Post-Roe World Presents Big Challenges for Healthtech

Here’s how tech-enabled reproductive healthcare companies are responding to the overturn of Roe v. Wade.

Written by Charli Renken
Published on Sep. 07, 2022
Post-Roe World Presents Big Challenges for Healthtech
Image: Built In

It’s been two months since the Supreme Court overturn Roe v. Wade, the landmark case that until recently protected the right to an abortion. The case being overturned has left abortion access up to the regulation of individual states, many of which have already banned or severely restricted abortions. As a result, many abortion providers are working under strict oversight while others have closed entirely. Healthtech companies are also being impacted whether by increased demand or by navigating new laws that could change how they operate.

The reproductive healthtech industry, including telehealth startups and tech-enabled abortion providers, is facing two big challenges at the same time: skyrocketing demand and distrust from users.

So far, 15 states have implemented bans on abortion care to some degree, either making abortions completely illegal or limited to pregnancies that haven’t passed the 20-week mark. This is causing major delays in patients getting care and many are flocking to “abortion islands” like Illinois, a state where abortion is legal that borders states where it isn’t.

For other reproductive healthtech or femtech companies like period trackers and IVF treatment providers, user distrust is a major obstacle they’re having to navigate. When Roe v. Wade was overturned, many took to social media to urge users of these tech products to cease usage for fear of their data being leaked. These companies are having to get creative and reevaluate their privacy policies to hang onto users.  

With abortion care suddenly unavailable for thousands of people, tech is positioned in a unique place to help. However, with the laws around abortion care and health data privacy in a state of transition, navigating the new landscape of how the tech industry can help make reproductive care accessible is difficult.

 

Telehealth and Abortion Care

Telehealth has become a major tool for abortion providers to connect with those in need of care. Carafem, a reproductive health organization based in Washington, D.C., has been using telehealth since the start of the pandemic to make reproductive care — including abortion care — more accessible. The organization’s COO Melissa Grant said she’s seen a spike in telehealth appointments since the Supreme Court’s ruling, even in states where abortion isn’t heavily restricted or illegal. 

“Because the appointments are filling up, we’ve begun to say, ‘If you don’t need or really care if you have a visit in person or might even prefer the confidentiality and discreet nature of being seen at home, do telehealth,’” Grant told Built In in an interview. “It helps to leave [in-person] appointments available for people who are further into their pregnancy or have a medical situation such that they have to have an in-person appointment.” 

For those traveling for abortion care, telehealth appointments can help cut down on travel time and expenses. Instead of driving all the way to a clinic in another state that’s usually located in a major city, patients can instead travel across state lines and have their appointment over the phone. If they’re prescribed an abortion pill, organizations like carafem and tech-enabled abortion provider Hey Jane can send the pill to a location for pick up in the same state the appointment took place. 

What is an Abortion Pill?

  • Abortion pills, commonly mifepristone and misoprostol, are a common, safe method of terminating a pregnancy less than 10 weeks along. The medication is typically taken in two doses over the course of several hours. 
  • More than half of all abortions in the U.S. are done through medication rather than in-person procedures.
  • Sources: “Mifeprex (mifepristone) Information,” FDA and “Abortion Pills Now Account for More Than Half of U.S. Abortions,” The New York Times

“You have to take the pills in that state, though,” Grant warns. 

Patients who pick up abortion pills and take them across state lines could be held legally responsible. For those without access to travel funds or places to stay while taking the pills, Grant encourages them to reach out to abortion travel funds and other organizations helping people receive care, many of which carafem currently partners with.

Carafem isn’t the only tech company seeing an increase in demand for its services. According to Hey Jane’s CEO and co-founder Kiki Freedman, states without abortion restrictions were reporting long wait times for care even months before the Supreme Court overturned Roe v. Wade. 

“Those healthcare systems will be even further strained under this new decision and individuals who want to access an abortion, regardless of where they live, will need more options to obtain this essential healthcare [service],” Freedman said in a statement. “Already the majority of abortions are performed through medication, and abortion care via mailed medication will be a crucial form of access for many people moving forward.”

