Veterinary Telemedicine: A Practitioner's Guide

The current context has forced the adoption of new ways of practicing veterinary medicine with little opportunity to train, prepare or establish best practices. So, I thought we should take this opportunity for a collective pause, a collective deep breath-in - to explore the why, the what and, importantly, the how of veterinary telemedicine. We will discuss the appropriate extent of digitalisation in the veterinary context, the essentials and the nice-to-haves in the veterinary tele-toolkit, and work through specific customer and patient journeys. All of this will be informed by key insights and best practices from the tens of thousands of veterinary virtual care interactions that have taken place on the PetsApp platform.

So what even is telemedicine? 

I thought we’d do what every good vet does when confronted by something unusual, and the very thing that makes our heart sink when we hear pet owners have been at it - I googled it. So, tele comes from the Greek, meaning far, and has come to mean reaching over a distance, carried out between two remote points, or performed through electronic transmission.

Medicine - well we all have a sense of what that is - it’s the science or practice of the diagnosis, treatment and prevention of disease.

That makes telemedicine the diagnosis, treatment and prevention of disease from afar, which makes sense. This could be by video consult, text chat or just on the telephone.

And this should all sound familiar, even if the jargon is a little cumbersome. 

Because as vets, we're already doing telemedicine!

A few months ago, my brother-in-law and his wonderful fiancee, Kyla, rescued a Labrador mix, named Camden. In the image above, I have tracked the messages they’ve sent me querying different issues - from his diet, to a dry nose, a sore paw, coughs and sneezes, and a patch of hair loss. Yesterday they really tested me with the question as to whether they can give supplements to Camden to prevent lawn burn.

But from diet to lawn burn, I was not involved in diagnosis or prescribing treatment, more often than not I was providing reassurance or pointing them in the direction of their own vet, with a better sense of how urgently that sort of issue needs to be addressed. More than (or not quite) telemedicine, this was digital patient advocacy. Upon encountering a pet issue, pet owners lucky enough to have the personal acquaintance of a veterinary professional, are able to effortless delegate pet care decisions to someone better able to make them. Someone that can help inform the best route to resolution.

Digital patient advocacy, why bother?

Okay, but I’m guessing at your clinic, most your clients aren’t your brother-in-law or even the fiancee of your brother-in-law. So, why should you bother exploring digital patient advocacy opportunities within your veterinary practice?

Well, there’s this idea, promulgated by super smart venture capitalists in Silicon Valley, that software is eating the world. Taking over every aspect of our lives. But pets are fundamentally physically beings. You need physical clinics to serve their physical needs, in order to offer a joined up pet care experience.

You can’t upload a patient, canine or otherwise to the cloud - no matter how much Fluffy might look like one. And the experience of owning a pet is intrinsically a physical one.

No problem, you might say, we can create you an all-singing, all-dancing pet robotic dinosaur (the video above is worth a watch!). He’ll mimic much of the physical experience of owning a pet. You can tickle him on his chin touch sensor, he’ll feel you stroking him in his force feedback sensors, hear you with his binaural microphones and fall asleep to you gently rocking him detected via his tilt and shake sensors. And the best part is you don’t need to walk him or feed him. He’ll never get sick and there’s no danger that he’ll pee on your Anatolian rug.

Anyone ever heard of Pleo? Do you have one? Nope. And yet, over 50% of all households own a needy, sickness-prone, defecation factory, also known as a pet. There’s something intrinsic to picking up the faeces of another species that we find therapeutic. In other words, part of the value of owning a pet comes in the effort we put into looking after them - and it is a mistake to seek to use technology to eliminate that.

Customer effort

When you get to thinking about it, experiences where the investment of customer effort is part of the value generated through that experience are not unique to the pet care sector, or the health care sector - it crops up more often than you might think.

Digitalisation can be an amazing tool in reducing customer effort. But sometimes if you eliminate customer effort altogether you also eliminate the customer. Just as Pleo is no threat to pet ownership, ToughMudder would not improve ticket sales by rebranding themselves EasyMudder. 

That said, clearly not all effort is created equal - a laborious appointment booking experience, for example, is unlikely to be an area where effort equates to value. No one’s going to get to the end of an overly long online form feeling grateful to us for the warm glow of pride they feel in their achievement. More likely, they're going to drop-out halfway through the form and go back to Googling or hoping-for-the-best.

One example of a high effort touchpoint that kept coming up in our pet owner survey but that I’d never previously thought to include in a veterinary customer corridor was loading the kids into the car. Now, I searched a stock image website for loading a kid into a car seat, and the first result was this very happy scene...

However, that does not reflect my experience at all. Not to worry, a few pages in and I found this - much more like it...

One kid in the car. One kid out the car. One kid neither in nor out the car, and a dog vomiting in the back.

With this in mind, we need to tease apart those aspects of the customer experience that are effortful but value additive versus those parts that are effortful but value erosive. A good way to approach this is to map out the existing customer corridor touchpoint by touchpoint. As clients journey along the corridor they get a sense of the customer effort involved in doing business with you, and they come to a judgement around value perception.

Pet owner - customer corridors

Above I’ve mapped out the customer corridor for a generic veterinary visit. An owner identifies a problem, finds a vet to visit, books an appointment with them, travels to the clinic, checks in at reception, waits in the waiting room, maybe has a nurse check over the animal before proceeding to a veterinary consultation, where they decide on next steps. The owner then pays at reception, and hopefully the vet follows-up on the issue. 

While we can’t turn pets into robotic dinosaurs, there are clearly plenty of opportunities for digitalisation here. From the initial discovery process and appointment booking to payment and follow-up. And we’ve made some progress on this in the veterinary sector with most clinics now accepting they need to engage with the internet, clinics offering online forms to book appointments, digital pharmacies (which can see veterinary revenue leak away from the veterinary clinic), and many more vets engaging with the full range of email and SMS options for client follow-ups and reminders. However, broadly the experience architecture still looks the same for different owners of different pets with different issues. 

I’ve had owners go through the whole high effort experience because they thought they found a worrying lump on their pet’s body, only to have me tell them that this is one of their cat’s nipples. But he’s a male cat they said. Yes, that’s right I said, subconsciously looking down at my own chest. Ah, they said, already struggling to bundle their cat back into its basket. It helps if you reverse them in... Needless to say this effortful experience wasn’t particularly value additive to the experience of pet ownership. 

On the flipside, I’ve had owners bring in pets far too late in the disease course because of the stress, effort and practicality of bringing their sick pet in sooner - me telling them it’s too late isn’t value additive either.

Pet care concierge

What if the real digitisation opportunity here is in providing mechanisms for filtering and personalising the pet care experience for each pet and each owner, and even each member of the veterinary team - rather than slinging them down the same customer corridor, the same physical experience as everyone else? Ma Yun (Founder of Alibaba), in proposing his New Retail concept has suggested that “the boundary between offline and online commerce disappears as we focus on fulfilling the personalised needs of each customer.”

So, we should seek to travel from a single generic customer corridor for everyone. To multiple corridors with tailored touchpoints. This is not just digital augmentation but also digital curation of personalised physical services. Because playing Russian roulette with whether your pet needs to be physically seen by a vet is not value additive to the experience of pet ownership. 

This is exactly what PetsApp seeks to achieve. We believe in the strength of the human-animal bond, and we believe that - deployed correctly - technology can help enhance that bond. While PetsApp enables veterinary clinics to offer text chat and video consultations to pet owners, I do not believe for one minute that virtual consultations will replace physical consultations - instead we believe existing veterinary clinics will deploy telemedicine to curate and augment the physical services that already exist, providing a low effort access point to veterinary expertise that competes with Dr Google or “hoping for the best” - and helps determine what the best combination of digital and physical experiences will look like for any individual pet owner and their pet. 

It’s not about uploading the pet to the cloud but rather putting the pet front-and-centre of a mobile-first health care experience that proactively engages pet owners in the care of their animal in a manner that is maximally relevant to them.

The Veterinary Innovation Council found that only 2 out of 24 pet issues each year are addressed by veterinary expertise. That means 92% of all pet issues go unaddressed by those best able to address them. We want to help veterinary clinics remove barriers to pet owners accessing veterinary expertise, such that the veterinary clinic can compete with Dr Google or simply “hoping for the best” as the first response of a pet owner facing a pet issue - thus expanding our patient advocacy opportunities.

Make it easy for pet owners to delegate care decisions

Remember my brother-in-law’s fiancee Kyla and her Labrador-mix, Camden? In the four months since Camden joined their family, she presented 6 pet issues to me - this is on top of various vet visits. That’s 6 issues in four months, which extrapolates to 18 issues per year. By removing all barriers to accessing veterinary expertise, I’m getting access to 9 times as many patient advocacy opportunities as a vet ordinarily would. We’re expanding our patient advocacy efforts from 8% to 75%. In other words, we become front-of-mind rather than last-resort when people are facing pet issues. Turns out, trust and convenience is a powerful combination.

Traditional vet clinics do a great job of capturing pet issues at point of need. When the pet is obviously unhealthy. However, “point of need” is as currently defined by the pet owner - and they may over estimated the importance of a nipple they haven’t noticed before, while underestimating the importance of their cat’s frequent litter tray visits.

With PetsApp, clinic can reduce customer effort to the point where they are able to see issues when pet owners first notice them or even at point of curiosity. Remember, this does not mean that the issues are trivial - for example, we had one pet owner, an experienced pet owner with 3 dogs - their newest dog, a golden retriever, needed to go out to the toilet 8 to 12 times each day. This had been going on for 3 months. But the owner’s heuristic for whether to go to the vet was if their pet was in pain. Now this pet was in discomfort, no doubt, but the owner did not perceive them to be in pain. In fact, they just assumed this was normal for that dog, and as a loving owner, they were willing to accommodate the needs of their newest family member. But when the owner discovered their clinic was now offering PetsApp, the niggling doubt at the back of their mind was sufficient for them to strike up a conversation. They were convinced that the issue justified a veterinary visit, and the issue was resolved. The pet’s life was improved. The pet owner’s life was improved. And the veterinary team had access to a patient advocacy opportunity they might otherwise have missed.

So telemedicine tools designed and deployed correctly allow you to digitally augment your existing patient advocacy efforts.

Okay, we’ve covered the what and why, but how about the how?

How do we do veterinary telemedicine effectively?

How do we digitally extend our veterinary clinics?

I thought it would be a good idea for us to explore a few potential customer journeys together. The first I want to do in the context of Covid, and the delivery of socially distanced veterinary care, then we’ll move beyond this to look at other potential customer journeys for both now and in the future. Please note, not every example is going to be relevant to your specific context or potentially your local regulation but hopefully these serve as some ideas to inspire your tailored approach. For example, I’ve suggest the role of the team member that would be responsible for each step - you’re obviously better placed to decide exactly who that should be but the important thing is that your platform and processes allow for collaboration across the team, and operational flexibility based on the composition of your team.

Socially distanced veterinary care

Now, you want to start each interaction by clearly setting client expectations. It’s easy to unintentionally over-promise here, and disappoint pet owners despite your efforts to go above-and-beyond. This is just going to cause frustration on both sides. Clinics using PetsApp get incredible customer reviews, and much of this is to do with setting expectations ahead of time. Each interaction starts with an automated message - in the video demo above it just says “Hi, how can we help?” But this is your opportunity to explain average response times, opening hours, what you want people to use the service for, what you don’t want them to use it for, what to do in an emergency… etc.

A number of clinics, using other platforms, turn-off their messaging capability outside of normal hours - this is a mistake. So long as you clearly state the hours within which an owner can expect a reply, and give instructions on what to do in case of emergency, it’s a good idea to leave this opportunity for client engagement open. What we’ve seen is that some pet owners use this opportunity to delegate non-urgent tasks to the veterinary clinic while they are front-of-mind for them, without expecting anything like an immediate response. For example, they may have gotten home late and noticed their prescription dog food is running low - let them send you a message to initiate a click-and-collect order for the food, otherwise the next time they think of the dog food situation may be in the local supermarket or while browsing online, and you’ve missed your opportunity to drive compliance with that particular veterinary recommendation - in other words, what is best for that pet.

Appointment booking

Okay, so let’s imagine the pet owner begins chatting with the receptionist, and they decide the issue justifies an in-clinic visit - they proceed to book an appointment via the text chat. Pre-covid, 38.1% of all in-app interactions led to an appointment recommendation, and 30.5% of all chats have included an appointment being booked via the app. The beauty of this is you can collect all the pre-consult information you could possible wish for, and give the client instructions e.g. around withholding food ahead of surgery.

Now it’s appointment time but rather than conducting the admission consultation in-clinic we’re going do a video admit consultation. You can even send the PDF consent form via the text chat - this works for estimates and blood results too.

You’ll want to do a socially distanced drop-off of the patient - we’ve seen the judicious placement of hooks for dog leashes, one-in-one out policies etc.

Inpatient updates

Next, while the pet is in the clinic, the pet owner is going to want updates. We’re all familiar with the games of phone tag that absolutely no one loves, where the owner calls reception, the receptionist tries to find the relevant person to get an update for the owner - that person is inevitably drawing blood from a fractious cat, so you tell the owner they’ll call back and you leave a message on a clipboard somewhere - well you know how that goes - nobody’s got time for that, least of all now. By having an ongoing point of contact with the pet owner you can avoid the phone tag, and be proactive in engaging with them in the care of their pet.

These inpatient updates have some really nice consequences for the entire veterinary team. It reduces stress on reception, but in many cases the nursing team can take charge of this engagement opportunity, freeing up vet time. But if the vets want the nurses to take on this task, they have to keep them well-briefed clinically - increasing job satisfaction for both the vet and the nurse. The clients then get visibility of the things the nurse does that they otherwise often never hear about. For example, we learnt of one example among thousands, where the nurse messaged the owner that their dog had recovered well and that the nurse was just about to feed them their lunch. The client replied saying: “He loves chicken.” The nurse was able to reply: “I’m actually cooking some for him now.” And guess what the next message is? A photo of the nurse hand feeding the dog some chicken. The nurse was doing all of this anyway, but the client may never have known. Clearly the pet owner was delighted, bonding them to the clinic as a whole, while providing incredible job satisfaction for that nurse. Another example would be a nurse sharing that the pre-anaesthetic blood results are all fine. Now, all too often we forget to share these insights with owners and we miss an opportunity to enhance the value perception. If the owner never sees the value in getting those results, what do you think is going to happen to their compliance next time you suggest a blood test? It’s going to go down - it’s amazing what seeing a bit of science can do for an owner, and we all know how important this information is to us clinically, and to the health and wellbeing of that animal. Pre-covid, about a quarter of all chats were started by the veterinary team, outbound to the owner, and the vast majority of these were for purposes of inpatient updates.

Digital payments

Okay, so you’ve done the in-clinic procedure. Time to collect payment. Cash is a big no-no right now, and you want to reduce time spent in-clinic. So, it’s a good idea to collect payments remotely. Giving credit card details out over the phone is not always the most comfortable experience for a pet owner, so great to collect digital payment if you can. Here you really want to look at your payment processing fees, if these fees are much higher than a couple of percent then it becomes cost prohibitive to take payments for anything and everything in the way you’ll want to. On PetsApp we use a Stripe integration that works really well for all forms of payment, and the fees are just 1.4% + 20p per transaction. As a result, we’re seeing payments being taken for the telemedicine services but also in-clinic procedures and click-and-collect or delivery orders of prescription diets, parasiticides and repeat prescriptions, for example. Where the owner has not been seen recently enough to allow the order to be completed from the clinic’s side, an in-clinic appointment can be booked when appropriate. The average transaction value through PetsApp currently floats between £50-60, which is super healthy, and we’re processing literally thousands of transactions on behalf of veterinary clinics.

Video discharge consultation

The inpatient updates we talked about earlier flow seamlessly into the idea of using the app for video discharge consultations. Typically a discharge consultation is free, bundled within the price of a procedure. This free consultation commonly happens in the peak after-work period, competing for capacity with paid consultations. Given the patient is in the clinic with the clinician, there is absolutely no regulatory barrier to conducting this consultation remotely earlier in the day at a non-peak time. Most pet owners can take 7 minutes (the average length of a PetsApp video consult) out of their day to do a video call, where they can receive the discharge instructions. The in-clinic visit is then just for the purposes of pick-up.

You can then schedule yourself a follow-up text chat with the pet owner to check in on progress - maybe you want them to send you a photo of the surgical wound, or give you an idea of how the current treatment is progressing.

Push notification reminders

After that the pet owner falls into the usually flow of reminders. However, if you’ve deployed an app-based solution, you now have access to push notifications as an option, which in contrast to text messages are essentially cost free, they also pull the owner straight into another interaction, where you can also collect payment, book an appointment or jump onto a video consult as needed, making compliance with your recommendations much easier.

At the end of each interaction, we proactively request client feedback - and we can talk about that a bit more later. For now, the next customer corridor I want to look at is the video consultation.

Vet video consults

Under the current circumstance, for understandable reasons, there is a slightly unhelpful emphasis on video consults. The concept of a one-and-done video consult puts undue pressure on the pet, pet owner and clinician. Pets aren’t always going to perform for the camera - and they may not express the clinical signs that triggered the video consult in the 7 minutes that they’re on screen. For that reason, you want a tool where the owner can send you photos and video asynchronously, ahead of the video consult - giving them the best chance of capturing decent images, helping you to see what is going on.

Setting pet owner expectations

Here again, you start with the automated message setting client expectations. Maybe a member of the reception team fields the initial query, handing off to a member of the clinical team who can triage and take an initial history as appropriate. They can also, as mentioned, request photos and videos to help get a deeper insight into the issue. When you’re dealing remotely with a pet owner and their pet’s issue, and you’re not sure what to ask next, asking for photos and videos is a great next step. In this case, on the basis of the information gathered, let's say we decide a video consult is the appropriate next step. 

At this point maybe we hand-off to a member of the reception team to schedule the video consult and take payment. Taking payment for the video consult at the time of scheduling the consult is another top tip. It helps ensure the pet owner will be ready and waiting by their phone at the time of the consultation, deepening the social contract. It also helps set owner expectations, avoiding any chance of an owner saying they didn’t realise there was a cost associated with the consult after-the-fact. In terms of taking payment, many clinics are using access to telemedicine as a neat way to drive penetration of the Pet Health Plans. On PetsApp we have a little button showing the veterinary team very clearly whether or not that pet is a member of the Pet Health Club, this helps them determine whether or not to charge for the consultation.

Prior to the video consultation you might want to message the owner with some tips on how to get the most out of the video consult. Top tips include having their phone to-hand at the time of the video call, making sure it has plenty of charge, taking the call somewhere they have good wifi, checking they’ve allowed push notification, as well as access to their webcam and microphone, advise they take the call away from any noisy household appliances, and have the pet in the room with them, so you don’t have to follow them on an under-the-bed search for the cat. I know many clinics have done really good, instructive social media posts along these lines, and we have getting-started help docs that you can also use: https://docs.petsapp.com/

Next the video consult takes place. Lets pause our customer corridor here to have a look at what the data from PetsApp interactions can tell us about what to expect.

The range of issues you’re going to be dealing with via telemedicine video consults are going to reflect those that you see at your clinic normally. Common issues are skin, GI, urinary issues and nutrition. As mentioned, the average video consult lasts about 7 minutes. Some vets before they start doing the video consults worry a little bit about duration, and how will they keep the video consults time limited. To a great extent, video consults rely on many of the same consultation skills and techniques you’ll be deploying in the real world, potentially without even noticing. For example, if we want to bring a real-world consultation to an end, we’ll begin to set expectations around the next interaction to signpost that this one is coming to end, we’ll often change the tone of voice, we’ll rise to stand if we were previously seated, and for those that really can’t take a hint, we’ll move towards the door confidently opening it for them! The virtual equivalent might be the communication of next steps, for example: "Okay Mrs Jones, well what we’ll do is I’ll type up a little summary of what we’ve discussed today and send it through to you in the text chat on the app. I’ll set a follow-up to check-in with you on how Teddy is doing in a week’s time. If any questions in the meantime you can always drop us a message. Thanks then, bye now."

Failing that, “Oh crap, my battery is on 1%, sorry Mrs Jones bbyyeee!" Works too. Just kidding, of course. (But I'm sure I'm not the only vet that has, on very rare occasion, found cause to wish for a big red hang-up button during a consult in the real world.)

Joking aside, the continuity that the text chat provides, and the ability to hand-off to colleagues and schedule follow-ups eases the transition at the end of the video consult, making it much less abrupt. Again, taking some of the pressure off. Forget a question, or remember a differential, you can follow-up with the owner at your leisure.

Vet video consult outcomes

In terms of outcomes from video consults - the following data is pre-Covid - about 10% of cases require an emergency visit to the vets, 50% require a non-urgent visit, and 40% can be resolved via the video consult alone. 

With regards to who you’ll be speaking to, in the current context anyone and everyone is engaging with the technology, perhaps with a slight bias towards men and millennials. When we surveyed pet owners we found the vast majority of pets have multiple caretakers. However, in clinic you are more likely to see women bring the pet to the vet than men. Interestingly, via PetsApp you are relatively more likely to see men compared to in-clinic visits, potentially unlocking access to another pet care stakeholder.

Similarly, the majority of baby boomers describe veterinary care as accessible. However, the majority of Millennials describe veterinary care as inaccessible. There is evidence that Millennials are among the most compliant pet owners, being more likely to comply with dental recommendations, for example. This makes sense when you consider that they’re the first generation to really grow up with pets as “siblings”. What’s more, Millennials are now also the largest pet owning demographic. So, there’s this large, highly compliant pet owning population that think veterinary products and services are inaccessible - that sounds like both a challenge and opportunity. There’s good evidence that PetsApp solves that problem, unlocking a significant opportunity.

Okay, so you’ve done your 7 minute video consult. Perhaps you recommended some products, like a prescription refill or a toothbrush, whatever, via that video consult - you’re going to need to take payment. Ah, but you already took payment ahead of time - how is the owner going to feel about having to pay again? Well, it again comes down to customer effort and how difficult or easy you plan to make it for them. With PetsApp once they’ve paid once it’s super easy to pay again as payment details are stored securely, and they even have access to Apple Pay or Google Pay as payment options depending on the device they’re using. You’d be surprised how many customer reviews include pet owners raving about ease of payment - not something we’d particularly expected.

Next you should forward book your text chat follow-up as we discussed for the in-clinic visit flow.

So, we talked a bit about how the current emphasis on video consults can be unhelpful and set unrealistic expectations on what can be achieved remotely in 7 minutes. However, on the flipside, I think we underestimate just how much ongoing asynchronous interactions with pet owners can augment our existing patient advocacy and even improve the quality of the medicine that we’re practicing. 

Asynchronous veterinary virtual care by text chat

Think about surveying the home environment of a blocked cat (having resolved the emergency, of course!), getting a look at the particular excretion giving cause for pet owner concern that day, differentiating between intermittent fainting or seizures, coughing vs unproductive wretching, catch the goose honk of a collapsing trachea, helping an owner with difficult end-of-life decision for their pet, assessing the lameness of a nervous dog that guards their sore limb in practice, receiving a photo of the ingredients in the product Buster happens to have ingested this week, and tracking those frustrating skin cases through a combination of photos and in-clinic visits. And that last point is important, because longer term, we should NOT be seeing this technology as a like-for-like replacement of a veterinary visit but rather an additional tool in our armoury, digitally augmenting our existing efforts. If this was an article on ultrasonography, and I told you that ultrasound can diagnose and cure every disease, you’d laugh me out of town. If on the other hand, I said ultrasound is a super handy tool for diagnosing certain conditions, and you’re likely to get better at it the more you use it, then that makes a lot of sense, right? The same is true of telemedicine and digital patient advocacy more broadly. We shouldn’t see it as a cure-all but we also shouldn’t use its limitations as an excuse not to engage with it at all.

As an aside, having a text chat backbone to your telemedicine efforts also allows the veterinary support team to make progress with some of the administrative elements of the patient journey.

Monetising text chat

However, can we monetise an interaction that doesn’t include a video consult? Sure, why not? If you’re delivering value to the pet owner, you are entitled to capture a portion of that value. And in the text chat customer corridor example above, we can see one way to do exactly that. Some clinics have a fee for a certain period of unlimited text chat access to the veterinary team. People tend to get a bit scared by that mention of “unlimited”, for your average chat, you’re talking 6 messages and a photo per chat on average - fear not!

Having explored three potential customer corridors together, I thought it was worth illustrating what this all might look like in terms of a joined up, online-to-offline patient experience. The video below does just that. It was produced pre-Covid, and uses preventive dentistry as the worked example, which at time of writing is not currently appropriate (at least in the UK). However, hopefully you can see the broader message and apply as relevant to your situation.

Pet owner feedback

I mentioned earlier, and as you can see in the video above, we collect pet owner feedback at the end of each interaction on PetsApp. We use a metric called Customer Effort Score - where we ask pet owners how easy we made it for them to address their issue. Iterating against this feedback is super important for us in terms of delivering the best product for you guys, but also super important for the veterinary teams we serve in terms of working out what “excellence” looks like in the context of digital patient advocacy.

Well, one thing is very clear - pet owners love it. The average Customer Effort Score rating is 4.7/5 and we have over 1,350 Apple App Store ratings, with an average score of 4.9/5. And it's you guys, not us, that they are typically raving about and to whom they are sincerely grateful.

And just as we should seek to reduce effort for pet owners, in all of this, we should also be careful not overburden ourselves. Thomas Edison once said something about genius being 99% perspiration and 1% inspiration. Our friend from earlier, Ma Yun, disagrees - he reckons it’s lazy people that create history by providing path of least resistance ways of doing things, ensuring that they actually get done, and that people are willing to engage.

This strikes me as instructive for our approach to telemedicine and digital patient advocacy. We should not overcomplicate, or seek to exceptionalise. We should, as I’ve tried to do here, identify the key points of difference and think carefully about the experience, but as far as possible we should look at how we do things currently, and what is the closest approximation in the virtual process. Hopefully you will see this is the sort of pragmatic approach that I’ve tried to take here, and it’s exactly what has allowed us to achieve telemedicine implementations at clinics within 24 hours.

However, there are some areas where that’s easier said than done. For instance, there was this study that showed that under normal circumstances in a GP consultation, if the GP touched the patient on the shoulder it doubled the patient’s perceived length of time spent with the doctor. What’s the virtual equivalent of a touch on the shoulder? It’s non-obvious right? But this is the sort of place where your feedback comes in.

Veterinary team feedback

Early on we had feedback from veterinary team members that pet owners would often use emojis in their messages, and while this was an option for the veterinary team using the app, it was not an option to reply with an emoji when using the PetsApp dashboard on a desktop or laptop. The veterinary team member said that replying without using emojis when the owner was using them felt sort of judgemental and overly formal, and didn’t reflect their clinic brand’s tone of voice. So, of course, we added an emoji picker to the dashboard. Is a thumbs up and paw print emoji the equivalent of a reassuring touch on the shoulder, ermm... I’m not sure we’re there yet but it’s only by thinking deeply about the user experience and iterating that we will get there.

And that’s the key because we are shooting at a moving target. I think Jeff Bezos, founder of Amazon, puts it best: “One thing I love about customers is that they are divinely discontent. Their expectations are never static - they go up. It’s human nature. We didn’t ascend from our hunter-gatherer days by being satisfied. People have a voracious appetite for a better way, and yesterday’s ‘wow’ quickly becomes today’s ‘ordinary’”.

I hope this article, these insights and the tools we have developed and are developing at PetsApp, will help you and your teams capture tomorrow’s wow!