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.

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 the create-chat dialog, BloomText shows Secure text with link and Insecure text when you select one patient and send 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, select your organization, then the Plan tab.
3. Choose the Patient SMS contact tier that fits your monthly contact volume and complete checkout.

Only administrators can see the Plan tab. If you don't see it, ask an admin in your organization 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 → Phone numbers. 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 tab. Go to Directory → Patients → Create new, fill in any combination of: phone number, first name, last name, date of birth (DOB), medical record number (MRN), and email.

• Create conversation dialog. Type a patient's phone number or email into the "new conversation" field and select Patient. The patient record is created on the fly.

• CSV import. For large lists, prepare a CSV and import it from the patients directory. See Broadcasts overview for the column schema — the import format is shared.

5. Send a message

Open the Inbox and click the purple + button. The popover shows Create a chat and Start a video chat — pick Create a chat. (There is no "Send SMS" option here; SMS is a send mode chosen inside the conversation, not from this menu.)

In the new-conversation dialog, enter the patient's phone number and select Patient. Under Send via…, BloomText shows two buttons, Secure text with link and Insecure text, when you are sending from a team with an assigned phone number and exactly one patient is selected. More information opens a side-by-side comparison of the two, including whether each can contain PHI. When you pick Insecure text, More information turns into an orange alert as a reminder; it doesn't stop you from sending. If an insecure text is unavailable, BloomText keeps the message as a Secure text with link and explains what is missing.

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.

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 orange Insecure pill in the inbox and an Insecure text label in the chat header. Hover over 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 Secure text with link. The message box also reminds you not to include PHI.

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 — useful for audit trails and follow-ups.

7. Audit and switch inbox views

The inbox can be scoped to a single phone number / team. Click the inbox icon and switch to the team associated with your phone number to see only conversations that belong to that number. Switching back shows your full inbox.

Edge cases / gotchas

• PHI must go in a secure text with link. An insecure text can't contain PHI. When in doubt, use Secure text with link.
• Insecure text is conditional in the create-chat dialog. It is available only when you send from a team with an assigned phone number and select one patient.
• 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. An insecure text has no delivery-read signal from carriers; absence of a receipt is not the same as unread.

Related flows

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