Automated Patient Communication Software
We build patient communication software that sends reminders, recalls, results notices and two-way SMS from your EHR's own appointment and result events, with TCPA consent and opt-out handling, minimum-necessary message content and delivery tracking.
The challenge behind the brief
Updated September 2026.
Automated patient communication software sends the right message to the right patient when something happens in the EHR: an appointment is booked, moved or missed, a result is released, a patient is discharged or a recall comes due. We build it for provider groups, health systems, digital health companies and EHR vendors that need communication tied to their own scheduling and results data rather than a separate list that drifts out of date.
A production system is more than an SMS gateway. It listens to HL7 v2 SIU and ORU feeds or FHIR Appointment and DiagnosticReport events, decides who may be contacted on which channel under the patient's consent and the TCPA healthcare rules, writes each message to the minimum necessary standard, handles STOP and HELP replies, tracks carrier delivery receipts, and writes every outbound and inbound message back to the chart as a FHIR Communication so staff see one history. Patients reply to confirm, cancel or reschedule, and the change lands in the EHR schedule instead of a staff inbox.
Need a conversational assistant as well? See our AI virtual health assistant. Need the EHR connection alone? Start with EHR integration services or HL7 integration services, delivered on Interoply, our integration platform. Ready to scope it? Book a 30-minute scoping call.
Primary sources: FCC 2015 TCPA Declaratory Ruling and Order (healthcare exemption), FCC 2024 consent revocation order, FCC 2024 ruling on AI-generated voices, HHS minimum necessary guidance, 45 CFR 164.522 confidential communications, FHIR R4 Communication and The Campaign Registry for A2P 10DLC.
Define the right scope
Reminders at the intervals your clinics choose, triggered by HL7 SIU S12 (new), S13 (rescheduled), S14 (modified) and S15 (cancelled) messages or FHIR Appointment changes. Patients reply C to confirm or R to reschedule; confirmations update the appointment status in the EHR and cancellations release the slot for the waitlist.
Recall lists built from the EHR for overdue annual visits, screenings, immunizations and chronic care follow-ups, with outreach cadences that stop as soon as the patient books. Recall rules use the same data as your HEDIS and value-based care reporting, so outreach and measurement agree.
When an ORU R01 or FHIR DiagnosticReport is released to the portal, the patient receives a notice that a result is ready, not the result itself. Timing rules respect the Cures Act expectation that results are available without delay and any clinician-review holds your organization sets for sensitive tests.
Free-text replies routed to the right team queue with the patient's context, templated responses, assignment and escalation timers. Every inbound and outbound message is stored as a FHIR Communication linked to the patient and encounter, so the conversation is part of the record.
Pre-visit instructions, intake and consent form links, insurance card capture and check-in, plus post-discharge follow-ups triggered by ADT A03 events to support readmission prevention programs.
Voice agents that confirm, cancel and reschedule by phone, reading open slots through FHIR Slot and booking through Appointment, with a clear disclosure and hand-off to staff. Since the FCC's February 2024 ruling, AI-generated voices count as artificial voices under the TCPA, so the same consent rules apply as for prerecorded calls.
Templates in each patient's preferred language from Patient.communication or the EHR language field, with clinician-approved translations. Segment counts are planned per language: GSM-7 messages carry 160 characters per segment, while Unicode messages in scripts such as Chinese, Vietnamese or Arabic carry 70.
Carrier delivery receipts (queued, sent, delivered, undelivered, failed) and error codes captured for every message, landline and invalid numbers detected before sending, and fallback from SMS to voice or email by rule. Failed reminders appear on a worklist instead of disappearing.
One consent record per patient and channel, capturing how and when consent was given, the purpose it covers and every revocation. STOP, QUIT, END, REVOKE, OPT OUT, CANCEL and UNSUBSCRIBE replies are processed automatically, and opt-outs requested by phone or at the front desk are recorded in the same place.
Explore the service in detail
Off-the-shelf patient engagement platforms suit single-EHR practices with standard workflows. A custom build or extension fits when communication is part of your product or your workflows are not standard.
Consent and opt-out logic belongs in the platform, not in staff training.
Each EHR exposes schedule and result events differently. We confirm the path per EHR during discovery.
Every engagement ends with software and documentation your team can run.
Scope, not screen count, sets the budget. We estimate against these drivers after discovery.
What to evaluate in your partner
Our team has built more than 350 interfaces on Mirth Connect, and we have run one SMART on FHIR app against the Epic and Oracle Health developer sandboxes in a single session. Reminders are only as reliable as the schedule feed behind them, so that is where we start.
We sign BAAs, and Nirmitee is ISO 27001:2022 certified. PHI stays out of message bodies unless the patient has chosen otherwise, data is encrypted in transit and at rest, and every message, consent change and staff action is logged.
Client names are withheld; each is a real engagement. We built a chronic pain patient app and clinician portal that keeps patients reporting between visits, an oncology copilot that answers only from the patient's record and hands off to the care team, and dental practice software that runs scheduling, charting and billing in one system.
