Big pharma and advances in medicine get a lot of attention for improving health, but several recently published studies show that communication technology may actually drive some of the changes that could have the biggest impact. Telemedicine is being safely and effectively used to expand access to a wide range of health care services including adult and neonatal intensive care, cardiology, psychiatry, and emergency medicine.
Advances in telemedicine, for example, are a growing part of the solution to the shortage of health care providers in rural communities and as a new study shows, for women seeking abortion. Rural communities are home to 20 percent of the U.S. population but have only 9 percent of the physicians. Moreover, 87 percent of all U.S. counties and 97 percent of rural counties have no abortion provider. In light of these daunting statistics, telemedicine holds unprecedented promise of improved access and higher quality of care for hard-to-reach communities.
Alongside the promise of telemedicine come the concerns that any new technology brings. Not long ago, it was only in science fiction that we imagined robots would help us care for critically sick babies or that we could trust technology enough to use it to monitor high risk pregnancy from far away. As with any technology or medical procedure, we must proceed soberly and ethically, and consider acceptability, safety and quality of care alongside the benefits new technologies bring. But we also have to allow for evidence-based advances in medicine irrespective of ideology.
The recent publication of a new study finds telemedicine for the delivery of medication abortion to be a safe and effective means of very early abortion. The study, conducted by a multi-disciplinary team led by Dr. Daniel Grossman at Ibis Reproductive Health evaluated a program run by Planned Parenthood of the Heartland/Iowa to provide medication abortion using telemedicine at clinic sites not staffed by a physician.
The team’s findings, published in the August 2011 issue of Obstetrics and Gynecology, show that telemedicine provision of abortion is effective, is safe with a low complication rate that is on par with in-person provision, and is highly acceptable to patients. This is good news for women seeking abortion, and good news for telemedicine – our hopes for which continue to appear well-founded.
Unfortunately, laws singling out abortion and banning the use of telemedicine are undermining this promise and threaten telemedicine as a whole. Six states have passed legislation that bans the use of telemedicine for abortion and three more states are expected to re-introduce similar laws in their next legislative sessions. These laws are dishonest in their claims of protecting women’s health, ignoring data that show that telemedicine is safely being used not only for abortion but for many more medically-challenging situations and procedures including neonatal intensive care and monitoring cardiac distress. Laws that single out abortion are based in ideology, not evidence, and establish a dangerous precedent: it is neither practical nor ethical to restrict an individual’s access to medical technology because of controversy over the personal decisions she makes.
If we let ideology guide telemedicine policy on abortion, we run the risk that ideology will also prohibit other remote health care procedures, irrespective of need or proven safety.
Advocates for abortion rights and for telemedicine must work together to achieve policies and practices that support telemedicine’s promise: improved access to health care for all. As we move forward into a future in which telemedicine will become an increasingly prominent part of health care delivery, particularly for hard-to-reach populations and rural communities, our policies and practices must be evidence-based. It is imperative that we improve and expand access to the widest range of health care services, especially for those who have gone without. Sacrificing telemedicine on the altar of abortion politics serves no one, and brings harm to those who most stand to benefit from the improved health that is telemedicine’s promise.