Iowa court OKs abortion by telemedicine

From the mHealthNews archive
By Eric Wicklund

Reversing a recent trend in state legislative action, Iowa's Supreme Court has rejected that state's ban on administering abortion drugs through telemedicine.

The unanimous decision, issued on Friday, allows Iowa's three Planned Parenthood clinics to continue treating women through two-way video consults. The court stated that since the organization had only those three clinics in the state, the ban would place an "undue burden" on women who would need to travel hundreds of miles to visit one of them at a time when a doctor is there.

[See also: Arkansas, Idaho OK telemedicine bills]

Iowa's Board of Medicine had issued the ban in 2013, ruling that a doctor must be in the same location as the patient to administer abortion-inducing medications. Planned Parenthood, which had been using telemedicine to treat women since 2008, filed suit that September, claiming the board's ruling was political. The ruling was upheld by an Iowa court in August 2014, then appealed to the state Supreme Court.

The issue won't likely end here. Several states have reacted strongly to the idea of facilitating abortions by telemedicine, with 16 mandating that a physician be present when the drugs are administered and only Minnesota allowing the procedure via telemedicine. And those against the practice need only look to Texas, whose state medical board is seeking to prevent doctors from making some diagnoses and issuing prescriptions to new patients via telemedicine, insisting that they first have a face-to-face encounter.

According to Planned Parenthood officials, a trained staff member is with each patient during the procedure to take vital signs, perform an ultrasound and collect a blood sample.  The doctor consulting by two-way video then views that information, talks to both patient and staff member, then remotely unlocks a receptacle  containing the abortion-inducing drugs. Both doctor and staff member then watch the patient take the medication.

[See also: 2 telemedicine bills set to return to Congress]

According to Reuters, Iowa's high court noted that telemedicine is allowed in the state, so there's little evidence to argue that it couldn't be used by Planned Parenthood.

“Whenever telemedicine occurs, the physician at the remote location does not perform a physical examination of the patient. It is difficult to avoid the conclusion that the board's medical concerns about telemedicine are selectively limited to abortion,” said Justice David Wiggins, writing for the court.

Mark Bowden, the Iowa Board of Medicine's executive director, told Reuters the board will take up the court's decision at its July meeting.

"The board adopted the rule to address what it saw as the unsafe practice of medicine," he said. "The rule did not adopt the rule to place an undue burden on women seeking to terminate their pregnancies."


The ruling also didn't sit well with Iowa Gov. Terry Branstad.

“After receiving petitions from medical professionals from all across Iowa that raised concerns about the quality of care women were receiving under these webcam procedures, the Iowa Board of Medicine provided a standard of care for webcam abortions,” Branstad's spokesman, Jimmy Centers, said in a statement. “Although the court upheld parental notification, the governor is extremely disappointed that the Iowa Board of Medicine's action, which ensured women received the high standard of care that they deserve, was reversed by the Iowa Supreme Court.”


[See also: Remote monitoring success comes in many forms]