Chronic Disease Management for Recently Homeless Veterans: A Quality Improvement Program to Adapt Home Telehealth Technology for a Vulnerable Population (Medical Care)

​Although vulnerable populations may benefit from in-home health information technologies (HIT) that promote disease self-management, there is a "digital divide" in which these groups are often unlikely to use such programs. We describe the early phases of applying and testing an existing Veterans Affairs (VA) HIT-care management program, Care Coordination Home Telehealth (CCHT), to recently homeless veterans in the US Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) program. Peers were used to support patient participation.

Fourteen eligible veterans in HUD-VASH agreed to CCHT participation. Ten of these veterans opted to have adjunctive peer support and the other four enrolled in CCHT usual care.   Although barriers to enrollment/engagement must be addressed, this subset of veterans in HUD-VASH was satisfied with CCHT. Most veterans did not require support from peers to engage in CCHT but valued peer social assistance amidst the isolation felt in their scattered-site homes.   HIT tools hold promise for in-home care management for recently housed veterans. Patient-level barriers to enrollment must be addressed in the next steps of quality improvement, testing and evaluating peer-driven CCHT recruitment.

 

Publication Authors:

• Sonya Gabrielian
• Anita Yuan
• Ronald M. Andersen, Ph.D.
• James McGuire
• Lisa Rubenstein
• Negar Sapir
• Lillian Gelberg, MD, MSPH