Innovative Approaches to Providing Healthcare to Homeless Populations via Telehealth

Cellphones are increasingly accessible, even among homeless individuals—one of the most vulnerable and underserved groups in America, where the average life expectancy is only 51 years. Traditionally difficult to reach by healthcare providers, this population has historically faced significant barriers to medical care. However, the adoption of telehealth during the pandemic has opened new avenues for delivering healthcare services effectively.

Despite assumptions that homeless people might lack the resources for technology, many possess cellphones, internet access, and suitable plans, making telehealth a feasible option. Katherine Koh, an assistant professor at Harvard Medical School and psychiatrist at Massachusetts General Hospital, highlights that telehealth has significantly improved access for homeless patients. Her clinical experience demonstrated that appointment no-show rates decreased when care was delivered remotely, with some patients maintaining weekly contact over several months—something not achievable with in-person visits.

Telehealth proves particularly beneficial for behavioral health, as many mental health conditions do not require physical exams, and for managing chronic diseases such as diabetes or infectious diseases. It has been effectively used for opioid use disorder treatments, including Suboxone prescriptions. While some patients prefer video visits, many can be adequately engaged via audio calls, especially when supported by staff assistance with technology setup.

The most pressing health challenges for homeless individuals include trauma-related mental health issues, substance use disorders, and chronic physical illnesses like cardiovascular disease and respiratory problems, which contribute to the starkly lower mortality rate in this population. Though telehealth increases engagement and access, more research is needed to determine whether it reduces emergency and inpatient hospitalizations.

Efforts in this realm emphasize innovation, such as utilizing AI to track health outcomes, which can bridge the gap brought on by exclusion from technological advances historically. Pending further evidence, the current success suggests telehealth can be a vital tool in addressing healthcare disparities among homeless populations.

Factors contributing to rising homelessness include increasing housing costs, stagnant wages, migration without sufficient support systems, and natural disasters like the Maui wildfires. Addressing this crisis necessitates long-term solutions such as expanding affordable housing, preventing homelessness through early intervention, and providing extended temporary housing until permanent support is available.

Koh emphasizes that prevention is crucial, alongside immediate housing efforts. The situation at Mass and Cass in Boston exemplifies the complexity of homelessness, where longstanding trauma, lack of affordable housing, and systemic issues perpetuate cycles of displacement. Solutions require comprehensive strategies that include funding sustainable housing options and addressing root causes of homelessness.