By Christina Bossinakis
During the second installment of its ongoing webinar series, the Grayson-Jockey Club Research Foundation presented the “Importance of transparency in medical records; monitoring horses between starts” Tuesday afternoon. Chief Veterinary Officer of The Stronach Group's Dr. Dionne Benson moderated the discussion and was joined by private racetrack practitioner Dr. Ryan Carpenter (Equine Medical Center, Cypress, Ca.); Dr. William Farmer (Equine Medical Director, Churchill Downs Incorporated) and Dr. Scott Palmer (Equine Medical Director, New York State Gaming Commission).
Leading off the 1-hour discussion was the necessity of the transparency in medical records and who should have access to the information.
“Some of the information in racing is used exclusively for a regulatory purpose, while some information is intended for use by racing stakeholders and other information is prepared for public distribution,” said Dr. Palmer. “With these different audiences and needs we have to be attentive to those differences and our information needs to be packaged for each of them.”
Regarding how much information should be available, he added, “Overall, we do have a philosophy in our commission to be very transparent. And there are the folks, and I would be included in this category, who are on a 'need to know' basis for the information but you're often in conflict with those that fall into the 'want to know' basis. Trying to reconcile these two perspectives is a challenge.”
Offering the view of the same issue from a private practitioner's perspective, Dr. Carpenter added, “I think the regulatory body in whatever state you are working in should have access to everything you do. I think you should be very accurate on how you record your information, not only in terms of your paperwork and the interactions with the California Horse Racing Board, but also the conversations with the regulatory vets. I found that's the best way to develop a working relationship that puts the horses's best interest first.”
He continued, “Where it's a bit different for me is when dealing with the 'want to know' group. It's what you make public to the general public. That's tough because there's a lot of conversations taking place with the trainer or the owner about the diagnosic approach to that horse that, without the context of the conversation, it gets lost. So people can start drawing inferences and assumptions that are not correct because it tells the story they may want to tell. Regarding the transparency to the public, I don't think the nitty gritty details are important. But a summary is fine.”
Dr. Farmer, the former official veterinarian for the CHRB, was appointed to his post at Churchill Downs last fall. Noting some of the challenges stemming from the differing amount of information received in his posts, past and present, he said, “I think it is a team approach where, from the association side working with the regulatory body, to be able to work together. We don't get to see the confidentials, but what we have done at our Churchill properties are acquire the exams prior to entries, so that we do get to see because those are our house rules. But with regards to the individuals treatments, we don't see those. So there is a hole from our side, so by working closely with the regulatory body, we hope to complete that picture.”
Addressing how the availability of medical records can influence rule enforcement within a jurisdiction, Dr. Palmer offered, “Rules can sometimes be difficult to enforce and there are often points of conflict or contention that can occur. To give an example, right now [in New York] we are doing quite a bit of hair testing on horses that had been in the custody of trainers that were indicted for the alleged use of illegal medication. So we are compiling a large number of test results for these horses and at the same time, we require all the owners to provide medical records on their horses from December 2019 to the day they had they hair test done. We will be comparing those medical records with treatment records with our test results, and if everything lines up, then we have no problem. But if we have evidence of a prescription drug in a horse and there is no prescription or medical record that a veterinarian gave the drug, then that record represents an area of exposure for that trainer for regulatory action. A person can get away with a lot for a period of time, but there comes the moment when they get caught up in regulatory process and there are enormous consequences as a result.”
“These things are enforceable. It's not a perfect system but it's a good system.”
Dr. Farmer, who also served as an out-of-competition coordinator and consultant for the Breeders' Cup, underscored the importance of developing a system of uniform record keeping to facilitate both the delivery of information relating to the enforcement of rules.
“At Churchill Downs, the volume of information that is coming in on a continual basis is enormous,” he said. “And then trying to decipher handwriting and what was the intention can be really challenging. So we need to look towards a consensus of an electronic medical record that is consistent across the board.”
One of the ways the Midatlantic regulatory group has tried to address equine welfare in the region is information (Horse Health Record) that is required to accompany all horses transferred in ownership through claiming.
“We are talking about continuity of care and trying to provide core information from the claiming trainer to the claimant, so the horses has the best chance that their new caretaker is going to be able to make informed medical decisions about these horses,” explained Dr. Palmer. “The justification for this is we have epidemiological data that horses that are claimed are at increased risk for fatal musculo-skeletal injury for at least 30 days after the claim. We feel part of that risk can be mitigated if the new trainer gets appropriate medical information on the horse to make better medical decisions in terms of health care. We think it's a critical piece of information.”
Dr. Benson later asked the group on their thoughts on the optimal time to start keeping a horse's records and the importance of keeping those records throughout the lifetime of the horse.
“I believe it begins on the farm,” opined Dr. Carpenter. “There are a lot of things that take place prepping for a yearling sale or a 2-year-old in Training sale that would be very valuable information for a racetrack practitioner. We often deal with the end-product of the sale's arena. The more complete the medical record is, the better it is for us and even more importantly, the best thing for the horse.”
In the second half of the group discussion, the need to monitor horses between starts took center stage.
“We went through a rough time in California about a year ago and fortunately, through that time, came a lot of really good,” said Dr. Carpenter. “One of things that started because of monitoring was the requirement for a horse to be examined by the veterinarian within five days of a work or three days of entering in a race. That has been really great. It's allowed the veterinarian to be part of the conversation more. The other thing is there have been vets on the racetrack watching horses train in the mornings. As a vet on the backside, we generally don't have time to do this on our own. As we have developed our relationship with the vets, it has allowed us to identify things and have that second set of eyes watching a horse.”
When dealing with a large volume of horses and vast array of moving parts at various locations, Dr. Palmer pointed to the creation of the Racing Risk Management Program in New York which assesses a horse's risk factor while breaking it down at four different levels–unraced horses that are 4-year-olds and older; all horses that have had 120 days or longer layoff; horses that have accumulated 80 or more high-speed furlongs prior to a start; and horses that have been on the vet's list.
“This out of competition scrutiny is really important and the more of it we can do, the better,” he said. “Also, if we can use technology to help us do this, that's one way to address the scope of the problem which is enormous, since we cannot put a regulatory veterinarian at every training center and racetrack, I think using the technology of the Jockey Club's database and Encompass software is incredibly helpful.”
The next webinar in the series featuring–Track Surfaces: International standards for racing surfaces and the expansion of the Maintenance Quality System–will be held May 26. Presiding over the segment is Dr. Mick Peterson, Executive Director, Racing Surfaces Testing Laboratory; Professor, Biosystems and Agricultural Engineering at the University of Kentucky.
The free webinars are accessible each week at zoom.us/j/96557992970. Viewers will be able to ask questions through the Zoom webinar platform. All sessions start at 2 p.m. ET.