Digital Health's New Era: Balancing Access with Provider Workload

NEW YORK, NY – June 22, 2026 – The American healthcare landscape has fundamentally shifted. Digital tools like secure patient portals and health apps are no longer a fringe benefit but a core component of how millions of patients interact with their providers. A groundbreaking new study led by researchers at NYU Langone Health reveals that this digital evolution is supplementing, not replacing, traditional in-person care, creating a new hybrid reality that is reshaping the daily operations of hospitals and clinics nationwide.

The study, published today in the Journal of the American Medical Association (JAMA), represents the largest-ever analysis of its kind. Researchers evaluated over 8 billion patient-provider interactions from more than 140 million patient records between 2020 and 2025, sourced from the Epic Cosmos national dataset. The findings paint a clear picture: healthcare is becoming more continuous, moving beyond the confines of scheduled appointments.

The New Digital Front Door to Healthcare

The data shows a staggering transformation in communication patterns. Between 2020 and 2025, the volume of online portal messages from patients to providers surged by 153%, while telephone calls decreased by 6%. The average number of messages sent by patients more than doubled, from 2.2 per year in early 2020 to 5.4 per year by late 2025. In the first quarter of 2025 alone, 42 million patients—or 30% of all active patients on the Epic platform—sent a digital message to their clinician.

"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 study senior investigator Michal A. Mankowski, PhD, an assistant professor in the Department of Surgery at NYU Grossman School of Medicine. This shift, he noted, gives patients far more direct access to their care teams.

This digital engagement has not come at the expense of in-person care. The study found that traditional office visits have rebounded since the pandemic, stabilizing at an average of two to three visits per patient annually. Since 2020, the Epic systems logged a massive 1.77 billion in-person clinic visits alongside 1.34 billion patient messages and 146 million virtual telehealth visits. This confirms that a hybrid model is the new standard, where digital tools provide an ongoing connection that complements, rather than replaces, face-to-face consultations.

"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," Dr. Mankowski added.

The Double-Edged Sword: A New Digital Workload

While this unprecedented access is a major win for patients, it has created a significant new challenge for the healthcare system: the 'digital workload.' The massive influx of patient messages adds a substantial layer of responsibility onto providers who are already stretched thin. Industry reports indicate it is not uncommon for physicians to receive over 150 'In Basket' messages daily, a key factor contributing to burnout for nearly half of all physicians.

Study co-investigator Dorry L. Segev, MD, PhD, explained that the digital delivery of healthcare does not simply replace old workflows; it adds another complex layer. "Modern delivery of healthcare means increasingly that healthcare providers will have to balance their digital workload on top of their traditional clinical workload," said Dr. Segev, a professor and vice chair in the Department of Surgery at NYU Grossman School of Medicine.

This digital demand, often managed by clinicians outside of normal work hours, requires a systemic response. According to Dr. Segev, health systems must fundamentally rethink how they operate. To manage this new reality, hospitals and clinics have to strategically plan for future staffing, training, and technological support to prevent provider burnout and ensure the sustainability of this new care model.

Pioneering Solutions with AI and Operational Innovation

As a leader in patient care and medical research, NYU Langone Health is not just identifying the challenge—it is actively pioneering the solutions. The institution recognizes that technology, particularly artificial intelligence, is critical to managing the digital workload effectively.

"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," noted Dr. Segev, who is also a professor in NYU Grossman's Department of Population Health.

NYU Langone is already putting this vision into practice. The health system has licensed GPT-4 for internal use, allowing its physicians to securely experiment with generative AI to streamline tasks. It is actively using AI tools to speed up the drafting of physician notes. Furthermore, researchers at the institution have demonstrated that AI can draft responses to patient messages with accuracy comparable to human providers and, in some cases, with greater perceived empathy, all while ensuring a human clinician provides the final review. The organization has also developed an AI-based system to intelligently triage incoming patient messages, prioritizing urgent queries to ensure they are handled promptly and safely.

Building an Equitable and Resilient Hybrid Model

The integration of digital and in-person care is a strategic imperative for the future of healthcare. It promises a more efficient, resilient, and patient-centered ecosystem. However, building this hybrid model requires careful financial and operational planning to ensure it is both sustainable and equitable.

Recognizing that digital access is not universal, NYU Langone is committed to bridging potential disparities. The health system has launched targeted initiatives like 'JustMothers,' a digital program for Black and Hispanic pregnant women to address the maternal mortality crisis, and a virtual supportive oncology program for underserved lung cancer patients. It has also deployed a new interpretation service supporting 240 languages, ensuring that communication, whether digital or in-person, is clear and accessible to all patients.

As healthcare continues its digital transformation, the path forward requires a dual focus: empowering patients with greater access while simultaneously supporting providers with the advanced tools and new workflows needed to manage this new reality. Through its comprehensive research and forward-thinking innovation, NYU Langone Health is helping to define and build that more connected and sustainable future for all.