Veterinary Emergency Group (VEG) announced that it has launched a scribe role position in its hospitals, making it the first to do so in the veterinary medical field. The new position will work alongside doctors to help reduce the time they spend on documentation.

“By being the first to introduce a Scribe role to the veterinary medical field, we are positioned to make a huge impact on the industry and once again shift the paradigm,” said David Bessler, founder and CEO of the Veterinary Emergency Group, in an organizational release.

 “The Scribe role that has been used historically in traditional healthcare will offer a variety of benefits to the VEG team that includes burnout reduction, improved communications and workflow, customer benefit and career inroads.”

 the VEG Scribe position is cutting down documentation time by 87% ranging from 4 hours to 30 minutes. With the new position, VEG hopes this can help its doctors create a better work-life balance while raising morale, creating a ripple effect throughout each VEG hospital. The VEG Scribes are shown to increase medical quality and allow better communication between patients, doctors, and referring veterinarians through record-writing.

This new position will also help doctors provide undivided attention to clients by providing a better experience when in a VEG location, The VEG Scribes will also create more job opportunities within the veterinary emergency field as well as learn from other veterinary professionals within VEG. Currently, 100 VEG Scribes are working in various locations.

Veterinary Emergency Group is the First to Introduce a Scribe Role in the Veterinary Medical Field and Sets a New Industry-Wide Standard with Positive Outcomes. News release. Veterinary Emergency Group. November 29, 2023. Accessed January 22, 2024.

Articles

The VEG Scribe role will assist doctors by reducing the time they spent documentation per shift 

Scribe position introduced at emergency clinics 

Highly pathogenic avian influenza (HPAI) has been spreading across North America since January 2022.

 As of November 2023, more than 72 million cases of HPAI have been reported in wild birds and poultry flocks, and the virus has been confirmed in every state except Hawaii.

 Cases have also been documented in several species of mammals, including humans, with 1 case reported in the US.

HPAI is an influenza A virus. These viruses are further classified by variants of the surface proteins, hemagglutinin (HA) and neuraminidase (NA). Of the 18 HA subtypes and 11 NA subtypes that are known, those numbered 16 and 9, respectively, have been identified in birds.

 The virus involved in the current outbreak has an HA 5 protein and an NA 1 protein and is designated H5N1, a strain that has not been detected in the US since 2016.

 It is highly transmissible and very durable in the environment, and it is able to survive in water for 102 days at 28 0C or up to 207 days at 17 0C. In feces, the virus can survive for 7 days at 20 0C and 30 to 35 days at 4 0C.

 Viral particles can be found in secretions from the eyes, respiratory tract, and mouth, as well as in feces of infected birds. The virus also can be carried on feathers, skin, clothing, equipment, dirt, and other fomites.

In contrast to low pathogenic avian influenza (LPAI), HPAI viruses cause severe disease in infected birds, with the exception of waterfowl (ducks, geese, swans, shorebirds, etc). Waterfowl are considered natural carriers for avian influenza viruses and serve as a reservoir for the virus in the wild.

 Most waterfowl do not develop clinical signs of disease, though they may shed the virus for long periods of time and are one of the main sources of transmission to the pet bird population.

 HPAI outbreaks in other species, however, can result in morbidity and mortality of 90% to 100%.

Disease typically manifests as severe neurologic and respiratory signs, though other signs can be present. Infected birds may also die without displaying clinical signs beforehand. Although cases in mammals have been increasing, birds remain the primary at-risk population for HPAI. The current H5N1 outbreak appears to be particularly deadly to wild birds, especially birds of prey. The incubation period is generally 1 to 7 days, during which birds may transmit disease without showing outward physical signs.

 Note that longer incubation periods may occur, and the World Organisation for Animal Health recognizes HPAI incubation as 21 days, although this can vary by strain.

