When appointment calendars are booked, phones are ringing off the hook, and staff is short, it can be hard for veterinary practices to invest time and energy into learning about the latest technology offerings or updating programs already in place. But ignoring these options means ignoring opportunities to relieve pressure points in workflow throughout the hospital.

Workflow, a buzzworthy term making a surge in the veterinary industry, is the pattern of activity that takes a task from the to-do list to completion. Technology, in its many formats, can help with nearly every workflow in the practice, from the front desk to the back, and at every stage of the client experience. In the end, practices and teams can work more efficiently, freeing up more time to care for the patients they love.

Before clients & patients arrive: decrease those ringing phones!

Utilizing options for online appointment booking, online appointment requests, and remote check-in, practices can decrease ringing phones dramatically while meeting client demands and facilitating more appointments.

Real-time appointment scheduling online is a solution to frustrations of both pet owners and practice staff. Clients can book an appointment online, at their convenience, even if the office is closed—which doubles the practice’s capacity to make appointments. Receptionists are freed up for more tasks when they spend less time on the phone discussing various scheduling options with clients—a task that takes an average of 8 minutes for each appointment.

One survey found that nearly 70% of millennial pet owners—the largest pet-owning population

—preferred to book online. Another study found that 50% of appointments were made after business hours, and 17% of appointments made with an online booking tool were from new clients. However, just an estimated 25%

Practices can easily take advantage of this opportunity to reduce staff time, improve client appointment numbers, and be more accessible to their clients. Client engagement, satisfaction, and practice revenue improve when clients are able to book appointments promptly, receive online confirmation, and get reminders through your service or their own digital calendars.

Gone are the days of waiting for a client to hastily fill out a paper form while clutching a leashed pup, then trying to decipher illegible handwriting, manually entering the results, scanning registration forms, and filing them. Sending a link to an online client registration form that clients can complete at home before their appointment is a game changer for the new client workflow. Online forms improve the accuracy of information, time for the pet’s first appointment, and legal document storage.

Practices can include helpful information in appointment confirmation and reminder emails, texts, or app notifications. This added information can include instructions for clients to send, attach, or upload medical records ahead of time—allowing them to be included in the patient’s record before the appointment, so the veterinary care team can review rather than spend the appointment time chasing down old lab results. Additionally, practices can include helpful tips, drop-off or consent forms, and, in general, set expectations for clients for improving efficiency and understanding before the appointment even begins.

The check-in process: less typing, more customer service

When practices enable an online check-in form, pet owners can check in from the parking lot. In addition to helping maintain a healthy social distance during the COVID-19 pandemic, this trend will likely stay for many businesses as a post-pandemic option for pet owners. Checking in from the car eliminates exam room congestion and decreases stress for fearful or reactive patients. Receptionists can better focus on the clients in front of them and triage patients more efficiently into a room when their care team is ready.

Online check-in forms can also include questions about any other needs the pet owner might have after their appointment such as refills or vaccination certificates prepared for their grooming appointment. When the front desk knows this information ahead of time, they can start working on these needs while the patient is in the exam, improving the duration of the visit and the team’s ability to complete all the necessary services.

Some practices may choose to take their check-in forms a step further and link them to an online history form. Pet owners can use their wait time to provide the standard information we’ve been asking for years—why is their pet here today, what foods are they eating, any coughing/sneezing, vomiting or diarrhea, and the other usual suspects. Rather than asking and typing these standard questions, assistants and technicians can be preparing the room, vaccinations, or diagnostic tools, and then focus on more pertinent information—now from a written record the owner provides.

Many of the digital form tools also offer conditional logic, allowing automatic customization of the questions asked. For instance, if a pet owner selects a “nutrition consultation” from a dropdown list of appointment types, the subsequent questions will prompt the owner for information regarding their pet’s current food, amount, frequency, etc. However, if they select “annual exam,” the questions displayed will focus on the pet’s general lifestyle, risk assessment, and parasite preventives. By enabling these forms, practices can improve efficiency and obtain a written record of information from the pet owner: Instead of asking questions and typing answers into the medical record, the online history responses can simply be imported or copied and pasted into the patient’s subjective data, objective data assessment plan or SOAP note.

