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Five myths about mobile messaging in healthcare


Don’t let these common misconceptions stop you from this high-impact, low-cost way to engage with patients.

Over the past few decades, text messaging has evolved from an obscure, cost-prohibitive technology to a nearly ubiquitous means of communication, with 98% of all messages read. According to the Cellular Telephone Industries Association (CTIA), with 76% of seniors and 86% of low-income individuals owning a mobile phone, this technology spans socioeconomic divides and generational gaps. Despite widespread adoption, healthcare companies often fail to take advantage of this high-impact, low-cost way of engaging patients.

Many are hesitant to engage healthcare consumers via mobile messaging because of changing federal regulations and increased litigation related to text message campaigns. Here are the top five myths surrounding mobile messaging in healthcare.

Myth #1: Mobile messaging is prohibited by the TCPA

Contrary to what some may believe, the Telephone Consumer Protection Act (TCPA) actually doesn’t prohibit healthcare companies from engaging with patients via text message.

While the TCPA was originally enacted to set limitations for telemarketing during the dinner hour, it was later expanded to include unsolicited text messaging. But the Federal Communications Commission (FCC) looks favorably on healthcare messages, requiring the least restrictive level of consent for healthcare messages.

To determine if a message violates TCPA restrictions, the FCC generally evaluates whether or not the individual receiving the message would likely want to receive the message. Unlike traditional telemarketing messages, the answer is a resounding “yes” when it comes to texts related to the recipient’s health. Whereas telemarketing typically pushes a product or service, providing individuals with mobile content for their health and wellness allows them to take charge of their health-leading the FCC to classify healthcare messages as informational.

Myth #2: You must obtain prior written consent

In 2012, the FCC strengthened its TCPA regulations, requiring businesses to obtain prior express written consent when sending automated telemarketing messages to consumers. However, healthcare-related messages are specifically exempt from these enhanced consent requirements in the FCC’s regulations. Simply put, healthcare messages are not telemarketing messages.

As such, if a consumer has released his or her number to a healthcare organization, they have given all the consent that is required under the TCPA to lawfully send automated healthcare text messages to that individual’s mobile number. Because this information is generally gathered during the patient intake and insurance enrollment processes, healthcare organizations typically obtain all the consent needed under the TCPA through their standard business practices and do not need to change anything to begin engaging their consumers via text messaging.

A best practice is to conduct initial outreach immediately upon receiving the mobile number, sending a message welcoming them to the program and informing them of their intent to send health-related messages. At the same time, you should also provide the individual with the option of replying ‘STOP’ at any time to opt out of receiving any further communication. Since patients are allowed to opt out of receiving mobile messages, it’s in an organization’s best interest to diligently track these opt-out requests. 

Myth #3: Messages must be free to the end user

Another common misconception is that mobile messaging must be free to the end user. One new FCC exemption allows healthcare entities to send texts on their own behalf to individuals if they haven’t obtained consent directly from the recipient, so long as the communications are free of cost to the recipient, are related to an exigent medical situation, and meet a few other conditions. However, when the recipient has provided his or her phone number directly to the healthcare organization or its agent responsible for sending the text message, texts do not have to be free. 

An example of how this can work is that a pharmacy or drug manufacturer that receives a patient’s number from a doctor could use this new exemption to send messages on their own behalf. But the doctor or hospital that receives the patient’s number directly from the patient still have all of the consent needed to send autodialed healthcare messages on their own behalf. This new exemption doesn’t change that. 

Next: HIPAA considerations



Myth #4: Mobile messaging isn’t HIPAA compliant

While certain precautions must be taken when communicating sensitive patient information, mobile messaging is allowed under HIPAA. Under HIPAA’s privacy rule, patients can select their preferred means of communication for sensitive information, including text messaging.

Additionally, as HIPAA’s security rules dictate, businesses may approve texting as a means of patient engagement after performing a thorough risk analysis and establishing a secure communication platform.

In the end, nothing prevents a healthcare provider from communicating with a patient via text message as long as they apply reasonable safeguards when doing so.

Myth #5: Mobile messaging is just too risky

Despite all of this, many may still view mobile messaging as a risky endeavor.

While there has been litigation surrounding mobile messaging, the vast majority of these cases center around unsolicited telemarketing messages. However, since healthcare messages expressly fall outside of the restrictions on telemarketing messages under binding FCC decisions, they are provided additional legal protections.

As long as guidelines are followed, courts have no choice but to rule in favor of an organization in TCPA litigation. In one notable and recent healthcare case, Hudson v. Sharp Healthcare, a patient claimed a hospital violated the TCPA by contacting her to collect unpaid hospital bills via autodialed calls. However, since the FCC previously established a patient’s release of a telephone number during the intake process constituted prior consent, the court was obligated to dismiss the case.

With healthcare-related texts being among the most favored messages by the FCC, and as mobile messaging is one of the most effective means of communication, if you aren’t texting your healthcare consumers, you’re missing out. With a 98% read rate, mobile messaging provides a huge opportunity to boost patient engagement and drive improved outcomes.

When it comes down to it, you can’t afford not to be engaging with healthcare consumers via mobile messaging.


Chris Nicholson is the CEO of mPulse Mobile. He has more than 20 years of experience in healthcare and digital technology, from working in Fortune 100 companies to dynamic startups.

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