Utilizing Veterinary Technicians for Teletriage

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Teletriage is the preliminary assessment of a patient to determine the urgency and severity of a medical issue. Teletriage is a service that any practice can offer and shouldn’t be intimidating. This can occur with a technician through real-time video or asynchronous communication via chat- or a combination of both depending on the needs and wants of your practice. Teletriage can also serve large animal practices, small companion animal hospitals, and exotic species.

 

Benefits of Offering Veterinary Technician Teletriage

  • Increase client retention rates
  • Drive more revenue into your practice
  • Can be performed remotely outside of the physical practice
  • Improve client trust of your practice and the veterinary profession
  • Show value of client time and ER vet time by determining if the patient needs immediate care or if the medical issue can wait
  • Free up phone lines
  • Allows the veterinarian more time to physically see more patients in hospital

 

Patient Problems that can be Teletriaged

  • Toxic ingestion
  • Gastrointestinal
  • Urinary
  • Reproductive
  • Dermatology/Allergy
  • Musculoskeletal/Lameness
  • Respiratory
  • Ocular
  • Trauma (HBC, fall from height, dog attack, etc)
  • Post-surgical

 

Basic Triage Questions

  • What is the primary concern?
  • Duration of issue
  • Patient signalment
  • Any previous medical issues
  • What medications is the patient taking
  • Any trauma to the patient witnessed
  • Is the patient
    • Eating/drinking/urinating/defecating appropriately
    • Breathing easily and effectively
    • Bleeding or has obvious wounds
    • Ambulatory
    • Lethargic

 

Visual Triage Assessment

  • The client can send video or pictures of the following
    • Mucous membrane color
    • Wound, injury, or area of concern
    • General disposition of the patient
    • Movement of the patient (lameness)
    • Patient breathing
  • The client can provide respiratory and heart rates
    • Tell the client when to start and stop counting
    • Tell the client where to look to count respirations and where to feel for pulses
    • Breathing can also be calculated by the technician from a video a client sends
  • Technician can request a temperature to be taken of the patient if the client and patient are willing

 

Triage Categories

Red = Emergency care needed asap

  • Provide location and contact info for local ER
      • Send patient records and triage assessment directly to ER
  • Allow patient to be transferred to your practice for care
  • Dispatch to client/patient location/premise

Yellow = Not emergent, but needs care soon

  • Schedule next day or same day appointment

Green = Not emergent, can monitor at home

  • Schedule appointment for an appropriate date after initial triage assessment depending on patient issue
  • Schedule in clinic or telemedicine appointment
  • Can provide prescription (in hospital pickup or sent via online pharmacy) for patient issue if
      • appropriate for medical issue
      • have established VCPR
      • have veterinarian consent and dosing

 

Triage has been done by phone call by our front desk and technician staff for years- with far less information than can now be provided through a telehealth platform (like pictures and videos). The concept of tele-triage is not new- it’s now just improved!

 

Real-World Scenario

 

Patient

 

Pet:

Dude

Client:

Ashley

Signalment:
4yo, MN, 20lb Bichon Frise

Medical History:
No medical problems. UTD vaccines and preventive care.

 

Dude has been used to Ashley working from home during the pandemic. He usually is kenneled when left alone because he has a tendency to let curiosity get the best of him. Dude has been known to chew a shoe and topple the garbage can.

 

Since Ashley has been home, he is rarely kenneled, but enjoys his owner’s company.

 

Ashley is now heading back to the office after 1 year away. She buys a camera to be able to watch him on her phone while she is at work.

 

On her lunch break one day, she checks the camera to peek in on Dude and notices that he has gone through her weekend bag and is chewing on what looks like gum. Ashley is angry at him, but it’s only gum she thinks. Her coworker mentions something about gum being bad for dogs

 

Scenario A

 

As the day rolls on, Ashley becomes more concerned that this gum could be a problem for Dude, so she calls your office.

 

It’s 2pm and your clinic is slammed. Ashley receives a busy signal. She tries again and then goes to voicemail. She leaves a message that Dude has eaten gum and if he needs to be seen.

 

The voicemail goes unheard until near closing. Worried, your technician calls Ashley back and leaves a voicemail inquiring if the gum was sugar free. If so, he needs to go to the ER asap.

 

In true voicemail fashion, it goes unheard until the next morning. Ashley, then brings Dude into your clinic for hospitalization and treatment.

 

Despite your best efforts over the next few days, Dude succumbs to the effects of xylitol toxicity.

 

Scenario B: Anipanion Telehealth

 

As the day rolls on, Ashley becomes more concerned that this gum could be a problem for Dude. Having used Anipanion previously for Dude’s mass removal surgery, she sends a text inquiring about Dude’s gum ingestion.

 

Your awesome technician monitoring Anipanion responds within minutes to Ashley’s question. Your tech advises that she bring Dude in immediately for care since sugar-free gum is highly toxic to dogs. Your tech explains what will happen when Dude comes into the hospital.

 

Your tech alerts the staff who begin to set up for Dude’s arrival. Emesis drugs, activated charcoal, IV catheters, fluids, needles and syringes for labs are prepared along with a treatment plan for Ashley to sign and leave a deposit.

 

Ashley leaves work and arrives promptly at 2:30pm. Dude is immediately taken for treatment while your tech explains the process, how Dude will be cared for, and has all the appropriate paperwork signed.

 

Ashley receives Anipanion updates from your tech throughout his hospitalization. Over the next few days, Dude improves and is sent home with a clean bill of health.

 

Dude will be kenneled from now on while Ashley is at work, but otherwise will live to cause more mischief.

 

 

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