Department of Obstetrics and Gynecology, University of Southern California/LAC+USC Medical Center, Los Angeles, California, USA.
Department of Comparative Human Development, University of Chicago, Chicago, Illinois, USA.
Perspect Sex Reprod Health. 2022 Sep;54(3):80-89. doi: 10.1363/psrh.12207. Epub 2022 Sep 7.
The COVID-19 pandemic increased the provision of contraception through telemedicine. This qualitative study describes provider perceptions of how telemedicine provision of contraception has impacted patient care.
We interviewed 40 obstetrics-gynecology and family medicine physicians, midwives, nurse practitioners, and support staff providing contraception via telemedicine in practices across Illinois, including Planned Parenthood of Illinois (PPIL) health centers. We analyzed interview content to identify themes around the perceived impact of telemedicine implementation on contraception access, contraceptive counseling, patient privacy, and provision of long-acting reversible contraception (LARC).
Participants perceived that telemedicine implementation improved care by increasing contraception access, increasing focus on counseling while reducing bias, and allowing easier method switching. Participants thought disparities in telemedicine usage and limitations to the technological interface presented barriers to patient care. Participants' perceptions of how telemedicine implementation impacts patient privacy and LARC provision were mixed. Some participants found telemedicine implementation enhanced privacy, while others felt unable to ensure privacy in a virtual space. Participants found telemedicine modalities useful for counseling patients considering methods of LARC, but they sometimes presented an unnecessary extra step for those sure about receiving one at a practice offering same day insertion.
Providers felt telemedicine provision of contraception positively impacted patient care. Improvements to counseling and easier access to method switching suggest that telemedicine implementation may help reduce contraceptive coercion. Our findings highlight the need to integrate LARC care with telemedicine workflows, improve patient privacy protections, and promote equitable access to all telemedicine modalities.
COVID-19 大流行增加了通过远程医疗提供避孕措施的机会。本定性研究描述了提供者对远程医疗提供避孕措施如何影响患者护理的看法。
我们采访了 40 名在伊利诺伊州各地的妇产科和家庭医学医生、助产士、执业护士和提供远程医疗避孕服务的支持人员，包括伊利诺伊州计划生育协会 (PPIL) 健康中心。我们分析了访谈内容，以确定远程医疗实施对避孕措施获取、避孕咨询、患者隐私和长效可逆避孕 (LARC) 提供的感知影响的主题。
参与者认为远程医疗的实施通过增加避孕措施的获取、增加对咨询的关注同时减少偏见，以及更容易的方法转换，从而改善了护理。参与者认为远程医疗使用的差异和技术界面的限制对患者护理构成了障碍。参与者对远程医疗实施如何影响患者隐私和 LARC 提供的看法存在分歧。一些参与者认为远程医疗的实施增强了隐私，而另一些人则认为在虚拟空间中无法确保隐私。参与者发现远程医疗模式对考虑 LARC 方法的患者咨询有用，但对于那些在提供当日插入服务的实践中确定要接受一种方法的患者来说，有时会增加不必要的额外步骤。
提供者认为远程医疗提供避孕措施对患者护理产生了积极影响。咨询的改善和更容易获得方法转换表明，远程医疗的实施可能有助于减少避孕强制。我们的研究结果强调了需要将 LARC 护理与远程医疗工作流程集成、改善患者隐私保护以及促进所有远程医疗模式的公平获取。
