Telemedicine and e-Health最新文献

{"title":"Expansion in Teleophthalmology Use for Diabetic Retinopathy Screening During the COVID-19 Pandemic.","authors":"Lindsey Nguyen, Trisha Jaishankar, Tanvi Chokshi, Maria Jessica Cruz, Joshua Kim, Treysi Vargas-Ramos, Blake Snyder, Abraham Hang, Lauren Guajardo, Glenn Yiu","doi":"10.1089/tmj.2024.0526","DOIUrl":"https://doi.org/10.1089/tmj.2024.0526","url":null,"abstract":"<p><p><b>Introduction:</b> During the COVID-19 pandemic, the University of California, Davis Health (UCDH) system expanded teleophthalmology for diabetic retinopathy (DR) screening through increased sites and personnel, custom workflows, and improved awareness. Here, we report the outcomes of the expansion and investigate disparities during the pandemic lockdown. <b>Methods:</b> We retrospectively reviewed patients who received remote DR screening to compare demographic, socioeconomic, and clinical differences between individuals who underwent screening before, during, and after the COVID-19 lockdown. <b>Results:</b> UCDH increased quarterly teleophthalmology visits from 46.4 ± 13.9 before to 253.8 ± 38.0 visits after the COVID-19 lockdown (<i>p</i> < 0.001), while DR screening rates improved from 51.0 ± 1.5% to 56.9 ± 1.6% over that period (<i>p</i> = 0.03). During the pandemic, we observed greater proportions of unemployed (<i>p</i> < 0.001), higher-income (<i>p</i> < 0.001), geographically nearby (<i>p</i> = 0.001) patients, and fewer individuals with socioeconomic disadvantage as measured by their area deprivation index (<i>p</i> = 0.02). Fewer patients with poorly controlled diabetes (<i>p</i> = 0.014) or hypertension (<i>p</i> = 0.04) also received remote screening during the pandemic, although most of these disparities were no longer detectable after the initial lockdown. <b>Discussion:</b> Teleophthalmology expansion at UCDH during the COVID-19 pandemic led to sustained improvements in DR screening. Although some vulnerable individuals had reduced access to teleophthalmology during the initial lockdown, these disparities were not sustained postpandemic.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth Strategies in Arthritis Chronic Pain Management: Bibliometric Analysis of Two Decades of Research and Innovations.","authors":"Mahmoud Kandeel, Mohamed A Morsy, Khalid M Al Khodair, Sameer Alhojaily","doi":"10.1089/tmj.2024.0385","DOIUrl":"https://doi.org/10.1089/tmj.2024.0385","url":null,"abstract":"<p><p><b>Background:</b> Arthritis, characterized by joint inflammation, pain, and impaired daily activities, has seen a rapid increase globally. Telehealth has emerged as a transformative approach in managing chronic diseases, including arthritis, by overcoming barriers such as geographic limitations and high costs. <b>Objectives:</b> The primary objectives of this study were to conduct a comprehensive bibliometric analysis of telehealth in arthritis pain management over the past two decades, examine publication trends, citation patterns, and keyword co-occurrences related to telehealth strategies in arthritis management, identify key research areas, influential works, and emerging themes within the field. <b>Methods:</b> A comprehensive search was conducted in the Scopus database for articles related to telehealth in arthritis. A systematic screening process, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, was adopted. Bibliometric analysis was used for keyword analysis, citation analysis, and research trends. <b>Results:</b> The bibliometric analysis revealed significant trends in telehealth research for arthritis pain management. A sharp increase in publications was observed from 2020 onwards, coinciding with advancements in digital health technologies and the COVID-19 pandemic. Frequently occurring keywords included \"telemedicine,\" \"telehealth,\" \"digital health,\" \"m-health,\" and \"telerehabilitation.\" The top cited articles primarily explored the efficacy of telerehabilitation in managing postsurgical recovery and chronic knee pain. Emerging themes indicated an increased focus on mobile applications, digital health solutions, and patient-centered care. <b>Conclusion:</b> Telehealth has evolved from a novel concept to a mainstream solution in managing arthritis, driven by technological advancements and the necessity for accessible and cost-effective care.