Veterinarians who primarily or exclusively treat wild and outdoor companion birds are most likely to encounter HPAI in their patients. Nevertheless, any clinician seeing indoor or outdoor birds of any species must be aware of HPAI and of steps they can take to minimize the risk of spread within their facility. The first step is to be aware of HPAI outbreaks in your area. The CDC maintains a current situation web page with regularly updated information on cases in wild birds, poultry flocks, and mammals. This page also tracks human cases and overall public risk.

Patients should be screened with prioritized biosecurity according to risk. Although any bird can become infected with HPAI, birds that live outdoors are at higher risk of exposure. Backyard chickens, turkeys, and other poultry can be exposed to viral particles through direct contact with wild birds, their droppings, or contaminated soil and water.

Infected poultry can present with increased respiratory effort, lethargy, ataxia, stargazing, purple discoloration of the comb and wattles, and sudden death.

 A bird can be contagious without showing clinical signs during the incubation period, and waterfowl can carry the disease and be contagious without showing any clinical signs.

 Waterfowl with outdoor exposure should be considered potentially infectious, even if they are not displaying clinical signs of illness.

Birds that live outdoors should be examined in isolation from other patients, and facilities and equipment used for examination should be thoroughly disinfected. Use of personal protective equipment (PPE), including masks, hair covers, gloves, shoe covers, and gowns or coveralls, helps reduce risk of carrying viral particles on clothing or skin. PPE should be double-bagged and disposed of after use. Any non-disposable clothing, towels, or other objects used during examination should be thoroughly washed (with bleach) and dried (under high heat), separately from other laundry.

Examining outdoor birds at the end of the day, after handling other avian patients, may also help reduce the risk of disease spread. Viral particles can survive on contaminated surfaces for up to 7 days at room temperature,

 so even if your practice does not see birds every day, the risk of transmission is still present if infectious viral particles are allowed to remain in the environment.

Birds that live exclusively indoors are unlikely to be exposed to avian influenza. However, taking a thorough history of each indoor bird before performing a physical examination can be helpful in assessing HPAI risk. An owner with an indoor bird who also owns outdoor poultry or waterfowl, or who regularly interacts with these species, could potentially carry HPAI into their home and to their indoor birds.

After incubation, psittacine birds infected with HPAI may show severe respiratory and neurologic signs and sometimes die suddenly. After signs present, death usually follows quickly, often within a few days. Recovery is rare.

 Birds that are actively showing clinical signs, or that have had known exposure to outdoor poultry or wild birds within the last 2 weeks, should be treated as potentially infectious, and similar PPE and disinfection efforts should be taken.

An indoor-only bird with no exposure to the outdoors or to outdoor birds is unlikely to be exposed to avian influenza. Although infection cannot be ruled out in birds with severe neurologic or respiratory signs or sudden death, other differential diagnoses may be more likely, depending on patient history.

Although transmission to humans is very rare, HPAI is zoonotic. If there is any suspicion of HPAI, be sure to maintain a high standard of personal hygiene during and between clinic appointments. Protection with a face mask (N95 or greater protection), safety goggles, gloves, and covering garments is strongly recommended to reduce both zoonotic transmission and the chance of spreading infection throughout a facility.

Educating your clients, whether they own outdoor poultry or indoor birds, will help to prevent exposure and spread of HPAI. The US Department of Agriculture (USDA), for example, has numerous resources available to advise on biosecurity practices.

In general, indoor birds should be kept indoors, and outdoor birds should be protected from wild bird exposure as much as possible. Unfortunately, it is not possible to protect outdoor birds 100% from potential exposure, given the durability of the virus in the environment and the ease with which it is spread from wild birds. Nevertheless, good biosecurity practices can help reduce, if not eliminate, exposure risk.

Suspected cases of HPAI must be immediately reported to the Animal and Plant Health Inspection Service of the USDA as well as to state animal health officials. Each state has its own guidelines for reporting suspected cases of HPAI. Contact your state veterinarian’s office for further guidance.

