. And I do plan to publish the the results from the study in full. We'll submit for publication this year, so hopefully that will, will become available in the near future.
Thank you, Sarah. Does anyone in the house have any feedback from clients they'd like to share? I think that that working on the first step platform, we always ask for reviews at the end of every consultation, which is something that I was uncomfortable with at first because it's not something we ask clients in physical practise.
But certainly the, the outpouring of 5 star reviews for the idea, nothing to do with the individual vets necessarily, but the idea of being able to consult remotely has been truly astounding. So yeah, I think that most of the feedback that has been in any way negative would be linked to IT issues as opposed to the idea of accessing a vet online. So I, I found that really interesting.
Yeah, that's a really good point. I think tech has has vexed us all at some point from both the vets and the owner side. Does anyone else have any other feedback they'd like to share from owners?
For us, Jessica, I think you know that there's been obviously a mixed, you know, feeling, especially at the beginning when people had no choice but to use a video consultation. However, I think, you know, they quite quickly appreciated being able to have that, and suddenly our clients can book the video consultation themselves through our website throughetoria. So, you know, the fact that they are booking them again.
You know, surely shows that to some extent they are, you know, enjoying them and they are seeing the benefits in certain circumstances because they have put them despite at the moment being able to come in. So, you know, I don't know, I don't know what are their sort of main points, but it will be interesting to do a survey and certainly that's something I'm considering when I'll have 5 minutes to organise it. Excellent, thank you, Vanessa.
Chris, did you have any feedback from owners you wanted to share? Not really. I mean, nothing, nothing formal, that's going to, going to help other than, in my experience, clients are always hugely, grateful for that sort of continuity contact, so you know if you're phoning them in between consults and checking up on them and and and being accessible then they're always keen so I think that.
All these channels are going to increase that and generally that increases client satisfaction. Great, thank you. And Ellie, a closing comment from you, if you would please.
I think on the client perspective, it's for me, I think it's about choice. And I think, you know, what I've heard from practises is, is the. Struggles during the pandemic have been around clients feeling they have to interact with you in this way.
And that's been challenging when, for example, maybe they've been able to go to Tesco's and they don't understand why they're not able to see their vets. So I think it is, it is, when it's an, an active choice, rather than something that clients feel is their only option, then it's an entirely different sort of ball game. And then I think it's around expectations again.
Are they clear what you, you will feel you will be able to achieve in this consultation? Are you gonna meet their expectations by interacting in this particular way, rather than that other particular way? So, yeah.
And, and I think also just the importance of, of stories and positive client feedback in helping. Professionals who do want to try remote consulting kind of overcome some of the anxieties and, and worries, is that when we actually hear people's stories about why it helped them with their pets and why it made their lives easier, it, that's really important encouragement for us to try something that might feel a little bit difficult, or might have some anxiety attached to it for, for ourselves. Brilliant, thank you very much, Ellie.
Well, I hope you found today's first session valuable. Thank you very much for your engagement and participation. Please join me in saying a huge thank you to all of our panellists today.
Thank you so much, everyone, and thank you for the webinar vet hosting us. As I said earlier. Recording will be available in 24 hours, and if you have a moment to fill in the survey afterwards from webinar that, that would be super.
We'll be back again in a few minutes. Our aim would be was to start at 1:40. So, if we can have a quick changeover and grab a glass of water, then we will see you back in a few minutes.
Thank you. Excellent. So let's kick off with our second session as the last few people join us in the group.
Welcome back if you were with us for the first session. If you weren't, thank you very much for joining us today for the 2nd of our discussion panels on veterinary telehealth. We're very excited to be discussing remote consulting in 2020 and beyond with 5 more of our industry's leading experts.
So we split today into 2 sessions, and this is the 2nd. Thank you again to the webinar vet for hosting us. The recordings will be available within 24 hours, and, we would love your input.
So we've got several poll questions which we will start in just a moment. And if you have any questions for our panellists, do please pop them in the Q&A box. So the first panel, the first, poll I'd like to ask, sorry, is who's been using remote consulting during the past 12 months?
We know that this past year has been hugely challenging for the profession, and today we're focusing on two things. Firstly, sharing and reflecting our learnings from our collective experiences so far, and secondly, looking ahead to what the future of veterinary telehealth might hold. And these experiences have provided a great foundation on which we can continue exploring pet telehealth.
So our second panel this afternoon is more focused on the profession and our first panel focused on the clinical side of telemedicine. Our panellists are Charlotte Leroix, David Prine, Tom Jenkins, Sarah James, and Suzie Samuel. In a moment, I would like to ask our panellists to introduce themselves by way of the first question, which is directly related to their personal professional backgrounds.
So what is remote consulting? We know that remote consulting has meant something different to everyone over the past year. So I'd like to start by asking each of our panellists to share what telehealth means to them and their experience, please.
Tom, would you like to start us off? Yeah, happy to. So, I'm Tom Jenkins.
I'm founder and CEO of PetsApp, a client communication, mobile and web app, for veterinary clinics to better engage with pet owners. I'm a vet by training and prior to founding PetsApp, I ran veterinary clinics both here in the UK but also out in Asia. And Yeah, I think it's just been incredible how the scope of our definition of, telehealth or, or virtual care, or whatever you want to call it, has, has broadened.
And so our first product was a, video consultation platform for vets. So just Video and just vets. And now you've seen, you know, text chat, asynchronous, push notifications, images, videos, that sort of thing later on.
And I think, it was Sarah and Chris in the Previous session said it's any interaction that happens when the pet owner and, and the veterinary team member are not in the same room. But it's, it's expanded beyond that, even. Sometimes people are communicating via the app when they are in the same room, you know, during the concert, I'll just send you a video on that, or I just send you this PDF of this, you know, virtual handout.
So it's, I think it's beyond even virtual care, beyond telehealth, it's this digital or virtual augmentation of our existing patient advocacy efforts and, and client service. Excellent, thank you Tom. Charlotte, would you like to go next, please?
Yes, hello, everyone. Thank you very much for the opportunity to speak on this panel today. I'm formerly an equine practitioner and I also have a law degree and I work with veterinarians throughout the United States.
On veterinary business management issues, legal risks. I'm CEO of veterinary, business advisors. I'm also a founding member of the Virtual Veterinary Care Association, which, Jessica will be talking about a little bit.
Later, I think mechanically, we all know what telehealth is, and I think Tom just put it, put it out there very nicely. I like to look at telehealth is actually providing access to medical care to patients that may not otherwise have access to that medical care. Maybe because they're remotely located, maybe because the the owner cannot bring the animal in for all.
Sorts of reasons. COVID having been one of them that we've all, experienced. And it provides clients with, cost-effective care.
It's efficient, and it's timely as well. You know, if I have to take my pet pet in and it's gonna take me an hour, and I'm not even, and I have to leave work, so that's gonna be 3 or 4 hours, and I take it to a General practitioner when maybe somebody could have videoed, seen right away, had to be referred to an emergency practise, or perhaps I could have referred it to a specialist. I think it also heightens the standard of care.
