Mass General to Launch Home Hospital Care Program for Homeless Veterans

Ariadne Labs at Mass General Brigham is launching a new program to offer at-home hospital care for homeless veterans in transitional housing, according to a press release from the hospital.

The program, which is in partnership with the New England Center and Home for Veterans, will be open to participants in NECHV’s Safe Haven program, which provides transitional housing for veterans experiencing chronic homelessness.

Ariadne Labs, which co-leads the program with Mass General Brigham, is an initiative of Brigham and Women’s Hospital and the Harvard School of Public Health focused on health systems innovation.

“Those in our Safe Haven program are the most vulnerable and challenged Veterans we serve. The comprehensive on-site care offered by the Home Hospital program will help prevent the need for hospitalization and maintain their physical well-being,” Andy McCawley, NECHV President and CEO, said in a press release.

Home hospital care, which enables residents to receive regular medical care from their place of residence rather than having to go into the hospital, has existed as a model for years. However, homelessness patients have historically not been able to access care through this model.

“We have traditionally always excluded patients who are experiencing homelessness,” said Brigham and Women’s Home Hospita Medical Director David M. Levine. “It’s home hospital. You probably need a home, one might think, to participate.”

“I, for many, many years, have wanted to figure out a way that we can take care of patients experiencing homelessness,” he added. “That is the big change that we’re embarking on.”

Rachel E. Moyal-Smith, a clinical implementation specialist at Ariadne Labs, said they considered the specific needs of the population they are serving — both as individuals experiencing homelessness and as veterans — when designing the program.

“I think it was really good for us to be able to kind of train on both populations,” she said. “We also did some training on trauma-informed care, on what being a veteran means, so to prepare the home hospital team to come in and really provide person-centered care.”

“I’m really excited, though, that this is with veterans, because I’m a veteran, so this is a population that I really care deeply about,” Moyal-Smith said.

Levine referenced specific obstacles to caring for veterans, adding that hospitals and their logistics can be traumatizing.

“Hospitals can be very traumatic places for veterans. Even the transport to and from a hospital can be very traumatic for veterans, and so we are hoping that a lot of that trauma associated with healthcare facilities will not be there with this pathway,” Levine said.

According to Levine, the program will help break what he called a “deleterious cycle” that often affects patients experiencing homelessness.

“Part of what we’re trying to do with this pathway is to break that cycle and say, ‘Hey, we’re going to treat you right in place, right where you work. You don’t have to lose your belongings, your place in line, your housing, your connections,’” he said. “‘You’re going to stay right there. We'’e going to treat you for the acute illness, and then you can go keep on keeping on right from where you were again.’”