Source: DAIRY VETERINARIANS GROUP submitted to NRP
VCPR.ORG, AN INTERNET PLATFORM FOR DESIGN AND MANAGEMENT OF VETERINARY TREATMENT PROTOCOLS FOR LIVESTOCK, AND PRUDENT USE OF PRESCRIPTION DRUGS
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
COMPLETE
Funding Source
SMALL BUSINESS GRANT
Reporting Frequency
Annual
Accession No.
1016516
Grant No.
2018-33610-28580
Cumulative Award Amt.
$600,000.00
Proposal No.
2018-03172
Multistate No.
(N/A)
Project Start Date
Sep 1, 2018
Project End Date
Aug 31, 2022
Grant Year
2018
Program Code
[8.3]- Animal Production & Protection
Recipient Organization
DAIRY VETERINARIANS GROUP
832 COOT HILL RD
ARGYLE,NY 12809
Performing Department
(N/A)
Non Technical Summary
Private veterinarians, most of whom work from small independent clinical practices, are a critical link in maintaining appropriate use of the antibiotics, hormones, and other pharmaceuticals that are vital to the health and welfare of livestock. VCPR.ORG will develop an Internet-based tool set designed to help veterinary practitioners serve their clients and protect public health, as well as guarding the health and welfare of the nation's livestock. The system will be voluntary, and protect the privacy of the veterinarian-client-patient relationship (VCPR).
Animal Health Component
30%
Research Effort Categories
Basic
10%
Applied
30%
Developmental
60%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
30739103030100%
Knowledge Area
307 - Animal Management Systems;

Subject Of Investigation
3910 - Cross-commodity research--multiple animal species;

Field Of Science
3030 - Information and communication;
Goals / Objectives
General goals of VCPR.ORG are to facilitate management of food animals through better use of treatment protocols, particularly protocols for use of prescription drugs prescribed by veterinarians for use on farms. We will develop an integrated Internet-based system to help veterinarians design and prescribe protocols for their clients, then to monitor client compliance and protocol performance. 1.) Develop an online protocol editor for veterinarians, with built-in support for AMDUCA rules and a database of pharmaceuticals including FDA-approved drug label information. There will also be private and public libraries of protocol templates which may be modified for individual clients and circumstances.2.) Completed protocols may be prescribed for individual clients, creating a time-stamped archival copy of the protocol and included instructions. As authorized by the veterinarian, the protocol may be transferred in written or electronic format with appropriate privacy controls, so that it may be implemented on the farm and integrated within a management system used on the farm.3.) Develop review and maintenance tools so that protocols can be automatically evaluated for compliance with an extendable rule set, and the veterinarian and client notified of problems such as might occur with a change in regulations regarding an existing pharmaceutical. Protocols can be recalled or replaced, or include specific reporting requirements if specified by the prescribing doctor.4.) Private data collected by the system will be protected, but with the consent of users anonymized data may be aggregated for purposes such as government or private research and evaluating efficacy of protocols or practices in treating or preventing disease and improving animal welfare.
Project Methods
VCPR.ORG will be managed as a private entity independent of government regulatory authorities and pharmaceutical companies, serving the special needs of veterinarians in private food-animal practice and constrained by the ethical and legal standards standards of veterinary medicine. These include privacy of client data, which, in most states, may not be shared with government or private entities without permission from the client. VCPR.ORG cannot enforce government regulations, but willprovide high quality information to veterinarians and tools that will allow veterinarians to practice medicine within the requirements of the law efficiently and effectively.

