Abdomen - Left & Right Lateral, Ventrodorsal/Dorsoventral (3 recommended)

Forelimb - A minimum of 2 orthogonal projections for each region of interest

Hindlimb - A minimum of 2 orthogonal projections for each region of interest

Pelvis - Lateral, Ventrodorsal (2 recommended)

Skull - A minimum of 2 orthogonal projections for each region of interest

Spine - A minimum of 2 orthogonal projections for each region of interest

Thorax - Left & Right Lateral, Ventrodorsal/Dorsoventral (3 recommended)

Small Animal Full Body - Lateral, Ventrodorsal (3 recommended)

Image Scoring - The report view in VetMedStat will now include the specialist-provided image score, providing clinics with key feedback on their consult submission.

• Exceptional quality: There are no technical issues with this study. All anatomic regions could be thoroughly evaluated with identification of any abnormality present. It was possible to draw accurate and meaningful conclusions.
• Good quality: There are minor technical issues with this study. Abnormalities could be identified, and possibilities eliminated. It is possible, but unlikely, that these minor issues had a negative impact on the conclusions.
• Acceptable quality: There are moderate technical problems with this study. Regardless, it was possible to identify certain abnormalities and/or rule out others. Some conclusions could be drawn, but they may be incomplete and result in failure to identify the source of the clinical signs.
• Low quality: The number of technical problems had a significant impact on the amount and accuracy of diagnostic information that could be obtained from this study. There is high probability that important information was not detected, or that abnormalities were not displayed in a representative manner. There is significant concern that the technical problems could result in flawed or nonspecific conclusions for this patient. Please note, if human anatomy was captured then a score of “low quality” will be assigned to the study. Please review safety guidelines in the IDEXX Veterinary Radiation Safety Center and protect yourself and team from unnecessary radiation exposure.

Ultrasound/Echo Extended Study - An additional charge will be applied to those Ultrasound or Echocardiogram services that exceed our recommended protocols.

The recommended protocols for Ultrasound and Echocardiogram submissions can be found IDEXX Telemedicine Consultants resources

A modal displays on the Select Service page when an Ultrasound or Echocardiogram service is chosen and the number of cines or still images exceed the protocol for that service. The modal provides information on the protocol, links to the protocols, and the Extended Study fee amount. From there, you can Continue, Cancel Case, or Dismiss the modal.

The same information will be provided on the Case Summary page at the end of the submission process for further validation.

Additional validation to prevent unknown breeds for Canine/Feline submissions - Added validation so that “Other” cannot be selected as a breed for canine/feline submissions.

Refactor of Attachments Page Sections to Improve Usability - The Attachments Page sections have been restyled so it is clearer which section is for uploading and which the section displays uploaded images.

Added QA Report Content to VMS Report View - The VMS report view will now include the contents from any applicable QA reports. QA reports were previously only provided via PDF in emails to the clinic. This method aims to increase the QA report visibility so clinics have easier access to critical information. Includes report view in Admin.

Improved VMS and PDF Report View Consistency - A review of the VMS18 completed report view, VMS report view, and PDF report view was conducted and work was done to ensure proper visibility and consistency of patient history information.

New Recommendations Override - The clinic can opt out of specialist recommendations by using the recommendations setting in the clinic profile. A new user setting has been introduced to override the clinic setting. The default option will be Default to Clinic Setting, with the additional options to opt-in or out of recommendations.

Improved Patient Date of Birth Validation - The existing validation on the patient edit page does not properly recognize future dates in the date of birth field when cases are created via API/DICOM Sends. This can be easily overlooked by the clinic and leads to negative age values for the patient. The date of birth field validation has been improved to account for this scenario and provide an error message to the clinic.

Drag-over Style Added to Attachments Page - The drag and drop section of the VMS attachments page has been modified to reflect the proper interaction styling.

Introduce Predictive TAT - Throughout VetMedStat we will display a turnaround time that is calculated based on information from various sources (Humanity, case bank, customer segmentation, priority). The predictive time is currently focused on Common Pet Radiology (including advanced imaging). Other services will leverage static turnaround times. All turnaround times can be overridden via an Admin site tool as needed.

Dashboard - An additional column has been added to the Submitted table on the dashboard. This column will display the expected turnaround time for the submitted case. A pill will accompany the time indicating the case is On Time or Delayed. A table footer was added to provide some context around hours of operation, with a link to the Pricing & Turnaround Time page.

