Telehealth leaders' attitudes toward telemedicine provision of medication abortion: A qualitative study

Abstract

Background: Medication abortion is a simple, non-surgical method used in nearly one-third of non-hospital abortions in the United States. Telemedicine for medication abortion provision has been shown to be safe, effective, and acceptable to patients and providers, with comparable clinical outcomes to in-person abortion provision. Despite the documented safety of telemedicine for medication abortion, 19 US states prohibit the use of telemedicine to prescribe medication for abortion remotely. The purpose of this study was to explore the knowledge and attitudes of telehealth organization leaders towards telemedicine for medication abortion and bans on this use, and to situate these restrictions in the context of other telemedicine services.

Methods: We conducted in-depth interviews with 19 leaders of US telemedicine and telehealth organizations. Interviews were digitally recorded, transcribed, and analyzed using modified grounded theory methods.

Results: A majority of participants were unfamiliar with the use of telemedicine for medication abortion provision or existing bans on its use. Once the model was described to participants, most felt that telemedicine was appropriate or well-suited for medication abortion provision. No participants supported bans on telemedicine for medication abortion, and most felt such bans could negatively impact the use of telemedicine for other health care services.

Conclusions: Telehealth leaders knowledgeable about the benefits and risks of telemedicine reported favorable opinions of telemedicine use for medication abortion provision, believing it to be an appropriate use for telemedicine, and generally opposed bans on it. These thought leaders play an important role in shaping telemedicine regulations and can help advance evidence-based policies for telemedicine provision of medication abortion.