2-Way SMS Chat FAQs

2-Way SMS Chat FAQs

2-Way SMS Chat FAQs


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2-Way SMS Chat is now live in your setup!


This service enables staff and patients to connect directly via SMS in a HIPAA-compliant manner while avoiding playing phone tag. It improves patient convenience and overall patient satisfaction because SMS is a mode of communication that patients are already familiar with, and there is no need for patients to download apps or manage passwords. 2-Way SMS Chat also reduces phone volumes, increases staff productivity, and speeds up resolution times.


Below are some FAQS. For anything not on this list feel free to reach out to us. 


Staff-initiated Chat Conversations


Can I start a chat with a patient who is not on the schedule?

Yes, you can start a chat with any patient. Select "Messages" in the primary menu (left column) followed by "New Chat" in the top-right corner. Enter the patient name in the search field and select the patient from the list of matching patients to start a chat. 


Can I start a chat with a patient who is on the schedule?

Yes, you can do this by selecting "Schedule" in the primary menu (left column) followed by selecting the patient's appointment on the schedule. Then, select the "Chat" icon within that appointment's pane to start a chat with that patient. 


Is the 2-Way SMS Chat service HIPAA-compliant?

Yes! While leveraging the convenience, ease, and effectiveness of SMS-based texting, this service helps obtain the appropriate level of consent from the patient based on the type of conversation you wish to have. It allows the patient to unsubscribe at any time. It enables you to use secure form links to gather sensitive data when appropriate. It archives the transcription of each conversation into the patient record in your EMR. Read the rest of this FAQ for more details.


Where can I view the patient's subscription status i.e. whether the patient subscribed to 2-Way SMS Chat?

When you access the chat conversation (right column), you will see the patient name, MRN, cell number, and subscription status at the very top of the conversation. The status can be "SUBSCRIBED", "UNSUBSCRIBED", or "CONSENT PENDING".


Can I initiate a chat with the patient if the subscription status is "UNSUBSCRIBED"?

No. The "UNSUBSCRIBED" status indicates that the patient has explicitly requested (ex: by replying STOP in a previous conversation) not to be sent 2-Way SMS messages.


Can I initiate a chat with the patient if the subscription status is "SUBSCRIBED"?

Absolutely!


Can I initiate a chat with the patient if the subscription status is "CONSENT PENDING"?

It depends. As per HIPAA guidance on uses and disclosures of PHI (protected health information) data, there are scenarios when neither an authorization or an opportunity to agree or object is required. If you are sharing information with an individual directly about treatment, payment, or healthcare operations that is pertinent to themselves, then you can have a conversation with them without prior consent. For example, if you want to ask the patient to confirm an upcoming appointment, or ask a referred patient when they would like to schedule an appointment, you can do so even if the subscription status is "CONSENT PENDING". Obviously, you should always apply the "Minimum Necessary Standard" i.e. share the minimum necessary PHI to perform your responsibilities when the standard applies, at all times.


NOTE that there are scenarios when a valid signed authorization from the individual is required, or when the individual should be given an opportunity to agree or object. For example, if you are trying to market a service to a patient, or need to share significant amount of PHI data (ex: clinical notes related to a recent visit), you should not do so unless the subscription status is "SUBSCRIBED".


What are the different strategies to obtain patient consent for 2-Way SMS Chat?

Here are the strategies we recommend:

  1. If you have signed up for Simple Interact's Digital Patient Forms service, we include the 2-Way SMS Chat consent form in the NP Intake Forms Packet. This ensures that new patients are automatically subscribed i.e. their status will be changed to "SUBSCRIBED".
  2. For patients who have not yet subscribed i.e. are in "CONSENT PENDING" status, you can start a conversation, ask them to accept the 2-Way SMS Chat consent form, and send the link via text by clicking on the 'paperclip' icon and selecting Packets > Consent for 2-Way SMS Chat. When they complete the consent form, their status will be changed to "SUBSCRIBED".
  3. Patients who initiate a conversation by filling out the chat request form automatically go through the consent process, and their status will be changed to "SUBSCRIBED".

