Why two-way messaging is dead on arrival for healthcare

Two-way messaging might seem like a good way to increase patient engagement and help further a health system’s digital transformation goals. Eight in ten Americans won’t pick up calls from unknown numbers, but 70% of Americans check their phones within five minutes of receiving a notification. Why shouldn’t health systems communicate with patients with a channel they are likely to use?

Ultimately, two-way messaging fails to deliver on health systems’ operational objectives like increased efficiency and decreased call volume. It also presents challenges for both patients and staff.

Here’s why two-way messaging in healthcare was always destined to be dead on arrival.

1. Why two-way messaging doesn’t work for patients

Two-way messaging has limited functionality. For anything besides a simple exchange, patients have to be routed to another system. At worst, patients get frustrated and resort to a phone call – or give up entirely and find a different provider.

Here’s one example of how those limitations can play out: 

• A patient sees multiple specialists at a health system that recently adopted two-way messaging. 
• Since the switch, the patient has received messages from six different providers. 
• While it might have been easy to respond to just one or two texts from one provider, they struggle to manage texts from all of them.  
• The frustrated patient calls the health system and has to wait on hold to talk to a scheduler. 
• By the time the phone call gets picked up, the patient is irritated at how much time and effort it cost them to complete these basic tasks.

Because texting wasn’t sophisticated enough to handle the complexity of the patient’s needs, this created a fragmented and confusing patient experience.

2. Why two-way messaging doesn’t work for staff

Adding two-way messaging to the already lengthy list of things staff need to manage creates more work without simplifying anything else. In addition to answering phone calls and helping patients in-person, office staff now have the added manual work of texting patients back. 

Here’s an example of how this impacts staff:

• Since implementing two-way messaging, patients have been sending messages at all hours of the day and night.
• Staff receive notifications every time chatbots can’t adequately respond to patients — which happens often.
• Text messages may contain a great deal of clinical information. This has the potential to result in HIPAA violations and put patient data at risk.
• Some text messages are also hard to decipher, so staff give up on texting and switch to a phone call, making texting an unnecessary extra step. In fact, two-way messaging often relies on staff to switch to external links and applications. 

Like their patients, this experience leaves staff frustrated. Unlike their patients, this becomes their new normal and is a perfect recipe for burnout. 

3. Why two-way messaging doesn’t work for the bottom line

Healthcare leaders trying to meet digital transformation goals find that two-way messaging falls short of expectations.

Here’s one example of how it holds leaders back from meeting their goals: 

• Leaders invested in two-way messaging, hoping to improve the patient experience, but it doesn’t pay off as much as they expected.
• In fact, because of two-way messaging, they now need more people to manage the same amount of work — and their labor costs have continued to rise.
• Staff, frustrated by increased busywork, have burned out and many have left. 
• The organization has increased headcount, but continually upstaffing is expensive, and they are no closer to achieving strategic cost savings than they were a year prior. 

For leadership, the experience contributes to cynicism about the ability of technology to help achieve organizational goals, as this most recent investment fails to show the progress they had hoped.

When does texting make sense?

Texting can make sense for broadcast messaging, meaning one-way communication streams like reaching patients for one-off and non-scheduled announcements — for example, if a practice is closed due to bad weather or the doctor is sick. 

But for anything that leaves the channel open for patients to respond, texting can quickly get complicated and require more staff, not less. 

Better alternatives to two-way messaging

You want to meet patients where they are, but you also want to create a positive patient and staff experience. If two-way messaging doesn’t work, what does?

A healthcare automation platform like Notable improves patient engagement without adding work for staff.

Let’s take a look at what this means for the patient, staff, and the organization: 

• When the patient is due for care, the automation platform sends a personalized message to the patient with a link to schedule an appointment.
• The patient clicks through and schedules the right appointment with the right provider for their care needs in minutes, without needing to speak to a scheduler.
• The patient is prompted to fill out their personalized intake digitally. Established patients save time because they simply confirm that their information is correct. 
• At the end of their intake forms, they are shown their co-pay amount and given the opportunity to pay ahead of time. 
• Front desk staff and MAs save valuable time that would otherwise be spent on data entry, freeing them up to provide the care that patients deserve. 

Automation reduces the number of steps that both patients and staff have to take — whereas two-way messaging increases the complexity of patient-provider interactions. 

This approach also ensures healthcare organizations get accurate patient information on the front-end—which reduces errors that can hurt clinical outcomes, cause additional staff overhead and issues with payments.

Why automation produces better results

With automation, the right channel is used for the right type of communication without requiring a high lift.

• Patients still receive communications where they are most likely to engage—on their smartphones. 
• But rather than taking the next step by texting back, patients can tap a link and easily schedule, complete their intake forms, and pay. 

The patient gets a consumer-grade experience, staff are empowered to operate at their best, and health systems can scale effectively to meet their patient acquisition and retention goals.