Technology advances and its impact on veterinary practices – including e-CPD and e-learning options
(as printed in the Vet Nursing Times – see links to PDF versions at bottom of post)
The word technology means different things to different people. Many of us think of smartphones or sophisticated computers as cutting-edge technology and perhaps don’t imagine that there is much in the way of technological advancement occurring in everyday clinical practice. The truth is that there is a lot of advancement in a variety of technologies taking place in veterinary practice, and it is some of these that I aim to share with you today.
Technology is, for me, anything that helps us to do our jobs better, whether it be enabling us to perform tasks faster, more effectively, or to enable us to achieve a better outcome for our patients and clients. In essence, technological advances should, and usually do, enhance both our personal and working lives. There are three areas in which we see advances in technology in practice. The first is clinical technology; the classic ‘vetty’ gadgets, gizmos and systems that make the process of diagnosing, treating and managing our patients easier and more effective. Secondly, there are the advances in practice management and client communication technologies, an area which in my opinion has probably seen the biggest changes and which offer the biggest opportunities for really impacting on our clinics’ bottom lines. The third area for focus is the use of technology in education and CPD, important in ensuring our personal and professional growth and where technology is certainly having a big impact.
Although our focus is on first opinion practice, it is worth noting the fact that as general practitioners we have ready access to the very latest clinical technology and cutting-edge diagnostics and treatments through our ability to refer to our specialist colleagues. We are, as vets, able to pretty much do anything that is clinically possible and this is, in large part due to the huge advances in knowledge, expertise and technology at our disposal within the specialist fields.
Imaging is probably one of the main areas in which technology is at it’s most obvious. Gone are the days, for many of us, of long periods stuck in a dark, hot, generally uncomfortable radiography suite taking multiple radiographs and getting more and more frustrated at how long it can take just to get a simple series of images. It was a revelation when I moved to my second job and discovered the joys of digitial radiography. No need to fumble in the dark with open cassettes and film or handle noxious chemicals, and the images were pretty much instantaneously available. The system I first encountered was CR-tech, or Computed Radiography technology, involving the exposure of a plate, as per traditional methods, and then the processing of these films by way of a digital system. Since then there have been further advancements with the emergence of DDR-tech (Direct Digital Radiography), in which the plate is exposed and an image almost instantaneously appears on screen without the need to manually place the plate into a processing unit. This is possible due to the use of a syntillated plate, or direct digital panel (DDP), which effectively replaces the plethora of film cassettes that we’re used to using at present. Never has the phrase “take a quick X-ray” been so accurate!
In parallel to advances in the technological hardware itself comes developments in software, meaning that the process of taking, processing and working with radiographic images is much more user friendly and clinically helpful. There are, for example, bespoke software packages that will guide the vet through the correct measurements required for planning a tibial plateau levelling procedure, for example. The reduction in the sheer size and amount of necessary hardware, coupled with the options of cloud storage, where digital files are stored on a remote server away from the clinic (think Facebook, whereby your profile is actually hosted on a server in the US, or elsewhere, and not all on your desktop) has meant that even the smallest of clinics can boast an impressively powerful and versatile radiography capability, with none of the hassle associated with the secure storage, organisation and retrieval of hundreds of radiographs. Much simpler and much more elegant.
Ultrasound technology is another area where we have seen impressive changes in practice. From super-powerful, all singing, all dancing set-ups, such as the Logiq S7 Expert, which makes use of new matrix probes and B-flow technology, useful for assessing vascularisation in tumours, for example, to the miniaturisation of the scanners, allowing us to both reduce the amount of space taken up in our clinics and ‘take the scan to the patient,’ whether in a hospital or out on calls, the changes have been staggering. To have the kind of imaging power that we have in a device no bigger than a laptop computer is a sure sign of the advances in technology that we are enjoying as vets.
One of the key attributes of a true technical advancement is one which takes an established way of doing something and completely rethinks it, or revolutionises it. One such example of new technology that does just that is the v-gel, a new airway system for ventilating anaesthetised patients. The point to note is that it isn’t an endotracheal tube – that’s the revolutionary thing about it. Instead of inserting into the trachea, through the larynx, the v-gel creates an effective seal around the pharyngeal, laryngeal and upper airway tissues, thus positioning a large diameter opening directly over the larynx to permit normal gas exchange with no trauma to, or even contact with, the larynx. One of the key advantages of this new system is that rather than needing a tube that is in effect smaller in diameter than the trachea, the v-gel allows the tube to be larger in diameter than the patient’s trachea thus maximising air flow and exchange. The soft rubber tip, that atraumatically ‘plugs’ the oesophagus, also serves as a good counter to the risk from regurgitation under anaesthetic. Currently available for both rabbits and cats, with dog versions in development, these new tubes represent a fantastic example of a smart, cleverly designed advancement of an existing technology.