Submission - The turnaround times provided in the Select Service and Summary pages during case submission will be updated to reflect the new predictive turnaround times.

Report View - The report view in the VetMedStat patient page will now include an Estimated Deliverythat will capture the communicated turnaround time. A pill will accompany the time indicating the case is/was On Time or Delayed.

Pricing & TAT Page - The existing pricing page has been refactored to include the current turnaround time expectations for any given service. The header title has been changed from Pricing to Pricing & Turnaround Times.Header Widget: Current Turnaround TimesA new feature has been added to the VetMedStat header that provides a quick view of our most prominent services (Common Pet Radiograph Consult) and a link to the Pricing & Turnaround Times page.

Emails - Consultation emails have been updated to HTML. Added link to report view in VMS. The link to Survey Monkey has been removed and we will re-assess surveying clinics.

A new email notification will be sent to customers in the event of a case delay. The email will inform the client of the delay, provide helpful case information so that the client knows exactly which patient is impacted, and any new ETA if available. A link back to VetMedStat will also be provided. The recipient of this notification is controlled by the Consultation Reports communications setting.

Editing Cases In-Process: Keep Existing Turnaround Time Customers can now edit cases in-process without fear of losing their place in line. Cases that have not been assigned to a specialist can be re-opened, edited, resubmitted, and retain the original turnaround time expectations. The following edits are allowed:

1. Patient Name
2. Patient Weight
3. Patient Breed
4. Patient Age
5. Patient gender
6. Patient ID
7. Case presenting complaint
8. Case history
9. Case Images

These edits will cause a case to lose its place in the queue when resubmitted:

1. Service change
2. Priority change

User will have a 15-minute time limit for the updates. Anything beyond 15 minutes will be like a service change, and will update the Requested Date.

ECG Preview - Clinics can now preview ECGs before submitting a request for consult. By clicking on the eye icon on the ECG thumbnail, users will be taken to a view of the ECG.

Continued Improvements to Series Management Page - The warning messaging when clinics don’t meet the expected protocols has been modified so that clinics can more easily interpret the intent and take appropriate action if necessary. Clearer language, additional iconography, and dismiss actions have been added to improve the clinic experience.

Default Weight Setting - Clinics can now default their weight unit. This will ensure their desired weight unit (lbs, kg, grams, or ounces) are automatically selected when adding a new patient record. The weight unit will continue to reflect whatever value is provided in the DICOM or API transfer.

Additional Email Field - Clinic Settings now supports an additional email address field. This field can be leveraged for the forgot password workflow as well.

Improvements to Series Management Page - Based on customer interviews, feedback, and observations, the series management page has been streamlined to better handle or avoid clinic submission issues. Additional changes over the next few releases will continue to improve the customer experience.

1. Left panel: added instructional text for clinic to clearly state expectations. Can now drag images from the series container back to the left panel.
2. Image container improvements: Moved “remove” and “preview” icons for better visibility. Separated the “drag” feature from the image for better visibility.
3. Drag additional images in image container: Added instructional text to clearly state expectations.

Automatically Validate Patient Info - The patient info page will validate data when users click Save Information. Typically, upon API sends such as IDEXX Pacs and Web Pacs, and CardioPet, some patient info like weight doesn’t always come through and must be re-entered here. The page will now automatically present any validation errors upon landing on the page, making it easier for clinics to quickly add important info.

Automatically Lock Out Users after 10 Failed Attempts - To align with IDEXX’s broader security initiatives, an auto-lockout process has been implemented. After 10 failed password attempts, the user will be locked out. Users will need to go through the Forgot Password process or be unlocked by Telemedicine customer support. Unlocking the account assumes the user will use the existing password.

New Banner Message and Modal for Unavailable Services - Occasionally some services will be unavailable. When that happens, a banner displays on VetMedStat providing details on those services. That banner has been updated to take up less space on the page.

Guided Histories Update: Physical Exams for Exotics - The attachments page has been updated so that when a clinic is performing a manual upload, a new upload progress bar will display, making it easier to see the total progress of the upload.

Upload View Updated - Cases submitted for Exotics species will have 3 new questions added to the Physical Exam section. These questions capture history about the patient’s habitat and diet. The section has been renamed to Physical Exam and Husbandry.

