Pulse - January 2024 - 16

TOOLS FOR SUCCESS
CVMA Policy on
Veterinary Telehealth
Courtesy of CVMA
T
he CVMA supports the use of telemedicine
for cases in which it can be used
safely and appropriately, and at a standard
consistent with current veterinary medical
practice in this state. In accordance with
California's telemedicine law veterinarians
who use telemedicine are held to the same
standard of care that is expected of them
when seeing patients in-person.
California Business and Professions Code section 4826.6(c)
(1) states: " The same standards of care apply to veterinary
medicine services via telehealth and in-person veterinary
medical services. " Given that veterinarians practicing via telemedicine
cannot physically examine animal patients, this legal
requirement makes the use of telemedicine risky from both
general liability and administrative law standpoints. When
investigating and enforcing telemedicine-related complaints,
the state Veterinary Medical Board (VMB) will not consider
a separate (lower) standard of care for these cases; but rather
will expect veterinarians to practice at the same level as if
patients were seen in-person.
Keeping the standard of care
In consideration of the statement above, the CVMA recommends
that:
* Telemedicine only be used to diagnose new conditions in
patients when a previous in-person physical examination
or medically appropriate and timely visit to the premises
where the animals are kept has/have occurred in such time
as good standards of medical practice dictate.
* Telemedicine only be offered if the veterinarian providing
the service is associated with a California-registered veterinary
premises that is capable of seeing the animal patient
in-person if the need arises.
* All prescriptions issued via telemedicine be limited to 14
days and that refills only be given following an in-person
examination of the animal patient. (California Business
and Professions Code section 4826.6(g)(5) is explicit in
this limitation for antibiotic prescriptions.)
* Veterinarians who utilize telemedicine to establish a Veterinarian-Client-Patient
Relationship (VCPR) should check
with their insurance provider to ensure that adequate liability
coverage is included in their policy.
* The quality of the synchronous audio-video communi16
cation
should be adequate, and both the veterinarian and
client should have sufficient proficiency in using technology
to conduct an appointment.
* The animal patient and client should be visible to the veterinarian
in the synchronous audio-video appointment.
* If possible, the synchronous audio-video appointment
should be recorded and retained as part of the patient
medical record.
Using telemedicine
Veterinarians who opt to use telemedicine should also consider
the following:
California law prevents corporations and non-veterinarian
individuals from influencing the way veterinary medicine is
practiced. The VMB has legal enforcement authority against
non-licensed individuals or corporations that interfere in any
way with the professional judgment of a veterinarian. This
includes pressure to follow pre-written treatment protocols
and pressure to prescribe and sell select drugs. The following
sections of the California Business and Professions code are
explicit: 1, 4853(g), and 4883(t).
Any drug prescribed pursuant to federal Extra Label Drug
Use (ELDU) regulations and the Animal Medicinal Drug
Use Clarification Act (AMDUCA) requires an in-person
examination of the patient. Federal law permits veterinarians,
in accordance with their professional judgment and federal
regulations, to prescribe drugs in an off-label manner. OffJANUARY
2024
PULSE
Pulse - January 2024

Table of Contents for the Digital Edition of Pulse - January 2024
