Can Access to Telehealth Improve Abortion Care?

Telehealth involves using telecommunications technologies and electronic information to facilitate delivery and streamline access to health-related education, information, and services. Telehealth enables long-distance communication between provider and patient and provider and provider.

Telehealth involves exchanging services and information via email, text messages, live chat, video conferencing, or a specialized software application. The introduction of telehealth in healthcare facilities such as abortion clinics can provide instant access to specialized expertise, clinical knowledge, and services not available in densely populated parts of the United States.

Telehealth Can Transform the Country’s Healthcare System

Although more than half of the hospitals and clinics in the United States rely on telehealth, it still has yet to reach its full potential. Only 15% of doctors who worked in a medical setting used telehealth to interact with patients, whereas 11% used to it interact with other doctors.

The incorporation of telehealth in abortion clinics can improve abortion care in the country. Several women have to travel great distances for abortion care. With the introduction of telehealth, abortion clinics can make medication abortions readily available to women across the country, especially to those women who live in areas where there’s no access to reproductive health and abortion care services.

The Role Telehealth Plays in Abortion Care

In the United States, telehealth in abortion care has a limited role and is primarily a clinic-based service. This limitation has led to several people across the country not being able to access abortion care due to the distance. However, the gap in access can be closed if more abortion care clinics introduce medication abortion via telehealth using two models the site-to-site model and the direct-to-patient model.

The Site-to-Site Model

In the site-to-site mode, independent abortion care providers that use telehealth for medication abortion still need to schedule an in-person consultation and screening at a healthcare center. If they qualify for medication abortion, the healthcare clinic connects the patient to an abortion care clinic for further consultation via videoconference.

The clinician reviews their medical records, answers their questions, explains the procedure, and then authorizes medication abortion remotely. This process of administering medication abortion has been proven safe and effective with qualitative research indicating that both patients and clinicians identify it as a positive experience.

Direct-to-patient Model

The direct-to-patient model hasn’t been implemented and is being studied. The study, called the TeleAbortion Study, received special approval from the United States Food and Drug Administration (FDA). The study, which began in 2016, is available to abortion care clinics in eight states.

The direct-to-patient model doesn’t require a person to visit a healthcare center. Instead, the person is directed to a clinician via videoconference regardless of their location. If any tests are required, they would need to visit a healthcare facility or a local laboratory.

The abortion care clinic will then mail the pills directly to them. After taking the medication, the person completes all follow-up tests from their area to ensure the pregnancy has been terminated, followed by another videoconference. According to the data compiled from the four pilot states, Oregon, New York, Hawaii, and Washington, this model has shown to be a practical, acceptable, safe, and effective option for women.

The Future of Telehealth in Abortion Care

Telehealth expands access to medication abortion, but the politicization and legislation restrict its implementation in several states and threatens its expansion and innovation. Presently, only seventeen states require a clinician to be physically present when prescribing medication abortion, hence banning telehealth implementation.

The removal of these restrictions would enable abortion care providers to provide medication abortion to their patients. Although abortion care providers face several challenges and limitations, telehealth abortion may be introduced widely in the near future.

Currently, most states use the site-to-site model and/or the traditional model. Both models are safe and effective, with several abortion care providers expanding their services to residents of other states, especially to states where abortion care isn’t available.

The abortion care services may also offer additional services such as making travel arrangements, connecting to patients to organizations to fund their travel expenses and pay for food. They can even provide people with financial aid if necessary.

For now, patients in need of comprehensive reproductive health and abortion care services will need to rely on credible clinics trying to make abortion affordable and accessible to as many people as possible.