Telehealth holds promise for people experiencing homelessness: Report

Telehealth technologies have the potential to improve access to healthcare for people experiencing homelessness (PEH), according to researchers at the Medical University of South Carolina.

This group regularly encounters barriers to healthcare, which in turn increases vulnerability to illness, hospitalization and death.

Survey results, published in Telemedicine and e-Health, indicate telehealth is a healthcare delivery method for PEH that is feasible, accepted by patients and providers, and helpful for access to health care.

An initial survey indicated suboptimal access to medical care was evident, with many utilizing the ED or not getting the care they needed when faced with a medical problem.

Results from patient and provider surveys conducted by the research team further supported the use of telehealth modalities to improve access for PEH.

The majority of those surveyed (71%) said they were interested in at least one health service, and more than half (50.8%) had access to a mobile phone, while 71.4% had access to a computer, and nearly eight in 10 had access to the Internet.

Mental and physical health needs often had to be addressed for the PEH group considered in the study. The report noted that video visits have been shown to have high rates of physician satisfaction and diagnostic agreement with in-person visits.

When responding to questions pertaining to health care access, 77.2% selected an e-visit (online questionnaire) as a way they would be comfortable contacting a doctor, while 40.4% selected a video visit from their phone.

When asked about ways patients would feel comfortable receiving information about their health, nearly half of the survey respondents indicated text messages as their preferred option.

“Both texting and e-visits allow for asynchronous interactions with health care providers,” the report noted. “These may seem especially useful to PEH, as they have the flexibility of not requiring a scheduled visit, since the messages can be sent at any time and reviewed at the individual’s convenience.”

The study found a high satisfaction rate among those who participated in telehealth visits, while high proportions of respondents would have gone to the ED or not gotten care at all if they had not had access to telehealth services at the drop-in center.

In addition, the use of telehealth allowed providers more flexibility in their ability to provide care to patients, which the report noted is increasingly important in the current landscape of medical care for this largely uninsured group of patients.

Thus, the results suggest telehealth programs would be feasible for both patients and providers, and have the potential to improve care access.

“Using telehealth to increase access to care has the potential to reduce disparity in health outcomes for this vulnerable population and modify high-cost health care utilization patterns,” the report concluded. “Future directions include incorporation of medical student clinical training, resident physician telehealth training, and integration with mental health services.”