Patients and clinicians fed up with portal sprawl

A lot of U.S. patients now need the digital equivalent of a janitor’s key ring just to manage basic care: one login for hospital records, another for secure messages, another for labs, and sometimes another for bills. Federal survey data says 59% of people had multiple online medical records or portals in 2024, while only 7% used an app that tried to combine them. (healthit.gov, beckershospitalreview.com) The main portal in that stack is often MyChart, which is Epic Systems’ patient app. MyChart says patients can see medications, test results, appointments, bills, and price estimates in one place, even across multiple organizations that use Epic. (mychart.org) That sounds unified until a clinic uses something else for the parts MyChart does not handle well for that workflow. Spruce Health sells a separate communication platform for calls, texts, fax, secure messages, and video visits, and says it is used by more than 25,000 healthcare providers across 5 million patient accounts. (sprucehealth.com) So the “portal sprawl” complaint is not really about one bad app. It is what happens when a hospital record system, a messaging tool, a lab workflow, and a billing system each work fine on their own but land on the patient and front desk as four different doors with four different rules. (sprucehealth.com, ehrinpractice.com) Clinics feel the same fragmentation from the other side of the counter. A Medical Group Management Association report published last week said staff complaints about portal overload cluster around repetitive administrative work like prior authorizations, eligibility checks, claim status follow-up, and appeals. (mgma.com) Patients are using these tools more, not less. The Office of the National Coordinator for Health Information Technology said 65% of individuals nationally were offered and accessed their online medical record or portal in 2024, up from earlier years, and app-based access rose to 57% while web-based use fell to 42%. (healthit.gov, beckershospitalreview.com) That increase in usage makes fragmentation more visible because every extra handoff creates another place for results, refill requests, consent forms, or invoices to get stuck. A 2023 review of patient-portal interoperability research found recurring challenges in getting portals to work cleanly with electronic health record systems. (sciencedirect.com) Epic’s scale makes this especially hard to ignore. KLAS-based reporting in May 2025 said Epic added 176 multispecialty hospitals and 29,399 beds in 2024, widening its lead in the U.S. hospital electronic health record market. (fiercehealthcare.com, cnbc.com) When one company’s record system is that widespread, every sidecar tool has to explain why it exists next to it instead of inside it. The answer is usually speed or specialization: texting is faster than inbox messages, niche labs need custom routing, and independent clinics want workflows that a giant hospital system was not built around. (sprucehealth.com, mychart.org) That is why the business pitch around “one front door” keeps coming back. If a vendor can pull messaging, results routing, and billing into one workflow for staff, it is not selling prettier software so much as fewer clicks, fewer missed handoffs, and fewer “check the other portal” calls. (mgma.com, healthit.gov) The frustration showing up now is a sign that the first decade of digital health solved access before it solved coordination. Patients got records, clinicians got messaging, and administrators got portals, but many organizations still did not get a single place where all three line up. (healthit.gov, sciencedirect.com)