Think about how dramatically patient communication has changed. Not that long ago, most communication happened by telephone, mail, or face-to-face. Today, patients may receive texts, portal messages, automated reminders, electronic forms, and other digital communications, sometimes all from the same practice.
These tools can make communication faster and more convenient; however, adding more communication channels does not necessarily improve communication. So, we have to ask, “Are we making communication easier for the patient or just creating more ways to send information?” More communication options do not automatically mean better communication.
The Modern Patient Communication Journey
Patient communication is not a single interaction. It occurs throughout the entire patient journey. Communication may begin when the patient schedules an appointment and continues with reminders, forms, and pre-visit instructions. Communication continues when the patient arrives, throughout the clinical encounter, and well after the patient leaves the office.
The challenge is that patients do not experience these as separate systems or departments. They experience one practice, which means our communication needs to feel coordinated from beginning to end.
Technology has given us more ways to reach patients than ever before. That can improve access, convenience, and efficiency for both the patient and the practice.
But there is another side to this. A patient may receive a text, an email, and a portal notification about the same issue. They may send a portal message and then call the office because they do not know when, or if, someone will respond.
So, before we add another communication tool, we need to ask a few questions:
- Does this make communication easier?
- Is it clear what the patient should do next?
- Does the practice have a workflow for managing the response?
Automation is probably one of the best examples of both the opportunities and the challenges of digital communication. Automated messaging can be one of the most effective communication tools in a medical practice when used for the right things.
Consider communications that are routine and predictable, such as appointment reminders, confirmations, completing forms before the visit, preventive care reminders, or letting a patient know they need to schedule follow-up care. In these situations, automation can reduce repetitive staff work while providing patients with the right information, at the right time, for the right reason. An automated message should have a clear purpose. What do we want the patient to know or do after receiving it? If the patient has to read the message several times to figure that out, we have not really improved communication. Automation works best when communication is routine, predictable, time-sensitive, actionable, and consistent.
Automation should not replace every human interaction. Automate the routine, not the relationship. There are situations where a phone call or personal conversation is still the better communication tool. For complex medical discussions, most patients still want to hear a real voice. Think about a doctor explaining a new treatment plan or sharing abnormal test results.1 These moments need tone, empathy, and the chance for back-and-forth questions.1
One of the biggest frustrations occurs when an automated message tells the patient to contact the practice but does not provide an easy way to reach someone.
This is where practices need to periodically look at communication from the patient’s perspective and ask, “Are we removing friction, or have we simply automated the friction?”
The Patient Portal: More Than a Message Inbox
The patient portal has become much more than a place for patients to send us a message or look up a test result. When used effectively, it can become a central communication hub that connects the patient and the practice throughout the care journey.
Patients can schedule appointments, complete forms, request refills, review results and visit summaries, receive education, and communicate with their care team without making a phone call.
Age, language, accessibility, digital literacy, internet access, and personal preference can all influence portal use. The portal should expand access to communication, not create another barrier.
That convenience benefits the practice as well. Routine requests no longer rely on a phone call; information can be documented within the electronic health record (EHR), and messages can be routed to the appropriate person rather than relying on repeated phone calls and callbacks.
But simply offering a portal does not mean we have improved communication. We need to think about the patient experience with the portal.
- Is it easy to enroll?
- Do patients understand what they should use the portal for?
- Do patients know how quickly they can expect a response?
- Does the practice have a reliable workflow for portal use and monitoring?
If we encourage patients to use the portal but messages are not reviewed or routed appropriately, we have simply created another communication problem.
Not every patient is able to communicate digitally. Age, language, accessibility, digital literacy, internet access, and personal preference can all influence portal use. The portal should expand access to communication, not create another barrier.
One of the interesting consequences of successfully increasing portal use is that we create a new workload for the practice. We may reduce some telephone calls, but that does not necessarily mean the work disappears. Sometimes we have simply moved the communication from the telephone to the portal. And portal messages can create their own challenges:
- Who monitors the inbox? How frequently?
- Who handles scheduling questions?
- Who handles refill requests?
- What goes to the clinical staff?
- What requires physician review?
That is why every portal message needs a defined workflow
- First, route it to the appropriate person or team
- Second, respond at the appropriate level. If administrative staff can answer a scheduling question, it should not consume clinical time
- Third, establish clear escalation criteria. A seemingly routine message can contain symptoms or information that require clinical attention
- And finally, close the loop. Sending a response is not always the same as resolving the issue. We need to know whether the patient’s question or request was actually addressed
Without workflows, the portal can simply create another inbox that someone has to manage.
Response expectations are also important. Patients need to know that a portal is not appropriate for emergencies and that messages may not receive an immediate response.
AI Enters the Conversation
Artificial intelligence (AI) is becoming part of the communication workflow, sometimes without patients necessarily recognizing where it is being used. One of the most visible examples is AI-assisted documentation, particularly ambient technology that can capture the conversation during an encounter and help generate a draft note. AI creates the draft; however, the clinician owns the documentation.
The role of AI expands beyond clinical documentation. It may help draft responses to patient messages, summarize information, assist with patient instructions, support routing and prioritization, or handle certain routine administrative interactions.
The potential benefit of AI is significant. If AI can reduce some of the time staff and clinicians spend typing, searching, summarizing, and performing repetitive tasks, that may give them more time to focus on the patient.
But there is an important distinction between assisting with communication and being responsible for communication.
AI-generated information can be incomplete, inaccurate, lack context, or simply sound inappropriate for the situation. Someone still needs to determine whether the communication is correct and appropriate before it reaches the patient or becomes part of the medical record.
As these tools become more sophisticated, practices need to know when AI is being used, what information it has access to, and what safeguards are in place.
Know When to Switch Channels
One of the most important communication skills in a digital environment is recognizing when the communication channel is no longer working. Text messages and portal messages are excellent for routine, straightforward communication. But we’ve probably all experienced an email or text exchange that becomes longer and more confusing with every response. Healthcare is no different.
If we have exchanged several portal messages and still have not resolved the patient’s question, it may be time to pick up the phone.
If a patient is clearly frustrated or upset, continuing to send written messages may actually make the situation worse. Written communication does not always convey tone well, and the patient may interpret a brief response very differently than we intended.
Complex clinical information can present the same problem. A portal may be appropriate for delivering certain information, but the patient may need an opportunity to ask questions and have the information explained.
This does not mean abandoning digital communication. It means recognizing when we have reached its limit.
Conclusion
Technology has fundamentally changed the way medical practices communicate with patients, and that change is going to continue.
Automation can simplify routine communication. Portals can improve access and convenience. EHR tools can help connect the team and support better workflows. And AI has the potential to reduce some of the administrative burden that takes time and attention away from patients.
But none of these tools automatically creates good communication. We still have to make sure the message is clear, that we are using the appropriate communication channel, that someone is responsible for the response, and that the patient’s information is protected.
Most importantly, we cannot lose sight of the person on the other side of the technology. Patients may appreciate the convenience of a text, a portal, or online scheduling; however, when they are confused, worried, or need help, they still want to know that there is a person behind all of it.
Ultimately, the goal is not simply to modernize communication. It is to make communication better without making it less human.
Reference
- Galvez J. Text vs Phone Calls in Healthcare: Data-Driven Comparison. Curogram. June 15, 2026. https://curogram.com/blog/best-practices/patient- communication/text-vs-phone-calls-healthcare