Progress 09/01/18 to 08/31/22

Outputs
Target Audience: Veterinarians, veterinary educators, veterinary students, the general public. Changes/Problems:Pandemic issues prevented some planned in-person events, which had to be postponed into Phase III. What opportunities for training and professional development has the project provided?Several hundred veterinarians or veterinary students have created free accounts which give them access to the Protocol Editor and a discussion forum for topics relateds to protocol management. How have the results been disseminated to communities of interest?Conference and online presentations are listed under publications. An online discussion forum is maintained at https://forum.vcpr.org API is published at https://API.VCPR.ORG What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? The goals described for this project constitute a significant paradigm shift for busy veterinary practitoners, and workflows that arenot possible without appropriate tools. Developing those tools required a significant effort in engineering processes and data models, and then the equally challenging task of implementing those in computer software. This was an evolutionary process, and will continue to evolve with better understanding of the vast array of problems that veterinarians and their clients must address. Responding to concerns about antibiotic-resistant organisms andimproving records and procedures related to prescription drugs was an initial focus. Tools developed in this project make it feasible to collect very detailed information from farms and to enforce adherence to prescribed protocols, but that is just the beginning. For this project to be successful it must meet critical needs of users and allow veterinarians and animal owners to achieve better results in their daily work. This includes better medical outcomes, greater operational efficiency, better data collection, and less regulatory risk through better documentation and better understanding of regulations. This is an open and collaborative venture with extensive technical documentation of the data model and processes (the API) maintained in a public repository and published to the website https://API.VCPR.ORG. The samedocumentation used for internal software development is equally available to anyone that wants to develop add-on software, or even to compete. For example, a proof-of-concept application was developed for farms that allows farms to enroll cases to protocols prescribed for them, and track treatments and results. Other suppliers of farm records software are encouraged to use the public documentation of the API to allow their systems to include those capabilities within their proprietary systems, without having to re-invent the models and processes. The API documentation has all the information needed to connect systems and exchange data. Three distinct computer apps have beendeveloped and are currently available for free, though Phase III of this project will need to develop income from subscription fees or other support. The Protocol Editor is available only to licensed veterinarians and veterinary students. The OnFarm app is available to their clients. An Admin app is avaialble to system administrators. Each app functions within an Internet browser on either desktop computer or smartphone, connecting to backend services (the API) in the Internet cloud. The Protocol Editor allows doctors to create new treatment protocols or select (and modify if necessary) protocols from the online library. Protocols can be prescribed to clients, who then enroll cases using the OnFarm app. Both the prescribing vet and client can monitor cases online in real time. The innovative Protocol model includes numerous new capabilities designed to enhance the Veterinarian-Client-Patient relationship (VCPR) including Promises, Case Definition, treatment records, and structured instructions which can include images and links. The Editor also includes access to a drug formulary including the full FDA Standard Product Label (SPL) information. An"AMDUCABot" integrated within the Protocol Editor automatically classifies and tags treatments according to the algorithm specified in the AMDUCA Act of Congress (21 CFR 530). This makes it much easier for veterinarians to understand and comply with legal requirements for use of prescription drugs. When a protocol is prescribed, a permanent immutable snapshot is archived and made avaialble to the client. The protocol may be recalled or replaced by the prescribing doctor, but not altered, providing a private verifiable record of medical instructions. The prescribing doctor may also place limits on how many times a protocol may be used, and require specific information when cases are enrolled and treated, enabling detailed tracking of drug usage and response to treatments. This is private information, owned by doctor and client. There are many important potential uses of such data, which is either unavailable or costly to collect by other routes. It could be anonymized and sold, with the permission of the owners. Many challenges remain in Phase III, but a stable second-generation software product (https://VCPR.ORG) is deployed and available on the Internet. It has some remarkable capabilities and is backed by an innovative data model and an open API. Changing established behavior patterns is difficult, and often impossible without appropriate tools. With Phase II of this project there is an impressive tool set available, but much work remains. As this new paradigm and tool set is adopted by veterinarians, they will naturally encourage or require their farm clients to partcipate also in recording treatment and response data directly from the farm. Farms will have their own incentives, such as easier training of employees, prevention of costly errors, and better animal health. The public will benefit too, including helping maintain efficacy of antibiotics, improving animal health and welfare, and reducing the cost of foods. This all can be accomplished by voluntary participation driven by the needs of veterinarians and their clients. The open API will encourage development of independent applications connecting to the platform and evolving with time into a full system of electronic medical records for veterinary medicine. Easy transmission and monitoring of protocols and response data over the Internet is a first step in tele-health capabilities, and many supplemental tools could be added. Improved communication capabilities will stregthen the VCPR, and allow it to fulfill its role as a contract specifying shared responsibilities of veterinarian and client to animals and the public. Collection of accurate and highly detailed anonymized data has many potential benefits including monitoring of animal diseases in real time, increasing the pace of medical advances, and providing a basis for accurate and efficient regulations where those may be needed.

