Douglas G. Aspros
Innovation Station guest columnist Dr. Douglas G. Aspros is a Veterinary Innovation Council board member and the chief veterinary officer at Veterinary Practice Partners. An experienced clinician, he owned general practices and was the managing partner of an emergency hospital. A determined voice for diversity, he was a founding board member of the Women’s Veterinary Leadership Development Initiative. He served as president of the American Veterinary Medical Association in 2012-13.Read Articles Written by Douglas G. Aspros
I have been around long enough to be wary about futurists, the people who all too often predict a future that looks pretty much like today, only more so. None of these futurists seem to be able to see around corners or alert us to unanticipated dangers. Too bad the futurists of 1750 didn’t understand the long-term results of burning fossil fuels or forecast the coronavirus pandemic.
Every generation defines innovation differently, identifying the people who will drive the processes and newest technologies and propel society toward a brighter future. Boomers were promised a sparkling Jetsons future of robotic nannies and flying cars. Despite the amazing progress of the silicon revolution, what we’ve got so far are Roombas, Alexa and Apple CarPlay.
So, instead of writing about the veterinary equivalent of flying cars, I want to highlight four things that I think are in your future. Some are driven by technology and others are systems-based. As always, changes in social perspectives and values will be key.
Veterinary medicine has long been the Wild West of the medical space — a bunch of cowpoke towns waiting for the railroad to come through so that they can grow. Right now, folks are busy laying track.
Veterinary practices are computerized today because a solid case for managing client reminders was established early on. The American Animal Hospital Association’s Chart of Accounts made financial reporting more consistent, allowing for benchmarking and facilitating practice acquisitions by corporate platforms. What hasn’t yet been standardized are the service codes, or medical record formats, that would help us to better track how we deliver care. A few of the largest corporations, such as Banfield and VCA, have proprietary systems that allow them to better manage their medical teams and provide insights into care and services that otherwise would be concealed inside the practice management software.
As more practices are added to larger corporate platforms, our PIMS systems will have to change.
Standardizing evidence we collect around patient care (beyond reminders) will open a range of options, from understanding treatment efficacy to setting prices more strategically. Standard service codes will provide good actuarial data to the pet insurance industry, allow the companies to set rational premiums and grow market share. Even a moderate growth in the uptake of pet insurance could initiate a radical change in our business model, exposing the veterinary professional to third-party payers with real clout.
Legacy PIMS systems (onsite servers and semi-closed ecosystems) will lose ground to more flexible and cloud-based systems, which could retard the development of more standardized data collection. We’ll see how it shakes out.
2. Artificial Intelligence (AI)
Deep-learning systems are a rapidly growing reality in computer science. These programs use their experience to acquire knowledge that no human taught them. AI can use data delivered from human-developed databases or learn from their simulations.
One area of rapid deployment in human and veterinary medicine is image recognition. Computers are amazingly good at learning to correctly identify, for instance, the people in your Facebook feed. The same process has allowed the rapid and accurate processing of radiographic images, the analysis of urine sediment and the identification of parasite eggs in feces. Cytology will be the next diagnostic modality to come online in veterinary medicine.
With more and more imaging material to learn from in our digitized world, computer capabilities in all these domains will rapidly meet (and exceed) the accuracy of their human counterparts and at far lower costs and with ultrashort wait times.
The same process will further assist veterinarians in making clinical determinations. Providers will conduct real-time consultations driven by machine recognition of scientific patterns in diagnostic data that might have heretofore been hidden from us.
I expect the quality of care to improve for veterinary patients through the increased use and sophistication of AI applications, particularly in general practice settings and for clients who can’t afford a referral to a specialist. Speed, convenience and accuracy are moving us into a better tomorrow, today.
3. Virtual Care
Veterinarians have offered care at a distance for as long as the telephone has existed, but the advent of the smartphone and the demand for working virtually through the pandemic dramatically changed the landscape.
In the spring of 2020, many jurisdictions limited the types of services that veterinary practices could offer. In that space, finding a way to provide useful advice to patients in need was appealing and, as we all started working ourselves through platforms like Zoom, a peek into the future.
An explosion of communication platforms, mostly smartphone applications, allowed us to see high-quality images, support synchronous and asynchronous communications and, for really the first time, monetize the interaction. The veterinary industry — from member organizations like AAHA and the American Veterinary Medical Association to pharmaceutical and food companies to industry consultants — jumped on the bandwagon.
So far, the profession’s interest has been outstripped only by the enthusiasm of platform developers and venture capitalists. A new organization, the Veterinary Virtual Care Association, was formed nearly a year ago in an effort to develop and promote telehealth solutions in veterinary medicine.
The opportunities to solve real-world problems at scale through virtual care are to be determined. Will virtual care turn out to be the highway of the future or just a side road?
4. Expanding the Veterinary Workforce
In 1972, the AVMA authorized an accreditation program for educational institutions that would prepare veterinary technicians (animal nurses) for clinical practice. Fifty years later, we’re still working to expand the utilization of licensed veterinary technicians and develop uniform standards for their scope of practice. It’s been way too long.
The preparation and professional skills of technicians/nurses have continued to evolve, but their degree of autonomy and the value we allow them to deliver in veterinary practice hasn’t kept pace. We’re not nearly as efficient as we need to be given the shortage of veterinarians, the cost of veterinary care and the number of animals that need care but go without.
As the demand for services outstrips our ability to provide affordable care, doctors need to work more effectively in teams, retaining only the roles that require their level of training and leveraging the skills of other trained personnel.
In the post-pandemic world, with the accelerating strength of the human-animal bond, I expect the public to demand more affordable, humane care for companion animals than is currently available.
Expanding our use of technicians will require practices to do a better job of delegating responsibilities, which will enhance job satisfaction, allow for substantial increases in compensation and aid in retention. We need to embrace the need for a strong cadre of veterinary nurses.
The real innovation will be taking the next step: Follow the path set in human medicine and allow for midlevel practitioners, the equivalent of veterinary nurse practitioners, to join the veterinary health care team.
The Future Is Now
Those are some of the innovations poised to profoundly change the way we work and practice over the next decade. Beyond that, who knows. Flying cars, anyone?