Veterinarians are on the front lines for detecting this virus, and only through accurate and consistent reporting can we fully follow this disease’s progression. Polymerase chain reaction and agar gel immunodiffusion testing—both recommended for detection in poultry—are available for HPAI at select USDA-approved laboratories. By following these guidelines, practices should be able to not only screen patients for suspicion of HPAI but also keep the facility, patients, and staff safe.

Laurie Hess, DVM, DABVP (Avian Practice),

 is 1 of approximately 150 board-certified avian specialists worldwide. After graduating from Yale University, she earned her veterinary degree at Tufts University. She is the owner and medical director of the Veterinary Center for Birds & Exotics in Westchester County, New York, and serves as a professional services veterinarian for pet product retailer Chewy. Hess is also the author of Unlikely Companions: The Adventures of an Exotic Animal Doctor–a memoir about life as an exotic animal veterinarian.

 completed his veterinary education at Midwestern University in Phoenix, Arizona. He then completed an internship in raptor medicine and surgery at the Raptor Center in Minneapolis, Minnesota, where he triaged, treated, and rehabilitated birds of prey including hawks, owls, falcons, osprey, and eagles. 

Now pursuing board-certification in avian medicine and surgery, Huffaker works closely with Hess and her veterinary team in New York on all manner of exotic pets. When not treating patients, Huffaker enjoys spending time with his own exotic animals: a rabbit, a snake, a frog, and a 3-legged hamster.

Highlights in the history of avian influenza (bird flu) timeline – 2020-2023. Centers for Disease Control and Prevention. Updated February 27, 2023. Accessed December 14, 2023. https://www.cdc.gov/flu/avianflu/ timeline/avian-timeline-2020s.htm 

2022-2023 detections of highly pathogenic avian influenza in wild birds. US Department of Agriculture Animal and Plant Health Inspection Service. Updated December 12, 2023. Accessed December 14, 2023. https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/ animal-disease-information/avian/avian-influenza/ hpai-2022/2022-hpai-wild-birds

H5N1 bird flu: current situation summary. Centers for Disease Control and Prevention. Updated December 13, 2023. Accessed December 14, 2023. https://www.cdc.gov/flu/avianflu/avian-flu-summary.htm

U.S. case of human avian influenza A(H5) virus reported. News release. Centers for Disease Control and Prevention. April 28, 2022. Accessed December 14, 2023. www.cdc.gov/media/releases/2022/s0428-avian-flu.html

Avian influenza type A viruses. Centers for Disease Control and Prevention. Updated April 28, 2023. Accessed December 14, 2023. https://www.cdc.gov/flu/ avianflu/influenza-a-virus-subtypes.htm

Si Y, de Boer WF, Gong P. Different environmental drivers of highly pathogenic avian influenza H5N1 outbreaks in poultry and wild birds. 

. 2013;8(1):e53362. doi:10.1371/journal.pone.0053362

Avian influenza. American Veterinary Medical Association. Accessed December 14, 2023. https://www.avma.org/ resources-tools/animal-health-and-welfare/animal-health/ avian-influenza

Current bird flu situation in wild birds. Centers for Disease Control and Prevention. Updated March 11, 2022. Accessed December 14, 2023. https://www.cdc.gov/flu/ avianflu/wildbirds.htm

Case definition: avian influenza (AI). US Department of Agriculture Animal and Plant Health Inspection Service. March 2022. Accessed December 14, 2023. https://www.aphis.usda.gov/animal_health/monitoring_surveillance/ avian-influenza-case-definition.pdf

Avian influenza in birds. Centers for Disease Control and Prevention. Updated June 14, 2022. Accessed December 14, 2023. www.cdc.gov/flu/avianflu/avian-in-birds.htm

Wellehan JFX Jr, Lierz M, Phalen D, et al. Infectious disease. In: Speer BL, ed. 

