SRF050: Rapid Innovation & Adaptation in Contraceptive Care using Telemedicine: Evaluating Impact and Sustainability

Bonnie Song, BS; Lee Hasselbacher, JD; Zarina Wong, BA; Ashley McHugh; Debra Stulberg, MD


Context: The COVID-19 pandemic has affected provision of contraceptive services by limiting in-person visits and possibly disrupting contraception access.1,2 While such trends are emerging, there is a lack of knowledge around practice changes providers have adopted to address contraceptive need during the pandemic, the impact of these changes, and whether they will be sustainable in the long term. Objective: Understand role of telemedicine and other innovations in contraceptive service delivery and determine if/how these changes will be sustained. Human subjects review: Deemed exempt by University of Chicago’s IRB. Design: Qualitative study interviewing 20 providers (physicians, nurse practitioners and midwives) about experiences providing contraception through telemedicine with a semi-structured interview guide using the Consolidated Framework for Implementation Research (CFIR) & Patient Centered Contraceptive Care Framework. Recorded interviews conducted over Zoom/telephone are transcribed and analyzed for important themes. Setting: Illinois FQHCs, academic centers, and private practices. In a partner study, Planned Parenthood providers will be interviewed. Outcome measures: N/A. Anticipated Results: Of 4 providers interviewed thus far, all report telemedicine has positive impacts on addressing contraceptive need during the pandemic, such as by eliminating need for transportation or providing the ease of receiving contraceptive counseling at home. However, variability in which providers offer telemedicine over telephone, video, or both may still create barriers to accessible, high quality contraceptive services by limiting a provider’s ability to evaluate a patient or by limiting a patient’s ability to receive care if they do not have easy or private access to phone or video. Based on responses so far, the authors anticipate most providers will report wanting to maintain telemedicine as an option but also facing barriers to doing so, such as lack of agency within the greater organization they work under, or hesitancy about the future of reimbursement rates for telemedicine. Conclusions: Results will inform the role of telemedicine in helping to overcome barriers to contraceptive access during the pandemic and in the long term. The authors anticipate the rapid implementation of telemedicine will reveal important areas of improvement that will be needed to ensure a level of quality in contraceptive service delivery that is comparable to in-person services.
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Jack 11/21/2020

great work. so important. thanks

Bill Phillips 11/23/2020

Importnat topic. Great study, well presented. Thanks for sharing it at NAPCRG. Interested in your next steps. (Hope to see them here at NAPCRG next year.)

Bianca Allison MD MPH 12/22/2020

Thank you for sharing this great poster and hard work doing these qualitative interviews. We are doing a study that assesses the perspectives of adolescents and their parents when it comes to confidentiality and privacy, since that is definitely one of the key pieces in ascertaining the future impact of telehealth on contraception (and other sexual and reproductive health) delivery. I wonder if you all found anything around the specific types of contraception that are being counseled on and provided in the telehealth context, as in if there was a decrease in the number of LARC being initiated (since those require an in-person visit) and how though contraceptive access continues during telehealth if the overall efficacy of types of contraception used may be lower. Look forward to hearing more about your work!

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