Use the phone and web to expand EC access

While women wait for a decision from the Food and Drug Administration (FDA) on the status of moving emergency contraception over the counter (OTC), some family planning providers are looking at using the telephone and Internet to help expand access to the method.

More providers are looking into offering hotline numbers or web sites that enable women anywhere in their state to obtain a prescription for emergency contraceptive pills (ECPs) without a clinical appointment. They were spurred by a call from the Association of Reproductive Health Professionals (ARHP) and the Office of Population Research at Princeton (NJ) University, which jointly sponsor the toll-free Emergency Contraception Hotline [(888)-NOT-2-LATE] and the Emergency Contraception Website (http://not-2-late.com).

ARHP is interested in helping women access EC as quickly as possible, says Janet Riessman, ARHP’s director of communications. Over-the-counter access is the ideal way for women to access the time-sensitive medication 24 hours a day, seven days a week, says Riessman. Until that access is available, health care providers can and should offer to call in EC prescriptions and/or to give women EC prescriptions ahead of time, she notes. By doing so, women can access the drug more quickly when they need it, Riessman explains.

The EC Hotline has been important in getting the word out on EC. Since it was launched on Feb. 14, 1996, the hotline has received more than 525,000 calls. More detailed information on the method is available on the Emergency Contraception web site, which has received approximately 2.5 million visits since it was launched in October 1994. The hotline and the web site are completely confidential, available 24 hours a day in English and Spanish, and offer names and telephone numbers of providers of emergency contraception located near the caller’s area (in the United States and parts of Canada). The web site also is available in French and Arabic.

While your facility may be offering telephone EC assessment and prescription programs to nonestablished clients, has it considered publicizing this service to women throughout your state?

Such call-in prescription services for emergency contraceptive pills are available via telephone hotline in Connecticut, Georgia, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, New Mexico, New York, North Carolina, and Wisconsin. Call-in prescription services for emergency contraceptive pills are available on-line in Georgia, Illinois, Indiana, Massachusetts, Oregon, and Washington.

Setting up such a service entails:

  • establishing times during which such service is available to women;
  • conducting a simple health assessment over the phone;
  • calling in the prescription to a pharmacy of the women’s choice within your state.

Some states restrict physicians’ authority to issue prescriptions without a physical examination, so providers should speak with a lawyer prior to setting up a telephone or Internet service. The New York City-based Center for Reproductive (www.crlp.org) has researched restrictions and can provide information on individual state policies, says Bonnie Scott Jones, a staff attorney with the center.

Follow the lead of Planned Parenthood of Georgia in Atlanta, which was the first to launch such an access program in 1999.

In 1999, the affiliate provided about 2,600 doses of EC. In 2005, the affiliate provided 4,500 doses through its health centers and about 1,400 doses through its online and toll-free Emergency Contraception Connection, says Leola Reis, the affiliate’s vice president of communications, education, and outreach. The EC Connection now represents about 25-28% of the affiliate’s total EC provision, she notes.

EC telephone medical assessment and prescription are available from anywhere in Georgia by calling the service at (877) EC-PILLS [(877) 327-4557] or visiting its web site, www.ecconnection.org. The service is available Monday through Friday from 9 a.m.-4:30 p.m., Saturday from 9 a.m.-12:30 p.m., and Sundays from 1 p.m-4:30 p.m. Patients must use a credit card as payment for the $40 assessment; cost of the drug is not included. Also, patients must provide the name and phone number of their desired pharmacy for the prescription order. Each medical assessment takes about 20 minutes.

The EC Connection is located at the affiliate’s downtown Atlanta health center. Reis estimates that nurse practitioners and patient educators spend, on a cumulative basis, about two to three hours a day checking and responding to messages, phone calls, and e-mail associated with the program.

The telephone/internet program is just one facet of Planned Parenthood of Georgia’s commitment to broadening EC access, says Reis. For women who need a sliding fee scale to access EC, the affiliate’s health centers can provide such service. However, for those women with a credit card who may have no time or ability to come into the centers, the EC Connection meets their need, says Reis.

"I think that patients really like it," observes Reis of the EC Connection. It is clearly a niche market, she says. "It is a complement of our mission because we are about access, but we are also about access for women who do not have a lot of choices, either financial or location."

Resources

For information on state policies regarding telephone/Internet prescriptions for emergency contraception, contact:

  • Bonnie Scott Jones, Center for Reproductive Rights, 120 Wall St., New York, NY 10005. E-mail: bjones@reprorights.org.