Online patient portal messages to providers more than doubled between 2020 and 2025, according to a study published today in the Journal of the American Medical Association (JAMA). Researchers from NYU Langone Health found that digital messaging increased by 153%, rising from an average of 2.2 messages per patient per year in early 2020 to 5.4 in late 2025. Despite this shift, in-person clinic visits did not decline; instead, they experienced a modest 17% increase, growing from 2.37 to 2.77 visits per patient annually. Total telephone calls, however, decreased by 6% during the same five-year period.

The study represents the largest review of Epic electronic health records (EHR) to date, analyzing over 8 billion patient-provider interactions involving more than 140 million patient records across 2,067 hospitals and 47,100 health clinics in the U.S. Data show that in the first three months of 2025, 30% of the 42 million active patients on the platform sent a portal message to their clinician. The analysis indicates that 86% of message senders live in urban areas, 61% are women, and 36% fall within the 40 to 64 age range. Patients in the least socially vulnerable neighborhoods used messaging at a rate of one in three, compared to one in four for those in the most vulnerable areas.

Researchers suggest this digital shift creates a parallel, continuous layer of care rather than replacing episodic, in-person visits. The trend introduces new challenges for staffing, clinical workflows, and reimbursement models as providers must manage both traditional and digital workloads. To address these demands, clinicians are increasingly utilizing AI support programs, such as automated tools for drafting provider notes or chatbots designed to simplify patient content. Experts emphasize that healthcare systems must prioritize team-based approaches to manage the rising volume of messages and ensure that digital adoption does not exacerbate existing healthcare disparities among vulnerable populations.

The study utilized Epic Cosmos, a national dataset containing records for over 300 million patients. Investigators noted that while this research provides a national perspective on the digitalization of care, further studies are required to evaluate specific message characteristics, response times, and the long-term impact on clinician burnout. Future planned research aims to break down digital usage trends at regional and outpatient-specific levels to better inform operational planning and training for healthcare staff.

Since 2020, the way we talk to our doctors has changed significantly. People are now sending 153 percent more messages to their health providers through online patient portals (digital messaging platforms for health records). Instead of just calling, more patients are typing out their questions. You might expect that these messages would replace trips to the clinic, but the data shows the opposite. In-person appointments actually rose by 17 percent over the same period. It turns out that digital communication is not replacing traditional care; it is just adding an extra layer of tasks for doctors to handle on top of their face-to-face visits.

This massive study looked at 140 million patient records to see how this digital shift is unfolding across the country. It found that these messages are most common among women, people living in cities, and those between the ages of 40 and 64. Essentially, doctors are now running two parallel practices: one in the exam room and one in their digital inbox. Think of it like a shop owner who used to only serve walk-in customers but now also has to manage a never-ending stream of online orders. Because doctors are struggling to balance both, it is becoming difficult for them to provide timely care without getting overwhelmed.

To keep up with this constant stream of digital requests, many health systems are starting to use AI tools. These programs act like a helpful assistant that can suggest answers to patient questions or summarize medical notes, making the paperwork faster to finish. It is vital that hospitals get this right, because right now, people in wealthier neighborhoods are using these digital tools more than those in vulnerable areas. Moving forward, the goal is to make sure these AI tools help doctors work smarter without accidentally leaving behind patients who do not have easy access to the latest technology.