246778 Women's and providers' perspectives on telemedicine provision of medication abortion

Monday, October 31, 2011: 1:30 PM

Kate Grindlay, MSPH , Ibis Reproductive Health, Cambridge, MA
Todd Buchacker, RN , Planned Parenthood of the Heartland, Des Moines, IA
Kathleen Lane , Abortion Access Project, Cedar Rapids, IA
Daniel Grossman, MD , Ibis Reproductive Health, Oakland, CA
In states requiring physicians to dispense mifepristone, the small number of providers offering the method limits its uptake. In 2008, Planned Parenthood of the Heartland in Iowa began providing medication abortion via telemedicine at clinics without an on-site physician. We recently demonstrated that telemedicine provision was equally safe and effective as face-to-face physician provison, and acceptability may be higher among telemedicine clients. The purpose of this study was to evaluate qualitatively women's and providers' experiences with telemedicine provision of medication abortion.

Between October 2009-February 2010, in-depth interviews were conducted at Planned Parenthood clinics with 26 women receiving medication abortion services (21 telemedicine clients and 5 face-to-face clients), and 16 providers (2 physicians, 2 nurses, 6 counselors/educators, 5 center managers, and 1 study coordinator). Data were analyzed qualitatively for themes related to acceptability of the telemedicine service delivery model.

Women and providers cited numerous advantages of telemedicine, including decreased travel for women and physicians, greater flexibility and availability of locations and appointment times, and fewer cancelations due to weather compared to face-to-face provision. Overall, women were generally positive or indifferent about having the conversation with the doctor take place via telemedine, with most reporting it felt private/secure and in some cases even more comfortable than a face-to-face visit. However, other women had privacy concerns or preferred being in the same room with the physician, highlighting the importance of informing women about their options so they can choose their preferred model. Interviews also highlighted several ways the service could be improved.

Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public
Public health or related research

Learning Objectives:
Describe state abortion laws requiring mifepristone be dispensed by a physician and the impact they have on access to medication abortion for women, particularly in rural areas Explain the telemedicine model that Planned Parenthood of the Heartland in Iowa has developed to address barriers to access to medication abortion services Discuss women’s and providers’ experiences with telemedicine and the implications for future use of this service delivery model

Keywords: Abortion, Access and Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI overseeing this evaluation of telemedicine for the provision of medication abortion.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.