Current Therapy in Avian Medicine and Surgery

Prevention and antiviral treatment of bird flu viruses in people. Centers for Disease Control and Prevention. Updated October 31, 2022. Accessed December 14, 2023. https://www.cdc.gov/flu/avianflu/prevention. htm#Protective-actions-wild-birds

The current status of disease outbreak, concerns about transmission, and how veterinary professionals can help keep patients, clients, and staff safe

Assessing the risk of avian influenza

Happy Monday dvm360 readers! In case you missed the news last week, dvm360 is now accepting nominations for our 2024 Veterinary Hero Awards. Each year, we ask the veterinary community to honor a coworker, or themselves, who has improved the veterinary industry in categories ranging from dentistry to a practice manager in veterinary medicine. Learn more about the program and where to honor your veterinary hero 

After you nominate your hero, here is what you will be able to read about this week on dvm360.com:

Veterinary Emergency Group announced it has introduced the VEG Scribe position as a way to help veterinarians reduce time spent in documentation which in return can help veterinary professionals have a better work/life balance.

Our January cover story will be available online this week! Written by Laurie Hess, DVM, DABVP (Avian Practice), and Michael Huffaker, DVM, assess the risks of avian influenza, including the current state of the disease outbreak and how veterinary professionals can keep patients, staff, and clients safe.

On this week’s episode of The Vet Blast Podcast, Margo Roman DVM, CVA, COT, CPT, sits down with host Adam Christman, DVM, MBA, to help veterinary professionals get a better understanding of the microbiome.

Thrive Pet Healthcare recently introduced Meant to Thrive, a 1-year Doctor Mentorship program that will include personalized support from a dedicated Regional Doctor Mentor.

The American Association of Veterinary Medical Colleges (AAVMC) shared the news that Andrew T. Maccabe, DVM, will be stepping down as chief executive officer after spending 12 years in the position.

Royal Canine disclosed the results of a survey it conducted in partnership with the American Association of Feline Practitioners (AAFP) in the white paper 

Getting Cats Back to Your Practice with the AAFP Cat Friendly Certificate Program. 

The data for the study was collected from 822 individuals who finished the AAFP Cat Friendly Certificate through the Royal Canine-sponsored access.

Here is a sneak peek at this week’s headlines 

This week on dvm360.com: The current state and risks of avian influenza, and other veterinary news 

The dvm360 team attended the recent 2024 Veterinary Meeting & Expo (VMX) in Orlando, Florida, and covered a multitude of sessions. We are spotlighting 3 business/practice management articles from the conference below, but be sure to check out all of conference coverage 

The president of Not One More Vet, Carrie Jurney, DVM, DACVM (Neurology), explained common downfalls of veterinary teams and how to 

Josh Vaisman, MAPPCP, CCFP, cofounder of Flourish Veterinary Consulting based in Boulder, Colorado, explained the importance of creating a workplace that 

 to create a learning environment for everyone.

The Hollywood actor-writer-director, Dan Levy, was a 

 at VMX and provided inspirational universal messages and heartfelt moments that resonated with the audience of veterinary professionals.

Highlighting 3 conference articles from the 2024 Veterinary Meeting & Expo in Orlando, Florida

3 must-reads from VMX 2024

One aspect of taking care of a pet is managing their emotions and reactions when they are stressed. Certain situations, like surgery, can heighten stress and lead to a variety of adverse effects. When a pet is trying to heal, it is important to reduce as many stressors as possible. Adam Christman, DVM, MBA, of 

, spoke with Courtney Campbell, DVM, DACVS-SA, about how remote monitoring technologies are changing the recovery process for pets. They also discussed how these technologies improve time management for veterinary staff.

Courtney Campbell, DVM, DACVS-SA (left) and Adam Christman, DVM, MBA (right).

 Why is it so important to reduce stress for animals?

 There are so many reasons why we want to reduce stress in patients recovering from surgery, but a big reason is pain. When pets are stressed, their pain sensations are heightened due to the release of stress hormones. Chronic stress can reduce endorphins, healing, and immune system responses. Postoperative recovery for pets is not a singular moment in time, but a journey. We want to help them every step of that journey. 

