Patient Portal Messaging for Asynchronous Virtual Care During the COVID-19 Pandemic: Retrospective Analysis

Ming Huang, Aditya Khurana, George Mastorakos, Andrew Wen, Huan He, Liwei Wang, Sijia Liu, Yanshan Wang, Nansu Zong, Julie Prigge, Brian Costello, Nilay D Shah, Henry Ting, Jungwei Fan, Christi Patten, Hongfang Liu

Research output: Contribution to journalArticlepeer-review


Background: During the COVID-19 pandemic, patient portals and their message platforms allowed remote access to health care. Utilization patterns in patient messaging during the COVID-19 crisis have not been studied thoroughly. In this work, we propose characterizing patients and their use of asynchronous virtual care for COVID-19 via a retrospective analysis of patient portal messages. Objective: This study aimed to perform a retrospective analysis of portal messages to probe asynchronous patient responses to the COVID-19 crisis. Methods: We collected over 2 million patient-generated messages (PGMs) at Mayo Clinic during February 1 to August 31, 2020. We analyzed descriptive statistics on PGMs related to COVID-19 and incorporated patients' sociodemographic factors into the analysis. We analyzed the PGMs on COVID-19 in terms of COVID-19-related care (eg, COVID-19 symptom self-assessment and COVID-19 tests and results) and other health issues (eg, appointment cancellation, anxiety, and depression). Results: The majority of PGMs on COVID-19 pertained to COVID-19 symptom self-assessment (42.50%) and COVID-19 tests and results (30.84%). The PGMs related to COVID-19 symptom self-assessment and COVID-19 test results had dynamic patterns and peaks similar to the newly confirmed cases in the United States and in Minnesota. The trend of PGMs related to COVID-19 care plans paralleled trends in newly hospitalized cases and deaths. After an initial peak in March, the PGMs on issues such as appointment cancellations and anxiety regarding COVID-19 displayed a declining trend. The majority of message senders were 30-64 years old, married, female, White, or urban residents. This majority was an even higher proportion among patients who sent portal messages on COVID-19. Conclusions: During the COVID-19 pandemic, patients increased portal messaging utilization to address health care issues about COVID-19 (in particular, symptom self-assessment and tests and results). Trends in message usage closely followed national trends in new cases and hospitalizations. There is a wide disparity for minority and rural populations in the use of PGMs for addressing the COVID-19 crisis.

Original languageEnglish (US)
Article numbere35187
JournalJMIR Human Factors
Issue number2
StatePublished - Apr 2022


  • asynchronous communication
  • COVID-19
  • digital health
  • health care
  • healthcare
  • pandemic
  • patient portal
  • patient portal message
  • remote healthcare
  • utilization
  • virtual care

ASJC Scopus subject areas

  • Health Informatics
  • Human Factors and Ergonomics


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