Noted enhancements:

1. Non-ASCII characters included in the history by the clinic no longer result in a submit error.
2. The patient page no longer defaults the species or gender when adding a new patient.
3. We now auto-populate ultrasound stacks into the Echo series for Cardiology services.
4. Consolidated contrast study services to a single Survey Radiographs & Contrast Study Consult.
5. Added ability to share cases from Classic VetMedStat.
6. URL conversion: With the conversion of clients from Classic VetMedStat to the new VetMedSat, it’s time to revert the vetmedstat.com back to the main URL used by customers.
7. Stopped defaulting the requesting veterinarian with cases started via IDEXX Pacs, Web Pacs, or CardioPet.

Noted enhancements:

1. The “Type” info we show on the home page now displays the precise service name.
2. Follow-up consult services are now available for more Cardiology services.
3. Added series validation to more Cardiology services

Consolidated presenting complaint and question stream pages - The two pages have been consolidated to one in order to reduce our clinic’s submission effort. Choosing a presenting complaint on this page will immediately trigger the appropriate question stream.

Restyled presenting complaint buttons - The presenting complaint buttons have been restyled to make discovery of the additional information more intuitive for our clinics.

Series Selection: improved left panel navigation - The left panel of the question stream page now highlights the section when a user hovers over the area with their browser cursor so that they can better navigate the page.

Copy images from cases in Needs Attention (Dashboard) - Clinics will now be able to copy images from one case in Needs Attention and Canceled to another. This mainly addresses some scenarios where clinics unintentionally start multiple cases for the same patient.

Added metadata to the image preview - Clicking on the thumbnail to access the preview image will now also display the file name, date, and machine learning tag. This information should be helpful if the user needs to move the images into a series.

Series page UI improvements - Changes include:

1. Removed 'Select Series' header
2. Moved 'Remove Series' to be in line with series drop down
3. Updated background color
4. Changed box lines to dashed & teal
5. Removed instructional text 'Drag files from the left panel to attach them to this series.'
6. Combined the Series Selection & Service into one header ' Series Selection'.
7. Added instructional text under the Series Selection 'Please select the image series that best represents this case and add additional series if needed. Drag and drop attachments from the left panel to attach them to a series.

Made changes to thumbnails size and info on the series page - The image thumbnails on the series page were modified to improve the drag and drop experience.

Added error message to alert user of computer and VMS time difference - If a user’s computer time is more than 1 hour and 10 seconds different than VetMedStat, we will display an error, “We have detected that your computer or mobile device's clock is out of sync with the correct time. Please update the time using your settings and try logging back in.“

Increased the allowable time difference between VetMedStat and the user’s computer - Increased the allowable time difference between VMS and the user’s computer in order to reduce instances of blank screens in VetMedStat.

Changed the displayed values for case status on the dashboard - VetMedStat provides a case status to the user on the clinic dashboard. Statuses are more useful and understandable to the clinic user.

Starting a new case will save the patient name - When starting a new case from the dashboard, the use is required to search for an existing patient first in order to reduce duplicate patient entries in VMS. When a patient is not found, the user clicks Add New Patient, and VMS will now preserve the patient name in the new patient form.

Login attempts by clinics in certain statuses will show new messaging - A login attempt by a clinic listed as idle, deactivated, or delinquent, will now display a message prompting the user to contact customer support.

Fixed date of birth field to not allow entries prior to Jan 1, 1900 - Added validation to the date of birth field so that entries earlier than January 1, 1900 are disallowed.

Fixed issue where case could be updated by clinic while still in a submitted status - Some logic was added in order to avoid an unintended update to a submitted case.

Improved question stream submission - Consolidated multi-tabbed question layout into a more efficient single page form. Required questions are now identified with a red asterisk (*).

Start a new case with copied images - You can now start a case from a previously completed report. This allows you to request a new service without having to resend your images to VetMedStat.

View more completed cases - Use the “Show More” link near the Completed Cases section to search for other cases by date range.

Auto-Populate ECG files into series - Cardiology cases will now auto-populate the ECG file as well as radiograph images in the series page during case submission.

Modified the patient age input - We tweaked the way you enter your patient’s age. We also maxed the age input at 160 (human) years.

Introduced a consolidated Support Page - The support page is a collection of resources to find the help you need when you need it. This includes links to IDEXX Telemedicine Consultants Resources, access to frequently requested tutorials, The Telemedicine Directory of Services, and quick access to the IDEXX Telemedicine support email and phone number.

