Can you text patient about appointments?

Patient privacy is biggest obstacle

Many patients are accustomed to receiving text messages from friends, retailers, and workplaces, and they probably expect to be able to receive texts from you.

"We've taken proactive steps to accommodate our patients in this way," says Brian A. Todd, CHAM, manager of patient access staff development and training at Lourdes Health System in Camden, NJ. "In fact, we have some of this communication already in place."

These steps occur when patients go online and request their own appointments on the hospital's website:

• Once the request is submitted, the scheduler schedules the patient without the need for a phone call.

• The patient receives an email with a link to view the scheduled date, time, and procedure-specific instructions.

"Our patients who choose a more traditional method of scheduling, via the phone, also have the opportunity to receive their appointment instructions via email, as well as an appointment reminder two days prior to the procedure," says Todd.

Text messaging is the next step, says Todd, adding that he envisions his patient access department texting patients to remind them that a payment plan bill is due, and emailing consent forms so that patients can read and review them carefully before signing. "In this day and age of smart phones, the goal is to keep the patient informed while they're on the go," he says. "Keeping the patient well-informed while being brief and succinct is a challenge; 160 characters only goes so far!" Todd recommends considering these items:

• Patients might be annoyed if they receive what they consider to be too many text messages.

"There's the balance of keeping the patient informed, while not bombarding them with message after message," says Todd. "The last thing we want to do is desensitize them to our message."

• Patient privacy regulations must be complied with.

This area is the biggest obstacle for patient access areas to overcome when texting patients, according to Todd. "You want to make sure you're compliant at all times. Ensuring you're securely communicating [protected health information] with your patients is paramount," he says.

One approach is to provide a link to a secure database so patients can validate their identity before disclosing information. "Obtaining consent to communicate with a patient in this way is crucial, especially when establishing a text communication," says Todd.

• Consents should be revisited and updated at regular intervals.

A confidentiality breach could inadvertently occur if patients change their mobile phone number or hand it off to a friend or family member, without informing their providers, explains Todd.

"Having a way for the patient to communicate back to a patient access representative, should this become necessary, is also something to think about," says Todd.

• Patients might have questions about the initial email or text sent by patient access.

Your system should guide the patient to call a patient access representative instead of emailing questions, recommends Todd.

"This limits the amount of 'back and forth' emails. It mitigates the responsibility to constantly man an inbox," he says. (See related story, below, on implementing texting in patient access areas.)


For more information on texting and emailing patients, contact:

  • Brian A. Todd, CHAM, Manager, Patient Access Staff Development & Training, Lourdes Health System, Camden, NJ. Phone: (856) 824-3125. Email:

Piloting texting? Here's how to start

If you want to begin texting and emailing patients, the easiest way to start is to replace a current communication process, according to Brian A. Todd, CHAM, manager of patient access staff development and training at Lourdes Health System in Camden, NJ.

For example, a registration area could text or email patients about an appointment for a scheduled procedure. "You potentially could start with a reoccurring patient population to ensure the kinks are worked out. That feedback will be readily available to you," says Todd. "Once that is done, advancing to include a larger population should be a breeze." He recommends taking these steps:

1. Identify which patients wish to receive texts and emails from your patient access department.

"There is a specific patient population that would utilize and truly appreciate these services," says Todd. "Being able to identify this target audience becomes key."

2. Build a database of email addresses and mobile phone numbers.

Obtaining this information at all registration areas would be ideal, says Todd, whether that type of registration would warrant this type of communication or not.

"This is where the IT folks come into play, in building a field to make this possible," says Todd. "Finding a vendor to facilitate this type of communication might also be an alternative."

3. Identify the types of communication you'd like to establish.

It might be that you are sending "save the date" information to all patients, or you might be looking to target specific groups of patients.

"This is where meeting with the clinical folks may come in handy, to find out what would they like to communicate to patients," says Todd. "Collaborating with IT to make this truly happen falls right in line at this point."

4. Keep risk management and corporate compliance associates informed and in the loop.

"It's easy to step over the compliance line and not even know it," says Todd. For example, a registrar might send a non-secure email including patient-identifying information in the body of the message.

"This could pose a compliance breach," Todd says. "To overcome this, having a patient log in to a secure database to view their information is a viable option."

5. Begin by sending emails alerting patients to health fairs sponsored by the organization or annual flu vaccine availability reminders.

"Hopefully before a blast email is sent, glitches will have been identified and mitigated," says Todd.

6. Send text messages for general communications, and send emails for patient-specific messages.

"The key to keep in mind when developing these types of communication is, 'What do you ultimately want to accomplish?'" says Todd. "If it's just a general reminder, text it. If it's something more involved, email it securely."