LAUSR

Objectives: Many family planning providers faced disruptions to service delivery from the COVID-19 pandemic and needed to quickly implement telemedicine for contraceptive care. This study describes how Illinois providers responded to the uptake of telemedicine. Methods: We interviewed clinicians (n=20) from non-Planned Parenthood clinics (July – September 2020) and clinicians and staff (n=17) from Planned Parenthood of Illinois sites (December 2020 – March 2021) across the state. Interviews were conducted by phone or video, audio-recorded, transcribed, and coded in Dedoose. Analysis revealed themes focusing on telemedicine's effects on patient care and access to comprehensive contraceptive services, and on steps needed to improve telemedicine and sustain its benefits post-pandemic. Results: Interviewees expressed mostly positive attitudes towards telemedicine, highlighting its utility for counseling and prescription contraceptive methods, with additional benefits for rural patients and patients facing transportation, childcare, or other barriers to in-person visits. Challenges included rapid telemedicine rollout, patient barriers to accessing technology platforms, and reduced access to long-acting reversible contraception (LARC). Providers implemented changes to mitigate barriers, such as prioritizing same-day LARC insertion and removals, and eliminating required post-LARC follow-up visits. Providers noted virtual visits enhanced privacy for some and compromised privacy for others. All participants observed that continuation of telemedicine contraceptive services would depend on equitable reimbursement for telehealth services. Conclusions: Telemedicine contraception services can enhance access for patients who face barriers to care beyond those created by the pandemic. However, reimbursement parity for providers, patient-centered flexibility regarding telemedicine options, and measures to ensure access to all methods are important for long-term success.