For a study, researchers analyzed sudden variation of remote abortion service operations among health care settings and described the utilization of telehealth consultations with medications posted directly to patients. Investigators processed 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 telehealth abortion services. Interviews were recorded, transcribed, and analyzed. Staff roles, policies, and procedures were compared across practice settings. Among all practice settings, telehealth abortion services consisted of 5 operational steps: Patient involvement, care consultations, payment, medication dispensing, and follow-up communication. Online services and solo primary care practices utilized asynchronous procedures to establish eligibility and execute consultations, resulting in more efficient services (2-5 minutes), whereas family planning and health system clinics utilized synchronous video encounters with a duration of 10-30 minutes of clinician time. Family planning and health system primary care clinics mailed medications from clinic stock or internal pharmacies, while independent primary care practices and online services usually utilized mail-order pharmacies. Patients using these online healthcare services could asynchronously get follow-ups, whereas other practice settings scheduled synchronous appointments. Sudden changes executed in response to disrupted in-person reproductive health care included remote medication abortion services with telehealth assessment/follow-up and mailed medications. Though consistency in operational procedures was found among health care settings, allowing for service adaptations for particular locations. Acknowledging remote abortion service operations might process the dissemination of a span of patient-centered reproductive health services.
Source – annfammed.org/content/20/4/336