{"id":"https://openalex.org/W4409772336","doi":"https://doi.org/10.1038/s41746-025-01586-2","title":"Opportunities and risks of artificial intelligence in patient portal messaging in primary care","display_name":"Opportunities and risks of artificial intelligence in patient portal messaging in primary care","publication_year":2025,"publication_date":"2025-04-24","ids":{"openalex":"https://openalex.org/W4409772336","doi":"https://doi.org/10.1038/s41746-025-01586-2","pmid":"https://pubmed.ncbi.nlm.nih.gov/40275104"},"language":"en","primary_location":{"id":"doi:10.1038/s41746-025-01586-2","is_oa":true,"landing_page_url":"https://doi.org/10.1038/s41746-025-01586-2","pdf_url":"https://www.nature.com/articles/s41746-025-01586-2.pdf","source":{"id":"https://openalex.org/S4210195431","display_name":"npj Digital Medicine","issn_l":"2398-6352","issn":["2398-6352"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310319908","host_organization_name":"Nature Portfolio","host_organization_lineage":["https://openalex.org/P4310319908","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Nature Portfolio","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"npj Digital Medicine","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.nature.com/articles/s41746-025-01586-2.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5006564091","display_name":"Joshua Biro","orcid":"https://orcid.org/0000-0001-7362-4138"},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Joshua M. Biro","raw_affiliation_strings":["MedStar Health National Center for Human Factors in Healthcare, Washington, DC, USA. Joshua.M.Biro@medstar.net"],"affiliations":[{"raw_affiliation_string":"MedStar Health National Center for Human Factors in Healthcare, Washington, DC, USA. Joshua.M.Biro@medstar.net","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5113349195","display_name":"Jessica L. Handley","orcid":null},"institutions":[{"id":"https://openalex.org/I86755215","display_name":"MedStar Health","ror":"https://ror.org/05atemp08","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I86755215"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jessica L. Handley","raw_affiliation_strings":["MedStar Health National Center for Human Factors in Healthcare, Washington, DC, USA"],"affiliations":[{"raw_affiliation_string":"MedStar Health National Center for Human Factors in Healthcare, Washington, DC, USA","institution_ids":["https://openalex.org/I86755215"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5046158316","display_name":"J. Malcolm McCurry","orcid":"https://orcid.org/0000-0003-1988-8807"},"institutions":[{"id":"https://openalex.org/I1288214837","display_name":"United States Naval Research Laboratory","ror":"https://ror.org/04d23a975","country_code":"US","type":"facility","lineage":["https://openalex.org/I1288214837","https://openalex.org/I1330347796","https://openalex.org/I175003984","https://openalex.org/I3130687028"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"J. Malcolm McCurry","raw_affiliation_strings":["Naval Research Laboratory, Washington, DC, USA"],"affiliations":[{"raw_affiliation_string":"Naval Research Laboratory, Washington, DC, USA","institution_ids":["https://openalex.org/I1288214837"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5026396063","display_name":"Adam Visconti","orcid":"https://orcid.org/0000-0001-6257-1691"},"institutions":[{"id":"https://openalex.org/I184565670","display_name":"Georgetown University","ror":"https://ror.org/05vzafd60","country_code":"US","type":"education","lineage":["https://openalex.org/I184565670"]},{"id":"https://openalex.org/I2799903593","display_name":"Georgetown University Medical Center","ror":"https://ror.org/00hjz7x27","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2799903593"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Adam Visconti","raw_affiliation_strings":["Georgetown University Medical Center, Washington, DC, USA"],"affiliations":[{"raw_affiliation_string":"Georgetown University Medical Center, Washington, DC, USA","institution_ids":["https://openalex.org/I2799903593","https://openalex.org/I184565670"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5033766577","display_name":"Jeffrey M. Weinfeld","orcid":"https://orcid.org/0000-0001-9884-6554"},"institutions":[{"id":"https://openalex.org/I184565670","display_name":"Georgetown University","ror":"https://ror.org/05vzafd60","country_code":"US","type":"education","lineage":["https://openalex.org/I184565670"]},{"id":"https://openalex.org/I2799903593","display_name":"Georgetown University Medical Center","ror":"https://ror.org/00hjz7x27","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2799903593"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jeffrey Weinfeld","raw_affiliation_strings":["Georgetown University Medical Center, Washington, DC, USA"],"affiliations":[{"raw_affiliation_string":"Georgetown University Medical Center, Washington, DC, USA","institution_ids":["https://openalex.org/I2799903593","https://openalex.org/I184565670"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5056412737","display_name":"J. Gregory Trafton","orcid":"https://orcid.org/0000-0001-5048-6780"},"institutions":[{"id":"https://openalex.org/I1288214837","display_name":"United