So it's not only the operational aspects, which are challenging themselves as well, but it's clearly at the end of the day, it's access to medical care that perhaps they would not have had, otherwise. Great, thank you very much, Charlotte. Sarah James, would you like to go next, please?
Thanks Jess. So I'm Sarah. I work at Bought by Many Pet Insurance.
I'm an RBN by trade, and I've worked in vet practises in the UK for about 10 years, and I joined Bought by Many in 2019. So we were the first ever pet insurance provider in the UK to offer completely unlimited and free 24/7 video calls with vets. So we've partnered with the lovely team at First Vet, to do that.
So it doesn't actually affect our customers. Premiums, it doesn't come out of their vet fee cover amounts either. So we found that lockdown meant that thousands and thousands of our customers, have actually now had at least one online consult, and the feedback from that has been overwhelmingly positive.
For me, in practise, I really liked doing, emails, so telehealth in an email platform, with certain customers with certain types of pets, cats being one of them, and aggressive, dogs were a very good. Candidate for email consults with owners, they could send us videos and pictures of what was going on in the home environment, and you wouldn't have that stress of that dog having to come into the practise in many instances. So that's my kind of practical clinical experience with telehealth.
Great, thank you, Sarah. Suzie, would you like to follow on please? Thanks, thanks, Jessica, and, and, and thanks for having me.
I'm the CEO and founder of Vet Help Direct, which is a platform that aims to reduce barriers, to owners in accessing veterinary care. And I'm also the founder and non-executive director of Vets Digital, which is a veterinary specialist digital. Marketing agency.
I was a practising vet for 13 years, having a husband in the Navy. I worked in a large number of different veterinary practises, covering farm animals, small animal, and a really wide range of demographics. So I've met lots of different clients and and different practise setups.
I, I agree with everyone so far that that telehealth is, is just super wide. I absolutely loved, Chris's comments that it all started with the telephone, when the telephone was invented. I think that's, very true, and I would argue, you know, we've been doing telemedicine since 2006, when we first launched our, interactive symptom checker.
The poison's guide, is, is a triage form of, of telehealth. We have live chats with registered veterinary nurses that that practises can outsource to. Pet owners can log in and access their vaccination and medical records from the practise management system.
Is that telehealth? I'm not sure, but they can order products and they can manage their pet's health that way. We started exploring video consults, sort of early 2019, and, obviously a more, more traditional form of consultation of, of, telehealth.
And in 2020, we launched sort of in the middle of the COVID outbreak, and I think all I can say is that that COVID certainly accelerated every form of telehealth. So our live chats increased by, 75%, symptom checker use was up over 100%. And then obviously the video consultations, thousands in, in a very short space of time.
And there were kind of highs and lows that we experienced with that journey that we went on with the vets. You know, real obvious things from the COVID vets that could carry on working full time, despite shielding with, with really serious health problems. But we also other highs and the completely un-COVID related started coming out, so vets who'd Delivered veterinary care to animals that hadn't seen a vet for years because they were so aggressive and so nervous.
And like Sarah was mentioning, sort of idiopathic cystitis, all the benefits of being able to see nervous patients, with, without stressing them out. And then, and then the lows, so vets complaining about having motion sickness, as the pet owners pointing the camera in the right direction for them to have a look. And then also seeing anatomical parts of owners that they actually wanted to see was another unexpected downside of, of telemedicine.
But, I think one thing that's very, very clear, is that the consumer demand is still extremely strong for all forms of telehealth. And just to give you a sort of very brief insight as that as a as a final point to our sort of introduction really is that in November 2019, we asked 998. Pet owners, if they'd like to have video consultations with their own vet, and 38% said yes.
And we then repeated the survey in June 2020, and that had gone up to 68%. And we then looked at a population of, of pet owners who'd actually had a video consultation with their own vet during lockdown, and that went up to 80%. So I think this is a trend that is gathering momentum, and has only been consolidated by COVID.
Thank you, Susie, and thank you for sharing some numbers behind what we're all talking about. David, would you like to round off our introductions please? Yeah, sure.
I don't even know what to fill in after all these answers basically, but, my name is David. I'm one of the co-founders of First Vet, and the CEO and I think I'm not the vet, by the way, which might be worth just disclosing before we. Even start this panel properly.
But I've been involved within the space for the last 13 years now, from different perspectives, but everything stemming from a bunch of content-driven websites primarily based around text-based question books as with specialists and really well experienced vets that we found back in 2008. And I think that from, from my perspective originally what telehealth stands for as a, as an area as of today, aside from everything that's already been mentioned, which I think is great and sort of encompasses most things is Like this topic has the possibility to kind of formalise, control, and actually set the rules for something that has unofficially been going on for a really, really long time and that is actively asked for by a really large portion of the consumers out on the market today. I still remember when we were starting to discuss video consultations like formally back in 2014, 2015, before we even started working with first but specifically full time.
I was like, yeah, I see no use of this. I already speak on the phone for free for 4 hours a day. Like, yeah, exactly, like that's one piece of the problem, but also like from my consumer perspective, it's like when we were starting to, and, and we still are discussing like, you know, prescription rights, VCPR, all these types of topics it's like, I think this is a great opportunity in time to really capture that potential in the market and make sure that we make our customers more happy with the services that are being delivered by practises and associated for like.
For that, for example, or insurers like ABM, while, while sort of really staying in the forefront of things, which is something that I don't think that the pet industry as a whole has always been really good at, you know, in comparison with other businesses and markets, basically. I think it's a, it's a hugely interesting topic to discuss, a bit subjective, of course, but. Great, thank you very much, David.
So from the first poll question, we can see that 75% of our audience today, I understand there will be some overlap from the previous session, but 75% have used remote consulting over the past year. So I'd be interested to know in our second poll, where do you look for further resources and support for remote consulting. And whilst people are answering that.
I'd like to come to Charlotte on our next question please, cos I know that your your time with us is limited today. So in the US you've defined the veterinary client patient relationship, the VCPR and various terms around telehealth, teleconsulting, etc. And our British Veterinary Association has recently said they're in favour of adopting that.
You've also set up the virtual Veterinary Care Association, which you mentioned earlier over the past year to support the veterinary profession. So how important do you think that defining telemedicine and the ecosystem around it has been, and what do you think are the next steps for the US? And I was able to change around my schedule so I will be able to stay, but thank you for your graciousness.
So the, the veterinary client-patient relationship is a concept within the legal framework in the United States that requires a veterinarian to have sufficient knowledge of the patient before they can practise veterinary medicine on that patient, meaning diagnose and treatment plan. And sufficient knowledge has been interpreted as having had a physical exam. And of course, you can imagine that requiring a physical exam is the number one obstruction to providing telemedicine services.
