Telemedicine projects to improve access to abortion care
Telemedicine is the provision of healthcare at a distance using information and communication technology, and is increasingly being used across medical specialties, with more than half of US hospitals using telemedicine in some way. In 2008, Planned Parenthood of the Heartland in Iowa launched a telemedicine service to provide medication abortion care at rural clinics. Ibis evaluated this service and found that telemedicine provision of medication abortion is safe, effective, and acceptable to women and providers. Ninety-nine percent of telemedicine patients had a successful abortion, and adverse events, such as going to the emergency room or needing a blood transfusion, were rare, occurring among 1% of patients seen either by telemedicine or in a face-to-face physician visit. While satisfaction with the abortion was high among all patients (91% reported they were ‘very satisfied’), telemedicine patients were more likely to report they would recommend the service to a friend compared with face-to-face patients. Our research also showed that telemedicine availability resulted in women accessing abortion services at earlier gestational ages and increased access to services for women living in remote parts of the state. Furthermore, qualitative research that we conducted in Iowa and Alaska showed that telemedicine for medication abortion was highly acceptable to providers with minimal impact on the clinic.
Our research evaluating the use of telemedicine for medication abortion services demonstrates that restricting telemedicine for medication abortion is not evidence based, and limits women’s access to high-quality abortion care, particularly in rural areas. We are now evaluating the safety, feasibility, and acceptability, and cost of telemedicine in other settings and using other modalities.