Project Increases Telehealth Access Among Veterans Facing Homelessness

Researchers expanded telehealth access for homeless veterans by 5.5 percent in 16 weeks through a quality improvement project.

While aiming to overcome the digital divide, a study published in Annals of Family Medicine described how the Veterans Administration (VA) implemented a quality improvement project to improve telehealth access for homeless veterans.

Although telehealth has provided countless benefits to patients throughout the COVID-19 pandemic, various populations experienced care barriers due to a lack of virtual care resources. One population that faced this issue was veterans experiencing homelessness.

In 2020, 66,433 people faced homelessness in Los Angeles, 3,902 of whom were veterans. Conducted by the national VA Homeless Patient Aligned Care Teams (HPACTs), a new quality improvement project aimed to increase the prevalence of telehealth video visits by 10 percent in 16 weeks.

Researchers used comprehensive strategies to reach this goal. They used a flowchart that supported standardized workflows for video visits, the Digital Divide Consult process to connect homeless veterans to technological support, and implemented monthly meetings to review progress, conduct live demonstrations of video visit applications supported by the VA, and share successful best practices.

Upon review of results following the study period, researchers found a high success level associated with their efforts. Within the 16 weeks, the proportion of video visits among all telehealth appointments went from 4.8 percent in December 2020 to 10.3 percent in April 2021.

Regarding demographics, researchers noticed that 19 percent of patients younger than 60 and 10 percent older than 60 used video telehealth. Also, 19 percent of those in long-term supportive housing and 12 percent in other living conditions participated in video uptake.

Along with the positive results of the study, researchers noted various takeaways. While trying to battle the digital divide, methods such as video visit workflows, sustained education, and maximizing resources assisted homeless veterans in obtaining care.

Their recommendations for the future involved taking steps to determine the causes of the differences in video telehealth use among those residing in different environments.

Recently, various efforts have aimed to provide underserved populations with better care access and eliminate disparities.

In January, a collaboration between Truveta and Lexis Nexis Risk Solutions aimed to leverage de-identified data to improve health research and provide more information on health equity to address care gaps.

Another study from September found that easing primary care access led to improved chronic disease management. After reviewing data from various Chicago neighborhoods, researchers found that access to care, rather than income, significantly influences chronic disease rates, indicating that additional primary care resources would be beneficial.

Further, research shows that telehealth can be beneficial for improving care access for homeless populations, thereby enhancing health outcomes. A 2021 survey found that had homeless residents in an urban city in the South not had access to telehealth, more than one in three would not have sought care at all, and 29.1 percent would have gone to the emergency department instead.