So what we're trying to, so when, when you're looking at what are the next steps for implementing telemedicine, I view this as really two areas. One is implementing in clinical practise, and this is where We've got great minds coming in and how to monetize, where's, you know, how do you implement operationally, how to re-engineer operationally. But the second one is how do we get over these regulatory, constraints.
And I, I believe the VCPR is an excellent concept, and that should stay because it gives a parameters as to when is it that I'm actually engaged to provide veterinary medicine, when is it I have sufficient. When is it that I'm taking responsibility? What I personally believe in the United States, what we need to do is soften the concept and remove this requirement of a physical exam, because actually, I am of the opinion now with all technology that's available to us.
Before the technology, I understand it's required to have a physical exam. But now, requiring that is actually an obstruction because we know that we to get a physical exam on a patient is not always in their best interests. In fact, we know that exotics are often better evaluated in their environment.
We've had some great examples about felines hating to come to veterinary practise and when you get a stressed cat in your practise, it is no longer, you know, any of the vitals you see on them is no longer their vitals, and depending how long they've been waiting in the waiting room and get stressed out, I mean, all the blood chemistry is gonna be out of whack. As well. So I actually see telehealth is increasing the standard of care.
It does not replace the physical exam, and I think somebody else in your clinical panel, by the way, which great clinicians mentioned this is, it's your veterinarian's judgement to decide whether or not to do the physical exam. Just like it's your judgement. Do I take an X-ray?
Do I do surgery? Do I do an ultrasound? We make those decisions every day and tell them.
Medicine is just a new tool, by which to do that. And I wanna quickly comment on something that Ellie Russell said about the fear of misdiagnosis. Of course, there's gonna be more misdiagnosis with telehealth.
Just like there's more misdiagnosis with every piece of technology we've introduced in veterinary medicine. This is not new. Before we had X-ray technology, you didn't have to worry about not taking enough views.
You didn't have to worry about. Taking the wrong views. You didn't have to worry about the quality of X-rays, right?
Well, now that we have the technology, you make those mistakes. Yes, you're making an error, but that's because of the use of the technology. With telehealth, we will set standards, and I think that's what the Virtual Veterinary Care Association is trying to do.
It's dedicated to developing best practises, setting standards and protocols, and I encourage everyone to go to VVCA.org, become I'm a member, there's already a plethora of various resources there to help you with, implementing, giving you resources on the tech. There's so many technology platforms out there, great resource.
I mean, the technology is way ahead, way, way ahead of evolution in the sense of the regulatory as usual. But, so that, that's kind of how I see the, the next steps. Wonderful, thank you, Charlotte.
So let's come back across to the UK and I think Suzie touched on this earlier with regards to needing to define what we mean. It's very wide open in our . UK system.
So what are the next steps, Suzie, would you like to take this next, please? Yes, I, I kind of think one of the things that happened with COVID is that vets were using telemedicine in just really such extraordinary circumstances, that and in many cases very non ideal ways. So they were, instead of looking at at telemedicine, which is, is the way that we've sort of been evolving our conversation as part of a journey with a vet.
So if you're seeing a vet sort of 6 or 7 times over the course of a particular Treatment. You might have an initial chat with them via telemedicine, to start the conversation, reduce barriers, get them to understand why they need to come in. Then there's going to be the physical examination.
There's possibly gonna be tests, diagnostics, maybe surgery. Of course, that has to be hands-on. There's never going to be an alternative for that.
But then, when it comes to the follow-ups, maybe one of the two post-optes might valuably be remote and save you from having to stick the children in the car and, and find a parking space and carry your cat for miles. And, and just saving one vet visit like that is valuable. And, and that's very, very different to how the vets were using it and being forced to use it during telemedicine, where they were having to use it to see patients full.
Unless they, you know, really were defined as a as an absolute emergency. And I think that created, sort of, you know, these problems with people misdiagnosing and and and and few instances like that. So I think really, once we get back to the status quo, whenever that is and and whatever that looks like, I think for the practises that we deal with, which is obviously our focus, so dealing with vets using Telemedicine with their own clients.
This isn't the biggest problem, the VCPR, because actually, 9 times out of 10, they're either just triaging, or else they're seeing a patient that they've seen very recently for a follow-up or something like that. So I, I don't feel like this is a huge issue for the vets in practise. I think much more of an issue is the practicalities of integrating it into their normal workflow and making sure it doesn't generate extra work for the team.
Brilliant, and I think that's a really good point, and I would like to throw that out to the audience to share with us their kind of key challenges that they've faced during the last year, and we'll come on to that in just a bit. But David, if I could come back to you on what's next in terms of defining telehealth and the VCPR. Yeah, so kind of alluding to what I said earlier, I think that I think that we should be able to see great movement within the space for the coming few years because it's basically what is what the market kind of deserves, I think, just.
Sort of looking at at it from different perspectives, I find it hard to define telehealth as a whole in relation to this regulatory environment because telehealth means and should mean different things for different actors within the value chain because it plays different roles in relation to different actors within the value chain relating to follow-up consultations post operation, for example, or . Pre in-person visit triaging services or claims management for insurance providers, like whatever it might be, it means different things for different actors and it should do so. So I think that a clear, not necessarily a definition, but more of a Diversification.
Of those different means of communications, how they complement each other and how that actually works from a consumer perspective, is the next step that we should, should take together because it feels as if we've focused extensively during the last couple of years sort of establishing the concept of video consults specifically, but there's so much more that could be, that could be used in order to, as Tom alluded to earlier, like augment the vet experience, like everything that does not necessarily . Include like touching and feeling the path itself within an examination room, like. Everything that has to do with follow-up, in practise visits, sharing content of how your, how your pet is behaving at home.
Even kind of catering to the pets that I've understood, at least many vets don't even want in their practises, like pet dogs with keel cuff. Like you don't want that dog coming into your practise and sort of, coming at other dogs and being in and around them. It's like, You know, there are many different specific symptoms that we can kind of divide up into different pockets along that value chain as well, which I think is the next step.
And then also help. Help vet's more. More accurately diagnose pets over time when it comes to chronical diseases and more continuous continuous control of pets actually are doing via wearables and associated tools as well, like self-tests, etc.
Will be very interesting to follow the development on during the current time. Thank you, David, and I guess, yes, the common goal for everyone is getting the pet, the help it needs in a timely fashion. Tom, did you have anything to add on this?
Sure, to, to just be completely candid, sometimes I find the regulatory conversation a little bit tedious, a little bit boring. I have my own opinions on it, around trusting the professional judgement of vets, but also keeping your local veterinary practise at the heart of the pet care experience and that. People in general should see their vet more often.
I physically see them more often, as well as sort of virtually interact with the veterinary team, and more often. I think pets are relatively underserved healthcare consumers. But look, you know, the practises we deal with, we work with clinics in North America, the UK, Ireland.
