Patient-physician communication is moving online. While face-to-face communication remains critical, information technologies (e.g. SMS, email, e-visit system) have been used to serve additional communication channels between patients and providers beyond clinical encounters. Our study investigated a patient portal system implemented in a large medical center. We employed both quantitative and qualitative methods to analyze 1172 interactions via the portal among patients, physicians, nurses and secretaries. Our analysis revealed rich accounts about the topics patients communicated with their providers and how patients discussed sensitive issues regarding their routine illness management. This helped their providers understand patients better not only in their medical situation but also how patients coped with chronic diseases in their larger social context. Furthermore, this study explores how information technologies can be better designed to empower patient-provider communication, facilitate information delivery, and enable patients and general populations to take an active role in their routine healthcare management.published or submitted for publicationis peer reviewe