Homeless care providers’ perspectives about care coordination and how mhealth technology can facilitate care coordination for people experiencing homelessness: a qualitative analysis

People experiencing homelessness (PEH) have complex healthcare and social service needs. Care coordination is one strategy used to help PEH navigate healthcare and social services, but gaps remain in understanding care coordination across health and social services sectors. mHealth technology has the potential to enhance care coordination for PEH. The study objectives were to: (1) understand healthcare and social services providers’ perspectives about care coordination for PEH, and (2) explore provider perceptions of how mHealth technology may facilitate the care coordination process for PEH. Twenty-six healthcare and social service providers were interviewed to obtain feedback on an existing mHealth intervention. A subset of questions from these interviews was analyzed to address the study aims. A thematic, deductive qualitative analysis utilized the Agency for Healthcare Research and Quality (AHRQ) Care Coordination Framework as a guide for the main themes. Subthemes were coded inductively; literature was used to define codes when appropriate. Using the AHRQ Care Coordination Framework, nine themes were developed: Align Resources with Patient and Population Needs; Assess and Prioritze Needs and Goals; Communication; Create a Proactive Plan of Care; Establish Accountability and Negotiate Responsibility; Facilitate Transitions; Link to Community Resources; Monitor, Follow-Up, and Respond to Changes; and Support Self-Management Goals. Subthemes were identified for each theme. Three ideas were salient across the themes and subthemes: Relational Continuity, Self-Care Agency, and Inter-Organization Collaboration. The context of homelessness, which included Accessibility, Competing Demands, Resource Scarcity and Awareness, and System Assumptions, was also essential for understanding care coordination for PEH. The analysis revealed that mHealth technology can be a tool to activate PEH by Increasing Awareness, Enhancing Self-Efficacy, and Enabling Self-Care. This study identified important mechanisms in coordinating care for PEH as described by healthcare and social service providers. These findings may help other providers to understand the key interplay of healthcare and social services for PEH along with mHealth interventions as potential facilitators of this process.