How EHR Patient Portals Prevented 21 million Missed Appointments and What This Means for Clinicians and Healthcare Systems - A Commentary

Data from Epic, a widely used electronic health record (EHR) system, revealed that patient portal use was associated with approximately 21 million fewer missed appointments across the United States in 2024. Converting these findings to rates, patients with activated portal accounts experienced roughly 1,700 fewer no-shows per 100,000 scheduled visits compared to non-users. The greatest benefit was observed among middle-aged patients. This commentary examines the implications of such findings for clinicians and health systems, exploring possible mechanisms such as appointment reminders, rapid rescheduling, and direct communication with care teams. While the evidence suggests that portals can improve adherence and support stronger doctor-patient relationships, the findings derive from observational data and may reflect underlying patient engagement differences. Equity considerations are critical, as portal adoption can exacerbate disparities for populations with limited broadband access, device availability, or digital literacy. Recommendations are provided for both practitioners and developers to enhance portal usability, integrate sign-up into every patient touch point, link cancellations to automated rebooking systems, and monitor scheduling efficiency. By translating these insights into practice, healthcare systems can maximize the operational and access benefits of patient portals while ensuring inclusive adoption.