No technology can replace the examination by a veterinarian and technician team. But it can help what we do with that information—the assessments, the diagnostic results, and the treatment plans—and how we share it with our clients.

Instead of completing the exam, writing or typing out a medical record, and generating a patient summary report card, veterinarians may take advantage of dictation software and PIMS with built-in client templates. Doctors frustrated by playing phone tag to relay exam findings or diagnostic results may find it more efficient to record a quick screen-share video and send the link via email or text before moving on to their next appointment—delivering the information the pet owner needs and in a way that doesn’t require both the veterinary team and the owners to be present and available at the same time.

Diagnostic tools continue to advance at a rapid rate—at minimum providing us better ways to share results with owners at the click of a button and, at their best, using artificial intelligence (AI) and advanced algorithms to calculate measurements, diagnose cytologies and automatically generate advanced reports faster than we can see the next appointment. When practices upgrade their diagnostic tools to coordinate with integrated practice management systems, veterinary teams can invoice, print requisition forms, and link results to patient records with the click of a button.

A recent study that looked at pet owner preferences for receiving updates about their hospitalized pet found that nearly 40% of pet owners would prefer to receive updates about their pet via text.

 Texting can keep the care team’s workflow of updating pet owners more efficient. Texting is widely adopted by today’s population with some studies showing use as high as 97% of Americans. In addition, more than 60% of Americans respond to a text within 1 to 2 minutes

. Regardless of the tools used, technology enhancements can augment the practice of medicine, improve the efficiency of our patient care, and enhance the value of the services we provide.

Gone are the days of sending the client up front to wait in a line behind a rambunctious pup or terrified cat. Using mobile terminals, practice teams can receive payment in the room and give owners the option for a printed, emailed, or texted receipt, and then allow them to exit the room and straight to their car. This makes the nearly 500 average credit card and debit card swipes handled by veterinary practices each month

 during checkouts much more efficient for the team and the client, and the pet would likely appreciate it, too. Additionally, using a payment processing system that is fully integrated with the practice’s PIMS can save practices up to 25 hours of staff time in reconciliation and dual data entry.

Many practices already use an automated process for follow-up care, whether PIMS reminder to make a phone call to check in on the patient after their appointment or surgery or an automated one that is sent. Upgrading this process to a multimodal approach with PIMS integration offers practices the ability to further streamline reminders and reach clients via phone, text, email or postcard, or a combination based on the client’s preference. Automation means this workflow can be eliminated, or greatly decreased, for the front desk team.

With any luck, the veterinary-client relationship isn’t limited to a single annual appointment and continues to grow and evolve over time. When practices use technology to continue to meet pet owner needs, loyalty to the veterinary care team will increase.

Upgrading prescription management technology to those that integrate with PIMS allows practices to create, approve and renew scripts for ongoing prescription diets, parasite preventatives, and chronic medications. Practices can send automatic refill reminders and notify them of any potential expiries—preventing problems before they arise for the pet owner, the veterinary team, and the pet.

Allowing clients to access important information like vaccine records to share with boarding, training and grooming facilities can improve customer satisfaction and decrease calls to the front desk. In emergency or referral situations when clients seek outside veterinary care, medical record access can limit frustrations and improve patient care. Portals can also provide areas for owners to request appointments and prescription refills, and send secure messages to their pet’s care team—asynchronous communication that can be a workflow game changer.

Practices using updated technology programs that offer email, texting, or app chat communication options may also find improved workflows in communicating with pet owners about nonurgent questions, sharing helpful practice and pet health information, and continuing to serve as a resource for pet owners. By using these technologies (vs traditional phone call communication), practices can improve efficiency and meet client preferences for communication alike. Staff time is decreased when practices can schedule reminders, newsletters and push notifications, utilize templates, and include links to practice resources.

Today’s pet owners, particularly those under 36 years of age—now the largest pet-owning segment of the population

— have created a demand for improved technology as part of their pet’s health care. Pet owners are utilizing technology at touch points throughout the veterinary experience—from online research of review sites and social media when selecting a veterinarian, to visiting a practice’s website to check hours and scheduling an appointment, to requesting records via email, app or portal access, and utilizing texts and emails for notification of results and next steps.