States Naval Research Laboratory","ror":"https://ror.org/04d23a975","country_code":"US","type":"facility","lineage":["https://openalex.org/I1288214837","https://openalex.org/I1330347796","https://openalex.org/I175003984","https://openalex.org/I3130687028"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"J. Gregory Trafton","raw_affiliation_strings":["Naval Research Laboratory, Washington, DC, USA"],"affiliations":[{"raw_affiliation_string":"Naval Research Laboratory, Washington, DC, USA","institution_ids":["https://openalex.org/I1288214837"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5037268899","display_name":"Raj M. Ratwani","orcid":"https://orcid.org/0000-0002-8623-6123"},"institutions":[{"id":"https://openalex.org/I184565670","display_name":"Georgetown University","ror":"https://ror.org/05vzafd60","country_code":"US","type":"education","lineage":["https://openalex.org/I184565670"]},{"id":"https://openalex.org/I86755215","display_name":"MedStar Health","ror":"https://ror.org/05atemp08","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I86755215"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Raj M. Ratwani","raw_affiliation_strings":["Georgetown University School of Medicine, Washington, DC, USA","MedStar Health National Center for Human Factors in Healthcare, Washington, DC, USA"],"affiliations":[{"raw_affiliation_string":"Georgetown University School of Medicine, Washington, DC, USA","institution_ids":["https://openalex.org/I184565670"]},{"raw_affiliation_string":"MedStar Health National Center for Human Factors in Healthcare, Washington, DC, USA","institution_ids":["https://openalex.org/I86755215"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":7,"corresponding_author_ids":["https://openalex.org/A5006564091"],"corresponding_institution_ids":[],"apc_list":{"value":3060,"currency":"USD","value_usd":3060},"apc_paid":{"value":3060,"currency":"USD","value_usd":3060},"fwci":49.4166,"has_fulltext":true,"cited_by_count":18,"citation_normalized_percentile":{"value":0.99751342,"is_in_top_1_percent":true,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":99,"max":100},"biblio":{"volume":"8","issue":"1","first_page":"222","last_page":"222"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.9879000186920166,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.9879000186920166,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10912","display_name":"Telemedicine and Telehealth Implementation","score":0.9850999712944031,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.9728999733924866,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/primary-care","display_name":"Primary care","score":0.6239187717437744},{"id":"https://openalex.org/keywords/patient-portal","display_name":"Patient portal","score":0.4622580409049988},{"id":"https://openalex.org/keywords/medicine","display_name":"Medicine","score":0.3650878667831421},{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.3515697419643402},{"id":"https://openalex.org/keywords/family-medicine","display_name":"Family medicine","score":0.1419990062713623},{"id":"https://openalex.org/keywords/health-care","display_name":"Health care","score":0.12103092670440674},{"id":"https://openalex.org/keywords/political-science","display_name":"Political science","score":0.10614430904388428}],"concepts":[{"id":"https://openalex.org/C2984752397","wikidata":"https://www.wikidata.org/wiki/Q3259956","display_name":"Primary care","level":2,"score":0.6239187717437744},{"id":"https://openalex.org/C2776153502","wikidata":"https://www.wikidata.org/wiki/Q7144994","display_name":"Patient portal","level":3,"score":0.4622580409049988},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3650878667831421},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.3515697419643402},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.1419990062713623},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.12103092670440674},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.10614430904388428},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.0}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.1038/s41746-025-01586-2","is_oa":true,"landing_page_url":"https://doi.org/10.1038/s41746-025-01586-2","pdf_url":"https://www.nature.com/articles/s41746-025-01586-2.pdf","source":{"id":"https://openalex.org/S4210195431","display_name":"npj Digital Medicine","issn_l":"2398-6352","issn":["2398-6352"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310319908","host_organization_name":"Nature Portfolio","host_organization_lineage":["https://openalex.org/P4310319908","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Nature Portfolio","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"npj Digital Medicine","raw_type":"journal-article"},{"id":"pmid:40275104","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/40275104","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"NPJ digital medicine","raw_type":null},{"id":"pmh:oai:doaj.org/article:942c47a88cd840588de8e449469dbd9e","is_oa":true,"landing_page_url":"https://doaj.org/article/942c47a88cd840588de8e449469dbd9e","pdf_url":null,"source":{"id":"https://openalex.org/S112646816","display_name":"SHILAP