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

Abstract: 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. This paper evaluates the use of VA-issued video telehealth tablets among Veterans experiencing homelessness in the VA system. They first evaluated the adoption of tablets among Veterans experiencing homelessness and housed Veterans and then analyzed health record and tablet utilization data to compare characteristics of both subpopulations, to identify factors associated with tablet use among Veterans experiencing homelessness. In total, 12,148 VA patients receiving tablets between October 2017 and March 2019, this study focussed on the 1470 VA Veterans experiencing homelessness receiving tablets (12.1%).
Tablet use was looked at within 6 months of receipt for mental health, primary or specialty care. The authors found 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; in rural settings ; those with post-traumatic stress disorder, and less common among those who were Black and those with a substance use disorder or persistent housing instability. The authors conclude 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.