When the practice dedicates the resources to adopt, implement, test, and assess new technology, the team’s improved workflows can result in:

improved client education, compliance and value perception;

Whether your practice embraces app chat and telemedicine or is just starting out with its first techy tool, the investment in time, energy, and attention will be well worth the wait.

How can pet clinics please Millennials? Weave. Accessed June 6, 2020. https://mma.prnewswire.com/media/973536/Weave_infographic_millen- nial_pet_owners.pdf

Can online booking boost your veterinary practice revenue? Covetrus. November 1, 2018. Accessed August 3, 2020. https:// softwareservices.covetrus.com/global/client-solutions/ how-online-booking-can-boost-practice-revenue/

. 2021. Accessed August 3, 2020. www.merckvetmanual.com/resourcespages/pet-health-overview

Kogan L, Schoenfeld R, Santi S. Medical updates and appointment confir- mations: pet owners’ perceptions of current practices and preferences. 

. 2019;6:80. doi:10.3389/fvets.2019.00080

2021 Texting and SMS Marketing Statistics. SimpleTexting. Accessed October 28, 2021. https://simpletexting.com/2021-texting-statistics/

Payment processing. Covetrus. Accessed October 28, 2021. https://soft- ware.covetrus.com/veterinary-solutions/veterinary-payment-processing/

Articles

Technology can provide solutions that smooth out the rough edges in clinical workflow by addressing pain points for patients and clinicians alike.

Benefits of upgrading technology for clinic workflow

 will take place in the extraordinary San Diego, California—also known as “America’s Finest City”—from December 2 to 5. Are you attending? If so, here are some noteworthy sites to visit before, after, or in between sessions to get the full experience of this captivating destination.

Since 1989, these iconic sightseeing trolleys have been taking passengers on a 2-hour tour of San Diego and Coronado that covers 25 miles and over 100 points of interest.

 Personalize your expedition as you can get on and off at any of the popular stops including Seaport Village, Petco Park, Little Italy, and more. The Old Town Trolley Tours offer “transportainment”—a combination of transportation and entertainment with engaging narration performed by the conductors during the ride, highlighting fascinating anecdotes and tales.

Balboa Park features 1400 acres of breathtaking greenery with plants and landscape housing more than 16 museums, various performing arts venues, delightful gardens, trails, and other attractions. The architecture at this landmark is predominantly Spanish style, with low-rise buildings among the beautiful natural backdrop. Some of the many sites at the park include the San Diego Natural History Museum, Museum of Photographic Arts, Alcazar Garden, Botanical Building, the San Diego Zoo, and Casa de Balboa.

Regardless of what kind of beachgoer you are, there is a beach for you in San Diego. Mission Beach is an ideal spot for those in favor of a boardwalk and sea view cafes, and Ocean Beach includes Dog Beach where dogs can run off leash and explore the area. For those interested in hiking and trails, Torrey Pines State Natural Reserve is the coastline destination for you.

Immerse yourself in the rich history of the past with this park that encapsulates the feel of Mexican and early American periods from 1821 to 1872 when this settlement developed from a small Mexican pueblo. Visit a working blacksmith shop, art studio, or one of the numerous charming restaurants, plus purchase authentic Mexican crafts and appreciate live mariachi music. Various historic buildings have been repaired and others have been added to replicate the same architectural style.

The ARTS DISTRICT Liberty Station displays authenticity, heritage, and culture with artists and dancers, boutiques, a golf course, a seasonal holiday rink, a variety of event venues, cinemas, local restaurants, and a public market. It is located within 360 waterfront acres of the former Naval Training Center San Diego and integrates Spanish Colonial Royal architecture and vast landscaped areas. From those highlighting film to culinary arts to music, some of the constantly changing festivals also may be taking place during your stay. See the event calendar here: 

https://libertystation.com/events/calendar

The San Diego Zoo is a 100-acre wildlife sanctuary and among the largest and most renowned zoos in the country, located along a striking landscaped canyon. It is home to over 12,000 rare and endangered animals representing more than 650 species and subspecies

 and has exotic animals ranging from giant pandas to gorillas to koalas to leopards to sloths and beyond, with animal enclosures that mimic natural environments for each species. What’s more, it showcases a botanical collection of over 700,000 plants from around the world.

