As homelessness continues to rise across the United States, there is a critical need for research on how best to deliver and optimize care for individuals experiencing homelessness. Katherine Koh, MD, MSc, a clinician investigator in the Department of Psychiatry at Mass General Hospital (MGH) and a member of the Boston Health Care for the Homeless Program (BHCHP) Street Team, has been at the forefront of this effort. In a recent article published in JAMA Internal Medicine, Dr. Koh and colleagues discuss how telehealth has the capacity to transform access to care for this vulnerable population.
Each year, Boston Health Care for the Homeless Program (BHCHP) provides medical services to more than 11,000 individuals. With the COVID-19 pandemic in 2020, the program was forced to pivot rapidly to providing services via telehealth. Despite initial skepticism about whether virtual visits would work in this population, the results were encouraging: within the first six months, 76% of behavioral health visits and 26% of medical visits were conducted via telehealth.
Five years later, telehealth remains an integral part of BHCHP’s model of care. Today, half of behavioral health patients have had at least one telehealth visit in the past year. Primary care clinicians report that telehealth is particularly valuable for follow-up appointments in which physical examination is less critical, such as diabetes management and buprenorphine treatment.
Why has telehealth been effective? As Dr. Koh explains in an interview with the Harvard Gazette, one of the leading barriers to care for patients experiencing homelessness is transportation. Telehealth eliminates this hurdle and reduces the need for patients to choose between attending an appointment and addressing pressing survival needs. By lowering these barriers, telehealth makes care more accessible.
Still, challenges remain. Phones are frequently lost or stolen, and the cost of mobile plans can be prohibitive, leaving many patients with only intermittent access. Dr. Koh highlights potential solutions, such as creating telehealth hubs with reliable Wi-Fi in accessible community spaces like drop-in centers or shelters.
Telehealth has proven surprisingly successful in extending care to patients experiencing homelessness, helping to bridge the gap between medical providers and those living outside of traditional healthcare systems. Continued research and innovation will be essential to sustain and expand this model for the patients who stand to benefit most.
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Koh KA, Baggett TP, De Las Nueces D, Mehrotra A. Telehealth for Patients Experiencing Homelessness-An Unexpected Opportunity. JAMA Intern Med. 2025 Aug 11.
Katherine Koh, MD, MSc is a practicing psychiatrist at Mass General Hospital, a member of the Street Team at the Boston Health Care for the Homeless Program and an Assistant Professor in Psychiatry at Harvard Medical School. As a member of the street team at BHCHP, she focuses her clinical care on homeless patients who live on the street through a combination of street outreach, clinic sessions, and home visits for patients recently or unstably housed. She also maintains a general outpatient practice at MGH and conducts research on the health of homeless populations. Her primary interest is improving systems of mental health care for homeless patients.
