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In recent years, text messaging in healthcare has gone from a niche phenomenon to something that many providers have incorporated into their patient communications. This is even more pronounced in 2021, in the shadow of the ongoing COVID-19 pandemic. Everyone has rapidly adapted to a new wave of telehealth, and we need to be able to remotely communicate as effectively as possible.

Almost 40% of Americans are still fearful of visiting their doctors for a checkup while the risk of COVID-19 remains. 30% of patients have not seen their doctors for a routine checkup since the onset of the pandemic. We need text messaging in healthcare to plug this gap. Patients want access to their doctors, health information, and a positive healthcare experience. But they don’t want to expose themselves to unnecessary risks. Text messaging offers the best of both worlds, through SMS appointment reminders, text-based scheduling, and more.

Text messages are powerful because patients like them. They have a 98% open rate and most are responded to within 90 seconds. This convenience and immediacy makes text messaging for medical offices highly appealing.

Dr. Yifeng Hu is an associate professor of new media and health communication and the chair of the communication studies department at The College of New Jersey. She says text messaging in healthcare falls into three distinct camps:

  • Health interventions, where texting is used to provide patients with information, reminders, and support.
  • Texting as a communication tool between patients and healthcare providers or medical offices.
  • Texting is also playing a growing role in AI, which allows chatbots to have intelligent, and increasingly detailed, conversations with people.

Health interventions

Texting as a health-intervention technique is the most common form of text messaging in healthcare. There’s strong evidence that these (primarily automated) messages are an effective way to improve public health. Texting helps providers get in touch with patients and help them make sense of complicated health information,particularly if the stakes are high.

One of the biggest applications of SMS for healthcare providers is contacting patients for appointment reminders, follow-ups, and instructions. A 2021 medical study reported 70% adherence of patients to their providers’ instructions after receiving motivational messages through text.

Sending patients information and instruction prior to a procedure or appointment positively impacts medical compliance by patients. Ultimately, this results in better healthcare outcomes for patients, says a 2021 Perelman School of Medicine study. In a different research, 81.1% of patients treated for human immunodeficiency virus said they preferred receiving text message adherence reminders. As a result, patients’ health literacy significantly improved and travel time to clinics fully accelerated.

Such figures present a strong case why text messaging for medical offices and clinics must be implemented across the board.

From patient to provider

Text messaging in healthcare enables patients to conveniently and easily contact their providers through a channel they prefer.

In a 2021 study of patients’ communication preferences post discharge, 97% of respondents reported text messaging as a tool they use for general, day to day communication. The same study revealed that 76% use it for managing their health, including contacting their providers for appointments, information requests, and regular updates.

“When patients feel empowered and more in charge of their own health, they will become more motivated and also more informed. The evidence shows that this leads to better doctor-patient relationships.”

— Dr. Yifeng Hu, Associate Professor of New Media and Health Communication

According to Hu, this kind of texting is especially good for doctor-patient relationships. It employs what’s called the “transactional model of communication,” a two-way social interaction in which both parties listen and contribute, and both have equal power and control over the situation. “Traditionally, healthcare providers have the upper hand, and patients are in the submissive role, so they feel vulnerable,” Hu said. Patients frequently emerge from the doctor’s office without fully understanding what the doctor has said or what’s required of them.

“In healthcare, some of the biggest problems stem from miscommunications. Miscommunications can be in the form of not understanding my diagnosis, or not understanding how to change a dressing [on a wound] or take my medication,” Hall said. “How do you disseminate that knowledge effectively?”

According to Hu, implementing text messaging in healthcare affords patients a comfortable space in which to get the information they need. “That empowers patients,” she said. “And when patients feel empowered and more in charge of their own health, they will become more motivated and also more informed. The evidence shows that this leads to better doctor-patient relationships.”

Hall says there’s also simply a pragmatic benefit to SMS for healthcare: “Text messages are really just this short way to disseminate information quickly and with not much effort.”


And finally, although the newest generation of health-related chatbots rarely use the term “texting,” Hu says that’s precisely what they do. She cites the example of Woebot, which engages users in a text conversation based on cognitive-behavioral principles. The essential idea is to improve your mood—or navigate a high-stress situation—using the chatbot’s cues.

There are also chatbots designed to serve as virtual health consultants, like Your.MD and Babylon Health. And lest you think that all chatbots are intended for patient use, the landscape now includes options like Safedrugbot, which gives doctors information about how medications might affect a breastfeeding patient. Such innovations are very promising for the future of text communication in health and social care.

Moving forward

Texting is far from a new invention: SMS technology is about 30 years old. And in terms of health intervention, Hu said, like providing motivational information and check-ins to patients, it’s old news. “Ten years ago it was new, but there are so many newer technologies for intervention. I see fewer articles for texting interventions,” she said.

But “a lot of healthcare providers are still way behind in terms of using new media technologies for communication,” Hu said. Healthcare organizations are just beginning to explore the possibilities of text messaging in healthcare, the back and forth communication with their patients. “It’s a new reinvention of a not-very-new technology,” she said.

As for the future of text messaging in healthcare, Hu thinks it will “be immersed into more advanced, encompassing technologies, such as AI-powered SMS appointment reminder solutions, mobile-native health monitoring apps, and medical wearables that track personal health data and connect patients with health providers in real time.”

It might not be called “texting” anymore—the term is no longer cutting-edge—but short, back-and-forth messaging will continue to be a part of the healthcare models to come. Text communication in health and social care is only going to get more sophisticated and complex. Nonetheless, Hu says that stand-alone texting will still have some role to play in health interventions, simply because of its convenience and security: “It’s low cost, widely accessible, and very universal.”