Washington law sets rules for veterinarians' remote animal care

The law allows a veterinarian to establish a care relationship through telehealth in specified cases. This applies when an animal cannot access clinic care because of substantial challenges, such as major transportation problems or a long wait for an appointment, or has an urgent condition that could cause suffering if care is delayed. The veterinarian must record the substantial challenge or urgent condition behind each consultation. The veterinarian may not treat the animal for more than a year after the first telehealth consultation unless a Washington-licensed veterinarian examines it in person during that year. The veterinarian may refuse treatment if an in-person exam is needed. When practical, the veterinarian must have an arrangement with a Washington-registered practice for referrals. The in-person exam must happen within one year after the first telehealth consultation for the veterinarian to continue treatment beyond that year. An exam may be needed sooner if medically appropriate.

Once a care relationship exists, a veterinarian may use telehealth for ongoing care and decides whether an in-person exam is medically appropriate. This applies to ongoing care after a veterinarian-client-patient relationship has been established. A relationship generally requires the veterinarian to take responsibility for clinical decisions, the client to agree to follow instructions, and the veterinarian to know enough about the animal to make at least a preliminary diagnosis. The relationship extends to veterinarians at the same premises or mobile practice, but not to other veterinarians solely because they can access the animal's records. Without a relationship, telehealth is limited to listed services, including advice, emergency triage, certain prescriptions, and poison control.

The law limits how long veterinarians may prescribe drugs through telehealth without an in-person exam. These limits apply to veterinarians providing care through telehealth. Prescription drugs must be used or prescribed by or on the order of a licensed veterinarian under applicable federal and state rules. A veterinarian may not prescribe a drug for longer than three months without an in-person exam, or prescribe the same drug again unless a veterinarian has examined the animal in person. Antimicrobial and anti-inflammatory drugs are limited to 14 days of treatment; another prescription for the same condition, including a refill, requires an in-person exam. Other listed exceptions allow certain services without an established relationship, including sedation to help an animal get to an in-person visit and limited dispensing of another veterinarian's prescription. The three-month limit runs from the date the prescription is issued. The 14-day limit applies to the length of treatment.

The law requires commercial animal operations to have a written agreement with a veterinarian of record who oversees drug use and treatment. This applies to animals or animal products used in commercial activities, including food production, medical testing, and livestock breeding. Oversight covers all drugs used in the operation and includes treatment plans, staff training, record review, drug inventory and labeling, and checks on compliance and results. If telehealth is used between in-person exams, the veterinarian must visit at least once each year after an initial in-person visit to the premises. Drugs and prescriptions must have time limits suited to the operation and cover only animal groups the veterinarian directly oversees. The annual in-person visit is required when telehealth is used between exams, after the veterinarian's initial in-person visit to the operation.