In various, sort of regulatory frameworks, and we see them doing click and collect ordering of medications, inpatient updates to avoid getting to phone tag, discharge consultations, even done asynchronously earlier in the vet's day, so you take the pressure off the evening. Consultation block. You know, all these things, discovering, cats that they never heard about, you know, they invite, a dog owner to join the platform, and we asked them, you know, is there anyone else?
Is there anyone we've missed? And suddenly there's this cat that the veterinary team never knew about that they now have a chance to advocate for. All these things are happening.
Firmly within, within the existing regulatory environment. And so I think sometimes we use that conversation as to distract from all the ways we could augment our existing efforts. Yeah, that's a great point.
Thank you, Tom. Sarah, did you have anything to add? Well, I think everyone has done a very good job of, you know, kind of telling it how it is, and I can only agree with everyone really.
You know, I think Telehealth is here to stay, whether we like it or not. And I think everyone has a collective responsibility to just make sure that it compromises. Our sort of in-person care, you know, and just kind of optimise that, that experience, I suppose, and not forget that, you know, we can make a pet's life a lot better at the end of it, you know, which should be why we're all invested in this space in the first place.
Can I just fill in real quick as well, because it's very easy to put like in these types of panels to be very, very vet-centric in our views on stuff, right? While the sort of the guiding star over time to a very large portion needs to be the consumer view on service delivery as well. What's actually asked for, what's actually needed from their point of perspective, not necessarily what, what, what us within the profession think that it needs and kind of caters to our needs in practise.
And I think, just opening that spectrum up and becoming a bit more customer centric. For the industry as a whole, I think that telehealth can really provide a bridging sort of solution in reaching that target and just creating a, a more, more flexible and comfortable work environment for vets and better catered to pet owner needs in more cost efficient ways basically over time, which I find hugely interesting, because like, yeah, you've always been able to call your best practise. And it's impossible for me as an old vet to describe the symptoms that I'm experiencing.
So in 90% of the time, the recommendation is always, yeah, you know what, I'm really not sure you should probably just come in. Like there's so much to cater to there. Charlotte, did you have something to?
Yeah, I'd like to piggyback on what David had said cause it's very compelling because at the end of the day it's the consumer that's going to drive this. We have no control of this. It's the consumer that is going, and they will find tools to do this.
And if we as a veterinary profession do not participate. And participate quickly, they will find alternative to veterinarians. And that will hurt the pets, you know, and the veterinary profession and everything linked to the veterinary profession in the long run if we don't move rapidly enough to accommodate, you know, to, to meet the needs and in particular, because It, it, it will provide, but it is a higher standard of care.
I, I think everybody pretty much agrees with that if it's done properly. Thank you, Charlotte. I'd like to launch the final poll to our audience and find out what your perspective of remote consulting is, whether it's positive, neutral, or negative.
And whilst we're considering that, I'd like to ask the next question. So the common queries and problems that, we have come across in practise are things like technology and having a structure to providing remote consulting. And Ellie Russell from BDS Training earlier shared with us some informal dialogue from vet team conversations over the last 12 months, and the, the common themes that I think will resonate with many people were that practises have felt overwhelmed, they felt disconnected from their customers and their clinics, and they've also struggled with.
Rapid change management and mobilising their teams. So I'd like to ask our panellists for their thoughts on the consultation journey, and how our vet teams can be, you know, play different roles in order to deliver an effective remote consultation. Suzie, would you like to start with this one, please?
Oh, I think you're on mute. So the team, the, the, sorry about being on mute, the, the most successful clinics that we've worked with, for any form of remote working are the are the teams, are the clinics where the whole team is involved. So I think it's a really good point.
The reception staff are just crucial here and, and, and so. Of sort of overlooked and the focus is on on the vets, whereas actually the reception people are the ones that are the real experts on getting people booked in, managing them through, through that, that flow. And, and then I think it's, it's the technology, so trying to sort of automate as much of that flow as possible.
What we're hearing from clinics at the moment is that they're just Super strapped for time. Everything's taking twice as long as it normally would do. And yet they're very busy and there's a, a huge demand, and, and obviously the limitations on the services that they can provide, through COVID.
So I think that's where technology comes in. It's trying to really focus on, reducing the Pressure, the administrative pressure on staff, and then that feeds into David's point that allows them and then puts the vets in a position where they can deliver on that consumer demand, because there is a real mismatch at the moment between consumer demand and what vets are able to provide. That's interesting, and Tom, what are your thoughts on this?
Yeah, I, I agree with a lot of what, what Suzy said there about it being engaging the whole veterinary team. In fact, the power users on PetsApp are the receptionists, then the veterinary nurses, and then the vets. But I think a big part of this is, you know, one of the the founding thesis of PetsApp was that only 8% of all pet issues get addressed by veterinary expertise, so 92% of pet issues go unaddressed by those best placed to address them.
Now, you tell that to a vetting team and they're like, I would love to help, but that feels like an unfillable well of need, and I'm already stretched, right? So, one thing that we need to do a better job of is setting client expectations. Too often it's like we try and go above and beyond and we set expectations right up here, and if we deliver just Below that, we end up with unhappy clients.
So you want to engage with tools that allow you to set realistic expectations ahead of time that you can then potentially exceed. And so, for example, on the text chat on PetSA, we have an automated welcome message that the clinic set for themselves. It tells them, we're available between these hours.
Within these hours, we have a 30 to 60 minute response time, and then this helps you deliver the what's in it for me to the veterinary team, because if they see this is just one more reason to miss their lunch break, or just one more reason not to get out on time, it's not going to stick. So instead, if you say, hey, you know that phone constantly ringing, and we tell you you've got 3 rings to answer it. If you direct those queries through to an asynchronous text chat, you've actually got 30 minutes, 60 minutes, you know, a non-urgent query comes in, you're about to go on your lunch break.
Go and get your lunch, reply to it later. We have chats that come in out of hours while the clinic is closed, let's say 9 p.m.
The owner says, look, I've run out of the food for, for Becky. Could I get some more of it? They don't expect an immediate reply.
They're just delegating an item from their to do list to the clinic's to do list. The clinic replies say 10 a.m.
This is a genuine example, 13 hour response time. We collect customer feedback at the end of every experience. They say, 5 out of 5, super fast response.
13 hours versus 3 rings. So I think We can use this technology to reset these kind of expectations. They don't live in the veterinary clinic every day, day in, day out, like we do.
They interact with us infrequently enough. You know, I wish they interact with us more, but they interact with us infrequently enough that we do have these perpetual opportunities to reset those expectations and iterate on the experience that we're providing, and these tools just allow us to, to do that. That's great, thank you very much, Tom.
David, would you like to follow on from that, please? Yeah, I mean, I think what Tom just mentioned as well kind of caters to, to the role the different formats of telehealth and telemedicine can play within the value chain as well. And also kind of catering to the fact of frequency of vet visits because it's always been something that that everyone looking for.