Revista de lepidopterolog\u00eda","issn_l":"0300-5267","issn":["0300-5267","2340-4078"],"is_oa":true,"is_in_doaj":true,"is_core":false,"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"npj Digital Medicine, Vol 8, Iss 1, Pp 1-6 (2025)","raw_type":"article"},{"id":"pmh:oai:europepmc.org:10832281","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12022076","pdf_url":null,"source":{"id":"https://openalex.org/S4306400806","display_name":"Europe PMC (PubMed Central)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1303153112","host_organization_name":"European Bioinformatics Institute","host_organization_lineage":["https://openalex.org/I1303153112"],"host_organization_lineage_names":[],"type":"repository"},"license":"other-oa","license_id":"https://openalex.org/licenses/other-oa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1038/s41746-025-01586-2","is_oa":true,"landing_page_url":"https://doi.org/10.1038/s41746-025-01586-2","pdf_url":"https://www.nature.com/articles/s41746-025-01586-2.pdf","source":{"id":"https://openalex.org/S4210195431","display_name":"npj Digital Medicine","issn_l":"2398-6352","issn":["2398-6352"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310319908","host_organization_name":"Nature Portfolio","host_organization_lineage":["https://openalex.org/P4310319908","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Nature Portfolio","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"npj Digital Medicine","raw_type":"journal-article"},"sustainable_development_goals":[],"awards":[{"id":"https://openalex.org/G3955947853","display_name":null,"funder_award_id":"1R03HS030307-01","funder_id":"https://openalex.org/F4320332177","funder_display_name":"Agency for Healthcare Research and Quality"}],"funders":[{"id":"https://openalex.org/F4320332177","display_name":"Agency for Healthcare Research and Quality","ror":"https://ror.org/03jmfdf59"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4409772336.pdf","grobid_xml":"https://content.openalex.org/works/W4409772336.grobid-xml"},"referenced_works_count":22,"referenced_works":["https://openalex.org/W1526704262","https://openalex.org/W1974836735","https://openalex.org/W1996728935","https://openalex.org/W2057333762","https://openalex.org/W2081011876","https://openalex.org/W2281090488","https://openalex.org/W2754518417","https://openalex.org/W2961046602","https://openalex.org/W2996946491","https://openalex.org/W3005890082","https://openalex.org/W3021036350","https://openalex.org/W3134273711","https://openalex.org/W3205353327","https://openalex.org/W4200043507","https://openalex.org/W4214528748","https://openalex.org/W4310421787","https://openalex.org/W4366350958","https://openalex.org/W4390062159","https://openalex.org/W4392986561","https://openalex.org/W4394807113","https://openalex.org/W4395067201","https://openalex.org/W4400863680"],"related_works":["https://openalex.org/W4391375266","https://openalex.org/W2899084033","https://openalex.org/W2748952813","https://openalex.org/W3031052312","https://openalex.org/W4389568370","https://openalex.org/W3032375762","https://openalex.org/W1995515455","https://openalex.org/W2080531066","https://openalex.org/W3108674512","https://openalex.org/W1506200166"],"abstract_inverted_index":{"The":[0,19],"rapid":[1],"increase":[2],"in":[3,35,66],"patient":[4,30,71,79,130],"portal":[5,72,80],"messaging":[6],"has":[7,32],"heightened":[8],"the":[9,46,134],"workload":[10,121],"for":[11,136,143],"primary":[12],"care":[13],"physicians":[14],"(PCPs),":[15],"contributing":[16],"to":[17,26,29,70],"burnout.":[18],"use":[20],"of":[21,50,83,105,114],"generative":[22],"artificial":[23],"intelligence":[24],"(AI)":[25],"draft":[27,68],"responses":[28,69],"messages":[31],"shown":[33],"promise":[34],"reducing":[36],"cognitive":[37,120],"burden,":[38],"yet":[39],"there":[40],"is":[41],"still":[42],"much":[43],"unknown":[44],"about":[45],"safety":[47,131],"and":[48,63,103,122,140],"perceptions":[49],"using":[51],"AI":[52,117,144],"drafts.":[53],"This":[54],"cross-sectional":[55],"simulation":[56],"study":[57],"assessed":[58],"whether":[59],"PCPs":[60,76],"could":[61],"identify":[62],"correct":[64],"errors":[65,86,128],"AI-generated":[67],"messages.":[73],"Twenty":[74],"practicing":[75],"reviewed":[77],"18":[78],"messages,":[81],"four":[82],"which":[84],"contained":[85],"categorized":[87],"as":[88],"objective":[89],"inaccuracies":[90],"or":[91],"potentially":[92],"harmful":[93],"omissions.":[94],"Each":[95],"error":[96],"was":[97],"insufficiently":[98],"addressed":[99],"by":[100],"13-15":[101],"participants,":[102],"35-45%":[104],"erroneous":[106],"drafts":[107,118],"were":[108],"submitted":[109],"entirely":[110],"unedited.":[111],"While":[112],"80%":[113],"participants":[115],"agreed":[116],"reduced":[119],"75%":[123],"found":[124],"them":[125],"safe,":[126],"uncorrected":[127],"highlight":[129],"risks,":[132],"underscoring":[133],"need":[135],"improved":[137],"design,":[138],"training,":[139],"error-detection":[141],"mechanisms":[142],"tools.":[145]},"counts_by_year":[{"year":2026,"cited_by_count":9},{"year":2025,"cited_by_count":9}],"updated_date":"2026-04-10T15:06:20.359241","created_date":"2025-10-10T00:00:00"}
