Digital Health Communication: The Rise of Patient Portal Messages
Online portal messages sent to providers have more than doubled from 2020 to 2025 as patients now have more direct access to healthcare professionals. Despite this surge in digital communication, a recent study reveals that there hasn’t been a corresponding decline in clinic visits. The study suggests that digital medicine increases doctors’ workloads without substituting in-person care.
Increased Digital Communication
At least 12% of Americans now communicate with their healthcare providers about appointments, test results, and ongoing treatments through secure online patient portals and health apps. This insight comes from a study conducted by researchers at NYU Langone Health, recently published in the Journal of the American Medical Association (JAMA).
The frequency of online portal messages has skyrocketed by 153% from 2020 to 2025, increasing from an average of 2.2 per year to 5.4 per year per patient. Despite this growth, office visits remain steady, with an average of two to three visits per year, slightly increasing by 17% during the study period.
Impact on Healthcare Workflows
Interestingly, while digital communication has increased, total phone calls have decreased by 6%. “Our study shows that the use of patient portals, health apps, and messaging is now a routine part of daily patient care across America,” said lead study investigator Michal A. Mankowski, Ph.D., assistant professor in the Department of Surgery at NYU Grossman School of Medicine.
The research is the most extensive review of communications recorded in Epic’s electronic health records, analyzing over 8 billion patient-provider interactions from January 2020 to December 2025. It encompassed more than 140 million patient records from 2,067 hospitals and 47,100 health clinics in the United States.
Statistics and Data Insights
The number of Americans with an active Epic health record rose from 94 million in 2020 to 140 million in 2025. During this period, there were 1.77 billion doctor visits, 1.59 billion phone calls, and 146 million virtual telehealth portal visits. Patients sent 1.34 billion messages to their healthcare providers and received approximately 3.25 billion online portal messages from providers.
“An important message from our paper is that we thought an increase in portal messaging would reduce the number of office visits, but that does not appear to be the case,” Mankowski noted at a press conference. “This is a new modality that health systems and providers need to embrace and prepare for.”
Adapting to Digital Health Realities
In early 2025, 30% of active patients on Epic, or about 42 million people, communicated with their doctors through a portal health app. “Our findings show that while digital health tools have become a core part of healthcare delivery, the delivery is more continuous and no longer tied to scheduled appointments during routine work hours,” Mankowski added.
While digital health apps and messaging options have simplified patient-provider communication, they have also affected staffing, workflow, and reimbursement. “Modern healthcare increasingly means that providers must balance digital workloads with traditional clinical duties,” said study co-investigator Dorry L. Segev, MD, Ph.D.
NYU Langone is leveraging AI assistance tools to expedite the creation of physician and provider notes, addressing the demands of the digital healthcare layer that operates alongside traditional systems. Wearable devices, virtual care platforms, and AI-powered chatbots offer continuous care, presenting both opportunities and challenges.
Disparities and Future Directions
The study also highlighted disparities in portal message usage. Based on 2025 data, the majority of message senders, 86%, lived in urban areas, with women making up 61% of users. A disparity was noted as one in three patients in the least at-risk neighborhoods used messaging, compared to about one in four in the most at-risk areas. This discrepancy could widen existing access gaps.
“We see disparities between more vulnerable populations, and eliminating those disparities is crucial for the healthcare system,” Mankowski emphasized. Provider organizations must consider a team-based approach to address these challenges effectively.
Future studies will delve deeper into message characteristics, response times, and the impact on providers. Researchers plan to examine digital usage trends within health systems, including NYU Langone, to assess regional and outpatient clinic-specific changes that could influence operational planning.
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