If the patient is subscribed in our EMR system, does that transfer over to Simple Interact?

No, patients will have to provide consent specifically for 2-Way SMS Chat. To obtain consent, use the strategies suggested in the FAQ above.


What should I do if a patient requests to be removed from SMS communication?

At any time, the patient can reply STOP to unsubscribe. If they insist on you doing it, you can update patient preferences by selecting Patients > search for patient > Edit Patient Preferences > Opt Out of SMS Chat > Yes > Save. In both cases, the patient's status changes to "UNSUBSCRIBED". As suggested in the FAQ above, do not start conversations with unsubscribed patients. 


To ensure HIPAA compliance when using 2-Way SMS Chat, what are the best practices to send or receive PHI data?

The primary purpose of this service is to efficiently conduct conversations related to business operations with patients without having to make phone calls and waste time playing phone tag. Note that while you can certainly have conversations related to clinical information, this service is not a replacement for your telehealth service. With that being said, here are the best practices to send or receive PHI data using this service. 


Sending: As explained in the above FAQ, you should always apply the "Minimum Necessary Standard" i.e. share the minimum necessary PHI to perform your responsibilities when the standard applies. If the patient is in "CONSENT PENDING" status, make sure it is a scenario where you are sharing information with an individual directly about treatment, payment, or healthcare operations that is pertinent to themselves. This is a scenario when neither an authorization or an opportunity to agree or object is required to share PHI. Also, for your convenience, you can use prebuilt form packets to share certain information like appointment details (ex: select 'paperclip' icon > Packets > Appointment Details). The patient receives a URL link that they can click to view their upcoming appointment details on a secure web form. If patient is in "SUBSCRIBED" status, you have more leeway to share additional PHI data like clinical notes. 

Receiving: The best way to gather PHI data from patients is by texting them a URL link to a prebuilt form packet (ex: Submit Photo of Insurance card, Fill Release of Information, Fill HPI form). Simply select 'paperclip' icon > Packets > specific packet. The patient receives a URL link that they can click to view and fill a secure web form. The completed form is accessible to you in the chat conversation. Alternatively, if you want to ask a patient to share PHI data with you in clear text, make sure they are in "SUBSCRIBED" status.
 
Can patients see staff members' full names in chats?

No, patients will only see the staff members' first name in the auto-generated message when starting a 2-Way SMS chat.

Example: "Hi John, ASHLEY from ABC Clinic has started an SMS conversation with you."


What happens if a patient doesn’t respond to my message?

The chat remains open until manually archived by staff, OR it will be automatically archived if there has been no activity for >7 days or the total number of active chats is >500.


Can the system identify if the patient's phone is a landline and not a cell number?

No. We treat your PM/EMR systems as the source of truth and pull the cell number from there. We recommend that scheduling staff make sure they add home number and cell numbers in the appropriate fields in the PM/EMR. 


Patient-initiated Conversations


How do patients initiate a chat conversation?

Patients can start a new chat via the following mechanisms:

  1. Patient selects the "Text Us" link on your website and fills out the chat request form
  2. Patient responds to a previous conversation that has already been archived. This triggers an automated text to the patient asking them to click the included link to the chat request form and fill it out.
  3. Patients calls your phone system which is programmed to offer a "press 5 to switch to 2way texting" option. Patient selects that option which results in "phone forwarding" to the dedicated texting number. This triggers an automated text to the patient asking them to click the included link to the chat request form and fill it out.

The chat request form gathers patient identification, consent for 2-Way SMS Chat, and triages what kind of request this is (ex: appointment request vs. billing vs. refill vs. records release). Based on the kind of request it is, the forms gather additional contextual information from the patient. Once submitted, the request is added to the shared inbox in our dashboard and routed to the appropriate team or team member.


How does a staff member know when there is a new chat request from a patient?