I think that the industry as a whole and pets specifically would be very benefited by speaking more frequently to vets. However, if the consumer view always is that it's like every time that I speak to my vet, it's €500 it's gonna be quite hard to push that behaviour over time in a constructive way from both perspectives. And I think it's much, much better to, to increase those levels of touch points and, and, and do it constructively for both parties in a way that is.
That is profitable for both parties. And, and also not to view telehealth and telemedicine as something directly substituting your clinical work, because if you do that and only make yourself individually available via telehealth solution for like, I have this gap on Thursday between 2 and 4 p.m.
I'm gonna make myself available then so all my consumers can call me via my telehealth solution and get help like, that's not what customers are asking for. They're asking for like the right help at the right instance and if, if the if the use case has always been just call and just come in, I think. The level of the, the level of like levers that we can use these formats for in order to increase touch points without pushing unnecessary costs for consumers or insurance companies or wherever it might be, while increasing touch points and increasing animal welfare in the end as well, is, is mega important actually.
. From from all different perspectives within the equation, those are my five cents. Yeah, as, as we've touched on, you know, common, common goals there, Tom, I was going to come back to you, you had your hand up. Yeah, just to say that, I'm sure cost is an element, but in, in our experience and our, pet owner research, cost is not the number one, barrier to consumption of veterinary products and services.
Convenience is. We have this very high trust touch point where people, you know, that I've talked to describe their beautiful relationship with their vet. But they also, as Suzie said earlier, are reluctant to load the kids into the car with the dog vomiting in the back and when they're not sure that that's what's to be done, or, the cat that they, they think they're doing the right thing by protecting that cat from a visit to the, to the vet.
Oh, guess what? What I've discovered through the pet owner reviews of PetsApp is that they actually worry about our convenience, the convenience of the veterinary team. So often we see reviews saying, this is a great way to interact with my vet, without pes, like, without feeling like I'm pestering them.
So good to be able to interact with them in a way that they can respond in their own time. And as a vet, like, like with all the biases I hold, it was just like so refreshing to see that the pet owners actually Care about us and want to do the right thing by us, but unfortunately, that all too often means the, the pet is not getting the care that they need, or at least not getting it as soon as they need it. So I think for, for your local veterinary clinics, if you can layer convenience on top of trust and do this in a way that doesn't require more of your already stretched team, then like, you've got this undisruptible business concept.
Fantastic point, thank you very much, Tom. Charlotte, I'd like to come to you next in terms of your experience of veterinarians making the most of remote consultations and making that journey for vets and owners, you know, optimal. So clearly there's gonna be some re-engineering that's gonna be required in the operations, but it what I share certainly with veterinarians is that it certainly can't be more painful than having converted to electronic medical record keeping, which is monumental hassle for many, many practises, and it involves every member of the veterinary team.
And if they could do that, they can adopt, you know, ways to deliver telemedicine. In an efficient and productive way. And I encourage every veterinarian on the planet to start doing it right now with rechecks, because rechecks, you've seen the patient, so you have that physical exam component.
The client feels comfortable because you've actually seen their pet. The veterinarian feels comfortable because they've seen the pet, and they can, it's, it's really wonderful onboarding process to get veterinarians. The staff to start using it so that when we will be able to use it to set up a first time meeting with the pet and the client, and we have never seen them perhaps before or the physical exam was 3 years ago, I think we'll be much more comfortable because we'll have established, we'll have just given that confidence to everyone all around, and then they can kind of test the waters.
OK, technologically, how are we going to do this? That's great, thank you very much, Charlotte. Something we started touching on at the end of the previous session was feedback from customers.
We've already touched on that as well today and Sarah, I think this is something where you can share your experience because obviously you then talk to owners at the far side of that pet care health journey. So I wondered what you could add from the owner's perspective for us. Yeah, absolutely.
So really just building on Tom's point, I suppose that, in many instances, you know, our customers are using the first bet service because they're really worried about pestering that bet that's on call. It's 1112 o'clock at night, . You know, they're not really happy with their pet, but they don't want to interrupt that vet's evening, because the last time they called, you know, the vet might have been busy doing something, or they know it's gonna take the vet, you know, sort of 2030 minutes to get to the practise.
And they're not sure if it's really worth it. So we've had loads of really lovely customer feedback where, the first vet consult was actually ended in, a vet referral. So that first vet has said to the owner, look, actually, you know, you've got a right to be worried.
I really think your pet does need to be seen now or in the next few hours. And that just puts the pet owner's mind at rest. That they really are doing the right thing at the right time for their pet, which has been really lovely to see.
And then I guess equally, we've seen instances, of first time pet owners that genuinely don't know what they should be doing, and they don't know, you know, what they can and can't do. They don't know what the. The out of hours situation is often, you know, they're not sure whether they're going to get through to their own practise.
They're not sure whether they need to go to a different emergency centre. So it's just convenience, I suppose, and it's just putting their minds at rest. And some customers have actually been really surprised at how much can be done in a video consult setting.
You know, they've actually taught themselves how to look at their sort of cat's gum colour and what that actually means and how to look and see if they're hydrated enough. So I think there's a lot of customer education that can be achieved remotely, that perhaps we've never really considered, and that can only really advance just the general pet ownership and care that that our pet owners are giving, so it can only be a positive thing. Can I, can I fill in on that as well?
What we've seen historically or historically, what we're seeing across really highly insured markets as well, it's this strange type of consumer behaviour where people who have pet insurance are like, I could go in now, but I really don't want to take time off work. I might just visit it Friday night at 11 p.m.
Instead, and I think that's really poor from all different aspects. It's poor from an animal wel welfare type of perspective because that pet is taking up time that somebody who deserves it more would have would have benefited from. It's more expensive for the insurer and in the end, the customer.
And it isn't necessarily the highest income for the for the clinic or practise either. It's like it's a classic loose loose loose type of triangle where, where like the structural setup of the market has been facilitating that because of Some kind of lack of involvement along the way of what triaging actually constitutes, and I think that's a great opportunity as well among among the highly insured markets, which is a behaviour that we're seeing as prices increase over time, yet credit risk kind of moves from. Customers' pocket into insurers or whoever that might be like health plan providers or whichever actor that is basically feels like I'm focusing a lot on cost here.
It's not my point, but, you know, from a, from a customer point of view, I think it's a relevant factor including the equation which oftentimes in these settings tends to get missed out on. I think, it's worth at least noting from, from that perspective, I think. That's great, thank you very much, David, and that's very neatly brought a link into our next question.
So just touching back on our final poll question, we've got, 66% of our audience have had positive experiences of remote consulting, 34% neutral, and nobody in this poll had a negative experience to share. So Tom, I'd like to come to you on this next question. Let's talk.
Finances and the bottom line, and that impact on the profession. Many people feel that virtual care can change the structure and revenue of physical veterinary practises. What impact, positive or negative, would you say that telehealth has and how does that look?
