Article Figures & Data
Figures
- Figure 1.
Five steps used to provide remote medication abortion service across health service settings.
Tables
- Table 1.
Characteristics of Service Delivery Sites (N = 14) By Clinic Size and Interviewee Roles in Clinic and Service Operations
Site No. Clinic Sizea No. Interviewed Role in Clinic Role in Abortion Service Independent primary care practices 1 1 1 FP OSD 2 1 1 FP OSD 3 1 1 FP OSD 4 2-10 1 FP IMP 5 2-10 1 FP IMP Telemedicine-only health care clinics 6 2-10 2 NP OSD 7 11-50 1 ADM OSD 8 1 2 FP, ADM OSD Specialty family planning clinics 9 2-10 1 FP OSD 10 1 1 FP OSD 11 11-50 5 FP, NP, ADM OSD 12 1 1 FP IMP Multispecialty health systems 13 >50 1 FP OSD 14 >50 1 FP OSD Note: The implementation role includes clinicians and administrators involved in the implementation of a telehealth abortion service. The operations and service delivery role includes clinicians or administrators who are involved in the day-to-day operations of providing service to patients.
FP = family physician; NP = nurse practitioner; ADM = administrator; OSD = operations, service delivery; IMP = implementation
↵a Clinic size is based on the number of clinicians in the practice.
- Table 2.
Components of the 5 Steps for Remote Medication Abortion Service Operation Across 4 Health Care Settings (N = 14)
Operational Factor Practice Settings Independent Primary Care Practices (n = 5) Telemedicine-Only Health Care Clinics (n = 3) Specialized Family Planning Clinics (n = 4) Primary Care in Multispecialty Health System (n = 2) Patient engagement Importance of marketinga Moderately important Very important Moderately important Unimportant Mechanism for recruitmentb Website Website Website, call clinic Internal referral, call clinic Method of screening Questionnaire Questionnaire Questionnaire Call clinic Scheduling consultationc Automated Automated Automated Call clinic Patient consultation Technology platforms used Doxy.me Kareo, Rhinogram DocuSign, Doxy.me, Phone.com DocuSign Type clinic staffd Clinician Care coordinator, clinician Care coordinator, clinician Clinician Type of visite Synchronous Asynchronous Synchronous Asynchronous Synchronous Synchronous Duration, mine 10-30 2-5 10-20 2-5 20-30 10-30 Payment Source of fundsg Insurance, cash Cash Insurance, cash Insurance, Cash cost, $ 70-150 199-375 500-575 No Data Medication dispensing Method of deliveryh Mailed, pick up, drop off Mailed Mailed, pick up Mailed, pick up Type of pharmacy Mail order, clinic stock Mail order Clinic stock Mail order, health system pharmacy Follow-up communication Typee Synchronous Asynchronous Synchronous Synchronous Timing after medication taken 2-3 d 3 d and 4 wk 1-2 wk 1 d and 4 wk ↵a Measured using a Likert Scale: 1 = unimportant; 2 = slightly unimportant; 3 = moderately important; 4 = important; 5 = very important.
↵b Mechanisms: website = patient navigates to clinic website to request abortion service; internal referral = primary care clinician refers patient to in-house abortion service; call clinic = patient calls clinic to discuss abortion service.
↵c Automated = website system automatically proceeds to scheduling options.
↵d Clinician = a family physician or nurse practitioner; care coordinator = member of abortion care team who screens and counsels patient before meeting a clinician.
↵e Synchronous = a live, scheduled telephone or video call; asynchronous = a non-live e-mail, chat, or messaging function, also known as an e-visit.
f Duration of visit = total time for clinician to meet with patient and complete all documentation.
↵g Insurance = private or federal/state insurance plan; cash = patient pays with cash or credit.
↵h Mailed = medications are mailed directly to a patient; pick up = patient picks up medication from clinic; drop off = clinician personally delivers medications to patient.
VISUAL ABSTRACT
