Messaging is where a lot of coaching happens now. It's also the one part of the job that rarely shows up on anyone's calendar. A member writes in on a Tuesday night. When should they hear back, and whose time pays for the answer?
Here's what the research says about message volume and what people expect from a reply, the promise we'd make, and how to staff it.
Message volume keeps climbing
Across health care, messages have grown faster than any other kind of contact. A study in JAMA of about 8 billion encounters at more than 2,000 hospitals found that patient-written portal messages rose from just under one per patient a year in 2020 to two and a half in 2025. Office visits rose 17% over the same stretch. The messages didn't replace visits. They came on top of them.
Long et al., JAMA 2026, 2,000+ hospitals
That's health system data, not coaching programs. But anyone running a coaching team will recognize the pattern. The more a member trusts their coach, the more they write.
What members expect from a reply
People don't want the same speed for every message. In a 2026 survey of 1,185 U.S. adults, people chose between a quick AI answer within five minutes and an answer reviewed by a doctor or nurse within 48 hours. For scheduling and refill requests, 57.4% wanted the quick answer. For medical questions, 63.1% would rather wait for the reviewed one.
It was a hypothetical choice about health system portals, and the slower answer was still drafted by AI, so it doesn't map neatly onto coaching. The useful part is the split. People want routine requests handled fast, and they'll wait for an answer that takes real thought when they know a person is behind it.
Why a clear promise matters more than speed
Coaching works partly through accountability, and accountability depends on knowing what to expect. Supportive accountability, a widely cited model for human support in digital health programs, puts it plainly:
Adherence is not possible when expectations are unknown or unclear.
Mohr et al., Journal of Medical Internet Research, 2011
It's a model, not a trial, but it matches what coaching teams see. A member who knows the reply is coming tomorrow waits for it. A member who doesn't know sends the message again, or stops writing.
Setting a member message response time
This is our view, from running coaching programs. Promise a window for each kind of message, and tell members before they ever send one.
Acknowledge every message right away
A short automatic reply that says when they'll hear back. It's a small thing, and it takes the guessing out of the wait.
Same business day for logistics
Scheduling, app and account questions don't need a coach. Send them to whoever handles admin, or answer them with a saved reply.
One business day for coaching questions
Anything about the member's plan, a setback or a goal. A thoughtful answer the next business day beats a rushed one in ten minutes.
Never for urgent needs
Tell members messages aren't watched around the clock, and where to go instead: 911 for emergencies, 988 for a mental health crisis, and their doctor for medical questions like new symptoms, medication changes or test results. Those questions usually fall outside a coach's scope of practice anyway, so the promise should say who answers them.
How to staff the inbox
A promise only holds if someone's time is set aside for it. In a Cleveland Clinic study of 150 primary care clinicians, incoming messages roughly doubled in two years, and every 10 extra messages a quarter went with about 12 more minutes of computer work outside scheduled hours. When messaging isn't on the schedule, it lands in the evening.
Here's how we'd keep it off the evening shift:
Where Avidon fits
Avidon's communication tools let coaching teams send secure messages, emails and texts from one place, with saved templates and outreach scheduled ahead of time. When check-ins arrive on a steady rhythm, members spend less time wondering what comes next.
If you run coaching programs for clients or members, see how Avidon works for coaching companies.
