Telehealth, Teletriage, and Telemedicine

What is telehealth?

Telehealth is not a specific service.  It is a broad term that refers to the use of virtual information-gathering technologies to provide many different health-related services. Telehealth services can be delivered by a variety of methods, including telephone, text messaging, internet chat, and videoconferencing.

When you think of telehealth, your mind may immediately jump to telemedicine, in which a doctor diagnoses and treats a condition remotely. However, telemedicine is just one category under the broad umbrella of telehealth. Telehealth also includes other categories, such as teletriage and health education.

What is triage?

In medicine, triage involves performing an initial assessment to determine the urgency of an illness or injury. Your veterinary hospital performs patient triage daily, just like human hospitals.

If you arrive at your veterinarian’s office without a scheduled appointment, concerned about your sick pet, a triage exam is typically performed to determine whether your pet requires immediate care or whether it can be addressed later in the day. For example, a dog that has been hit by a car and is struggling to breathe is an emergency that would be addressed immediately, while a cat that has been scratching at her ears for several days (but is otherwise acting normally) may be seen later in the day.

What is teletriage?

Teletriage is the act of performing triage remotely, via telephone or internet. When you call your veterinary clinic to schedule an appointment, the receptionists likely perform some degree of teletriage, which allows them to determine whether your pet needs to be seen immediately or whether it is okay to wait for the next available opening, later in the week.

What happens when your veterinary clinic is closed and both the veterinarian and receptionists are unreachable?

If your pet develops an illness or injury after hours, it can be difficult to know whether your pet needs immediate emergency care or whether it’s appropriate to wait for your regular veterinary hospital to re-open. This situation is exactly what teletriage is designed to address. Teletriage services help determine the urgency of your pet’s medical concern.

How does a teletriage service work?

A teletriage service will first ask questions about your pet’s current illness or injury. These questions are like the questions your veterinarian or veterinary technician would ask during an in-person visit. For example, you may be asked:

• What is your pet’s problem?
• When did you first notice this problem?
• Is this problem getting better or worse over time, or is it remaining constant?
• Has your pet ever experienced a similar problem in the past?
• Is your pet eating and drinking normally?
• Is your pet lethargic?

Next, you may be asked to examine your pet and provide information about your pet’s condition. For example, you may be asked to:

• Check your pet’s temperature
• Assess your pet’s gum color 
• Measure a lump or growth
• Feel a body part for swelling

Based on this information, the teletriage service will determine how urgent your pet’s concern is and how quickly veterinary care is needed. The teletriage service may advise you to take your pet to an emergency clinic immediately or may tell you it is okay to wait and call your veterinarian when they re-open. Teletriage services may even be able to refer you to a telemedicine provider who can provide a remote evaluation of your pet.

What is telemedicine?

Telemedicine is the practice of medicine at a distance. In the context of veterinary medicine, telemedicine refers to a veterinarian formulating a diagnosis and treatment plan for your pet without an in-person examination. Unlike teletriage, telemedicine can only be performed by a licensed veterinarian.

Often, telemedicine is only permitted within the context of an existing veterinarian-client-patient relationship (VCPR), which means that veterinarians can only offer telemedicine services for their existing clients, under most circumstances. However, some federal and local governments have relaxed the requirements surrounding telemedicine and establishing a VCPR. These legal changes have made telemedicine available to a wider range of pet owners.

Can telehealth replace all veterinary visits?

In-person veterinary visits are still essential for your pet’s health. Subtle abnormalities can only be detected with an in-person physical exam and diagnostic tests, so telehealth will never completely replace in-person veterinary care.

However, telehealth can supplement the care provided during in-person visits and can also provide a safe and practical method of receiving some veterinary care during times of physical or social distancing.