Provider perspectives on telehealth for contraceptive care: "the provider isn't going want to use it unless it's easy to use".

BACKGROUND

Telehealth services for contraception expanded significantly during the COVID-19 pandemic, but continued coverage for these services is uncertain. This study assessed providers' recent experiences delivering contraceptive care via telehealth to improve these services.

METHODS

We conducted semi-structured qualitative interviews with healthcare practitioners in the U.S. providing contraceptive services (N = 41) from August 2022 to August 2024 to investigate telehealth practices for contraceptive care. We used thematic analysis to code the data and identify barriers and facilitators of telehealth use by providers. We identified themes using a modified Consolidated Framework for Implementation Research (CFIR) to assess factors that affected provision of telehealth contraceptive care.

RESULTS

We identified and mapped three main themes across CFIR domains: the incompatibility of telehealth with clinic systems and need for additional clinic support; varying preferences for in-person versus telehealth care; and the mixed impact of telehealth on patient privacy, agency, and rapport. Overall, participants enthusiastically discussed telehealth benefits for contraceptive care delivery. Some, however, limited their use of telehealth due to clinic requirements for Pap tests or onsite blood pressure readings for hormonal contraceptives. Many participants noted that judgment is needed to ensure privacy and caution in situations such as intimate partner violence and with certain patients such as adolescents.

CONCLUSION

Results reflected the enduring benefits of telehealth for contraceptive care. The reported barriers highlight changes needed to efficiently expand the scope of telehealth services. Our findings point to the importance of prioritizing and investing in telehealth services to reach patients who otherwise face challenges completing in-person care. Additionally, these findings may inform ongoing policy debates about continued coverage for this innovative method of service delivery.