Front Line Innovations in Veterinary Medicine

It's not all artificial intelligence around here, good ideas come from all sorts of places.

The trick is to figure out ways to explore the edges of possibility that surround you. This can be as simple as changing the physical environment you work in, or cultivating a specific kind of social network, or maintaining certain habits in the way you seek out and store information.

Johnson, Steven. Where Good Ideas Come From (p. 41). Penguin Publishing Group. Kindle Edition.

I founded and own my practice in Chadds Ford, Pennsylvania. It’s my hometown and I like practicing here. Practicing medicine where I grew up stokes my desire to practice excellent medicine. Many of the people I serve have been friends and neighbors for far longer than they’ve been clients. It’s an additional motivation.

Some of the things I do in the pursuit of being a “good doctor” are intensely personal. I spend time reviewing journal articles and studying. I study every day, sometimes leadership, medicine, surgery, business, history, or philosophy. I maintain extensive notes and reading lists in cloud-based organizational software. There’s even an app on my phone that will pull a variety of notes and quotes from that source at random and offer them for my review in a daily email. I won’t make it out like I don’t enjoy this aspect of my work, but it mandates some diligence and consistent effort.

Another aspect of providing care is the organizational management of the hospital and the care system. There’s much that goes into medical care than a doctor knowing things. The practice and performance of medicine is an endeavor that mandates a team working in concert. Rarely has the phrase “easier said than done” been so applicable.

My staff is not “well-trained,” a phrase in the past tense that implies completion and end, rather we are constantly learning, iterating, and improving. We are not well-trained, but we are training well. And we rely on other organizations that have developed solutions in order to help us provide better care. In the interest of disclosure, I have business relationships with the following companies. While such relationships are broadly commercially available, I confess that I like the people behind these names and logos and branding. Some have become good friends of mine, connected by our common goals and like-mindedness.

The DALL E 3 image generator created this when I used this essay as a prompt. AI imagines me as much more handsome than I am.

One of the great joys of our connected world is the opportunities it offers to meet people from all over the planet. The companies below have founders and corporate officers from four countries and three continents. They offer a variety of experiences and perspectives and insights that would’ve been all but impossible for a small-town veterinarian to access in years past.

Mascotte Health

Mascotte is a company that provides remote, fractional support for reception, technician, and management duties in the hospital. They answer my phones, communicate with the in-hospital staff, field online client questions, emails, prescription requests, and the like.

It’s useful for me because I can outsource things in a fractional manner but maintain the reliability and quality of outcomes. I might need 60 hours of work done, but hiring one full-time and one part-time employee, or two part-time employees can be difficult, time-consuming, and expensive. Onboarding and training more so. But it’s much more affordable on this as-needed basis with certified and experienced technicians. The costs scale with my needs, and the service has paid for itself many times over.

Remote CSR operations are not innovative, but doing it this well is.

They’re driven by their founder, Bora Hamamcioglu, whose business savvy is profound. Mascotte is the second company he’s founded, and he’s proven extraordinarily talented at refining and executing the more granular aspects of operations, which I think is crucial to a remote service in a technically demanding field like ours. It’s easy for the sort of work he’s mastered to be cast as boring or bland or beneath notice, but those of us here in the trenches know that the devil is in the details. Small mistakes are dangerous in a hospital, and his keen eye for those potential stumbling blocks - thus preventing the stumble - is utterly invaluable. My hospital is much better off for the work of him and his team.

Digitail

Digitail bills itself as “modern veterinary software you wish you’d had sooner,” which is exactly as straightforward as it sounds. It also happens to be true. Many veterinary practice management systems fall short of “doing it all” and so practices end up cobbling together a variety of softwares to serve their needs in a fashion that resembles, at best, my ten-year old’s LEGO builds (charming and delightfully clever) and, at worst, Frankenstein’s monster (horrifying and hated by villagers).

Digitail is a remarkable company driven by remarkable co-founders, Sebastian Gabor and Ruxandra Pui. I haven’t yet had the chance to know Ruxandra very well, but as CPO of a company with an excellent product, it’s hard to argue with the quality of what’s been produced. Sebastian, whom I’ve gotten to know, immediately strikes everyone he meets as the very model of a modern major general tech CEO. He’s sharp, insightful, driven, and genuinely friendly. He, like Bora, is a second-time founder. Having already launched and sold a successful company, he brings the kind of experience that is uncommon in the world of veterinary medicine. He’s seems to see the horizon of technology with unique clarity, that is to say he possesses vision.

