Impact of a Patient Portal-Based Telehealth Outreach Program on Recall of Patients with Open-Angle Glaucoma

Abstract

Purpose:

This study evaluated the effectiveness of a patient portal (PP)-based telehealth outreach program, executed by a physician extender, in returning patients with open-angle glaucoma (OAG) who were lost to follow-up (LTFU) to care.

Methods:

Patients with OAG who were LTFU and not evaluated in the prior 6 months were randomized 1:1 to receive either a return-to-care notification via their PP or by standard operating procedures. PP messages alerted patients that they might be overdue for glaucoma care and encouraged them to make an appointment or refill medications, as appropriate. The rate of return appointments was assessed 90 days postintervention.

Results:

Among 2,250 patients with OAG, 257 patients were identified as LTFU (11.4%). Not having an active PP was the factor most strongly associated with being LTFU (32% vs. 22%, p < 0.001). LTFU patients with a PP were less likely to have recently accessed their portal compared with those not LTFU (20 days vs. 16 days, p < 0.001). Patients contacted through their PP were more than twice as likely to return for eye care compared with those who did not receive this intervention (23% vs. 11%, p = 0.033). Notably, visual field (VF) depression was less (−2.14 dB vs. −4.10 dB, p = 0.028), and retinal nerve fiber layer thickness was greater (77 µm vs. 73 µm, p = 0.028) in the patients who returned to care compared with those who remained LTFU.

Conclusions:

Engagement of patients with OAG through an online PP may improve glaucoma care by increasing the rate at which patients return for eye care.