Source: KN VETERINARY SERVICES, PLLC submitted to NRP
APPLICATION TO PROVIDE HIGH QUALITY IN HOUSE, TELEHEALTH AND MOBILE VETERINARY SERVICES TO RURAL CENTRAL TEXAS.
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
COMPLETE
Funding Source
Reporting Frequency
Annual
Accession No.
1017284
Grant No.
2018-70024-28822
Cumulative Award Amt.
$121,000.00
Proposal No.
2018-05588
Multistate No.
(N/A)
Project Start Date
Sep 1, 2018
Project End Date
Aug 31, 2021
Grant Year
2018
Program Code
[VSGPR]- Veterinary Services Grant Program Rural Practice Enhancement Grants
Recipient Organization
KN VETERINARY SERVICES, PLLC
4117 HWY 6
CLIFTON,TX 76634
Performing Department
(N/A)
Non Technical Summary
The concentration of beef cattle in this underserved area is large, with many large ranches and operations. The area of Texas we are located in, situated half way between Dallas and Austin, lends itself to be a growing area for smaller operations and non-traditional niche market operations. Since being selected for service in this area, we (Clifton Veterinary Clinic) have continued to serve the beef cattle operations in the same capacity they have been served in for 50 years. While these relationships stay strong, our methods of serving them are being challenged with aged equipment. Also, we have challenges meeting the needs of some newer operations, especially those without handling facilities, those producers who are first generation ranchers, and those whose geographical distance makes them difficult to reach. The explosion of programs such as 44 Farms beef--located just 81 miles from our practice--has begun to greatly influence the way producers operate, as veterinarians we must rise to meet the needs of this growing population--if the way producers operate is changing, we must change along with the industry to meet the needs of our producers. We measured the number of calls taken per week, and then measured the number of calls we cannot safely or best serve the animals based on lack of facilities, geographical distance, or knowledge of the client over the course of one month; on average, we are unable to help two new producers each week due to lack of mobile facilities. In addition to the niche marketing programs, we also have a large number of smaller "backyard" producers who are retiring or relocating to a rural life from the Dallas/Ft. Worth Metroplex. These, often first generation, producers do not have large acreage and very nearly all of them cannot afford to put in handling facilities for 20-30 head of cattle, an expenditure that would not make sense financially for them.This practices shortage area is large and encompasses some of the largest ranching land between two major metropolitan areas. The vastness of some ranches makes veterinary intervention with cattle challenging. Additionally, the location of this area between Dallas and Austin has created a market force for niche market products, these producers are often more difficult to reach due to lack of facilities smaller overhead and lack of targeted educational opportunities. Our funds request will allow us to reach more producers through innovative telehealth services, fully capable mobile facilities, advanced in house facilities and student training with TAMU veterinary center at WTAMU.
Animal Health Component
(N/A)
Research Effort Categories
Basic
(N/A)
Applied
(N/A)
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
3083310106070%
3083610106010%
3083820106020%
Goals / Objectives
Objectives: Overarching aim: To expand current services to beef cattle clients by improving existing facilities, utilizing new telemedicine technology to leverage existing staff and time, and offering new mobile facility features, and to help support new generations of veterinarians by offering preceptorships that help teach rural practice sustainability. Financially, these goals are front end loaded with the majority of the equipment costs coming in year one. However, the long term impact of this project is only limited by the durability of the equipment, as beyond the funding timeline, equipment will still be able to be used to meet the needs of our producers. This allows for a two tiered impact for the practice: ability to offer more services to a wider number of producers, and ability to maintain a sustainable practice model by allowing for a new income stream.To continue to offer high quality medicine services and position our clinic as an expert source for medicine and production questions and needsAccomplishing this will require:The upgrade of current equipment (immediately/year 1): the tilt chute in the clinic currently was purchased in 1996. We can no longer use the tilt feature which drastically limits our ability to do lameness and podiatry. Additionally, repairs to the current chute are costing annually around $4,ooo and we are told now there are limitations to the repairs that can be madeTo leverage veterinarian time and utilize support staff more efficiently by offering innovative telehealth services.Accomplishing this will require:A platform available that would allow clients with a valid VCPR to access doctors in the clinic to help triage, advise and potentially diagnose via the internet. This innovative service will allow producers access to veterinarians potentially without a farm call. We anticipate that some needs will be able to be treated on farm by our paraprofessionals, some will require a veterinarian to go to the farm still, and others might be able to be adequately treated by the producers without additional help. (begin in year 1/ continue to refine in year 2-3)This will allow a much broader reach of our services without the time and expense of travel to the ranch in every circumstance.Marketing directed at promoting this new serviceTo focus efforts towards reaching underserved producers: those with small operations and/ or operations without good working facilities; We currently turn down an average of 2 new clients/calls per week due to lack of mobile capabilities.Reaching these producers will require several components:Placing the burden of overhead/facilities on the veterinarian rather than the client: "We can come to you with a chute, or pick up an animal and bring it in for you." Rather than "If you can get the animal here, we can help you. Otherwise we won't be able to do much."Purchase of mobile handling facilities, mobile truck with mobile vet clinic on bed, and trailer for clinic haul in option (immediately/year 1)Education of new generations of producers in ways that appeal to them: webinar/Facebook Live events, booths and educational "experiences" set up at local farmer's markets and fairs (ongoing)To help to educate current and future veterinary students in our innovative practice situationPart of the solution to rural practice shortage situations, is leading by example and teaching and training students on new and innovative approaches to practice sustainability.Partnership with the TVMC at WTAMU to allow 2-3 student preceptors per year, with deferred travel and lodging costs (ongoing)
Project Methods
Expanding servicesproviding a unique telehealth alternative for long distance or challenging geographic casesproviding fully mobile alternatives to haul inproviding increased haul in capacity with a new chuteTraining for producersproviding unique meetings detailing new services/products/methods/legislation that affects their specific operationsbeing available for consultation and education on a one on one basisproviding opportunities for producers to meet and collaborateTraining for students:Providing funded externships for DVM studentsfocusing on rural practice and the unique needs of DVM's and clients in this environmentproviding students with an opportunity of both haul in and fully mobile practice

