Over the past several years, the landscape of healthcare communication in the United States has undergone a profound transformation. A landmark study led by researchers at NYU Langone Health has unveiled that at least 12 percent of Americans now routinely engage with their healthcare providers through secure online patient portals and health applications. This shift toward digital interaction complements, rather than supplants, traditional in-person medical visits, marking an evolution in how healthcare institutions manage patient care and communication workflows day-to-day.
The comprehensive study scrutinized a massive dataset derived from Epic electronic health records, the most widely utilized system across U.S. hospitals and clinics. Analyzing more than 140 million patient records spanning 2,067 hospitals and 47,100 outpatient clinics, researchers evaluated over 8 billion documented interactions between patients and providers covering the period from January 2020 through December 2025. The findings provide unprecedented insights into the pandemic-driven acceleration and normalization of digital healthcare communications.
Published online in the Journal of the American Medical Association (JAMA) on June 22, 2026, the study reveals that patient messages routed through online portals more than doubled during this five-year window, increasing by a striking 153 percent. In stark contrast, traditional telephone communications decreased by 6 percent, signaling a fundamental shift in patient preference for digital messaging platforms over phone calls when managing appointments, test results, and ongoing treatments. Concurrently, the number of Americans with active Epic health records surged from 94 million in 2020 to 140 million in 2025, underscoring the rapid adoption of digital healthcare infrastructure nationwide.
Interestingly, the rise in digital portal usage has not come at the expense of in-person medical appointments. Instead, visits to healthcare providers have rebounded robustly since the pandemic’s height, stabilizing at an average of two to three office visits per patient annually. This coexistence of digital and physical care modalities suggests a hybrid model of healthcare delivery is emerging — one that enhances patient access and convenience while preserving the clinical benefits of face-to-face consultations.
The volume of patient-initiated messages has escalated sharply, with average annual communications rising from 2.2 per patient in early 2020 to 5.4 by late 2025. Senior investigator Michal A. Mankowski, PhD, assistant professor in the Department of Surgery at NYU Grossman School of Medicine, emphasized the significance of these findings, stating that digital health tools have become ingrained in everyday patient care rather than being peripheral or adjunct options. The increased accessibility to physicians and clinical staff suggests a shift toward more continuous, untethered healthcare interactions, no longer confined to scheduled appointments within traditional office hours.
Importantly, this new digital-first communication paradigm introduces additional operational complexity for healthcare providers. Co-investigator Dorry L. Segev, MD, PhD, professor and vice chair in Surgery at NYU Grossman, explained that digital workflows add layered demands atop established clinical duties. This necessitates forward-looking staffing strategies and innovative support systems to sustain provider efficiency and prevent burnout. Effective integration of messaging platforms, electronic clinical notes, online billing, and remote counseling are critical components in redesigning provider workflows for the digital age.
Dr. Segev highlighted the growing role of artificial intelligence in facilitating these transitions. NYU Langone is already implementing AI tools that expedite the drafting of clinical documentation and streamline provider communications, indicating a rapidly evolving technological ecosystem supporting modern medicine. AI-powered chatbots and content framing systems can reduce message complexity, enabling clinicians to focus on higher-value tasks while maintaining high-quality patient engagement and care continuity.
The vast scale and granularity of the Epic Cosmos dataset underpinning the study is notable. Covering over 300 million American patients’ records from a majority of Epic-using institutions, this repository offers a unique vantage point to analyze national healthcare trends. Despite Epic’s role as the largest electronic health record vendor, the study was conducted independently, with the company playing no direct role in data analysis to ensure scientific rigor and impartiality.
Beyond confirming the marked increase in digital communications, the study quantified interaction volumes: between 2020 and 2025, patients booked at least 1.77 billion in-person visits through Epic systems, sent 1.34 billion messages to providers, and received 3.25 billion portal messages in return. Telephone calls totaled 1.59 billion, with 146 million telehealth video visits logged, illustrating the multiplicity of engagement channels coexisting in contemporary healthcare delivery.
Looking ahead, the NYU Langone research team plans to delve deeper into regional and outpatient clinic-specific digital usage trends. This next phase aims to generate actionable insights capable of informing operational planning, resource allocation, and the customization of digital health services according to local healthcare ecosystem characteristics.
This pioneering study affords a valuable roadmap for healthcare systems navigating the digital transformation prompted by the COVID-19 pandemic and sustained technological advances. By demonstrating how patients and providers seamlessly integrate online messaging and portals with conventional visits, the research heralds a new era in which healthcare is increasingly continuous, accessible beyond office hours, and optimized through technological augmentation.
NYU Langone Health, the study’s home institution, is recognized nationally for outstanding clinical outcomes and academic leadership. The health system comprises multiple inpatient facilities, specialty centers such as the Perlmutter Cancer Center, and over 330 outpatient sites throughout New York and Florida. NYU Langone’s integration of cutting-edge digital tools exemplifies its commitment to innovation in patient care delivery.
This comprehensive investigation not only offers strategic insights to hospital administrators and clinicians but also highlights the imperative for training healthcare professionals to effectively navigate burgeoning digital workflows. Mastery of patient messaging platforms, AI-assisted documentation, and virtual counseling is fast becoming a core competency in modern medical practice.
In summary, the study presents a compelling portrait of a healthcare landscape in flux — one where the patient-provider relationship has expanded its temporal and spatial boundaries through secure online portals, while in-person care remains indispensable. The dual rise of digital and physical engagements reflects a balanced, hybrid model with transformative potential to enhance healthcare access, efficiency, and patient satisfaction across the United States.
Subject of Research: People
Article Title: Trends in Patient Portal Messages, Office Visits, and Telephone Encounters
News Publication Date: 22-Jun-2026
Web References: http://dx.doi.org/10.1001/jama.2026.8690
References: Journal of the American Medical Association (JAMA), 10.1001/jama.2026.8690
Keywords: Electronic medical records, Informatics
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