Iowa state board votes to halt “tele-med” abortions

Iowa Medical Society expresses concern that block could affect other tele-medicine practices

DES MOINES – A state panel that oversees and regulates physicians and medical practices in Iowa voted Friday to adopt rules curtailing doctors’ ability to dispense abortion-inducing pills via a video-conferencing system, citing concerns over the medical care being provided to rural women.

The Iowa Board of Medicine voted 8-2 to approve proposed administrative rule that would establish standards of practice for physicians who prescribe and administer abortion-inducing drugs. The revised rules – which could take effect in November – would require in-person meetings between doctors and patients along with direct after-care services.

“How can any of us possibly find that a medical abortion performed over the Internet is as safe as one provided by a physician in person at the bedside? I will vote for adopting this rule,” said board chairman Greg Hoversten, an Iowa City physician who formerly served in the Iowa House as a Sioux City representative.

“It is not about abortion, this is about standard of care,” said Dr. Hamed Tewfix, an Iowa City physician who moved that the board adopt a rule change to effectively halt the telemedicine services currently provided at clinics operated by Planned Parenthood of the Heartland.

At issue is a practice whereby licensed physicians use a remote-controlled system to conduct medical assessments with patients in rural Iowa clinics. They then are able to dispense Mifepristone, also known as RU-486, in the early stages of a pregnancy.

Proponents say Planned Parenthood’s practice – implemented in 2008 -- is safe and patients get the same level of care as those who see a doctor in person. They contend telemedicine procedure was thoroughly researched to ensure it was in full compliance with Iowa law and service helps women in remote parts of the state.

However, board member Msgr. Frank Bognanno of Des Moines expressed concern that abortion-related services were being provided without adequate guidelines and administered by medical assistants with minimal training.

“This is Iowa. This isn’t Tanzania. What’s going on here?” Bognanno said in expressing concern that young women are being given a pill and told to call an 800 number if they experience complications.

“I think we could do a little better than this. This is a big deal. This isn’t like taking an aspirin,” he said. “This is substandard.”

Board member Anne Gales, a Bode attorney, said she preferred the state panel made up of 10 members all appointed by Gov. Terry Branstad delay a decision until a subcommittee made up of physicians on the board and other stakeholders could thoroughly examine the issue, especially the impact on rural women.

Abortion opponents asked the state board to block the program, saying it violates state medical standards and poses a health risk to women because it doesn't entail a face-to-face meeting with the doctor.

Following the meeting, Jill June, president and chief executive officer of Planned Parenthood of the Heartland, issued a statement charging that the board has “rushed to judgment” in voting to ban telemedicine delivery for medication abortion for Iowa women.

“This decision is a political attack aimed at restricting access to abortion in Iowa. Proponents of this rule aren’t against telemedicine technology; they are against safe, legal abortion and are unjustly targeting our system with no scientific information or evidence to back their claims,” June said.

“This undermines the concept and integrity of the Board of Medicine and health care in Iowa as we know it,” added June, who pledged that her agency would continue to provide medication abortion through telemedicine delivery at 15 health centers across Iowa until the rule goes into effect.

Prior to Friday’s vote, Planned Parenthood legal counsel Mike Falkstron requested that, if board members took action to approve the rule change, they stay the implementation after the Nov. 6 effective date pending any litigation over the issue. The board did not follow his recommendation, however.

“We’re just going to keep all of our options on the table. We will update you when any action has been taken,” Falkstron said after the meeting.

The Iowa Medical Society had asked the board to put the rule on hold rather than adopt it Friday, expressing concerns that other tele-medicine practices will be thrown into doubt if the board adopts the rule.

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