 As an orthopedic surgeon, are there moments postoperatively where you worry about taking pets’ vitals?

 Sometimes when you walk out of the operating room, someone on your animal care team will ask, “How did it go?” My response is always, “We’ll see.” When the patient leaves the operating room, the journey isn’t over. Recovery is the next part. For example, we want a dog to be able to sleep off anesthesia without being woken up repeatedly to check vitals. However, that needs to be done safely. One of the ways to accomplish this is through remote monitoring. It is an aspirational moment to always have eyes on a pet without requiring staff to check every 5 minutes or only getting snapshots of a dog’s vitals with each physical check-in. I have always imagined taking postoperative care in video form with continuous monitoring.

 Similar to a radar gun while driving, the VetGuardian uses radio waves and other remote sensing mechanisms to monitor the patient and can track temperature, pulse, and respiration. It also has an alarm that alerts veterinarians or veterinary technicians if those vitals are outside of a preset or customizable range. The camera on the device— which contains thermal imaging—allows for ‘eyes’ to always be on the patient and the ability to read heat maps. These capabilities put time back into the hands of the veterinary team.

This device keeps a record of every vital that is read. It removes the need to write down data and then enter them into a system later. Whether a pet had challenges during their recovery or not, a veterinarian is able to see accurate data for every minute of the recovery. 

 Walk me through some of the differences between veterinary practices that have the VetGuardian and those who don’t.

 One of the principal reasons why primary care practitioners may refer patients to a specialty practice is because they realize that practice may have technology available that they do not. This technology can be anything from a CT or MRI to a VetGuardian. Reaching out to other practices builds a sense of community between veterinarians.

Technology is worth the investment as a care provider. No matter the species, surgery can be a scary time. There is anxiety before, during, and after surgery. When pets come out of an operation, you want them to have a good experience. At every single stage, you want to put in that investment and make sure they have a comfortable recovery.

Improving patient recovery with remote vital monitoring

Stress reduction in animals

Happy Friday dvm360 readers! For those of you getting the winter weather and snowfall this weekend, we hope you and your families remain safe and warm inside. The dvm360 team has recently returned from the Veterinary Meeting & Expo and we have plenty of coverage already up and coming your way! Be sure to continue checking in on dvm360.com for our latest conference coverage and news within the veterinary industry.

Here is what was popular this week on dvm360.com:

 that the nominations for our fourth annual dvm360 Veterinary Heroes Awards are now being accepted. The program celebrates individuals within veterinary medicine who have achieved success in their careers and will be judged by a panel of judges.

During her lecture, "Four toxicities of a team" at VMX, Carrie Jurney, DVM, DACVM (Neurology), president of Not One More Vet, 

 some of the common traps managers fall into within the veterinary culture, even if the managers have the best intentions.

 of The Vet Blast Podcast, Jessie Brown, LVT, blood bank director at Veterinary Emergency Group, and Ken Yagi, MS, RVT, VTS (ECC), (SAIM), chief veterinary nursing officer at Veterinary Emergency Group, discuss more on blood banks in recognition of National Blood Donor Month with host Adam Christman, DVM, MBA.

 this week that the USDA for Veterinary Biologics determined that data from the company’s ECI0OSA-04 pivotal combined safety and efficacy study showed a reasonable expectation of efficiency, a critical step on the licensure pathway.

Jörg M. Steiner, Med Vet, Dr Med Vet, PhD, DACVIM-SAIM, DECVIM-CA, AGAF, sat down for an interview with dvm360 to 

 how most cases of pancreatitis are idiopathic, but some things could be attributed to the development of the disease, plus how it's important to speak to owners about certain feeding habits that can negatively affect the pet's health.

 its Defend Puppies. Defeat Parvo. The campaign this week hopes to increase education and awareness of the disease, plus how veterinary teams can have easier to its USDA conditionally approved Canine Parvovirus Monoclonal Antibody.