Well, we saw, clinics use PESApp to, you know, some of them actually grew their revenue year on year through, through lockdown, even, you know. And that, this is, has been the interesting change in use, of, of the product, is that initially, it was this revenue replacement. That was the thing is like some of these clinics were facing having to close, following staff, not being able to see people physically.
So like, how can we continue as a business, right? And, you know, I was very proud of the work we were doing to, you know, help protect people's jobs, keep that care there for, for pets, the support for pet owners, etc. But then as the, the, the first lockdown eased a little, what you actually saw was pent up demand and reduced capacity.
So then what people are looking for really is these capacity utilisation tools, ways to optimise capacity, ways to help their team face up to that pent pent up demand, despite the, the, difficulties of, of social distancing. And so that's when you do want to do things like take your discharge consultations out of that really busy evening consultation block and move them earlier into the day. Don't waste time with games of phone tag, especially when The phone lines are so congested, let's just text chat the, the owner an inpatient update, you know, a photo of their pet so that they can actually see their pets, it's an improved experience for the owner, but it takes us a second, rather than exchanging voicemails, etc.
So, I think you can, you know, ultimately, when, when we get to sort of the next normal, new normal, whatever you call it, you can see that there are opportunities here to increase capacity, augment. Efforts of our team, and then you have these kind of acquisition lead generation opportunities where we get to see issues, more often and earlier in the disease course, and where we can actually, you know, with, with web chat, it's a really good source of new client acquisition. So these tools working together, while simultaneously expanding the market for venting expertise, I think, it's gonna leave the, the, the profession and the sector, in, in very, in very good health.
That's excellent. And Suzie, would you like to follow on from Tom, please? Yeah, thanks.
I, I think, David's point earlier about this being really not a question of, of, of vest from a vet perspective, but looking at the consumer demand perspective as well is, is spot on. This consumer demand for telehealth is, is absolutely here. And in some ways vet clinics have, have no alternative but to answer that demand or or risk losing out to other, other people.
I see telehealth as a huge opportunity, in reducing barriers, to clients accessing care. So just like Sarah was saying, people aren't always sure whether their pet needs care or not, and they would rather put it off if they can. But if, if, if they can't, they're willing to come in and, our data shows sort of similar to what Tom was saying, really, but 44% of people, will delay seeking care for their pets, if they see if it gets better by itself.
. And that represents potentially quite a significant animal welfare challenge. So, our live chat, for example, 44% of the people, that's a synchronous messaging service, so slightly different to what we've spoken about so far. So providing that instant answer to people, it therefore has to be outsourced.
There's not a veterinary clinic, even very large ones can't manage that by themselves. But we're getting those 44% of people that are on the website, thinking. About veterinary care, looking for information, not making that actual leap to, contacting the practise, and we're removing that barrier.
We're explaining why they do need veterinary care, and we're, getting them signed up as a new client for the practise. So ultimately, you could feel like the veterinary nurse is giving out free advice, or you could say that actually, this is a brilliant way, to get clients on board and engaged with you. We generate on our, listing site Be Health Direct, we generate about 6000 calls to veterinary practises every month.
So a huge by providing that advice, you know, people, you could say, well, you're providing advice to people that are vets should be giving, and so are you removing from the bottom line of a veterinary practise? Absolutely not, because we're educating people on how important veterinary care is and for the health and welfare of their pets. And then through our interactive symptom checker, we advise about 30,000 pet owners every month that they need to have Veterinary appointment with the vets.
So it's, it's all everything approaching in lots of different ways, like everyone's been saying, and through all the different platforms that are available to reduce those barriers and make it as easy as possible for people to access and veterinary advice, and then ultimately get them into the vets in the best possible time scale. With video consults, there are a few sort of like issues in that people sometimes feel they don't want to pay the full amount for a video consult. And and then the vets are sort of And so we may, I think, see changes, in sort of pricing structures within veterinary practises, and, and we've in particular seen a rise in healthcare plans where video consults are free, or in-person consultations are all included, and I, I think we we'll definitely see a move more in that direction, so that vets can focus more on the best way to provide the care than having to worry about the best way they're gonna get money out of people, which they have to consider at the moment, and that's not always the most helpful way to engage.
Yeah, very good point there, thank you. Charlotte, do you have anything to add on this point? Yeah, I just wanted to add that as, you know, as long as the demand for veterinary services exceeds, The supply of veterinarians and certainly within the United States we experience a significant shortage of veterinary professionals and para professionals, and implementing telemedicine will allow us to extend that reach to provide more care.
I think there's a fear that people think, well, if you do all telemedicine consultations, there'll be nobody coming to the hospital. Well, actually, I think we'll be using the hospital resources much more efficiently for cases that actually have higher average client transaction rate that actually need those hospital. Visit.
So you'll see many more patients and your revenue will actually go up. And I think Tom mentioned how there's certainly, increases for that. And so I, I don't think there's a lot of solid evidence to support the fact that your revenue is going to go down because it's not a shifting from the exam room to tell a, yes, there's a shifting for those that should be viewed from a telemedicine perspective, but it's gonna flood in with the other cases that are actually going to, are more appropriately seen within the facility.
Excellent, thank you, Charlotte. Sarah, did you have anything to add on this? Yeah, sure.
So, for our support by many, we're not interested in taking any money out of any of our vet practises. I just want to be really clear on that. We're very, very happy that our customers are getting the right advice at the right time.
That will then lead into the right treatment for that pet. And if along the way the customer learns that actually next time their pet is showing those symptoms, it might be best that they just contact their practise straight away. You know, that is kind of what we're interested in.
We want to make sure that our practises that we work with, aren't overloaded with just hundreds of advice calls that they could be doing without, you know, downtime. When you're on call can be a bit of a struggle. I remember spending years of my life, being on call, so I know how difficult it is just to relax.
You're always terrified of that phone call coming in. So, yeah, we're, we're really interested in making sure that our owners know what is expected of them. So in their first vet appointment, you know, when the vet sort of says, look, actually, I, I do think your pet needs to be seen by your regular vet clinic, these are the sorts of things they might go through with you, and these are the sorts of things that, you know, they might want to do.
Our customers are then kind of forewarned, I suppose, before they actually go in. Into that regular vet clinic that it's not going to just be a consult for 50 pounds. You know, they're already expecting there might be some X-rays that need to be done, blood tests, or medications that that the vet might prescribe for their pets.
So I kind of hope that that is seen as a positive, by the vet practise and that vet that is then receiving our customer that has actually been directed directly towards the, in-person clinic. So, yeah, I think there's probably a lot of hype around. Pet insurers and costs and and taking money away from practises, but I, I can't stress enough that that's really not our interest here at all.
Thank you, sir, it's really helpful and interesting to hear the insurer perspective. David, did you have anything else to add here? I know you touched on it before.
Oh man, I can talk about this for hours, I think, but but I I I think it's, it's highly relevant what Sarah is saying as well, because us individually if we were to take that perspective, is like we're a freestanding telemedicine service, right? And we're independent. And I think that each individual actor within that value chain has different roles to play.