 Participate in the educational opportunities while supporting San Diego Zoo Wildlife Alliance’s conservation efforts at this zoo.

The 68-acre Sunset Cliffs Natural Park situated above the Pacific Ocean offers an awe-inspiring view of the Southern California sunset. Plus, the topography consists of complex carved coastal bluffs, arches, and sea caves for those who enjoy an all-around scenic site. During migration season, you can witness California gray whales migrating from the Bering Sea to Baja California.

Gaslamp Quarter National Historic District

 of San Diego, this district is the center of the city’s nightlife and is lined with restored late 19th- and early 20th-century Victorian architecture. There are restaurants with a plethora of menu options from bar food to fine dining; entertainment destinations including bars, clubs, cigar lounges, comedy shows, and live music venues; stylish shops; art galleries; and rooftop destinations. Gaslamp Quarter is approximately 16 blocks from Broadway to San Diego Bay so you can easily walk or travel it by bike taxi.

Old Town Trolley Tours of San Diego Inc. San Diego Tourism Authority. 2021. Accessed November 16, 2021. 

https://www.sandiego.org/members/tours-sightseeing/old-town-trolley-tours-of-san-diego-inc.aspx

San Diego Zoo 2021: fact sheet. News release. San Diego Zoo. 2021. Accessed November 16, 2021. 

https://zoo.sandiegozoo.org/pressroom/content-0

Gaslamp Quarter. Gaslamp Quarter Association. Accessed November 16, 2021. https://www.gaslamp.org/

Check out these popular, remarkable destinations in San Diego, California, to visit in between sessions while attending the upcoming Fetch dvm360® conference. 


Visiting San Diego with Fetch dvm360® 

Image provided by Cornell College of Veterinary Medicine

Thanksgiving is already a scary time to be a turkey, but 1 wild turkey faced even greater danger and came out the other side a survivor. The female turkey was severely injured after being attacked by a dog, but she is now safely recovering at Cornell’s Janet L. Swanson Wildlife Hospital.

The turkey was discovered by a member of the public and brought to a licensed wildlife rehabilitator in Chadwicks, New York, who then sent the turkey to the Wildlife Hospital. Upon assessment, the clinical team at the hospital found severe wounds on and around 1 of her legs, requiring intensive surgical and medical management.

“She had many wounds all over her body, but the life-threatening wounds were on her left side,” said Service Chief Dr. Sara Childs-Sanford. “She has had 3 surgeries so far to remove nonviable tissue and begin to close parts of the wounds which are both deep and wide. The tissues are kept clean and protected with large bandages (which the turkey likes to try to remove) and deep tissue infection is being treated with antibiotics based on information gained from bacterial cultures.”

Despite the extensive trauma and intensive treatment, the injured turkey remained resilient. “She handled the treatment extremely well,” Childs-Sanford said.

The wild bird is currently receiving medications to help keep her comfortable after the traumatic experience.“We have to medicate her twice a day, so we are lucky that she is easy to work with,” Childs-Sanford said. “She has maintained a great appetite throughout her stay, and in addition to her normal diet she is particularly fond of an occasional fruit salad, especially watermelon.”

The turkey is expected to make a full recovery and eventually be released back into the wild. "When her wound is healed, she’ll return to the original wildlife rehabilitator to regrow all of her feathers, and to be acclimated to a larger area and to outdoor temperatures, Childs-Sanford said.“When she is ready, she will be released in a suitable habitat near where she came from, where the presence of turkey flocks that she can join has been confirmed,” she said.

“We are extremely thankful that Cornell is here to help thousands of wild animals in need each year, just like this turkey,” Childs-Sanford said. “We hope everyone’s Thanksgiving holiday is filled with joy and gratitude.

Wild turkey patient at Cornell College of Veterinary Medicine has reason for gratitude. News Release. Cornell College of Veterinary Medicine. November 22, 2021.

One lucky wild turkey overcame a near-death experience with a dog, thanks to quick action and expertise in care at Cornell’s Janet L. Swanson Wildlife Hospital. 

