Patients Without Borders: Using Telehealth to Provide an International Experience in Veterinary Global Health for Veterinary Students.

There is an increasing need to produce veterinarians with knowledge and critical thinking skills that will allow them to participate in veterinary global health equity delivery, particularly in the developing world, where many people remain dependent on animal-based agriculture for a living. This need for veterinarians trained in global health is reflected by the demand among students for greater exposure and education. At the same time, many students are held back from on-site training in global health due to constraints of cost, time, or family obligations. The purpose of this article is to describe the use of a telemedicine approach to educating veterinary students at Tufts Cummings School of Veterinary Medicine. This approach simultaneously provides expert consultation and support for a pro bono hospital in the developing world. The development of a telemedicine teaching service is discussed, from initial ad hoc email consultation among friends and associates to a more formal use of store-and-forward delivery of data along with real-time videoconferencing on a regular basis, termed tele-rounds. The practicalities of data delivery and exchange and best use of available bandwidth are also discussed, as this very mundane information is critical to efficient and useful tele-rounds. Students are able to participate in discussion of cases that they would never see in their usual clinical sphere and to become familiar with diagnostic and treatment approaches to these cases. By having the patient "virtually" brought to us, tele-rounds also decrease the usual carbon footprint of global health delivery.