And in relation to the positioning that we've chosen and, and, and have been working on together with both by many, for example, has been working tremendously well because it builds trust along the value chain and makes people feel confident that the fact that they're making the right decision for their pet's own good. And also, like, from, from my perspective, I know that if I call off hours to one of the major, major hospitals in Stockholm where I live. I get to speak to a receptionist or nurse, and that might be completely fine as well.
But most people want that direct connection with somebody that who they feel that they really can trust, and, or at least feel that the, the consequence of that call corresponds with their expectations and as, as Sarah mentioned as well, I think telemedicine plays a huge role in Actually creating satisfied customers in practise as well, because people will have a much deeper understanding. Of what to expect when they actually show up, and what needs to be done, which I think we can see in our data even affects the time efficacy of practises instead, which I think alludes to what Tom mentioned of his member practises actually increasing revenue, driven by telemedicine as a tool. So I think like just positioned in a correct way, there's so much to be gained from telehealth as a whole.
Because it's such an unformalized piece of how veterinary practises typically are operating as of today, and just by sort of lifting that lid up and sort of lifting that workup of you noxious can bring so much good with it and include independent actors such as First Bet, for example. You know, the, the, the actors who are tied into individual practises like PetSA, for example, that Direct, like, you know, each individual aron platform here plays different roles within the ecosystem for catering to different needs, and I feel that it oftentimes gets a bit too. To singular from that perspective, which is unfortunate actually, but I think we're getting there step by step.
We are and I think this, you know, the conversations we're having here today are are great in terms of looking at this ecosystem as a whole, that very holistic approach. So as we draw to a close, I'd like to invite our audience to pop any questions they have for our panellists in the Q&A box, and David, I'd like to. Come back to you with our final question first please.
Looking ahead to the future with our crystal ball, do you think that telehealth is going to change care standards? Do you think it's going to change how pets are insured? Perhaps are we going to see any changes at the end of the COVID pandemic, or is something else going to change?
What are your thoughts on this? OK, another question I can talk about for hours, but, . Yes, to some extent, but I don't necessarily believe that telehealth should be the driver of that change.
I think that consumer needs and the way that veterinary practises are working as of today should be the drivers of that change. If that even makes sense, I don't know, but like, telehealth feels, feels a hugely important role within the value chain and within the ecosystem, but it's driven by the actual consumer needs, not as a means of it of its own, you know. Which is exemplified by all the actors that I've heard about, you know, this last year driven by COVID, who very reactively get video consultation tools and be like, yes, this will save my business.
I'll make myself available for those 2 hours every Thursday and everything will be fine and dandy because I can't have my, my practise open the way that I used to. It's like, That's not the way that it works. It's like it's facilitating and reaching these customers when they actually need it in a much more efficient way and making sure that they end up at the right instance within that car chain and while also.
Kind of including and this might be just taking my chin out a little bit, but I'm not sure, like including the economical drivers within the veterinary industry as a whole, which has undergone huge changes within the last just 10 years, right, of practise consolidation driven by private actors or big corporates, like it is changing the landscape and this is a natural piece of that landscape changing. So I think it will, will definitely increase animal welfare, allow vet practises to interact with their clients much more often without having. Those interactions stress their vets out, reflect on poor customer ratings or stressing the pet owners and pets out, even, we just sort of addressing.
Addressing the right things at the right time. Now I'm gonna stop talking because otherwise I'm just gonna continue. Thank you, David.
Sarah, can I come to you next please? What are your thoughts? Yeah, of course, thank you.
So, I guess with my insurance hat on, over the last sort of 12 months or so, we have seen, a phenomenal amount of pets getting insured for the first time. I'm sure everyone in the audience and on the panel are very aware of the kind of puppy. Pandemic that's going on at the moment, certainly in the UK.
So, yeah, we were very pleased to see that actually, more and more pet owners were looking to get that pet insured, so that if the worst was to happen, that they're covered, you know, they can maybe just about afford the, monthly insurance premium. But if they're faced with a 23, 400 pound bill and upwards, for that vet treatment that they've got to pay themselves, there's just, you know, no way they'd be able. To manage that.
So we've been really kind of pleased, that we've been able to kind of, you know, support a lot of pet owners through a period where perhaps they may not, have been able to keep that pet, themselves. So, I guess looking in the future, from a pet insurance point of view, we're always going to need pets to be vaccinated, and have a regular vet checkup, just to try and spot any problems early. You know, we're, we're not interested in, delaying vet treatment, ultimately that that may actually cost more in the grand scheme of things.
So we're, we're really interested in educating our owners to be proactive, about being a responsible pet owner, I suppose. We've certainly got no plans to take out any of our requirements, for vaccines, annual health checks, dental checks, those sorts of things, so. We can't see that in-person care is ever gonna need to be replaced.
You know, it's always gonna be a, a compliment all of this telehealth, sort of opportunity. So, yeah, I think there's definitely lots of ways that things can be improved. And I think change is only natural and without it we'd probably be really stuck.
So, yeah, I think change is, is a good thing as long as it's done in the right way. Thank you, Sarah. Charlotte, what are your thoughts on changes for the future with remote consulting?
So there's no doubt in my mind that the availability of telemedicine will increase the standard of care for so many reasons that everyone has articulated today. I think the veterinary profession, like many professions, are a little bit resistant to change and, and some people change certainly, you know, certainly quicker than others. But I think if we view telemedicine is just tool in our toolbox to provide veterinary care.
It's not so scary anymore. It's just another way that we provide, care, like we've adopted so many other modalities to provide better care to our patients. And telehealth does it because it improves the timing, because you can see a patient immediately.
And it will never take the veterinarian's judgement away, nor should it. And if the veterinary believes that you need to see the patient, then they should say, we need to see the patient. And I do, so there were questions here about prescribing medications.
Again, I mean, once, but for the regulatory constraints, if you think that you can prescribe a medicine through a telemedicine consult, then do it. You know, you can't do it now, so don't do it, you know, in certain circumstances. But the point Once you ignore the law for a minute, it's always based on your judgement.
And if you made the wrong judgement, then there's gonna be consequences, both at the regulatory and the lawsuit, just like there's consequences today, if you didn't do something that you should have done. The risk isn't really different. It's just unknown because we're not familiar, but just like you learn how to use the other modalities.
So it is, it's clearly here to stay. Thank you very much, Charlotte. Suzie, did you have any thoughts for the future?
Yeah, yeah, I was gonna start with exactly the same sentence as Charlotte, but yes, it has improved standards, it will improve standards. It has improved them already, and I think it will do further. It's just getting people through the door, ultimately.
It's really interesting. I'm just looking at the chat, and, and there's a lady called Eve Cohen, and she said that, most of her consults are people who do end up coming into the hospital anyway. And I, I think it, it's just more evidence.
It's just reducing barriers. Is helping people know that they are doing this highly inconvenient thing of going to the vets for a good reason and that it needs to be done. I think it's gonna result in better animal welfare, better, for the veterinary businesses and better for the pet owners.
