Guide - Telemedicine

Telemedicine refers to the provision of specific veterinary medical advice and veterinary treatment of an animal(s) or group of animals based on a virtual assessment by means of telecommunication technology where no in-person physical examination or in-person premise visit of the animal(s) or group of animals by the veterinarian takes place. Practicing via telemedicine does not alter a veterinarian’s existing legal and/or professional obligations. 

Telemedicine does not include teleconsultation between veterinarians where colleagues in different physical locations consult virtually with each other. In cases of teleconsultation, legal and/or professional obligations remain with the veterinarian who established the veterinarian-client-patient relationship (VCPR). 

If a veterinarian is providing general advice to an individual that is not specific to their animal and could be applied to many animals, this is not considered practising via telemedicine. This would be considered telehealth, which encompasses both telemedicine and general advice. To review the full definition of telehealth, please refer to the Professional Practice Standard: Telemedicine. 

In Ontario, triage is considered specific veterinary medical advice and falls under the practice of veterinary medicine. When triage is provided using electronic means (i.e. teletriage), it is a component of practicing via telemedicine.  

A veterinarian’s legal and professional obligations are unchanged whether triage is performed in-person or using electronic means. 

Telemedicine is a method or mode of delivering veterinary medicine. A veterinarian uses professional judgement to determine what services to provide via telemedicine, in accordance with the relevant legislation and College standards. A veterinarian provides services via telemedicine to the extent that is possible without an in-person examination or in-person premise visit. 

All veterinarians who provide veterinary services via telemedicine to an animal(s) or group of animals located in Ontario must be licensed with the College regardless of the location of the veterinarian. 

A veterinarian licensed in Ontario providing veterinary services to an animal(s) or group of animals who resides outside of Ontario would need to meet the regulatory requirements of the jurisdiction where the animal resides.  

The College maintains its regulatory authority to investigate any complaints made about a veterinarian licensed in Ontario regardless of whether the veterinarian and/or the animal(s) or group of animals is physically located in Ontario. 

All veterinarians who provide veterinary services via telemedicine to an animal(s) or group of animals located in Ontario must be working at or from an accredited facility in Ontario. The veterinarian does not have to be physically present at the accredited facility in order to provide services. 

Yes. For more information related to these requirements please contact the College’s accreditation team. 

A veterinarian may choose to utilize a third-party company’s platform to connect with clients in order to deliver veterinary services via telemedicine when practicing from an accredited facility. The platform is a conduit or interface between the client and the veterinarian and is not in itself an accredited facility. The veterinarian is solely responsible for the services provided via telemedicine, including collecting fees from clients for these services and medical record-keeping.  

Third-party providers of software (who are non-veterinarians) that assist veterinarians in providing telemedicine services should not hold themselves out as providing veterinary telemedicine services to the public. For more information, please see the Professional Practice Standard: Conflicts of Interest in the Practice of Veterinary Medicine and the Position Statement: Unauthorized Practice. 

A veterinarian is permitted to prescribe a drug for an animal(s) or group of animal(s) via telemedicine. The professional expectations related to this allowance are outlined in the Professional Practice Standard: Prescribing a Drug and are repeated in the Professional Practice Standard: Telemedicine. 

There are specific circumstances where a veterinarian is permitted to prescribe a non-controlled drug to an animal(s) or group of animals for an immediate, short-term need when they have obtained recent and sufficient knowledge through a virtual examination or premise visit. The professional expectations related to this allowance are outlined in the Professional Practice Standard: Prescribing a Drug and are repeated in the Professional Practice Standard: Telemedicine. 

Veterinarians are permitted to establish a VCPR without an in-person physical examination or in-person premise visit. This can include use of different technologies including, but not limited to, telephone and video teleconference. A VCPR established in this way holds the same expectations as when the relationship is established in-person. For more information, please refer to the Professional Practice Standard: Establishing, Maintaining and Discontinuing a Veterinarian-Client-Patient Relationship (VCPR).  

Example: Dr. Smith is working at Clinic A in Ontario and provides veterinary services via telemedicine. They receive a phone call from Susan, who is not a client. Susan recently moved to Ontario and has a concern about their dog. Dr. Smith determines that the concern can be addressed via telemedicine. Susan and Dr. Smith establish a VCPR over the phone whereby they discuss and confirm the scope of services to be provided. 

A veterinarian should always clearly identify themselves. They should also;  

• indicate their location and accredited facility name to their client(s) as an assurance of the veterinarian’s identity;  
• indicate that this information is verifiable on the College’s public register; •  
• ensure their client(s) know the scope of services they can provide, and how to obtain in-person care if needed;  
• ensure their client(s) are aware of any relevant privacy and security issues involved in accessing veterinary care via telemedicine. 

A veterinarian must maintain all relevant aspects of record keeping in accordance with the Professional Practice Standard: Medical Records. 

Veterinarians are subject to the Personal Information Protection and Electronic Documents Act (PIPEDA). This includes personal information gathered via telemedicine after obtaining client consent-to collect, use or dis close the information.  

A veterinarian must also ensure client confidentiality is maintained as per s. 17. (1) 6. in Regulation 1093. For more information, please refer to the Privacy in Your Practice section of the College’s website. 

Expectations for medical recordkeeping are not changed if a veterinarian is using a third-party company’s platform to practice via telemedicine. A veterinarian is required to keep the original physical and/or electronic copy of the medical records in the accredited veterinary facility where veterinary services are provided. For more information, please see the College’s Professional Practice Standard: Medical Records and the Guide to the Professional Practice Standard: Medical Records. 

A veterinarian may choose to charge a fee for services provide via telemedicine. 

Telemedicine may be one option for providing after-hours care services. For more information, please see the Policy Statement: After-Hours Care Services. 

A veterinarian uses their professional judgment to determine when to delegate a task to an auxiliary. They must practise in accordance with the Professional Practice Standard Delegation, and any other legislation and College standards relevant to the specific circumstance.  

Example: Dr. Clason, a large animal veterinarian, has a telephone consultation with a producer with whom they have previously established a VCPR. The producer informs the veterinarian that they have a cow that has a large wound on its leg. The producer provides Dr. Clason with digital pictures of the wound. Dr. Clason takes a history and reviews the pictures. They recently conducted an in-person premise visit where the cow is located. They determine that diagnostic tests are required to have sufficient information to provide a diagnosis. Dr. Clason discusses this with the producer and advises that they would like to send their auxiliary to the farm today to take some samples for testing. They obtain informed client consent to proceed with the auxiliary gathering the samples under delegation and indirect supervision through one of the accredited mobiles of the practice.