Patient Portal Messages Are Reshaping How Doctors and…

Patient Portal Messages Are Reshaping How Doctors and Patients Communicate A large national study published in JAMA has quantified something many clinicians have felt anecdotally for years: patient portal messaging has become a major, structurally embedded part of how patients and doctors communicate, growing far faster than other forms of contact. Researchers analysed deidentified electronic health record data from Epic Cosmos, covering over 2,000 hospitals and 47,100 clinics across the United States, examining communication patterns among more than 8 billion office visits, portal messages, telephone encounters and telehealth visits between 2020 and 2025. The headline trend: patient-authored portal messages increased by 153% over this period, rising from roughly one message per patient per year to two and a half. Office visits also increased, by 17%, while telephone encounters declined modestly, by 6%. Telehealth visits, despite their pandemic-era surge, settled by 2025 to a relatively small share of overall encounters. Importantly, when researchers examined whether rising messaging volume was simply replacing in-person visits, the data said otherwise. Increases in patient messaging were not associated with decreases in office visits — instead, messaging appears to function as an expansion of care between visits, not a substitute for them. The study