Remote delivery in reproductive health care: telehealth medical abortion service

For one study, researchers analyzed the sudden variation in remote abortion service operations among health care facilities and described the use of telehealth consultations with medications mailed directly to patients. The investigators conducted semi-structured interviews with 21 clinical staff from 4 practice settings: family planning clinics, online medical services, and primary care practices, independent or within multispecialty health systems. Clinicians and administrators explained their abortion services via telehealth. The interviews were recorded, transcribed and analyzed. Staff roles, policies and procedures were compared across practice settings. Across all practice settings, telehealth abortion services included 5 operational steps: patient involvement, care consultations, payment, medication distribution, and follow-up communication. Online services and solo primary care practices used asynchronous procedures to establish eligibility and run consultations, resulting in more efficient services (2-5 minutes), while family planning clinics and health system used synchronous video encounters lasting 10 to 30 clinician minutes. time. Family planning and primary care clinics in the health system mailed drugs from clinic stock or in-house pharmacies, while independent primary care practices and online services typically used mail-order pharmacies. correspondence. Patients using these online health services could get follow-ups asynchronously, while other practice settings scheduled synchronous appointments. Sudden changes executed in response to the disruption of in-person reproductive health care included remote medical abortion services with telehealth assessment/monitoring and mail-in medication. Although consistency of operating procedures has been seen across healthcare facilities, allowing for service adaptations for particular locations. Recognizing remote abortion service operations could address the spread of a range of patient-centered reproductive health services.

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