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Abortion Study Touts Telemedicine as a Care Management Tool

The report says a telemedicine platform in Alaska helps women get timely abortion care closer to home, and enables them to choose the services they want.

By Eric Wicklund

- A new study is reviving the ongoing debate of offering abortions by telemedicine, positioning the platform as a means of improving patient-centered care.

As reported in the Journal of Telemedicine and Telecare, a study conducted by researchers at the University of California-San Francisco found that women in Alaska who had access to abortion services via telemedicine were able to get care in a more timely manner and closer to home, and were better able to choose how they wanted an abortion.

Telemedicine abortions are a hot-button topic, banned in 19 states and heavily regulated in most others. Yet both sides of the debate see benefits to the technology, and an ongoing pilot in four states is testing whether the technology can improve clinical outcomes.

Some 23 percent of abortions performed in the U.S. in 2011 were non-surgical, or medical abortions. Advocates say this type of abortion could best be handled by telemedicine, especially in areas where access to a clinic is minimal, restricted or in some cases dangerous.

The Alaska study, led by Massachusetts-based Ibis Reproductive Health and UCSF’s Advancing New Standards in Reproductive Health (ANSIRH), didn’t report any impact on the number of abortions provided or notice any clinical benefits. But researchers said the telemedicine platform expanded the opportunities for women to receive timely care, as opposed to having only one or two days a month when they might be able to see a doctor in person at a clinic.

“This study adds to the robust evidence base that has clearly documented both the acceptability and large potential benefits of telemedicine provision of medication abortion,” Kate Grindlay, an Ibis Reproductive Health associate and lead author on the study, said in remarks accompanying the study. “Our results were in line with other research that has shown that this service can be easily integrated into other healthcare offered at a clinic, can help women access the services they want and need closer to home, and allows providers to offer high-level care to women from a distance.”

“This study reinforces that medication abortion provided via telemedicine is an important option for women, particularly in rural areas,” added Daniel Grossman, MD, one of the authors of the study, director of ANSIRH and professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at UCSF. “Our previous research found that telemedicine provision of medication abortion is equally as safe and effective as when the service is offered with an in-person visit, and in Iowa, its introduction was associated with a reduction in second-trimester abortion. This most recent paper suggests that this model of care will improve access to early abortion in Alaska as well, and we look forward to studying this in more depth in the coming years.”

Grossman and Grindlay were both part of that Iowa study in 2008, which found that telemedicine could improve access to abortion services for women living in remote areas, especially the 31 percent of women who had to travel more than 100 miles to access abortion services. In addition, that study saw a decrease in abortions in Iowa, and a decrease in the percentage of medical abortions from 54 percent to 46 percent, after the introduction of a telemedicine platform.

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