A bill sponsored by Ohio Senators Shane Wilkin and Steve Huffman was recently introduced which would establish requirements and procedures for a veterinarian licensed to practice in Ohio to conduct telehealth services.
Background
Several other states have enacted similar legislation, including Arizona, Florida, and California. Senate Bill 268, which proposes amendments to R.C. 4741.04, seeks to broaden the expansion of telehealth services in response to the COVID-19 pandemic beyond the practice of human medicine into the care and treatment of companions and farm animals. However, veterinarians who treat animals in the food production industry are not permitted to utilize telehealth options unless said veterinarian has previously established a veterinary-client-relationship in person.
While many veterinarians have already implemented telehealth protocols in their respective practices, and the Ohio Veterinary Medical Licensing Board has issued a position statement in favor of the practice, the requirements and procedures have not yet been codified, leaving some veterinarians leery of potential liability stemming from the practice.
The bill expands upon the definition of veterinary-client-patient-relationship and provides guidance to practicing veterinarians who wish to include telehealth as an option for their clients and patients.
Provisions & Consent Requirements
If enacted, veterinarians would be required to obtain informed consent from their client, including an acknowledgement that the standards of care governing the practice of veterinary medicine apply equally to in-person and virtual appointments. Further, documentation concerning this explicit consent must be maintained by the practice for a duration of no less than three years. Most practices retain medical records for significantly longer than three years, but the bill is silent as to how long the records must be retained once the client leaves the practice. Accordingly, veterinarians should air on the side of caution when implementing retention policies.
Much like the requirements in human medicine, the bill proposes that veterinarians must provide their name, contact information, and an alternate means of communication in the event the appointment is interrupted. And following the visit, the veterinarian must provide to the client, or otherwise make available, a written or digital copy of the visit. This record must include the veterinarian’s license number.
Finally, prior to a telehealth appointment, the veterinarian must inform the client that 1) depending on the circumstances, she may recommend an in-person visit; that she 2) is prohibited from prescribing certain drugs in the absence of an in-person visit; and that she 3) has the right to terminate the virtual appointment at any time.
Telehealth Limitations
As noted above, the bill permits veterinarians to prescribe medications via a telehealth appointment with the following conditions: 1) the prescription must be limited for a limited duration of fourteen (14) days, with the option of refilling another fourteen (14) days prescription after a follow-up virtual appointment – any additional refills will require an in-person appointment; 2) the veterinarian must notify the client that certain prescriptions may be available at a typical pharmacy, and, if requested, the prescription can be sent to the client’s preferred pharmacy; and, 3) the veterinarian is prohibited from prescribing controlled substances unless an in-person examination has occurred.
