New York City-based NYU Langone Health researchers published the largest-ever analysis of Epic EHR communications June 22 in JAMA, finding that digital tools now supplement rather than replace in-person care.
The study analyzed more than 140 million patient records from 2,067 hospitals and 47,100 clinics, covering over 8 billion patient-provider interactions logged in Epic between January 2020 and December 2025. Active Epic records grew from 94 million patients in 2020 to 140 million in 2025.
Online portal messages more than doubled over the period, rising 153%, while telephone calls dropped 6%. In the first quarter of 2025, 30% of active Epic patients — roughly 42 million people — sent a portal or health app message to a clinician. Among patients who message, the average climbed from 2.2 to 5.4 per year.
In-person visits, meanwhile, rebounded to two to three per patient annually, signaling that digital channels add to clinical workflows rather than displace them.
“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 senior investigator Michal Mankowski, PhD, assistant professor in the Department of Surgery at NYU Grossman School of Medicine, in a June 22 news release.
Co-investigator Dorry Segev, MD, PhD, stated that the shift forces operational planning: “Modern delivery of healthcare means increasingly that healthcare providers will have to balance their digital workload on top of their traditional clinical workload.”
The team drew on Epic Cosmos, a national dataset spanning more than 300 million patients; Epic had no role in the research.
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