Roe v Wade: How telemedicine could transform reproductive and abortion care

Following the US Supreme Court’s ruling on abortion, millions of Americans in half of the states will no longer fully possess rights to health and bodily integrity. We sat down with Choix’s CEO, Cindy Adam, to find out how the telemedicine clinic aims to help patients access reproductive and abortion care safely and legally.

FemTech World: What is Choix?

Cindy Adam: Choix (pronounced “choice”) is a telemedicine clinic that provides abortion care and other reproductive and sexual healthcare services such as emergency contraception and birth control.

We believe everyone should be free to make their own decisions about their bodies, their families, and their futures and we empower patients to get safe and affordable abortion care. All that’s needed is a phone or computer.

FTW: How did you establish Choix?

CA: Before launching Choix in the autumn of 2020, our providers were delivering contraceptive care via telehealth at other organisations and noticed a lack of abortion care provision, despite a solid and growing evidence base showing the safety of efficacy of the telehealth model.

Our founders came together to create the first asynchronous telehealth clinic providing abortion care – which has an efficacy rate consistent with in-person care, according to the Journal of the American Medical Association.  The focus was and continues to be on both the patient and provider experience of a telehealth platform because telehealth must be compassionate, easy and private.

So, we founded Choix with a vision of using telemedicine to expand access for all people who seek safe and affordable abortion care from the privacy of their own homes.

FTW: Why is Choix different?

CA: Our patients can communicate with us on their schedule via regular or encrypted text, depending on their preference. No appointments necessary. Core to the Choix offering is the experience of our founding clinicians in both the reproductive healthcare and telemedicine spaces. These forces combined allowed us to create a platform that centres both the patients and the providers.

Further, our medical leadership team’s continued participation in direct patient care allows us to implement recommendations from our providers to improve the provider and patient experience in real-time – recommendations that might take much longer to improve in other organisations.

There is also peace of mind for patients when they know their providers are experienced, knowledgeable and trustworthy. This is especially true for the abortion space, which carries a lot of stigma and where few patients have access to readily available information before they begin seeking abortion care.

FTW: Why is it important for women to have access to emergency contraception?

CA: It is essential for women and people with periods to have access to full spectrum reproductive health care – including abortion and all forms of contraception. This critical care is key to their overall health and quality of life, and there are significant medical, economic, and social benefits that come with access to care including:

• • Greater financial stability and independence
  • Lower rates of sexually-transmitted infections (STIs), teen pregnancies, HIV, gynaecological cancers, and complications caused by untreated STIs
  • The ability to treat painful periods, menstrual regulation and other non-contraceptive health benefits that come with access to hormonal contraception
  • Improved maternal health – fewer women dying in childbirth or experiencing severe complications
  • Safer abortions completed earlier in the pregnancy

FTW: How does Choix help women access abortion care at home?

CA: Choix currently serves women and people with periods in the states of California, Illinois, Colorado and New Mexico. Our patients begin care by completing an online medical questionnaire and creating a patient portal account after which they will be contacted by one of our clinicians.

Once the patient is approved for care, medications are shipped to them via Choix’s partner pharmacy, Honeybee Health. The patient is also sent educational materials and a video content to help them prepare for the process. We check in with patients through follow-ups and support patients throughout the process and we aim to help ease some of the financial, physical and emotional stresses that can come with in-person care by providing private, discrete and non-judgemental care at home. Through telemedicine, we aim to help expand access to care by saving patients both time and money.

FTW: As more than half of the US could ban abortion, what can clinics like Choix do to support women?

CA: It’s important for clinics to support all people seeking abortion care. We are prepared to meet the increased demand for medication abortion as a result of restrictions and bans on abortion care, and we are certainly seeing an increase in the number of people traveling from banned or restricted states.

Our platform allows us to scale quickly and efficiently and we are focused on growing our provider team to support the increased need for telehealth abortion care. Telemedicine clinics can also alleviate capacity issues in states that are seeing an influx of patients from states where abortion is banned or restricted, helping local clinics to reserve in-person visits for patients who require or prefer in-person care.

Choix can also help people coming to the states we are licensed to offer care – currently California, Illinois, Colorado and New Mexico. As with all healthcare, state residency is not a requirement for accessing care, but people do need to be in the states we serve for their telehealth visits and in order to receive medication.

FTW: How does Choix help opening up the conversation around women’s health and abortion care?

CA: Many people are still learning about the safety and efficacy of medication abortion in general, and the knowledge gap is even greater around medication abortion via telehealth. Ensuring that people are aware of the safety, reliability, and availability of abortion pills – both in-clinic and via telehealth –  is equally important. Sharing this essential information is something we at strive to do and we all can and should do.

FTW: What feedback did you get from those who accessed your services?

CA: We send a follow-up survey aftercare and we have got wonderful feedback from our patients both from a data and direct feedback perspective. This data is collected and shared with permission from our patients and has been made anonymous. On average, our patients score us a 4.6 out of 5 – with 5 being “perfect” – and 98 per cent of them would recommend Choix to a friend.

FTW: What are your ambitions for Choix for the next five years?

CA: Choix will continue to expand to every state where we can safely and legally provide abortion care, and our goal is to be in every single one of those states by the end of 2023. We will be expanding our sexual and reproductive healthcare services to include testing and treatment for sexually transmitted and vaginal infections. We are also working to connect with corporations who want to offer abortion care and sexual and reproductive healthcare benefits to their team members.