Hey Jane is a tech-enabled abortion provider that allows patients to meet with doctors over telehealth and mails abortion pills in just a few days. The company helps guide those seeking abortion care through the entire process. Patients have access to their care team via text and are also able to access support through a private peer-to-peer community forum.  

 

“Are Period Trackers Safe to Use?” and Other Privacy Concerns

After Roe v. Wade was overturned, many took to the internet to advise people to delete apps like period trackers which gather data on users’ menstrual cycle for fear of that information being potentially used against them in a court of law if they had an abortion where it wasn’t legal to do so.

While President Joe Biden recently issued an executive order to fortify data privacy, particularly data related to reproductive healthcare, many users are still distrustful of tech companies selling their data downstream or turning it over to law enforcement if subpoenaed.

Bethany Corbin, an attorney at Nixon Gwilt Law who brands herself as the “femtech lawyer,” has advice for both consumers and healthtech companies when it comes to health data privacy. She told Built In both groups need to be aware that in most cases HIPAA, a federal law that protects patient health information from being disclosed without patient consent, doesn’t apply to user data collected by healthtech companies. 

“I think consumers have this conception that because it is health data that they’re sharing, it’s going to automatically be protected under HIPAA and that’s not at all the case. HIPAA only applies if a company is a covered entity or business associate of that covered entity,” Corbin said. “If you are using things like period tracking apps and fertility apps, [services] that have coaches instead of licensed healthcare providers or that are all cash pay and not dealing with insurance, your data is not protected by HIPAA, even if it’s the same kind of data a healthcare provider would collect.”

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Corbin’s advice to consumers looking to safeguard their data is to take a closer look at apps and websites’ privacy policies. Specifically, she says, users should check for the section disclosing if and when a company holds the right to sell your information and if the policy has any loopholes for law enforcement or other federal agencies. 

When it comes to the healthtech industry winning back consumer trust, Corbin also has some advice.

“One thing that I have seen some companies do is shift away from cloud-based storage for data to storing the data on [consumer’s] actual cell phone or local device. That would mean if a law enforcement officer came and tried to subpoena that data from the company, they could legitimately say they don’t have access to that data,” she says, adding that law enforcement could still subpoena individual phone owners but at least consumers would have some autonomy over their data.

Companies in the reproductive healthtech industry seem to be responding thoughtfully to user concerns over privacy. Period tracking app Clue took proactive initiatives to assure users that their health data remains safe. According to a company statement, Clue does not sell its users’ data downstream and because the company is headquartered in Berlin, European law protects that data from being subpoenaed. 

“As a community built on trust, we know that a fundamental part of earning that trust is being transparent about how we use and protect the sensitive data that people choose to track with us. As a European company, Clue is obligated under the world’s strictest data privacy law, the European GDPR, to apply special protections to such health data. We understand that it can nevertheless be challenging to assess how apps use data, so we make several commitments to give our community peace of mind,” the company statement reads and goes on to list its various commitments to user privacy.

New York fertility and wellness company Kindbody also released a statement from its CEO Dr. Angie Beltsos asserting the organization’s commitment to protecting patient privacy.

“We stand with the American Society for Reproductive Medicine (ASRM) and the American College of Obstetricians and Gynecologists (ACOG) who have been hard at work to protect patients’ reproductive rights at both the national and state levels,” Beltsos said in a LinkedIn post. “In the days and weeks to come, we will work with these organizations and others to ensure that the privacy and rights of all of our patients are protected and that, regardless of where our patients live, they can safely access the healthcare they need.”

Kindbody is a fertility, gynecology and wellness company that provides its services in tech-enabled clinics across the nation. It brands itself as a modern approach to healthcare that offers services including IVF treatments, egg freezing, LGBTQ+ care and more. To continue protecting patients, Kindbody also offered patients the ability to move their embryos to facilities in less restrictive states.

Tech companies and consumers alike are having to make difficult and timely decisions in response to constantly changing legislation. As healthtech companies continue to navigate how to offer their services in a post-Roe world, one thing is certain — data privacy and access to care are of utmost importance.

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