We map your message types to TCPA, HIPAA and state rules with your compliance lead before the first template is written, and the platform enforces those rules rather than relying on staff memory.
Source code, infrastructure as code, templates and runbooks are delivered to your repositories and cloud account, and you choose the messaging vendor.
A reviewable delivery approach
Triggers and consent first, then channels, then two-way and voice.
Map every message type to its EHR trigger, audience, channel, consent basis and template.
Deliverables: event and template catalog, consent model, EHR integration path per system, carrier registration plan.
Build the EHR event feeds, reminder engine, consent service and SMS channel, and complete A2P 10DLC or toll-free registration.
Deliverables: live reminders and confirmations in one clinic, opt-out processing, delivery tracking and write-back to the EHR.
Add recall lists, results notices, the staff inbox and pre-visit and post-discharge messages, running in parallel with the pilot.
Deliverables: recall and results workflows, shared inbox with routing, dashboards for confirmations and failures.
Roll out to more clinics and add AI voice agents, more languages and further EHRs.
Deliverables: voice agent, translated templates, monitoring and an agreed support model.
Evaluating an integration or product partner? Explore the systems, workflows, and technical decisions behind our work.
Explore all case studies
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Explore the implementation
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Explore the implementation
Discover how a patient health record platform integrated 12 EMR systems using FHIR to deliver seamless interoperability and unified patient data.
Explore the implementationA working model for your priorities
Define the scope, ownership, and delivery responsibilities together. Commercial terms and team availability follow that conversation.
Bring a product or integration milestone. Agree the dependencies, deliverables, and acceptance criteria before implementation.
Explore engineering, integration, design, and QA support that works with your existing product and technical leads.
Before you choose a partner
Automated patient communication software sends appointment reminders, recalls, results notices, pre-visit instructions and follow-ups automatically when events happen in the EHR, and handles patient replies by SMS, voice, email or app. It connects to scheduling and results data, enforces consent and opt-out rules, and records every message in the patient's history.
Through HL7 v2 feeds from the interface engine (SIU for appointments, ORU for results, ADT for admissions and discharges), FHIR R4 APIs for Appointment, Slot, Patient and DiagnosticReport, or vendor APIs such as athenahealth's changed-data subscriptions. Replies and delivery status are written back, typically as FHIR Communication resources or HL7 messages, so staff see them in the chart.
Healthcare messages about treatment, such as appointment reminders and results notices, generally rely on the consent a patient gives by providing their number to the provider. Texts to wireless numbers sent under the FCC's healthcare exemption must also be free to the patient, name the provider, avoid marketing and billing content, stay within 160 characters, be limited to one per day and three per week, and include an opt-out. Marketing messages need prior express written consent.
Since 11 April 2025, FCC rules require that consent revoked by any reasonable means, including replies such as STOP, QUIT, END, REVOKE, OPT OUT, CANCEL or UNSUBSCRIBE, be honored within 10 business days. The software should process keyword replies automatically, record opt-outs made by phone or in person, and block further messages on that channel for that purpose.
Messages should carry only what the patient needs to act, following HIPAA's minimum necessary principle: the provider name, date, time and a link or reply option, not diagnoses or results. HHS guidance allows unencrypted text or email with PHI when the patient has been told the risks and prefers that channel, which the software records as a patient preference.
Yes. Replies such as C to confirm or R to reschedule update the appointment status in the EHR, cancellations free the slot for the waitlist, and rescheduling offers open slots read from FHIR Slot or the EHR's scheduling API.
When a result is released to the patient portal, an ORU message or FHIR DiagnosticReport event triggers a notice that a new result is ready, with a link to the portal. The result itself stays behind portal login, and rules can hold notices for tests your clinicians review before release.
Yes. Voice agents can confirm, cancel and reschedule appointments, answer routine questions and hand off to staff. The FCC ruled in February 2024 that AI-generated voices are artificial voices under the TCPA, so they need the same consent as prerecorded calls, and patients should be told they are speaking with an automated agent.
Yes. Templates are selected by the patient's preferred language from the EHR, translations are reviewed by your clinical and language services teams, and message length is planned per language, since Unicode scripts carry 70 characters per SMS segment instead of 160. Section 1557 of the Affordable Care Act requires covered entities to offer language assistance, which the messaging program should reflect.
Each message stores the carrier delivery receipt (queued, sent, delivered, undelivered or failed) and any error code. Numbers are checked for landlines and invalid lines before sending, failed messages fall back to another channel by rule, and a worklist shows patients who could not be reached.
Buy when you run one supported EHR with standard reminder and recall workflows. Build or extend when messaging is part of your own product, when you connect to several EHRs, when your specialty workflows are not standard, or when you need data and message history you control. Many teams keep their platform and build the missing layer around it.
The number of EHRs and trigger types, the channels (SMS, voice, AI voice agent, email, app), the depth of two-way messaging and the staff inbox, the number of languages, message volume and carrier fees, and the hosting environment. Discovery produces an estimate with these assumptions written down.
Let’s make the next step useful
Discuss your workflows, systems, and delivery priorities with the Nirmitee team.
