Each unsheltered person faces unique obstacles making it difficult to deliver healthcare to such a diverse population.
USC researchers say the solution begins with being able to ask the right questions. So they've created a new tool to get the answers they need.
Eddie Wynn has been living on the streets of Los Angeles for several years. He needs his prescriptions to sustain his heart condition.
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"I got a pacemaker," Wynn said. "I got two hearts."
Steven Douglas has been homeless for almost two decades. He also deals with serious medical issues.
"I got high blood pressure," Douglas said, "And I got renal kidney stones."
When a homeless person ends up in the hospital, how well they receive care depends on how well doctors understand their challenges. That's where the Street Medicine team from USC's Keck School of Medicine comes in.
Director Brett Feldman said, "We serve as a bridge between the hospital and the streets."
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Corinne Feldman is the clinical instructor of family medicine at the Keck School. She said, "We needed a vehicle to take what the streets have taught us and what the patients have taught us over the last 13 or 14 years."
Feldman and her husband Brett have been studying how to optimize healthcare to the homeless for more than decade. They developed and published a new standardized way to gather valuable information.
The acronym H.O.U.S.E.D. B.E.D.S. is the key.
"In medicine we use acronyms all the time to remember complicated things," Feldman said.
The H.O.U.S.E.D. B.E.D.S. acronym is designed to spur clinicians to ask questions they may not have been trained for. The answers could directly impact a patient's health and diagnosis.
Feldman said, "Their homelessness history for example helps us understand if they meet federal qualifications for being chronically homeless or transiently homeless."
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The tool covers every aspect of a person's living environment including access to services, clean water, bathrooms and their daily routines.
"In the hospital we are being consulted specifically because somebody is homeless so we want to share their reality with the rest of the inpatient team," Feldman said.
This tool can be applied to any homeless population in the world. It comes at a time when the average life expectancy for someone who is homeless is 40 to 52 years.
"If we can change that trajectory and use our medical knowledge paired with the resources that are available then we ought to be doing that," Feldman said.