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Check for updatesGenAI is increasingly used to draft replies to patient portal messages to reduce clinician workload.Evidence shows modest utilization and measurable workflow effects, alongside safety risks when clinicians miss errors or accept drafts with minimal editing.As deployments scale with deeper EHR integration and expanding transparency mandates, this Comment proposes governance that preserves efficiency without normalizing unsafe delegation: scoped use, risk tiering, accountable human authorship, auditability, and patient-facing transparency.Draft replies are becoming a care pathway, not a clerical aid
Johnny Sakr (2026) studied this question.