Publications

  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2022 Citation: Ehrlich, J.L. "The informatic foundations of practical veterinary treatment protocols, and the task of making them accessible to veterinary practitioners and clients" Virtual presentation for the 2022 Talbot Symposium of the Academy of Veterinary Informatics (AVI)https://avinformatics.org/Talbot-Symposium-2022
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2022 Citation: Ehrlich, J.L. "VCPR.ORG - an open internet-based system for managing veterinary treatment protocols in practice and research⿝. Presented at the 2022 International Conference on Production Diseases of animals (ICPD) in Madison WI and also available online https://uwmadison.eventsair.com/icpd22


Progress 09/01/20 to 08/31/21

Outputs
Target Audience: Veterinarians, veterinary educators, veterinary students, the general public. Changes/Problems:The Covid Pandemic has disrupted plans for live training sessions. These have been postponed, and redirected to the development of online training. What opportunities for training and professional development has the project provided?We are developing online courseware to train veterinarians in protocol design and management. Possibilities for live training have been temporarily blocked by Covid pandemic concerns. How have the results been disseminated to communities of interest?Two presentations were prepared for and accepted by the Academy of Veterijnary Informatics Talbot Symposium. The AVI is working on RACE approval and making the presentations available online. The VCPR.ORG website and discussion forum has been available throughout this period. What do you plan to do during the next reporting period to accomplish the goals?There are always software improvements to be made, but we are focusing on developing online materials and other forms of user training in this period.

Impacts
What was accomplished under these goals? Thes goals have been accomplished. We have additional goals in training users and developing cooperation between other software systems and educational organizations.

Publications

  • Type: Conference Papers and Presentations Status: Published Year Published: 2021 Citation: Veterinary treatment protocols as a pattern for clinical efficiency - the design phase. 26th Annual Talbot Veterinary Informatics Symposium
  • Type: Conference Papers and Presentations Status: Published Year Published: 2021 Citation: Treatment protocols - Promises 26th Annual Talbot Veterinary Informatics Symposium


Progress 09/01/19 to 08/31/20

Outputs
Target Audience: Veterinarians in food-animal practice, veterinary educators, veterinary students, the general public. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? Nothing Reported How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals? We will focus on disseminating information on the existing system, training users, identifying bugs and deficiencies in the existing software then fixing them.

Impacts
What was accomplished under these goals? Version 3.0 software implements all significant planned features.

Publications


    Progress 09/01/18 to 08/31/19

    Outputs
    Target Audience: Veterinarians in food-animal practice, veterinary educators, veterinary students, the general public. Changes/Problems:The importance and difficulties of communication and documentation increase exponentially as a project grows. Developing a sound process for quality control of communication is taking longer than anticipated. What opportunities for training and professional development has the project provided? Nothing Reported How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals?We expect to release a fully rebuilt online Protocol Editor based on the new APIs and address other general goals.

    Impacts
    What was accomplished under these goals? Moving from single-developer to team development has required developing a consistent build-and-deploy process, automated testing, and carefully documented and tested APIs for communication between the backend server and backend developers and the various applications that will use that information, whether they be developed by us or our business partners. This is prerequisite foundation work that has been the main part of our efforts in this period.

    Publications