A Telehealth Initiative to Overcome Health Care Barriers for People Experiencing Homelessness

Abstract

People experiencing homelessness (PEH) encounter barriers to health care, increasing their vulnerability to illness, hospitalization, and death. Telehealth can improve access to health care, but its use in PEH has been insufficiently evaluated. Needs assessment surveys completed by clients at an urban drop-in center for PEH (n = 63) showed mental (58.7%) and physical (52.4%) health challenges were common, as was emergency department (ED) use (75.9%, n = 54). Surveys collected after in-person and telehealth clinical visits showed patient satisfaction was >90% for both visit types (n = 125, 44.0% telehealth and 56.0% in person). Without access to telehealth visits, 29.1% of patients would have gone to the ED and 38.2% would not have gotten care. Providers (n = 93, 69.6% telehealth and 30.4% in person) were more likely to agree/strongly agree they made a positive impact on patients' health through telehealth (92.2%) than in person (71.4%) (p = 0.019). Telehealth is a feasible and potentially cost-effective method to increase access to health care and reduce health outcome disparities in PEH.

Effectiveness of telemedicine in outpatient parenteral antimicrobial therapy (Tele-OPAT): A systematic review

“…Although not rigorously evaluated in the reviewed articles, other potential benefits of tele-OPAT include reduced frequencies of clinic visits and late/missed appointments, and reduction in health disparities. 9, [34][35][36] By reducing in-person visits and travel-related emissions, tele-OPAT also offer a potential opportunity to reduce the carbon footprints of healthcare systems, and thus helps in the fight against climate change. 37 One key knowledge gap within the reviewed literature relates to patient experience and provider acceptance/perspectives on tele-OPAT.…”

Telemental Health for the Homeless Population: Lessons Learned when Leveraging Care

“…Technology-based treatments for mental health including tele-therapy, text messages, and mobile apps have been promising in delivering treatment to various populations. The COVID-19 pandemic certainly increased the popularity of telehealth solutions, transforming the way people receive health care; however, many providers from all specialties were developing telehealth tools prior to the pandemic [ 6 – 8 ].…”

“…In terms of success outcomes, telehealth modalities to improve access, specifically video visits, have been found to have high levels of satisfaction for both patients and providers [ 6 , 19 •, 21 ]. Recent research reveals technological interventions show high rates of clinical benefit, including reduction of symptoms of psychopathology, specifically for PTSD, depression, and anxiety [ 6 , 15 , 16 ].…”

“…In terms of success outcomes, telehealth modalities to improve access, specifically video visits, have been found to have high levels of satisfaction for both patients and providers [ 6 , 19 •, 21 ]. Recent research reveals technological interventions show high rates of clinical benefit, including reduction of symptoms of psychopathology, specifically for PTSD, depression, and anxiety [ 6 , 15 , 16 ]. As a means to overcome barriers with digital technology, research supports that incorporating telehealth into an urban permanent supportive housing setting also proves to be helpful in allowing clients to access tele-therapy from the comfort of their own home, or from a designated room located at the housing facility [ 22 ].…”

Outpatient Care Among Users and Nonusers of Direct-to-Patient Telehealth: Observational Study

“…A more recent study of telehealth found no differences in total outpatient visits after hospital discharge, early in the pandemic [ 8 ]. In a survey of people experiencing homelessness, 29.1% self-reported they would have sought care in an emergency department (ED) if they had not had access to telehealth [ 9 ]. Additional evidence on whether telehealth complements or substitutes for in-person care is lacking.…”