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teleconsultations' Impact on Referral Streamlining and Waitlist Reduction: A Large-Scale Retrospective Cohort Study of Over 200,000 Cases.","authors":"Juliana Nunes Pfeil, Natan Katz, Dimitris Rucks Varvaki Rados, Rodolfo Souza da Silva, Roberto Nunes Umpierre, Rita Mattiello, Rudi Roman, Erno Harzheim","doi":"10.1089/tmj.2025.0023","DOIUrl":"https://doi.org/10.1089/tmj.2025.0023","url":null,"abstract":"<p><p><b>Introduction:</b> Long waiting lists for elective medical consultations present significant challenges within health care systems globally. Remote consultation (teleconsultation) between a primary care physician and a specialist doctor can resolve some of these demands, reducing waiting lists. This study aims to evaluate the effectiveness of teleconsultations in reducing unnecessary specialist referrals and waitlist time within the referral process with primary care doctors. <b>Methods:</b> A retrospective cohort study was conducted from January 2017 to December 2019. The regulation process of specialized consultations waiting lists was made by two groups: (1) those regulated by RegulaSUS associated with the provision of teleconsultation and (2) those regulated by the usual procedures of the Ambulatory Regulation Center of the State of Rio Grande do Sul (contemporaneous controls group). The primary outcome evaluated the proportion of patients managed within primary health care (PHC) without requiring in-person specialist care, and the waitlist times during the regulation process were compared between the different groups. <b>Results:</b> The analysis encompassed 245,643 referral requests for specialized consultations across 23 medical specialties. The RegulaSUS project reduced the need for in-person specialized medical consultation by 29% (31.6% vs. 44.5%, <i>p</i> < 0.001). The median waitlist time was 1,140.4 (interquartile range [IQR], 1,393.6-476.6) days in individuals in the RegulaSUS and 1,271.0 (IQR, 778.4-1,723.0) control (<i>p</i> < 0.0001). <b>Discussion:</b> The RegulaSUS teleconsultations demonstrated an effective approach to increasing the resolution of primary care physicians, reducing unnecessary specialist referrals, and reducing waitlist time for specialized medical consultations. This initiative is a model for efficient referral management, prioritizing patients needing specialized care while optimizing health care resource allocation in PHC settings.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth and Telemedicine in the Management of Adult Patients after Liver Transplantation: A Scoping Review.","authors":"Rong Gao, Sheng-Ya Feng, Jie Zheng, Lin-Jun Zhai, Rong Liu","doi":"10.1089/tmj.2024.0359","DOIUrl":"10.1089/tmj.2024.0359","url":null,"abstract":"<p><p><b>Introduction:</b> Telemedicine can support home-based self-care for liver transplant recipients after discharge from the hospital. This study aimed to (1) provide an overview of the forms of home care for liver transplant patients; (2) identify the content elements of telemedicine in the home care of liver transplant patients; and (3) summarize the effect and outcome indexes of using telemedicine in liver transplantation patients. <b>Methods:</b> A search was performed in the electronic databases of PubMed, CINAHL, Web of Science, Cochrane Library, Embase, Google Scholar, CNKI, Wan Fang data and Wei Pu database through March 1, 2024. Subject heading and keywords were used to reflect the concepts of telemedicine, hepatic transplantation. Studies of tele-home care after transplantation in liver transplant recipients over 18 years of age and the form, content elements, and outcome assessments of telemedicine were included. <b>Results:</b> A total of 16 articles met the inclusion criteria, and from this, the application form of telemedicine in liver transplantation patients, intervention elements and evaluation outcome indexes were identified. The forms of application include internet platform, applications, network communication software, and portable devices; and the elements of intervention include telemonitoring, remote health guidance, telerecordings, teleconsultation, and telerehabilitation; and the outcome indicators include physiological indicators, psychological status, Quality of life, self-management ability, compliance, satisfactory degree, complication rate, readmission rate, and feasibility. <b>Conclusion:</b> Telemedicine is active and feasible in the home-based self-care of patients after liver transplantation, but its application is immature and there are still some problems.