Wild turkey patient has reason for gratitude this Thanksgiving

Cancer is a devastating disease for humans and the pets who are integral parts of their families. Cancer arises through accumulation of thousands of mutations, some of which generate drivers that lead to malignant transformation and cancer spread. Some of those mutations generate proteins that are recognized as foreign by the cancer-bearer’s immune system (cancer neoantigens). The growth and spread (metastasis) of a cancer involves complex interactions between cancer cells and normal host cells that populate the cancer tissue microenvironment. Some of those host cells suppress naturally occurring immune responses, which further promotes cancer growth and spread.

Recent advances in the fourth pillar of cancer treatment—immunotherapy—suggest that the immune system may be our best tool to cure more cancers. Various immune stimuli, including cancer vaccines and other biological response modifiers have been tested in dogs and humans with variable degrees of success. However, a notable challenge with these therapies is that while they will generate powerful immune responses against cancers, the effects of the immune cells—specifically T cells—that are generated from the stimulation and that infiltrate cancer tissue can be significantly suppressed by the cancer microenvironment. An example of these cancer defenses are checkpoint proteins on the surface of cancer cells. These checkpoint proteins identify cancer cells as “normal” cells and thus the immune system ignores them.

The capability of the immune system to kill cancer cells can be significantly boosted by removing T cells from the patient and converting them into effector T cells 

, away from the immunosuppressive environment that exists within the patient’s body. One such approach that has had success in the treatment of leukemias and lymphomas is cellular immunotherapy with genetically engineered effector T cells called chimeric antigen receptor (CAR) T cells. Another that also has had considerable success in selected cancers is tumor infiltrating lymphocyte (TIL) therapy. Both CAR-T cell and TIL therapies have produced instances of cancer regressions and long-term patient survival when used to treat human patients with widespread metastatic disease.

ELIAS Animal Health is on the forefront of cancer immunotherapy research and development. The company is developing a unique new approach to the treatment of canine cancer that takes advantage of the fact that vaccinating a cancer-bearing individual with their own cancer cells can generate a significant immune response to the targeted cancer cells and 

expansion and activation of a patient’s T cells can boost that immune response to produce more durable responses.

ELIAS’ adoptive cell therapy is being evaluated for the treatment of canine osteosarcoma. Data from the initial osteosarcoma study (n=14) demonstrated a favorable safety profile and showed 36% survivors at two years (

, July 2020). Based on the promising results in that early study, the company has completed enrollment in a larger 1:1 randomized clinical trial evaluating its adoptive cell therapy in comparison to a four-dose carboplatin treatment regimen, current standard of care for canine osteosarcoma. Results of that pivotal study are expected in late 2022.

The immune system is complex and not all patients respond to a particular treatment the same way. Many scientists and medical professionals believe that better and more consistent patient outcomes will be achieved with therapeutic combinations. Given the myriad of defenses within the cancer microenvironment, it is not surprising that better outcomes for some patients have been achieved using multimodal combination therapies. ELIAS is actively pursuing innovative technologies that, when combined, will deliver safe and effective treatments to a broad population of patients.

New technologies referred to as checkpoint inhibitors disrupt the immunosuppression that can be created by cancers and reveal the cancer cells to the immune system. Checkpoint inhibitors are designed to alter the tumor microenvironment such that the immune system can cause cancers to regress and in responsive patients, survival can be greatly extended.

Oncolytic viruses are another emerging immuno-oncology modality and have exciting potential to improve outcomes by turning cold tumors ‘hot’. Oncolytic viruses cause cancer cell apoptosis which releases the cancer neoantigens, stimulates an innate immune response, alters the tumor microenvironment and generates a tumor-specific adaptive T cell response.

These exciting scientific advances may be the key to unlocking the possibility for better outcomes in pets with cancer. As new innovations continue to accelerate, ELIAS Animal Health is a pioneer in the endeavor to bring more of these treatment options to the veterinary market.

Despite all the advancements in human medicine over the past few decades, veterinary medicine has seen little change until recently. Now, several new therapeutic developments have emerged specifically for use in veterinary medicine that have promising potential in changing how veterinarians treat cancer.

How cellular immunotherapy is making a difference in veterinary oncology

According to Brendan Lynch, VP of digital strategy and client experience at Veterinary Center of America Inc. (VCA) Animal Hospitals, the pandemic brought increased patient demands and higher client expectations with simultaneous veterinary staff shortages, empathy fatigue, and burnout across teams. Ergo, now more than ever innovative change is essential for veterinary professionals to stay healthy and to maintain a prosperous profession.

