Telehealth Can Improve Health Outcomes for Homeless Population

Telehealth has the potential to increase access to healthcare services and improve health outcomes for people experiencing homelessness, according to researchers at the Medical University of South Carolina.

In a study recently published in the Telemedicine and e-Health Journal, researchers gathered data from a community health clinic serving homeless residents in an urban southern city and staffed by MUSC care providers to measure access to care, quality of care, and patient satisfaction. The clinic offered both in-person and telehealth services.

High costs of care, transportation access, and lack of health insurance often prevent homeless individuals from seeking and receiving the healthcare services they need. Using telehealth for this population may present a way to overcome these barriers.

All patients accessing care at the clinic were surveyed before their appointment about access to care and their health. They also received a post-visit clinical survey that focused on satisfaction levels and future telehealth use. MUSC researchers then compared the responses of those who had a telehealth visit with those who had an in-person visit.

According to the study, telehealth yielded an overall satisfaction rate of 92.7 percent from this population. More than nine in ten patients said they felt the telehealth visit improved their health, saved them time, and made it easier to get in touch with a doctor. These satisfaction levels were comparable with the patients who received in-person visits.

Had they not had the opportunity to access telehealth, more than one in three patients (38.2 percent) surveyed said they would not have sought care at all, and 29.1 percent would have gone to the emergency department instead.

Nearly 60 percent of the patients characterized their health as fair or poor, highlighting the fact that many of these individuals need healthcare services but face barriers in accessing care. More than half (58.7 percent) of those surveyed said they are experiencing mental health conditions such as anxiety and depression, and 52.4 face physical health challenges such as chronic illnesses.

People experiencing homelessness frequently face struggles that are barriers all on their own but can also negatively impact their overall health outcomes. Nearly three quarters of survey participants (73 percent) were not employed and 52.4 percent did not have health insurance. 

Lack of transportation is a barrier as well. If healthcare services aren’t available at easily accessible locations such as a community health clinic, homeless individuals may not have the option to receive care in person.

That’s where telehealth can help. Some 71.4 percent of survey participants said they are interested in receiving at least one health service, such as a cancer screening or help with overcoming substance abuse. And more than half of the patients who visited the clinic had access to a mobile phone. Even more had access to a computer and the internet (71.4 and 77.8 percent, respectively).

The survey participants who used telehealth reported that they would be comfortable seeing a doctor through a store-and-forward telehealth platform and communicating through text messages. These asynchronous options offer convenient and flexible options for both patients and providers beyond the virtual visits.

Increased telehealth access could also reduce unnecessary emergency department traffic at local hospitals, which often become the primary care providers for the homeless. 

While telehealth proved to be beneficial for this particular population, it isn’t necessarily guaranteed to work for every homeless population. Not everyone has equal access to resources or the motivation to seek healthcare.

However, by using clinics that provide the necessary technology for telehealth on-site and are geographically accessible to people experiencing homelessness, telehealth has the potential to improve health outcomes for the homeless population.