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"375-385"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life Among Patients with Heart Failure with Reduced Ejection Fraction Receiving Telemedicine Care in Vietnam.","authors":"Phuong Minh Tran, Hieu Ba Tran, Dung Viet Nguyen, Hung Manh Pham, Loi Doan Do, Ha Quoc Nguyen, James N Kirkpatrick, Rajesh Janardhanan, Christopher M Reid, Hoai Thu Thi Nguyen","doi":"10.1089/tmj.2024.0440","DOIUrl":"10.1089/tmj.2024.0440","url":null,"abstract":"<p><p><b>Background:</b> Telemedicine is an effective method to monitor patients at home and improve outcomes of heart failure (HF), especially HF with reduced ejection fraction (HFrEF). However, little is known about the impact of telemedicine on the quality of life (QoL) among outpatients with HFrEF in lower-middle-income countries (LMICs). <b>Methods:</b> In this single-center, prospective, randomized, controlled, open, and parallel-group clinical trial in northern Vietnam, patients with HFrEF were allocated to either telemedicine or control groups. Participants in the experimental arm underwent a home-based telemedicine program with regular telephone follow-ups and consultations. Participants in the control group received usual care. Both groups were followed for 6 months. The primary outcome was the change in Minnesota Living with Heart Failure Questionnaire (MLHFQ) score from baseline. The analysis was conducted on an intention-to-treat basis. <b>Results:</b> A total of 223 participants were randomized into two groups-the telemedicine group and the usual care group. Of the 223, 170 patients [mean age: 61.5 ± 15.0 years; female: 122 (71.8%)] completed follow-up and were included in the final analysis (87 in the telemedicine group and 83 in the usual care group). At baseline, the MLHFQ scores were equivalent between the two groups (median [interquartile range]: 81 [73-92] vs. 81 [74-92]; <i>p</i> = 0.992). After 6-month follow-up, the telemedicine group showed greater improvement in MLHFQ total scores than the usual care group (mean change in MLHFQ score: -15.5 ± 14.0 vs. -1.3 ± 6.2; difference in change: -14.2 [95% confidence interval, CI: -17.5, -11.0]; <i>p</i> < 0.0001). Similar results were found for the MLHFQ physical dimension score (difference in change: -5.8 [95% CI: -7.4, -4.1]; <i>p</i> < 0.0001) and the MLHFQ emotional dimension score (difference in change: -3.2 [95% CI: -4.2, -2.2]; <i>p</i> < 0.0001). <b>Conclusions:</b> In this study, a telemedicine intervention significantly improved QoL compared with usual care among patients with HFrEF in an LMIC.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"431-440"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Preferences for Telemental Health Care in a Federally Qualified Health Center.","authors":"Rebecca L Emery Tavernier, Celia Blaszkowsky, Abigail Jacobs, Peyton Rogers, Grace Wang","doi":"10.1089/tmj.2024.0458","DOIUrl":"10.1089/tmj.2024.0458","url":null,"abstract":"<p><p><b>Objective</b>: This cross-sectional study evaluated whether preferences for attending mental health visits virtually or in-person vary by demographics and identified factors influencing these preferences among federally qualified health center (FQHC) patients. <b>Methods</b>: FQHC patients (<i>N</i> = 350) completed a satisfaction survey of their mental health care experiences in 2022. Demographic data were obtained from the electronic health record. Fisher's Exact tests were used to determine whether modality preferences (phone, video, or in-person) varied across demographic factors. Open-ended comments were qualitatively evaluated using an inductive approach to identify themes related to modality preferences. <b>Results</b>: Modality preferences varied by age and language (<i>p</i>'s <0.02) but not race and gender (<i>p</i>'s >0.36). Reasons for modality preferences fell within six themes: (1) convenience, (2) connection, (3) transportation/accessibility, (4) health concerns, (5) caretaking responsibilities, and (6) technology. <b>Conclusion</b>: These findings clarify the reasons FQHC patients prefer telemental health care and identify gaps in its usage.