Maggie Hale

Following the overturn of Roe v. Wade in 2022 (Dobbs v. Jackson), the need for accessible hormonal contraception increased significantly nationwide. We describe here an efficient and timely system, developed within the Intermountain Health (IH) System in Utah, to meet this need.

As background, Utah legislation from 2018 approved pharmacist-prescribed, self-administered hormonal contraception. Additionally, patients often faced an average wait time of 10 weeks for traditional office visits to obtain hormonal contraception, making access difficult.

After Dobbs, IH’s chief pharmacy officer and the medical director of obstetrics teamed up to utilize the existing legislation to expedite patient access to hormonal contraceptives.

A user-friendly online form was created to provide patients with an unauthenticated, asynchronous “visit” for desired prescriptions. This process, called On Demand, eliminated the need for in-person provider visits. The form gathers information for risk stratification, including blood pressure and BMI. Patients deemed low risk are sent hormonal contraception within 24 hours. Patients identified as high risk or those seeking LARCs are seen at rapid access clinics within 48 hours.

Since implementation of On Demand, 373 patients have received consultations. 54% of recipients chose home delivery, 22% chose pharmacy pickup, and 24% were seen in clinic. Notably, 30% of all cases were first-time customers to the IH system. The average patient wait time to receive birth control dropped from 70 days to 48 hours.

This reproducible, customer-centric model for providing hormonal contraception has dramatically reduced wait times, recruited new patients, and simplified the process of obtaining desired medication.