Most physicians I speak with understand that text messaging works. Patients are people, and people read texts and respond. For practices, that translates to appointments getting scheduled, no-shows declining, payments being made and staff spending less time chasing people by phone. What’s far less clear is how practices should get started with texting.
For small and midsize organizations, health care text messaging can feel like unfamiliar territory. Beyond using a personal or office cell phone, many practice leaders do not know what to look for in a technology partner or how to evaluate whether a texting solution is truly built for health care and for practices like their own.
What follows is a practical, play-by-play guide to evaluating texting vendors and their technology, helping today’s practices choose the right partner with confidence.
1. Decide what problem you are actually trying to solve
Before looking at vendors, it’s important to be clear about what you want texting to do. Practices that succeed with text messaging usually start with a small number of specific goals and then build from there.
Common starting points include the following:
Texting works best when it is tied to a clear outcome. Without that clarity, practices often invest in texting without seeing improvement in scheduling, collections or staff efficiency. If a vendor cannot explain how their platform supports real-world health care workflows, texting can quickly become another tool that looks good on paper but delivers little value.
As I often tell practice leaders, “Texting is not valuable because it’s fast. It’s valuable because it drives meaningful, quantifiable action.”
2. Understand what health care texting is and what it is not
Health care texting is not the same as texting friends, family or customers in other industries. Using personal phones or generic business texting solutions can create real problems. Messages may not be tracked consistently. Staff may send different information to different patients. Consent and opt-out rules can be difficult to manage. Most importantly, HIPAA and other compliance risks increase quickly.
A health care texting solution should be designed specifically for clinical and administrative communication, with a clear understanding of patient workflows and protected health information. When it isn’t, staff work harder to manage communication, and practices may assume they’re protected when they’re not.
If a vendor treats health care as “just another industry” they serve, consider that an early and likely significant warning sign.
3. Make sure two-way texting is standard, not an add-on
One-way texted reminders may reduce some missed appointments, but they only scratch the surface of what text messaging can do. Two-way, conversational texting allows patients to respond. They can confirm or reschedule appointments, ask questions about preparation, request help with payments or respond to outreach campaigns. Staff, in turn, can manage those conversations efficiently without picking up the phone.
For staff, two-way texting also reduces time spent returning voicemails and playing phone tag, which is where much of the hidden cost of communication builds up.
A simple test when evaluating texting vendors is to ask them to demonstrate how a patient replies to a message and what happens next. If that process feels awkward, fragmented or overly manual, staff adoption will suffer.
If patients cannot reply and get help, texting quickly becomes more of a broadcast tool than a communication channel.
Once texting is in place: How to intelligently expand use
Practices that see early success with text messaging rarely try to do everything at once. Instead, they build intentionally, adding new use cases as staff become comfortable and texting workflows become routine.
Common ways practices expand texting over time include the following:
- Moving from reminders to conversations. Practices often start with appointment reminders and confirmations, then expand into two-way conversations for rescheduling, preparation questions and follow-up support.
- Using texting beyond scheduling. Once staff see time savings, texting is often extended to payment reminders, recall campaigns and postvisit communication.
- Applying texting across teams. What begins at the front desk may later support clinical staff, care coordinators and billing teams, each with defined purposes and workflows. In some practices, texting is also used for staff communication around scheduling, benefits/open enrollment and key updates.
- Refining outreach with data. As practices review response rates and engagement data, messaging becomes more targeted and efficient, further reducing unnecessary outreach.
The most successful practices treat texting as a long-term communication channel rather than a onetime project. Starting small and expanding thoughtfully helps ensure adoption stays strong and workloads stay manageable.
4. Treat compliance and message delivery as nonnegotiables
This is where many practices run into trouble. Health care texting must account for patient consent, privacy requirements, and carrier rules designed to prevent spam and fraud. These factors directly affect whether messages are delivered and whether practices remain compliant.
When evaluating vendors, ask direct questions of those companies under consideration, such as these:
- How is patient consent collected and managed?
- How is protected health information safeguarded?
- What steps are taken to ensure messages reliably reach patients?
A strong partner should be able to answer these questions clearly and in plain language. Vague answers or heavy technical jargon are not reassuring.
The real-world impact of getting this wrong is often invisible until it becomes costly. Messages may never reach patients, even though staff believe they were sent. Patients may miss appointments or fail to complete required steps. Staff then spend additional time on outreach and follow-up calls, trying to fix a problem they did not know existed.
It is also worth knowing that mobile carriers are increasingly strict about filtering messages they consider noncompliant. Vendors who understand health care regulations and carrier requirements are far more likely to deliver messages consistently and protect practices from unnecessary risk and inefficiencies.
5. Prioritize ease of use over long feature lists
Small and midsize practices rarely need complicated systems. What they need is technology their staff will actually use.
A texting platform should feel intuitive. Staff should be able to send messages, manage conversations, launch basic outreach and review performance without extensive training or technical support. When systems feel overly complex, teams tend to default back to phone calls and manual workarounds.
Ease of use should not be considered a nice-to-have. It is often the difference between staff adoption and abandonment.
6. Look closely at pricing and partnership expectations
Texting costs can be confusing, especially when vendors separate software fees from carrier charges or setup costs. Practices should understand up front what they will pay and what that cost includes. Transparent pricing makes budgeting easier and avoids surprises down the road.
Just as important is the type of partnership a vendor offers. Health care communication is nuanced, and vendors who provide health care-specific training and guidance tend to help practices succeed faster and with fewer missteps. A simple question to ask is whether training, ongoing support and guidance are included or treated as add-on services.
7. Make sure you can see what is working
Texting should not operate as a black box. Practices benefit when they can see who received messages, who responded and which outreach efforts drove action. That visibility often comes from simple tools like trackable links, which show whether patients took the next step, like scheduling an appointment or making a payment. And that insight via analytics and reporting then allows teams to refine messaging, reduce wasted effort and target follow-up efforts.
“If you cannot measure it, you cannot improve it” applies just as much to patient communication as it does to clinical care.
8. Plan for adoption, not just implementation
Remember that buying technology does not automatically change behavior. Successful texting programs roll out gradually. They focus on a few high-impact use cases, train staff using real-world scenarios and integrate texting into existing workflows rather than forcing teams to reinvent them.
When done well, text messaging greatly reduces workload instead of adding to it. When rushed or poorly supported, it can create frustration and resistance.
9. Look for a vendor that provides ongoing support and guidance
Text messaging is not static. Regulations, carrier rules and patient expectations continue to evolve, and practices benefit from partners who remain involved after implementation.
Beyond technical support, strong vendors help practices identify best practices, refine workflows and uncover new high-impact use cases over time. This kind of guidance helps prevent texting from stalling after early wins and ensures it continues to deliver measurable value.
One useful indicator of a vendor’s long-term commitment is customer satisfaction. Vendors with consistently high satisfaction scores (e.g., Net Promoter Score) tend to invest in support, education and outcomes because their success depends on their customers’ success.
Making the right call
Text messaging can be one of the most practical and effective tools a medical practice adopts, but only when it is implemented and scaled thoughtfully. The right vendor helps practices communicate more clearly, reduce administrative burden, and improve clinical and financial performance. The wrong approach, on the other hand, introduces risk, confusion and wasted effort.
For practices considering health care texting, getting the decision right from the start makes all the difference.
Brandon Daniell is co-founder of Dialog Health, a provider of a HIPAA-compliant, conversational two-way texting platform organizations use to communicate and engage more effectively.