“I believe that it’s time to evolve, adapt and find new and better ways to do things that help our veterinary teams, our clients, and their pets,” he told Adam Christman, DVM, MBA, in this episode of The Vet Blast Podcast.

Lynch then described the efforts VCA has made to adapt practice operations during the pandemic and beyond, including how this has benefited clients and veterinary staff alike. 

“One of the things that I think was exciting that [VCA] leaned into a lot…is our digital abilities to improve access to care, increase convenience, and streamline the operational workflows," Lynch said. "We saw close to 50,000 clients use our telehealth services with 165% increase from before the pandemic and then we had sent and received over 11 million text messages between our hospital teams and clients and this was just in 2020 alone.”

“We’ve been seeing this adoption continue to accelerate going into 2021 which has been a great opportunity to help us streamline the experience for our clients and associates…This year to date, we’ve conducted or completed close to 2 million mobile payments transactions," he added. 

Listen to the full podcast below for more on the strides VCA has been making in veterinary practice innovation. 

Podcasts

In this episode of The Vet Blast Podcast, Dr Adam Christman is joined by Brendan Lynch, VP of digital strategy and client experience at VCA Animal Hospitals, who discloses not only why innovation matters but also how technology can advance the profession to new heights. 

Episode 71: The advancements and innovations in veterinary medicine

Can-Fite BioPharma Ltd—a biotechnology company accelerating a pipeline of proprietary small molecule drugs that address inflammatory, cancer, and liver diseases—has announced its veterinary development and commercialization partner, Vetbiolix, has launched a safety and efficacy study of Piclidenoson for the treatment of canine osteoarthritis.

safety findings are expected in Q1 2022, and efficacy data is expected in Q4 2022. Piclidenoson has been extensively tested in human clinical trials with a favorable safety profile across more than 1,500 human patients.

“Based on Piclidenoson’s safety profile in humans and small animals, we expect similar excellent results in dogs. We are hopeful that Piclidenoson may also show efficacy in osteoarthritis and offer relief to millions of dogs and their families,” said Pnina Fishman, PhD, Can-Fite CEO, in the release.

“Working with Vetbiolix for this veterinary indication, [we] aim to leverage our clinical pipeline to benefit animals while accelerating our path to commercialization through a capital-efficient strategy,” she added.

Piclidenoson is an oral drug with an excellent safety profile in human clinical trials and it may provide a necessary safe, effective treatment for canine osteoarthritis. The most frequently used existing treatments for this condition include oral non-steroidal anti-inflammatory drugs (NSAIDs) for pain control with substantial harmful side effects, and an injectable disease-modifying osteoarthritis drug (DMOAD) that targets the disease’s progress.

 of dogs have osteoarthritis—categorized by joint cartilage loss, joint capsule thickening, and new bone formation around the joint that results in limb dysfunction and pain. The canine osteoarthritis market is predicted to reach $3 billion by 2024.

Vetbiolix is responsible for all costs and development of Piclidenoson in the canine and feline osteoarthritis market, for which the company has the exclusive rights to Piclidenoson for 2 years under an option agreement. If the clinical studies provide positive results and Vetbiolix exercises its option to license from Can-Fite, then Vetbiolix will be required to pay Can-Fite upfront and milestone payments, along with royalties on sales upon regulatory approval for veterinary use.

Can-Fite’s Piclidenoson commences clinical study for the treatment of canine osteoarthritis. News release. Can-Fite BioPharma Ltd. November 23, 2021. Accessed November 24, 2021. https://www.businesswire.com/news/home/20211123005715/en/Can-Fite%E2%80%99s-Piclidenoson-Commences-Clinical-Study-for-the-Treatment-of-Canine-Osteoarthritis

Arthritis in dogs and cats. Saint Francis Animal Hospital. Accessed November 24, 2021. https://saintfrancisanimalhospital.com/2020/01/31/arthritis-in-dogs-and-cats/

With an excellent safety profile in human clinical trials, this drug may offer a much-needed solution for canine osteoarthritis as well. 