Connecting Homeless and Criminal Justice‐Involved Veterans to Primary Care: Process and Outcomes of a Learning Health System Activity

ABSTRACT Introduction The Department of Veterans Affairs (VA) undertook an initiative to ensure veterans enrolled in its national supported housing program or its criminal justice outreach program were connected to primary care for treatment and preventive healthcare. This article describes the process and outcomes of a learning health system initiative to empanel homeless and justice‐involved veterans in primary care in the largest, integrated healthcare system in the United States. Methods At the start of 2024, the Connecting Vulnerable Veterans to Care (CVVC) workgroup was created with interdisciplinary national, regional, and local VA leadership to work toward the goal of increasing the number of veterans in the Housing and Urban Development‐VA Supportive Housing (HUD‐VASH) program and the Veterans Justice Outreach (VJO) program who were empaneled in VA primary care. Within the CVVC workgroup, weekly meetings were organized with stakeholders, data dashboards were created and used to develop target outcomes, monitor progress, share organizational learning and knowledge, and form a culture of continuous inquiry and quality improvement. Participants were 142 VA medical centers with HUD‐VASH and VJO programs. The main outcome measure was the proportion of veterans empaneled in VA primary care. Results During this initiative, nearly all VA medical centers reached targeted benchmarks of 85% enrollment in primary care among veterans in the HUD‐VASH program and the majority of VA medical centers reached the goal of 80% enrollment in primary care among veterans in the VJO program. More specifically, among the 142 VA medical centers, 56% showed increased primary care enrollment in their HUD‐VASH program and 70% showed increased primary care enrollment in their VJO program. Conclusions This work illustrates how a learning health system initiative in a large, integrated national healthcare system supports activities that were associated with improved local engagement in primary care services.