Patient portal messages, EHR chat: How much time do docs spend?

Two new studies look at how patient portal messages and secure chat in the EHR are eating away at physicians’ time, with one finding that female hospitalists are spending more time on digital communication than their male counterparts.

A JAMA research letter found that the number of messages sent through patient portals jumped from 0.99 per patient per year in 2020 to 2.50 in 2025. During that time, patients who used portals to communicate with clinicians went from sending 2.2 messages to 5.4 messages per year.

The authors of the report claim it’s the first scientific look at how many messages patients are sending health care providers through portals.

The research letter looked at data from more than 2,000 hospitals and nearly 50,000 clinics encompassing 1.34 billion messages from patients. Researchers also examined patterns in 1.59 billion phone calls and 146 million telehealth encounters between patients and clinicians.

A MedPage Today analysis on the study reported that telephone encounters during the same period fell slightly, from 2.33 per patient per year to 2.20. Researchers also found a 17% increase in patient visits, from 2.37 visits per patient per year to 2.77.

A separate study of digital communication in the inpatient setting didn’t look at the growth of secure chat, but it did look at differences in the amount of time physicians spend on secure messaging based on gender.

The study, published in the Journal of Hospital Medicine, found that while female hospitalists in an academic hospital worked similar hours as men, women spent more time in the hospital’s EHR: 248 minutes per day vs. 222 for male hospitalists. That’s a difference of about 12%.

Researchers found that female hospitalists spent more time on secure chat than their male colleagues (38 vs. 34 minutes per day). Women hospitalists also exchanged more messages, sending 62 vs. 53 messages per day and receiving 56 vs. 48 messages per day.

The study looked at activity from July 2023 to June 2024 of just over 200 hospitalists. The group included a mix of adult and pediatric hospitalists and attendings and residents.

Trends in digital communication were similar in residents and attendings. And even when a new scheduling model that had physicians work less hours was implemented, the researchers found that gender differences in digital communication remained.

The authors warned that while digital communication technology was supposed to increase efficiency, “these tools may contribute to unequal digital workloads.” They said their data “underscore the need for equity-informed strategies” to reduce the burden of digital communications in the inpatient setting.

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