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

Outputs
Target Audience:4 DVM professional students, increased mobile demand during COVID heights as well as an influx of new residents and those seeking veterinary care in the area Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?4 DVM students went through our clinic in 2021. We also just signed an agreement with LMU vet school to provide externships as part of their clinical rotations and will be providing these rotations for TAMU and TTU students in the near future as well. How have the results been disseminated to communities of interest?Colleges of veterinary medicine What do you plan to do during the next reporting period to accomplish the goals?n/a

Impacts
What was accomplished under these goals? We continued our efforts with mobile livestock services to many new homesteaders in the area. Additionally, income from 2020 allowed us to renovate a house in the back of the clinic for exclusive use to house veterinary students. Though this was not part of the grant ( and no grant money used towards this project) it is a natural outflow of using the grant to help educate veterinary students. Money provided by the grant to house these individuals for the past 3 years was so successful, we decided to make housing (at our expense) a permanent part of our efforts here.

Publications


    Progress 09/01/18 to 08/31/21

    Outputs
    Target Audience:DVM professional students, new mobile livestock clients, and existing livestock clients we could serve better Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?1. DVM training relating to telehealth in rural medicine 2. DVM student training and housing 3. expanded facebook presence with educational tools and materials for producers 4. Hiring of a former USDA range specialist for our cattle health side How have the results been disseminated to communities of interest?Telehealth services, social media, word of mouth, DVM professional schools What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

    Impacts
    What was accomplished under these goals? Every goal was accomplished. Mobile services increased, telehealth platforms especially during COVID were expanded. Dr. Nicotre began giving lectures for DVM's during CE events to discuss the successes and pitfalls of these interactions in 2021. Many veterinary students were given externships and the continuation of the externship housing program with our decision to renovate a house on clinic property for DVM student externs moving forward- beyond the scope of these goals.

    Publications


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

      Outputs
      Target Audience:DVM professional students. New mobile livestock clients and exhisting livestock clients that we could serve better. Changes/Problems:2020 was a difficult year across the profession in general. We continued to serve local producers with the new equipment and expanded our reach to a cervid population in more outlying areas where DVMs were no longer availble to serve these clients. We are exploring additional opoortunities for DVM student externships for 2021 to "make up for lost time" in 2020. What opportunities for training and professional development has the project provided? Nothing Reported How have the results been disseminated to communities of interest?2020 utilization was almost fully electronic due to the pandemic What do you plan to do during the next reporting period to accomplish the goals?We have 2 students scheduled for externships over the next 9 months and are working towards having on premisis housing for student externs availble for 4th year roations from various universities as well as housing for summer externs for DVM students in their 1-3 years.

      Impacts
      What was accomplished under these goals? Goals 1 and 2 and all subheadings were completed in 2019 Goals 3 and 4 are ongoing and continue to be underway. 2020 was an outlier year in which no students were allowed in our practice. We combatted this challenge by utlizing online lectures for students and facilitating facebook live videos to help students in a remote fashion.

      Publications


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

        Outputs
        Target Audience:DVM professional students New mobile livestock clients existing livestock clients we could serve better 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?Facebook live, new website, on farm education Focus this fall on starting a local Texas Cattle Women Chapter What do you plan to do during the next reporting period to accomplish the goals?continue with current strategies

        Impacts
        What was accomplished under these goals? 1. To continue to offer high quality medicine services and position our clinic as an expert source for medicine and production questions and needs all equipment upgraded and in functional use daily 2.To leverage veterinarian time and utilize support staff more efficiently by offering innovative telehealth services. telehealth offered and education to clients on it's value and utilization happening daily 3.To focus efforts towards reaching underserved producers: those with small operations and/ or operations without good working facilities; We currently turn down an average of 2 new clients/calls per week due to lack of mobile capabilities. mobile calls have increased 10% with a focus on marketing this new service mobile equipment purchased, functional and utilized almost daily strong Facebook live focus reaches further and expands education to producers 4.To help to educate current and future veterinary students in our innovative practice situation 3 preceptors scheduled for August-December 2019

        Publications