Advanced imaging services for exotics are now available

Tablet? - Yup, fixed that drag and drop functionality.

New Password Reset Workflow - A new password reset workflow is now available. New passwords will follow more stringent complexity requirements in order to conform with IDEXX information systems security. Password reset links will expire after 20 minutes.

Refactored Service Selection - The Select Service page has been modified so you can choose the priority right away.

Updated minimum file size message - When a file does not meet the minimum file size requirement, it is “skipped” in the upload process on the Attachments page. A message is provided that now includes the 300 x 300 pixel requirement and the size of the attempted file.

Updated page title - A website’s page title is information that will display on a browser tab and some other places. It’ll now read “IDEXX VetMedStat”.

Updated warning message on species change - Improved experience around scenario where if a service has been selected and you choose to go back and change the species in the Edit Patient page, a warning message will inform you that prior service selection and history input will be removed.

Updated warning message on species change - Improved experience around scenario where if a service has been selected and you choose to go back and change the species in the Edit Patient page, a warning message will inform you that prior service selection and history input will be removed.

Updated size of drop-zone containers on series page - Minor UI tweak to gain some additional screen real estate.

Fixed an issue where cursor on clinic dashboard would erroneously indicate an element was clickable

Suggested Services by Modality - A new Suggested tab will display for canine and feline patients on the Service Selection screen and filter services matching the expected image types.

Automatically Populate Series - A collaborative effort between the IDEXX Digital Imaging, Telemedicine Medical, and Machine Learning teams produced a machine learning model to automatically populate radiograph image series.

The application will auto-populate the series with the first available images of each classification and include any additional images in the series. The radiograph series in scope for auto-population are Abdomen, Thorax, Skull, and Pelvis.

The auto-population is generated by our Machine Learning model and does not consider any laterality markers applied by the clinic or modality.

Updated Radiograph Series Protocols - Based on recommendations from our medical team, we deployed the following changes via Service Pack:

1. Abdomen: Swapped recommended Ventrodorsal or Dorsoventral for just Ventrodorsal
2. Thorax: Swapped recommended Ventrodorsal for Ventrodorsal or Dorsoventral
3. Skull: Swapped recommended Dorsoventral for Ventrodorsal or Dorsoventral

Question Stream Addition – General question added regarding patient’s attitude/demeanor.

Confirmation Messages for Completed Cases – A green confirmation message will be presented for several seconds on the dashboard when a submitted case has been completed (read out by a specialist). This aids clinic users who may be waiting at their computer/terminal for a case to be read.

Clickable Report Number on Dashboard - Clicking on the report number in the Completed Cases section will now take you to the patient’s report view. Clicking on View Report will continue to take you to the PDF browser view.

Addendum on Patient Page - Case addendums will now show on the report view in the patient page.

Non-U.S. Clinic Pricing Display - Work was done to ensure the pricing reflected accurately anywhere pricing displays to users in the application for our clinics not based in the U.S.

Shortened Question Streams - Question streams have been reduced by about 30%. Our medical team is regularly optimizing the question streams and identified an opportunity to capture the right information with fewer questions. These changes were made based on our medical team’s review of specialists’ feedback and client activity.

Added Four Questions Streams to Radiograph Services – The following services now have dedicated questions streams:

1. Ultrasounds
2. Contrast Studies
3. Fluoroscopy
4. Follow-Up Radiographs

Prior to this change, these services followed a generic history submission form. Now we can ask targeted questions specific to presenting complaints and these services.

Question Stream Addition – General question added regarding patient’s attitude/demeanor.

Added Pre-Op Screen Cardiology Service to Cardiology Services – ECG Screen & Thoracic Radiographs. This is an existing cardiology service that was initially overlooked in the previous release. That oversight has been corrected with this addition.

Saved Services Option - Now you can choose to save certain services in the service selection page. This allows you to further refine our broad list of services to those you may use more often. Services are saved by clicking the “star” icon in the menu of services.

Follow-Up Services - This service is only valid for a certain period after the original service was completed. Now, there must be a completed consult within 24 hours for this same patient.

Case Sharing - The new VetMedStat now supports the ability to share a case. This can be done at the time of case submission or from the patient page.

Confirmation Message upon Case Submission - A confirmation message will display in the upper right portion of the browser upon submitting a case. This provides additional assurance that the case submission has taken place.