Study finds digital healthcare now embedded in everyday care

NEW YORK — Digital health tools have evolved from a pandemic-era necessity into a core component of healthcare delivery, with patient-provider messaging via online portals and health apps now a routine part of care, according to a new study led by researchers at NYU Langone Health.

Published online June 22 in the Journal of the American Medical Association, the study analyzed more than 8 billion patient-provider interactions recorded between January 2020 and December 2025 across 2,067 hospitals and 47,100 clinics using Epic electronic health records. Researchers examined data from more than 140 million patient records, making it the largest review of Epic-recorded communications to date.

The findings show that online portal messages increased by 153% between 2020 and 2025, while telephone calls declined by 6% over the same period. The number of Americans with an active Epic health record grew from 94 million in 2020 to 140 million in 2025. In the first quarter of 2025 alone, 42 million patients, representing 30% of active Epic users, sent messages to their clinicians via a portal or health app.

Researchers found that digital engagement has not replaced traditional office visits. In-person appointments have rebounded to an average of two to three visits per patient annually. However, patient messaging activity has more than doubled, rising from an average of 2.2 messages per year in early 2020 to 5.4 by late 2025.

“Our study shows that use of patient portals, health apps, and messaging are now a routine part of everyday patient care across America, not simply side channels used occasionally,” said Michal A. Mankowski, Ph.D., senior investigator and assistant professor in the Department of Surgery at NYU Grossman School of Medicine.

“Our findings reveal that while digital health tools have become a core part of healthcare, delivery is becoming more continuous, timeless, and no longer tied to scheduled appointments during routine work hours,” Mankowski added.

The study highlights the growing operational impact of digital communications on healthcare organizations. Since 2020, patients have booked approximately 1.77 billion in-person clinic visits through Epic systems, sent 1.34 billion messages to providers, and received 3.25 billion portal messages from healthcare professionals. Researchers also documented 1.59 billion telephone calls and 146 million virtual telehealth visits.

According to study co-investigator Dorry L. Segev, M.D., Ph.D., the expansion of digital healthcare complements, rather than replaces, traditional clinical responsibilities.

“Modern delivery of healthcare means increasingly that healthcare providers will have to balance their digital workload on top of their traditional clinical workload,” Segev said. “Clinical staff will need to be trained in mastering the tools of messaging in healthcare; in using AI support programs, including chatbots that can frame content to minimize its complexity; and in making the most effective use of clinician time needed for online billing and online counseling.”

Segev noted that NYU Langone already uses artificial intelligence tools to accelerate physician note creation. Researchers plan to further examine regional and specialty-specific digital health trends to better understand how healthcare systems can adapt staffing and operational models to the growing volume of virtual interactions.

The study used data from Epic Cosmos, a national database of electronic health records for more than 300 million Americans. Researchers said the findings underscore that digital communication has become an increasingly important channel for patient engagement and care coordination across the U.S. healthcare system.