And I think that automation, is gonna be really key, and to making this a success. So just to give you a, a small example of that, that helpect new client registration is automatically synced with the practise management system. So, Something that might take 1015 minutes of dictating your name out over the phone or copying across details from an email, or a message into the practise management system.
That staff time is then freed up completely. And it's a, a, a double whammy because you've freed up the staff time, but you've also provided this really slick, gold standard digital customer experience that people have in other areas of their life, and they now expect when they go to the vets. So I think the more technology and with particularly practise management integrations and really focusing on that practise workflow, making sure that the team don't have extra work, indeed, they're freed up from work, will then empower them to offer that, gold standard customer, digital experience, to the pet owners.
So, yeah, I'm, I'm very excited about telehealth, and, and it's been great to hear everyone's perspective on it. I think the future is looking very bright, really, for a much better level of care, for pet owners. Thank you, Susie.
Tom, would you like to close with your thoughts, please? Sure, love him or hate him, Jeff Bezos has a great quotation on this. He says, yesterday's wow quickly becomes today's ordinary.
So I think we've got no choice but to keep iterating, keep moving forward, and I think it's been a point well made that pet owners want this and we should look at it in In terms of pets and jobs to be done. But, for Pets up at least, Bentley Teams are also our users, and we do have a duty of care, we do have a responsibility to them, and they want to help pets, right? But they shouldn't have to, give as much as they currently give, you know, with the burnout, etc.
How can we help them deliver on their personal mission, their professional mission. In a way that is more sustainable, more enjoyable, more flexible. I think that's part of our future, and that's part of the promise of, of, telemedicine, telehealth.
I also think it's the framing of the change. If more people are going to embrace this technology, one of the sort of comparables that people would, draw on is like changing out their practise management system, as Charlotte mentioned. Earlier.
Now that's a massive headache. It's a high point of like, veterinary team churn. This doesn't need to be that.
You can experiment iteratively. You can just introduce one or two use cases and layer on the others later. So I, I would just close by encouraging people to, to experiment and try this stuff and see where it takes you.
Wonderful, I think that is a great point to finish on, Tom, thank you very much. I do just have one question from the audience. I think we've probably covered some of the other ones, and as I said before, anything we haven't got to, we will come back to you, after the session.
But, in terms of being, 11 anonymous, member of the audience has raised the, the. Concern about potentially outsourcing remote consulting to other countries, you know, potentially for the UK English speaking, obviously, or other suitably qualified people. Can anyone comment on this as, what their thoughts are?
Is, is this a possibility for the future? I guess, I would liken it to . Customer services being overseas instead of within the country of origin.
I can, I can feel like kick off that if like thank you. I think it's a risk, definitely over time. I think that's one of the underlying reasons why we need to formalise the value chains and the way that these services are provided in a way that actually is sustainable and thus increase animal welfare rather than diminish it, because I think that given the dispersed regulatory frameworks from a worldwide perspective, there is an apparent risk of anyone, you know, going down that lane, but I think it would be wrong.
I think it would be, you know, as AI research has shown, like chatbots really, it doesn't do much change. Like, if I call, if I call the customer support, like I can hear that they're answering from somewhere else. I think that the vet delivery.
Still is so based on trust. And local knowledge to some extent that to sort of strip that piece from the equation, I don't think that either party within this field is ready to do that for a really long time. And I don't think it should be either.
However, having, you know, I don't know, part of your, vet team, having the possibility to travel to Thailand every 3 months and staff your off-hours availability to increase employment retention and satisfaction. I don't know that might be a great thing, but, but I see a pretty small risk for that. I think it, the only cases that I've heard about it so far has been for like competitive war services or equine vets, delivering carry across, .
Cross-border, and also when it comes to livestock to some extent, but that's like different to some extent of what I'm discussing here, I think. Thank you, David. Tom, did you have something to add?
Yeah, I think, it's, it's an interesting question and one that came up, you know, when we started the PetsApp journey, I remember being at BSAVA on a panel there, and it seemed to be that people's first instinct, when you mentioned telemedicine, was that you were talking about, someone in Singapore serving a prescribing opioids to a dying dog in Scotland or something like that. It's just, you know, it's like, that's not what we're talking about. .
I think David's right, that, that, that, there is a risk of, that some providers, unethical providers, doing that. You know, the best way to stop that happening? The best way to stop that happening is for your local veterinary clinic to provide the service that the pet owners want in the.
Manner that they want such that they would never tolerate such a low standard of care for their pets. And so, so much of this, encouragement to embrace digital transformation is also resisting disruption and maintaining the position of the local veterinary clinic at the heart of the pet care journey. Excellent, thank you very much, Tom.
Susie, did you want to add anything on this? Yeah, I mean, like Tom, our focus is on veterinary clinics, being able to really communicate much more readily, with their clients. So this is really sort of far removed from the, the problems and issues that our veterinary teams are facing and that the clients that we deal with, the pet owners that we deal with are, are thinking about.
You know, I think there's a huge value in. A vet that has access to the history of the pet that they're dealing with, and that knows the, the, the clinic knows them inside out. Obviously, that's not possible all the time.
People have to go to out of hours emergency services where their notes aren't often accessible, and the the team don't know the pet. And that's where there's a role, like David was saying, for all sorts of different providers and and where first bet's really valuable. But I think there's always going to be a real value for vets providing remote services to their.
Our own clients, some as part of that journey as a few steps on the journey. And it's difficult to see how a vet that's overseas, you know, first of all, you've got the question whether the qualifications are equivalent, and do they understand the endemic diseases in the area, the drugs that are available, and it seems like a very sort of difficult situation. And and as as Tom was saying, I think you'd hope that the veterinary practises are able to provide such a good level of service that that's not something that's ever really tempting for foreign owners.
Thank you very much, Suzie. Sarah, did you have any final comments on this? Yeah, absolutely.
So, I suppose as an insurance provider, first and foremost, it's the pet owner, our customers that that are the centre of our world, I suppose. And we really care about quality, so I think any temptation of outsourcing this sort of advice or service, it's just not, you're not gonna find a comparable service by outsourcing it internationally, I don't think. So I can't see how any pros are ever gonna outweigh, the cons, and we're, yeah.
We're very supportive of our pet owners, getting high quality care and advice, at the right time. So, yeah, I can see that this would be something that we would be looking into, certainly not anytime soon. You know, I don't think we have any problems with, with what's happening right now, so, yeah, we'll wait and see.
Excellent. Well, thank you all very much. Thank you to everyone for joining us for the second session today.
Please join me in saying a huge thank you to all of our panellists today. Thank you very much, everyone, and thank you to the Webinar vet for hosting us. As I mentioned earlier, the recording will be available to watch back in 24 hours, and we hope that you've found today really, really valuable.
Thank you very much, everyone. Thank you. Thank you.
