Patient portal messaging volume in the US increased by more than 150% between 2020 and 2025, with messages per patient rising from 0.99 to 2.50 per year.
Over 8 billion encounters were analyzed, showing that office visit rates also increased, while telephone encounters decreased modestly. Messaging prevalence was highest among females, middle-aged adults, and those living in low social vulnerability index quartiles or urban areas.
Increases in patient messaging were not associated with fewer in-person visits, indicating that portal communications are expanding, not substituting, traditional care.
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