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"483-489"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Tele-Pulmonary Rehabilitation in Patients with Chronic Obstructive Disease: A Systematic Review and Network Meta-Analysis.","authors":"Itsarawan Sakunrag, Natharin Boontha, Kansak Boonpattharatthiti, Teerapon Dhippayom","doi":"10.1089/tmj.2024.0476","DOIUrl":"10.1089/tmj.2024.0476","url":null,"abstract":"<p><p><b>Introduction:</b> Pulmonary rehabilitation (PR) is essential for long-term management of chronic obstructive pulmonary disease (COPD). However, evidence regarding the effectiveness of various PR delivered <i>via</i> telemedicine (tele-pulmonary rehabilitation [tele-PR]) is lacking. This study aims to assess the comparative effects of different tele-PR types on clinical outcomes in patients with COPD. <b>Methods:</b> The following databases were searched: PubMed, EMBASE, CENTRAL, CINAHL, and EBSCO Open Dissertations from inception to May 2023. We included randomized controlled trials, quasi-experimental, and cohort studies investigating the effects of tele-PR on exercise capacity. The Cochrane Effective Practice and Organization of Care Group risk of bias was used to assess the quality of included studies. Data were analyzed using STATA 17.0 with a random-effects model. Tele-PR comparisons were ranked using surface under the cumulative ranking (SUCRA). <b>Results:</b> Seven studies (<i>n</i> = 815) encompassing five tele-PR types were included in the network meta-analysis. Two studies were justified as having a high risk of bias. There were no significant differences among different types of tele-PR and face-to-face PR, in terms of improving the 6-minute walk test. However, the hierarchy estimation suggested that tele-coaching by virtual agents more often than three sessions per week is more likely to be better than other tele-PRs (SUCRA 95.4%). <b>Discussion:</b> While uncertainty persists regarding the optimal tele-PR delivery model, our study suggests that tele-PR was not different from face-to-face PR. However, limited studies and evidence of low-quality underscore the need for well-designed clinical trials to yield more robust comparative evidence.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"441-450"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote Consultations in General Practice in Ireland: Who Is Missing Out?","authors":"Ellen McHugh, Sheelah Connolly","doi":"10.1089/tmj.2024.0503","DOIUrl":"10.1089/tmj.2024.0503","url":null,"abstract":"<p><p><b>Introduction</b>: This research examines the characteristics associated with the use of remote consultations in general practice in Ireland during and after the COVID-19 pandemic. <b>Methods</b>: The analysis uses three waves of a nationally representative cross-sectional survey of health in Ireland (\"Healthy Ireland\" survey), relating to the years 2020/2021, 2021/2022, and 2022/2023. The sample includes people aged 15 and over who reported seeing a general practitioner (GP) in the 4 weeks prior to the survey. The outcome variable (\"remote consultation\") captures whether a respondent reported that their most recent GP consultation took place via telephone or video (\"remote consultation\"). Logistic regression analysis was used to assess the relationship between the likelihood of having a remote consultation and a range of potential explanatory variables including age, gender, insurance status, and socioeconomic status. <b>Results</b>: There was a significant decrease in the percentage of respondents reporting remote consultations over the period of analysis, from 39% in 2020/2021 to 10% in 2022/2023. In later periods, being female (odds ratio [OR] = 1.47 [1.04, 2.09]), having private health insurance (OR = 1.76 [1.13, 2.73]), and having a long-term health condition (OR = 1.53 [0.98, 2.39]) were positively associated with the probability of reporting a remote consultation, while being in an older age group (OR = 0.29 [0.13, 0.62]) was negatively associated with the likelihood of a remote consultation. <b>Discussion</b>: The high prevalence of remote consultations during the COVID-19 pandemic was not maintained in the postpandemic period. Policymakers should consider the reasons for this and consider the gendered, age-based, and insurance-based disparities in remote consultation utilization in the development and promotion of digital health care.