Dive Brief:
- Patient messages to providers have skyrocketed since the COVID-19 pandemic, giving patients more access to their clinicians but potentially increasing providers’ workloads, according to a study published this week in JAMA.
- Between 2020 and 2025, messages from patients sent through patient portals increased 153%. Office visits rose 17% during the same period, suggesting that messaging is expanding between-visit care instead of substituting for in-person services, according to the research.
- Additionally, the increase in messages impacts staffing, clinicians’ workflows and reimbursement. “Health systems may need to plan not only for increased messaging volume, but for addressing engagement gaps among underserved populations,” researchers wrote.
Dive Insight:
Patients’ access to their health information online — and the ability to engage with their clinicians — through portals has expanded significantly over the past decade.
That could have benefits for patients. Research shows the use of portals is linked to improved patient satisfaction, as well as better medication adherence, self-management of disease and preventative care.
And the volume of messages patients are sending to their clinicians is rising rapidly, according to the latest study in JAMA, which analyzed Epic electronic health record data across more than 2,000 hospitals and 47,000 clinics.
Patient-written portal messages rose from 0.99 messages per patient per year in 2020 to 2.5 messages in 2025. Messaging was most common among women, patients between the ages of 40 and 64, and those who lived in neighborhoods with limited social vulnerabilities.
Clinicians are writing more messages, too. During the same period, messages authored by clinicians or other staffers rose from 4.59 to 5.7, an increase of 24%, according to the research. Messaging intensity was particularly high at the peak of the pandemic in 2021, when volume more than doubled.
But the increase in messaging isn’t translating into less in-person care. Though telephone visits declined about 6% during the study period, office visits rose.
“The COVID-19 pandemic marked an early peak in telephone encounters and clinician- and staff-authored messages that only partially normalized, whereas patient-authored messaging increased gradually, indicating a structural shift in communication rather than a transient disruption,” the researchers wrote.
The growing number of patient messages could create new challenges for providers, who already worry that the amount of administrative work and other EHR tasks distract from patient care and extend into off-hours. Some research shows that a high volume of messages contributes to exhaustion and burnout among physicians.
Messaging could be an area where artificial intelligence tools could help, technology companies and advocates say. Generative AI products have been adopted for a range of healthcare tasks, including drafting clinical documentation and messages to patients, as well as triaging messages that might need immediate responses.
