{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T17:23:20Z","timestamp":1781112200427,"version":"3.54.1"},"reference-count":42,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Telemedicine and e-Health"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients with DR receiving intravitreal injection (IVI) therapy who were &gt;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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      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 \u2009\u00b1 \u20099.1 injections vs. 22 \u00b1 20 injections,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). The outreach program engaged 39 patients\n                      <jats:italic toggle=\"yes\">via<\/jats:italic>\n                      the patient portal and 28 patients\n                      <jats:italic toggle=\"yes\">via<\/jats:italic>\n                      the U.S. mail. A similar number of patients in each cohort was scheduled (13% vs. 14%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.862) and completed appointments (10% vs. 14%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/tmj.2024.0454","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T05:02:46Z","timestamp":1737349366000},"page":"459-467","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of a Patient Portal-Based Telehealth Outreach Program on Recall of Patients with Diabetic Retinopathy"],"prefix":"10.1177","volume":"31","author":[{"given":"Justin Y.","family":"Yip","sequence":"first","affiliation":[{"name":"Division of Ophthalmology, Department of Surgery, UMass Chan\u2014Lahey School of Medicine, Burlington, Massachusetts, USA."},{"name":"Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keara C.","family":"Geckeler","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Surgery, UMass Chan\u2014Lahey School of Medicine, Burlington, Massachusetts, USA."},{"name":"Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kailynn M.","family":"Barton","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Surgery, UMass Chan\u2014Lahey School of Medicine, Burlington, Massachusetts, USA."},{"name":"Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyoung","family":"Roh","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Surgery, UMass Chan\u2014Lahey School of Medicine, Burlington, Massachusetts, USA."},{"name":"Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Ramsey","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Surgery, UMass Chan\u2014Lahey School of Medicine, Burlington, Massachusetts, USA."},{"name":"Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, USA."},{"name":"Department of Graduate Studies, New England College of Optometry, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,7]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-2641"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2019.09.025"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414264"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.25029"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000001892"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2018.02.034"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2018.07.027"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2022.0334"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2415-8-9"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S368972"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40258-016-0231-8"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xops.2021.100059"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/IJG.0000000000002256"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10792-023-02906-9"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.2196\/26189"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/opo.12998"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S330913"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2020.03.023"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14746"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oret.2024.05.017"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oret.2018.06.004"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oret.2020.12.020"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/aos.14907"},{"key":"e_1_3_7_25_2","unstructured":"U.S. Centers for Medicare and Medicaid Services. 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