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"468-475"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Statewide Telemedicine Referral System for Regional Monoclonal Antibody Infusion Centers.","authors":"Romeo R Fairley, Andrew Ta, Tatiana Emanuel, Traceee Rose, Justine Skyler, Ralph Riviello","doi":"10.1089/tmj.2023.0666","DOIUrl":"10.1089/tmj.2023.0666","url":null,"abstract":"<p><p><b>Background:</b> Regional infusion centers (RICs) played an integral role in treating high-risk patients with COVID-19, with mild to moderate symptoms, who did not need acute hospitalization, with monoclonal antibodies. While any medical provider could place a RIC referral, it was recognized that many people face challenges with accessing care. A dedicated medical team was created to provide telemedical evaluation of patients and place appropriate referrals to RICs. The objective of this work was to assess patient populations who utilized a telemedicine referral system for COVID-19 antibody infusions. <b>Methods:</b> Providers used Pulsara, a Health Insurance Portability and Accountability Act-compliant video chat platform, to remotely screen patients and refer them to regional monoclonal antibody infusion centers if they met criteria. Basic demographic data were collected anonymously on all patients referred to the RICs, and medically underserved populations were determined using the uniform data system mapper. <b>Results:</b> A total of 6,031 patients were referred to RICs through Pulsara. Of these, 1,723 (29%) lived in medically underserved areas and 1,042 (17%) lived in mixed zones. In the second half of the program, 36 providers virtually screened 3,531 patients with 1,890 patients (53.5%) receiving an infusion. <b>Conclusions:</b> The successful implementation of a telehealth referral system facilitated the decentralization of monoclonal antibody infusion therapy from emergency departments to RICs. This system reached a significant number of people living within medically underserved areas.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"490-493"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Patient Portal-Based Telehealth Outreach Program on Recall of Patients with Diabetic Retinopathy.","authors":"Justin Y Yip, Keara C Geckeler, Kailynn M Barton, Shiyoung Roh, David J Ramsey","doi":"10.1089/tmj.2024.0454","DOIUrl":"10.1089/tmj.2024.0454","url":null,"abstract":"<p><p><b>Purpose:</b> To evaluate the effectiveness of a patient portal telehealth outreach program to return patients with diabetic retinopathy (DR) lost to follow-up (LTFU) for eye care. <b>Methods:</b> Patients with DR receiving intravitreal injection (IVI) therapy who were >90 days beyond recommended return were deemed LTFU. Outreach messages were sent via a patient portal, when available, or through the U.S. mail. Patients received information on how to schedule a retinal examination and a symptom-screening questionnaire. The adherence rate to scheduled appointments was assessed 90 days postintervention. Labor costs were estimated based on communication time. <b>Results:</b> Among 359 patients with DR receiving IVIs, 22% were LTFU, overdue by a median of 362 days. Receiving fewer IVIs was the factor most strongly associated with becoming LTFU (8.9  ±  9.1 injections vs. 22 ± 20 injections, <i>p</i> < 0.001). The outreach program engaged 39 patients <i>via</i> the patient portal and 28 patients <i>via</i> the U.S. mail. A similar number of patients in each cohort was scheduled (13% vs. 14%, <i>p</i> = 0.862) and completed appointments (10% vs. 14%, <i>p</i> = 0.616). Whereas patient-portal messages took an average of 64 s to send at a labor cost of $0.35/message, each letter sent by mail took approximately 5 min to prepare at a total cost of $2.19. <b>Conclusions:</b> A patient portal-based telehealth outreach program is effective at returning patients with DR to eye care and can be implemented at a lower cost, compared with conventional mailed recall letters. Efforts are needed to increase digital health literacy and access to improve the efficiency of health care delivery.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"459-467"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}