A Quality Improvement Innovation for Reproductive Health Planning in the Time of COVID

Objectives To see if an outreach approach with telehealth is feasible and acceptable to patients to talk about their reproductive health; and as a secondary outcome, capture data on time spent on the visit and what kind of information was discussed. Methods A registry was created from three family physicians’ panels of all adult patients with anticipated ability to become pregnant ages 18–45 who had not had a documented reproductive health discussion in the previous 6 months. Using that registry, outreach was performed to schedule a telehealth visit to discuss their reproductive health with their primary care provider. The visit was standardized using the One Key Question approach. For patients who agreed to participate in the research, the patient completed a survey about their experience. The provider also completed a survey on the time spent and the issues addressed. Results Two hundred and six patients were called. Ninety patients (44%) could not be reached. Of the remaining patients, 34 scheduled either a telehealth or in-person visit and 7 also agreed to participate in the survey. New information was uncovered in the visit in 86% of participants. The most common need uncovered during the visit was unrelated medical needs (71%), followed by preconception health education/advice (43%) and contraception needs/counseling (29%). Most participants found the telehealth visit valuable. Conclusions An outreach methodology can uncover unmet health needs, both reproductive and otherwise. We found that people who had the visit often needed something, but a majority of patients declined the visit saying that they did not think they needed it. It is possible that patients are not aware of the value of reproductive health discussions, and therefore clinicians need to take every opportunity to have these discussions whenever possible, whether through outreach or inreach (during already scheduled visits). Significance What is already known on this subject? Many patients still do not receive recommended reproductive health visits, which can increase their risk of unintended pregnancies with potential negative outcomes. What this study adds? Telehealth visits are one way that primary care providers can meet patients’ needs for reproductive health discussions and uncover unmet needs. Providers need to take every opportunity they can to make sure patients receive needed discussions about their reproductive health.