Abstract Body: Background and Objective
Telehealth provides a convenient and accessible way to manage hypertension, especially for patients facing socioeconomic challenges. Our internal medicine clinic in Washington, DC, serves a primarily urban population, many of whom experience food insecurity. This study aimed to assess the connection between neighborhood-level food insecurity, online patient portal registration, and patient engagement, defined as appointment attendance, in a hypertension telehealth clinic.

Methods and Analysis
We conducted a retrospective analysis of patients scheduled for hypertension telehealth visits between July 2024 and March 2025. Attendance at scheduled visits served as the primary outcome. ZIP codes were cross-referenced with a clinic-level food insecurity database, and we recorded patient portal enrollment status. Descriptive statistics were utilized to compare attendance across subgroups.

Results
Among 232 patients scheduled for telehealth visits, 218 had documented ZIP codes. Of these, 160 (73.4%) resided in food-insecure ZIP codes, and 109 (50%) had access to the online patient portal. Patients in food-insecure areas showed relatively high attendance (n=160) compared to those from non-food-insecure ZIP codes (n=58). Portal registration was associated with significantly higher attendance rates: 94.0% of registered patients attended versus 39.8% of those not registered.

Conclusion
Food insecurity did not negatively impact engagement in the hypertension telehealth clinic. However, online portal registration was strongly associated with increased attendance. Efforts to expand portal access and utilization may improve telehealth engagement and promote equity in care delivery for high-risk populations.