When a patient submits a new chat request, it gets added as a new task under Tasks > "Unassigned Tasks". The appropriate task bucket counts (in red) are also updated to indicate how many tasks are in pending status. Depending on the type of chat request  (ex: billing vs. appointment request), the system may automatically add tags to the task. In addition, the system may automatically route the task to a specific subfolder under Tasks. If a staff member's user account has matching tags, they will be able to see the task. When such a task is added, an audible "ding" is produced and the Simple Interact browser tab flashes "New Task" in order to draw your attention.


Can I assign a chat to a specific user?

Yes, you can do this by selecting a chat, selecting the edit/pencil icon, and entering another user's name in the "assigned to" field. This will result in the chat appearing under that user's "My Messages".


Can I assign a chat to a team of users?

Yes, you can do this by selecting a chat, selecting the edit/pencil icon, and selecting the appropriate tag names under "Tags". This will update the tags of the chat and will make it appear under "Unassigned Messages" for all team members who have matching filtering tags. One of those team members can then assign the chat to themselves.


Can multiple staff members respond to the same chat?

Yes, the platform allows team collaboration on a single chat.


How do I know when there is a new message from the patient for an ongoing conversation?

An ongoing chat aka conversation is typically filed under "My Messages", "Unassigned Messages", or "Assigned Messages". When a new message from the patient arrives for that conversation, it will change the status the conversation to "Pending Staff Response". The appropriate message bucket counts (in red) are also updated to indicate how many conversations are pending a staff response. You can also filter your view by Message Status > Pending Staff Response to filter out all other conversations.


Will patients expect an immediate response and 24x7 availability?

No. When submitting a chat request, the system sets clear expectations with patients that staff will only respond during office hours and on a delayed basis. This messaging that patients see can be customized to your needs. 


What is the recommended response time after I receive a patient message?

Respond promptly within a business day. For urgent issues, call the patient directly if needed.


What should I do if a patient submits a chat request about symptoms that cannot be addressed via chat?

Redirect the patient to call or schedule an appointment.


Can I get notified about new chat requests or new patient messages from within my EMR?

No. Staff must check Simple Interact dashboard directly. For EMRs that support SSO (single sign on), it is easy to auto-login from your EMR to Simple Interact.


If I mark a chat request task as “Done”, is the associated chat conversation archived?

Yes


If a patient submits two chat requests, is the first conversation archived upon submission of the second?

Yes 


If two chat requests are submitted by two different patients that share the same phone number, is the first conversation archived?

Yes


If a patient submits a chat request, then a staff member initiates a different chat conversation with that same patient, is the first chat request conversation archived?

No, the existing chat is opened.

General


Can my conversations be translated?

Yes, when a patient sends a message in a language other than English, you can click the translation toggle. The application will automatically detect the language and translate it to English. When the toggle is on and staff send a message, they can select which language they would like it translated to, make final edits, and send.


Can I send or receive documents (ex: patient test results) using the 2-Way SMS Chat service?

As of June 2025, we have not added the ability to upload a document and share a secure link via SMS. As already noted, you can send patients links to secure web forms that they can fill or sign. 


Can patients submit images from their phone camera?

Yes. To ensure patient privacy, send the patient a link to the Submit Photo packet (select 'paperclip' icon > Packets > Submit Photo). Patient can click on this link to open a secure web form which allows them to take images from their phone camera or upload a photo. Once submitted, a PDF with the images is accessible to you within the conversation.


How can I access chat history and PDF transcripts?

All archived conversations can be found under Archived Messages on our dashboard. Additionally, when a conversation is archived, the system automatically creates a PDF with the transcript of the conversation, and pushes the PDF into the patient record in your EMR system. Some EMRs allow us to specify the document category under which to file the PDF.


Are chats ever automatically archived?

Yes, chats are typically archived after 7 days of inactivity, but this timing is customizable. Chats may also be archived if the total number of active chats exceeds 500.