Foundation Proposal - Homeless Individuals in the United States
Foundation Proposal:
Debra Alvarado, Naida McDowell and Moenil Patel
Simmons School of Nursing and Health Sciences
Foundation Proposal:
Homeless individuals in the United States (US) are high utilizers of emergency room (ER) services. Specifically, individuals that are suffering from substance and alcohol abuse, and psychiatric disorders who are difficult to main-stream into integrated healthcare system with assistance from social services interventions. This paper will outline a proposal to request funds from grantors for the development and implementation of a shared Electronic Health Records (EHR) to provide continuity of care to the homeless population in the US.
Innovation
The Shared Electronic Health Record for the Homeless (SEHRH) is a data base system that will be shared and connected statewide and nationally to all hospitals and healthcare facilities providing services to the homeless population. The SEHRH will be utilized by healthcare providers to identify homeless individuals in an effort to provide continuity of care and improve homeless patient outcomes. The homeless population is at increased risk of requiring emergency health care services because of their living conditions and presence of concurrent illnesses. Additionally, this population mortality rate remains high compared to the rest of the non-homeless population (BON et al., 2014).
Researchers have studied the cost of caring for the homeless population but because of difficulties in identifying the patients as homeless and difficulty utilizing available electronic resources, a clear picture of the cost of caring for the homeless population is not available (Wen-Chieh et al., 2015). The SEHRH data base primarily will be utilized by health care providers to improve the morbidity and mortality rates of the US homeless population. This would be accomplished by providing information from prior visits and current health status of homeless patients to aid in developing a more comprehensive plan of care to meet the homeless individuals need while respecting their current lifestyle desires. This new approach that will improve the care of the homeless population by utilizing available EHR information not only to improve healthcare outcomes but may improve cost. Another unforeseen benefit may be the acquisition of data for future studies in the efforts of improving services and care provided to this disadvantaged population.
Problem1
Homeless individuals experience very high rates of psychiatric and lifestyle disorders, chronic and acute physical conditions, and injuries due to assaults and accidents. In addition, when these conditions remain unmanaged they may trigger urgent events or injuries that require emergency care services and hospitalization. This complex mix of healthcare conditions often leads to high usage pattern of hospitals and ER services by the homeless population (Bharel, M., 2016). Researchers have reported a four times higher utilization by the homeless population of hospital beds and ER services than the general population. (Wen-Chien et al., 2015)
Homeless individuals usually are brought to the ER by ambulance or walk to the nearest ER where they are provided with acute care and then discharged back to the streets (KU, Scott, Kertesz, and Pitts, 2010). The ER staff is not equipped to provide adequate discharge planning but a shared electronic system will ensure improved identification of individuals experiencing homelessness or housing instability and incorporate this knowledge into making appropriate discharge planning and referrals. Also this will provide the ER provider the needed medical information to provide effective and seamless continuous care in future acute encounters with the same individual homeless patient (Bon, S. et al., 2014)
Population at risk. Homeless Person or person experiencing housing instability.
Stakeholders. Healthcare Providers, Hospitals, US tax payers (Last Name, Year)
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