SMS messaging with patients

Overview

BloomText SMS Messaging lets your organization text patients in a HIPAA-compliant way. Customers use it to reduce call volume, improve patient satisfaction, and cut down on no-shows.

Watch how a first text to a new family works, then follow the steps below.

When the family replies, see See new texts and reply.

Not sure whether a message can go out as a plain text? Read Secure vs. insecure texting and HIPAA first. It explains which kind of text can contain PHI, with examples.

SMS sending requires a paid plan. Once enabled, your organization is assigned a phone number (or may port an existing number), and users on the assigned team can send texts from that number. In New chat, Send as offers Secure text or SMS text. SMS text is there when you send to one patient from a team with an assigned phone number.

Prerequisites

• The administrator role to upgrade the plan, pick a phone number, and assign users to the number's team.
• A paid SMS-enabled plan. See Update payment method and the pricing page.
• The patient's phone number.

Steps

1. Upgrade to a paid plan

If your organization does not already have SMS enabled:

1. Create an organization if you haven't already at app.bloomtext.com/#/welcome.
2. Open Settings from the lower-left gear icon, then Account, then the Plan tab.
3. Choose the Patient SMS contact tier that fits your monthly contact volume and complete checkout.

Only Owners and IT can see the Plan tab. If you don't see it, ask an Owner or IT person on your account to run this step.

2. Select a phone number

After upgrade, BloomText shows a Select a phone number action in Plan settings. Enter an area code to view available numbers. A local area code is recommended so patients recognize the number as local.

If you want to keep your organization's existing phone number, email support@bloomtext.com to start a port-in. Not every number is portable; the support team will confirm eligibility.

3. Assign coworkers to the number

Each phone number is tied to a team in BloomText. Team members can send SMS from that number and see every patient conversation linked to it.

Admins manage team membership under Directory → Teams. Add or remove members to control who can message patients and who sees patient conversations.

4. Add patients

You can add patients three ways:

• Directory. Go to Directory → Patients and click + (Add a patient). Fill in any combination of: phone number, first name, last name, date of birth (DOB), medical record number (MRN), and email.

• New chat. Click + at the top of the chat list and type the patient's name or number in To. If they aren't saved yet, click Add a patient under More, enter their details, and click Add. The demo at the top of this page shows this.

• CSV import. For large lists, add a CSV when you add recipients to a broadcast: rows that don't match a patient create one, and you map the columns yourself. See Add recipients to a broadcast.

5. Send a message

1. In Chats, click the + button at the top of the chat list. New chat opens.
2. In To, type the patient's name or number. If they aren't saved yet, click Add a patient under More.
3. Enter the mobile number and click Add. The patient is saved and lands in To.
4. Click Message at the top right of New chat.
5. Send as starts on Secure text. To send a plain text instead, click it and choose SMS text. It goes from your team's number, so don't include PHI.
6. Click Open chat. Nothing is sent or saved until your first text.
7. Type your message in the message box and press Send. That creates the chat and sends the text.

The info button next to Send as (Secure vs. SMS text) compares the two, including whether each can contain PHI. When you pick SMS text, New chat shows Don't include PHI. as a reminder; it doesn't stop you from sending. If SMS text is unavailable, it is greyed out with the reason, for example Needs a team with a texting number or One patient only, no coworkers or teams.

If you need several people — family members, caregivers, or other staff — in one secure thread rather than a single patient, start a group conversation instead.

SMS text (insecure text). Use for messages that contain no protected health information (PHI) — appointment reminders, directions, generic updates. The patient receives a regular text message from your organization's number and replies in their phone's messaging app. Carriers and the patient's phone store it unencrypted, so it can't contain PHI. Chats sent this way show an Insecure pill in the chat list and an Insecure text label in the chat header. Click either to see what an insecure text means. In the mobile app, tap the header label or long-press the pill. It ends with what to do if you need to send PHI: start a new chat with the patient and choose a secure text. The message box also reminds you not to include PHI.

Secure text (secure text with link). Use when the message contains PHI. The patient receives a text (and an email, if BloomText has one) with a secure BloomText link that opens a patient portal where they can view the message, documents, and reply when replies are enabled. Your message stays encrypted in BloomText rather than traveling over SMS. The link itself is the patient's access: anyone who has it can open the conversation until it expires, so send it only to the patient's own number or email.

6. Confirm the patient viewed the message

When a patient opens a secure conversation, their profile icon appears below the message they viewed. This is your confirmation that the secure message was received, which helps with follow-ups.

7. Switch inbox views

The inbox can be scoped to a single phone number / team. Click My Inbox at the top of the chat list and, under Jump to..., pick the team associated with your phone number to see only conversations that belong to that number. Pick My Inbox again to see your full inbox.

8. Export a conversation

To keep a copy of a conversation, for example for the patient's record, export it.

1. Open the conversation.
2. Click More settings (the three dots) in the chat header, then Export this chat.
3. Pick the dates to include. To add the files shared in the chat, turn on Include files shared by participants in the export.
4. Click Export chat.

Organization admins have two more exports:

• The member list. In your organization's settings, open the members list, click the download button, then Export in Export members.
• SMS logs for a team's number. In Directory, open the team, then click Export SMS logs on its details. You can pick dates from the last 180 days.

Edge cases / gotchas

• PHI must go in a secure text. An SMS text can't contain PHI. When in doubt, use Secure text.
• SMS text is conditional in New chat. It is available only when you send from a team with an assigned phone number to one patient, with no coworkers or teams in the chat.
• Link expiration. Secure message links expire after the configured window. If a patient reports a dead link, resend from the conversation — a new link is generated.
• Phone number portability. Not all numbers are portable (toll-free, numbers with active contracts at the current carrier, etc.). Contact support@bloomtext.com before promising patients a specific number.
• Team membership controls both sending and visibility. Removing a user from the phone number's team immediately revokes their ability to send from that number and their access to every historical conversation on it.
• Read receipts only fire for secure messages. Carriers don't report when an insecure text is read, so a missing receipt doesn't mean it's unread. To check whether a message went out, see Check delivery and fix failed messages.

Related flows

• Text patients from your business number
• Secure vs. insecure texting and HIPAA
• Getting started with BloomText
• Broadcast (mass) SMS to patients
• Update payment method