The software is cool. It’s what you wished your PIMS would do. It’s like upgrading from a PDA to an iPhone, it just works. It makes communications and management easy in a cloud-based system that isn’t owned by a massive company that may or may not be doing things with your data. Because of the people running the company, it’s evolving. In a world that’s changing fast, I want and need software that’s moving with it. Not every company is nimble enough to affect these kinds of changes, but I’ve had front-row seats to Digitail’s moves for a few years now and I’m impressed.

Maven

The newest addition to my hospital is Maven, a pet activity monitoring system centered around a nifty activity monitor and its supporting software. If you were going to build a product to appeal to a nerdy practice owner and once-upon-a-time-athlete who likes technology, obsesses over data, and has owned several Garmin running watches, Maven would get that person (read: me) hooked.

It does more than just monitor activity, it records activity and respiratory data within Maven’s monitoring system, available online, allowing for analysis by us in the hospital.

Though we’re still tinkering with the implementation (and it shall forever be thus), our best uses of the monitoring system seem to be perioperative surgical monitoring and monitoring of patients with chronic conditions. By monitoring the activity levels of patients pre- and post-operatively, we have a wildly accurate measure of the nature and speed of their recovery. When something is “off,” abnormalities detected by the customizable parameters of the monitor, we get an alert. A patient with chronic disease has a sudden bout of lethargy, for example? We get an alert. The alert, initiated by Maven, fielded by Mascotte and remotely logged into Digitail, creates a novel touchpoint with the client and allows us to offer attention and intervention much earlier than would otherwise be possible.

The company is led by founder Guilherme Coehlo, “G” for short. G is every bit the engineer who knows he’s built something incredibly useful and cool. He’s profoundly enthusiastic about his creation and I believe the data collected will provide us with a powerful new source of information about pet’s health.

While we don’t yet have all the insights possible for the application of a pet activity monitor like this, its relative economy and non-invasive nature invite widespread use. What if we could predict diseases or injuries and prevent them? What if we could intervene in illness that much sooner? The potential positive impact on medical outcomes is yet unquantified but could be profound. Such use will generate data and, I believe, make possible the creation of entirely novel and opportunistic areas of study and application to veterinary medicine. It’s early in the life of this product, but I can’t help but be enthusiastic about its future.

Roo

Roo is a platform for arranging relief veterinary services to veterinary practices. It sounds simple enough, but finding relief doctors used to be “the wild f—ing west” as one of my practice-owning colleagues so delicately put it.

The platform is straightforward and easy to use. It offers a chance for employers and relief doctors to rate and note details of practices and doctors. It has helped a solo practice owner like me find coverage for days when I need or want to travel or just take a day off.

Working as a relief doctor for Roo is useful as well because it allows me the chance to see how other hospitals solve problems similar to mine in different ways. It’s something like a professional exchange program. The great variety that exists in the practice of medicine - while still achieving high-quality care - never ceases to amaze me. It’s provided wonderful networking-building and learning opportunities.

I don’t know much about the leadership team at Roo, but I’ve gotten to know Dr. Andrew Findlaytor, their Senior Director of Veterinary Strategy and Services. In a profession that is often blind to technology and deaf to solutions for its struggles, Andrew stands out. He has the gift of asking good questions and the mind to put the answers to good use.

Conclusion

We don’t do this alone, at least we don’t do it very well. I pride myself on being a consummate, curious, and ever-learning generalist, so I know that I’m not an expert in everything. What I’ve been able to do is arrange teams and partnerships that further and enhance the practice of medicine at Old Ridge Veterinary Hospital. While the hospital is mine alone, the credit for its reputation and continued success is not. The value of a network of brilliant, creative, dedicated, and kind people cannot be understated.

“Innovative environments,” wrote author Steven Johnson, “are better at helping their inhabitants explore the adjacent possible, because they expose a wide and diverse sample of spare parts - mechanical or conceptual - and they encourage novel ways of recombining those parts.” And so I endeavor not only to create those environments, but to participate in them.