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Journal of General Internal Medicine
Published in: Journal of General Internal Medicine 8/2021

01-08-2021 | Post Traumatic Stress Disorder | Original Research

Use of Video Telehealth Tablets to Increase Access for Veterans Experiencing Homelessness

Authors: Lynn A. Garvin, PhD, MBA, Jiaqi Hu, MPH, MBBS, Cindie Slightam, MPH, D. Keith McInnes, ScD, MS, Donna M. Zulman, MD, MS

Published in: Journal of General Internal Medicine | Issue 8/2021

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Abstract

Background

Veterans experiencing homelessness face substantial barriers to accessing health and social services. In 2016, the Veterans Affairs (VA) healthcare system launched a unique program to distribute video-enabled tablets to Veterans with access barriers.

Objective

Evaluate the use of VA-issued video telehealth tablets among Veterans experiencing homelessness in the VA system.

Design

Guided by the RE-AIM framework, we first evaluated the adoption of tablets among Veterans experiencing homelessness and housed Veterans. We then analyzed health record and tablet utilization data to compare characteristics of both subpopulations, and used multivariable logistic regression to identify factors associated with tablet use among Veterans experiencing homelessness.

Patients

In total, 12,148 VA patients receiving tablets between October 2017 and March 2019, focusing on the 1470 VA Veterans experiencing homelessness receiving tablets (12.1%).

Main Measures

Tablet use within 6 months of receipt for mental health, primary or specialty care.

Key Results

Nearly half (45.9%) of Veterans experiencing homelessness who received a tablet had a video visit within 6 months of receipt, most frequently for telemental health. Tablet use was more common among Veterans experiencing homelessness who were younger (AOR = 2.77; P <.001); middle-aged (AOR = 2.28; P <.001); in rural settings (AOR = 1.46; P =.005); and those with post-traumatic stress disorder (AOR = 1.64; P <.001), and less common among those who were Black (AOR = 0.43; P <.001) and those with a substance use disorder (AOR = 0.59; P <.001) or persistent housing instability (AOR = 0.75; P = .023).

Conclusions

Telehealth care and connection for vulnerable populations are particularly salient during the COVID-19 pandemic but also beyond. VA’s distribution of video telehealth tablets offers healthcare access to Veterans experiencing homelessness; however, barriers remain for subpopulations. Tailored training and support for these patients may be needed to optimize telehealth tablet use and effectiveness.
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Metadata
Title
Use of Video Telehealth Tablets to Increase Access for Veterans Experiencing Homelessness
Authors
Lynn A. Garvin, PhD, MBA
Jiaqi Hu, MPH, MBBS
Cindie Slightam, MPH
D. Keith McInnes, ScD, MS
Donna M. Zulman, MD, MS
Publication date
01-08-2021
Publisher
Springer International Publishing
Published in
Journal of General Internal Medicine / Issue 8/2021
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-021-06900-8

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