We’re all aware of the need to better engage with and market to our clients, both current and prospective, with the level of competition between practices apparently increasing all of the time. The methods for doing so these days have never been so plentiful nor powerful, yet many of us are still failing to maximise on the potential returns that doing so could bring. One of the simplest ways of better engaging with our clients, and those who show an interest in our services, is through email and the careful but effective management of email lists. Email management services such as MailChimp, which enable even the most technophobic of users to set-up a mailing list, design a web form to be posted on a website, social media, or even accessed via a link which can be emailed, and then organise, manage and communicate effectively with the people on that list, are brilliant and it is amazing how useful they can be for practices. Imagine, for example, how impressed your clients would be to receive an email on their pet’s birthday wishing them many happy returns. Combining such a thoughtful gesture with a suggestion of a senior health check if the pet has just turned seven, for instance, could be an easy yet effective way of driving more business through your doors. Through careful segmentation of lists, such as having a list containing only those clients who own cats under 7 years of age, for example, it becomes much easier to provide them with relevant information that they will find interesting and useful, with the result being a much greater level of trust in and bonding with you and your practice. How many of us actively ask our clients or new prospects, for their email address? My guess is very few. The truth is that these days people almost expect to be asked for it and we should be making a greater effort to make use of the advances in email and online marketing, much of which is available either free or very low cost, especially when compared to other marketing media such as print. Done well, email could be the best use of technology you have in your practice at present.
Social media is another potentially powerful way to engage with our clients and to help make us stand out from the crowd. People are interested in what we do as vets and what can often seem like the most run of the mill, mundane, day to day event in our clinics may form the basis for a fantastic Tweet or Facebook post, which can encourage a conversation between people and raise the prominence of us and our clinics in a good way. Obviously care has to be exercised, like with anything, but Social Media is one surefire example of a recent technology that veterinary practices have a lot to potentially gain from. Some clinics have embraced this aspect of marketing, using it to converse with clients and to provide updates, information and education through the use of videos, for example. Engaging clients in such a manner is a great way of strengthening the bond they have with your practice.
Some clinics have embraced technology more than others with some even rewriting the rule books on how we can manage our practices. Vets Klinic in Swindon have just one desktop computer in their practice, with each vet and nurse issued their own, personal iPad on which the clinic’s bespoke practice management system is accessed, meaning that patients’ records are readily accessible no matter where you are in the clinic and making the consulting rooms, and other areas feel clutter free. Use of tablets also enables patients’ time within the clinic to be recorded, and photos and notes about their stay easily uploaded to their clinical ‘timeline.’ Owners can access their pet’s timeline and see in realtime how their pet is getting on. Clients are actively encouraged to register and book everything from appointments to surgery online, with an airline style booking system showing prices and times of appointments with each vet, with real-time variable pricing a feature and a discount on offer for clients who prepay in advance of their appointment.. Tablet computers do appear to be excellent devices for use in a busy hospital environment, with the ability to readily access a patient’s notes wherever you, as the vet or nurse, happen to be within the clinic.
The internet has quite simply revolutionised the way in which we access and consume CPD, with webinars and online learning resources becoming ever more commonly used, and available across virtually every platform, from smartphones to tablets and the trusty desktop computer. The advantages are clear: access to reliable, interesting CPD without the need and expense of taking time out of our busy clinical lives or the hassle of travel to attend lectures. With a plethora of providers, including many of the drug companies, learning online can be achieved at little to no cost and represents a very cost effective way of ensuring we keep our CPD current and maximising our CPD budgets. The only limitation that I could see from my experience of ‘attending’ a webinar was the fact that as the event was taking place on my computer and in the comfort of my own home, unless the speaker was particularly engaging, it was very easy to get distracted with other activities whilst convincing myself that I was still learning as I had the lecture playing. This coupled with the knowledge that I could always go back to the lecture and view it again at another time only acted to fuel my distraction. Somehow there just seems less risk of this happening when you’re physically present with the lecturer and other CPD attendees present in the same room. But then, maybe that’s just me and everyone else is a consumate good student at home. With so many other distractions constantly vying for our valuable attention the challenge, as I can see it, is for e-CPD providers to ensure that their content is as engaging and interesting as possible, including the use of mixed media, from standard lecture-style presentation slides and speech, to clever use of graphics, video and animations to really bring subject matter to life and inspire people. After all, the last thing any vet wants after a long, hard day in the clinic is to sit through a dull lecture, even if they do have the option of switching over, as it were.
One of the exciting challenges for the future will be in seeing how e-CPD can deliver more practical training, with a physical presence still very much required at present for practical CPD courses. Maybe a stepping stone will be the provision of ‘learning kits’, complete with necessary equipment and materials which the student can make use of whilst receiving remote instruction via a webinar or other means of e-learning. Although e-learning is delivering a wider and more accessible range of CPD to the profession, available at any time, anywhere and in any format, it is unlikely that it will completely usurp the strong desire we have as humans to actually congregate in the same space to receive educational instruction and socialise, as is clearly demonstrated by the continuing popularity of congresses, such as the London Vet Show.
Whether we realise it or not, technology and advances in it are all around us in practice. From the scanners we use to make diagnoses to the equipment we employ to safely manage our ill patients, or the plethora software tools, both bespoke and consumer options, technology is pervasive and empowering. It has changed the way we engage with clients, market our services, and continue our professional development, and all pointers are in the direction of yet more innovation and technological advancement, I for one watch on excitedly.
Links to the PDF versions of the original article, as printed in the Vet Nursing Times: