Wednesday, February 1, 2017

Bridging the Veterinary–Human Healthcare Communication Divide

By Jason W. Stull, 
VMD, MPVM, PhD, DACVPM, 
The Ohio State University College of Veterinary Medicine
and
Timothy Landers, 
PhD, RN, CNP, CIC, 
The Ohio State University College of Nursing


"Because pets are highly valued family members, pet and human health is interconnected, and veterinary and human healthcare professionals need to work together to ensure optimal household health. However, lack of communication often limits coordinated effort. Identifying when veterinary and human healthcare professionals should communicate, determining communication barriers, and incorporating practices to overcome the barriers are critical to improve pet and human health.

Know When to Communicate

Zoonotic Pathogens

Diseases transmissible between animals and humans (ie, zoonoses) are frequently encountered in veterinary medicine. The pathogens pose a health risk to veterinary patients, clients, and their other household members; those who are immunocompromised (eg, diabetic, receiving chemotherapy), young or elderly (ie, <5 or >65 years of age), or pregnant are at the greatest risk.


Human healthcare providers may have limited training in zoonoses, so veterinary professionals play an important role in educating their colleagues about these conditions, including the benefits of the human-animal bond. Providing such information can lead to balanced discussions about risks and benefits and produce solutions that will ensure optimal care for all household members.

Noninfectious Conditions

Given the strong connection between pets and humans, sharing with a client's healthcare provider information about the impact of a pet's health on the owner's physical or mental health (eg, needing support after the loss of a pet) can be helpful.

Be Aware of the Barriers

Veterinary and human healthcare professionals are all busy, which makes direct communication difficult. Also, federal acts limit information sharing. According to the Health Insurance Portability and Accountability Act (HIPAA), information about a person's health status (Protected Health Information[PHI]) is considered confidential and protected under privacy laws. Laws do permit sharing some information for coordination of care, but physicians may be reluctant to do so. In these cases, clients can provide their physicians with written approval to discuss their case with the veterinarian.

Overcome the Barriers

Know & Target the Audience

The human healthcare team includes many members, such as physicians, nurse practitioners, and physician assistants, who are excellent points of contact for pet-related health concerns. Nurses and nursing assistants, who may have more availability and direct contact with patients than physicians, can facilitate communication and are a good place to start.

Provide Key Information

A brief synopsis of the types of animals involved, their health and husbandry, potential human-animal health implications, and suggested resources will assist with communication - surprisingly perhaps, many human healthcare offices still prefer to use fax. A clear, succinct history will streamline the transfer of information, provide a focus for questions, and encourage follow-up.

Obtain Permission to Release Sensitive Information

Privacy laws allow veterinary team members to obtain a written waiver from clients to permit an exchange of PHI. The healthcare provider should also keep a copy of the waiver.

Trust the Fax

Faxing a brief communication to the human healthcare team can address privacy concerns, overcome time and scheduling barriers, and provide written documentation of communication and recommendations. Many offices prefer - and often require - faxing, which they consider a superior method in terms of privacy and written documentation. When potential legal or severe health risks exist, requesting confirmation of receipt (eg, phone call, returned fax) is advisable, and transmission logs should always be retained.

Open Doors

Veterinarians should reach out to clients' healthcare providers; for example, suggest clients give their physician the veterinarian's information so he or she can be contacted about the animal medicine perspective. Educational materials (eg, on zoonoses) can also help engage clients and healthcare members.

Respect Boundaries

Animal and human healthcare professionals each have important training and perspectives to contribute to the promotion of families with healthy humans and animals. Animal health professionals can help by politely providing important animal-related details. Pointing toward recent consensus or guidance documents may be especially useful.

The same approach can be used when discovering the human healthcare team has provided pet-related misinformation (eg, incorrectly suggesting the humans got pinworms or strep throat from the pet); a gentle refresher may be all that is needed. Human healthcare professionals can then use the information and their knowledge of their patients to make the best healthcare recommendations and decisions. 

Conclusion

Acknowledging each profession's contribution to family health is important. The veterinary team can assist the human healthcare team by providing expert information without overstepping professional boundaries."


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