The Twilio integration (Client Chat) allows EMR practices to chat with clients directly through Instinct!
⚡ Important Note: There is some setup involved before we can enable this feature at your hospital. To request the Client Chat feature, please have an admin from your practice email us at support@instinct.vet to get started.
Table Of Contents
🔎 Overview of Client Chat
How it Works:
- Our support team will help you get the integration with Twilio enabled
- Ensure your practice has a way to capture Consent from your clients that Opt-in to Messaging Services
- Enable notifications for each phone number a client approves
- Send and Receive messages from your clients
- Client’s can Opt-out (or back in) at any time simply by responding STOP (or START)
⚙️User Permissions
In order to use Client Chat your practice must have the Client Chat feature enabled and a hospital administrator will need to add the client_chat_full_access permission to the appropriate user role (or create a new one) in order for staff to send messages to clients.
For more information on how to enable permissions for users, check out our User Roles and Permissions Guide.
👤Client Account (one-time) Set-up
1. Obtain Consent From Clients
In compliance with paragraph 3 of the Instinct Science Messaging Services Addendum, the Telephone Consumer Protection Act of 1991, and other anti-spam laws applicable to SMS or similar communications, you will need to document client consent before sending the first message to each client. Clients will have the option to ‘opt out’ of receiving messages from your practice at any point by replying STOP.
We recommend creating a Messaging Consent Form template to be used in Charts, similar to the example below, to capture client consent.
2. Turn On Chat Notifications
Once consent is captured, notifications can be enabled for each phone number by navigating to the Account through the Business Office or by clicking on ‘Owner’ in the patient information bar to the left of the patient’s record.
Click on the 3-dot menu next to any phone number and select ‘Turn on chat notifications’.
📓 Please Note: There is no need to ‘Turn Off Chat Notifications’ in the Account modal unless you intend to block a client from opting back in later.
The icon to the right of the phone number indicates whether it is disabled or enabled for chat notifications.
✅ Opt-In or Opt-Out of Messages
Clients will receive a message with opt-out instructions the first time a message is sent from your practice. This opt-out message will not be visible in the message thread within Instinct.
“You are now subscribed to receive messages from <Practice Name>. You may unsubscribe at any time by replying “STOP”. Carrier rates may apply.”
When a client replies STOP, they will receive a message that they have been successfully unsubscribed. This reply will also automatically disable the ‘Type a message…’ field in the Client Chat modal, preventing staff from messaging the phone number.
Clients can opt back in at any point by texting START (as long as notifications are still enabled in the Account modal for that phone number).
👍 Best Practice Recommendations:
- Assign 1 person/team to monitor and create tasks as needed
- This team should have excellent/professional text communication skills
- Limit who has permission to text owners (only front desk team for example)
- We recommend that this team keeps the Chat modal open at all times to monitor incoming notifications
Future Functionality (stay tuned!):
- Port to existing numbers
- Snippets
- Support image files
- Management Tools/User notifications
💬 Using Client Chat
Click on the Client Chat icon in the navy blue panel to open Client Chat.
The Chat panel will automatically open in the expanded view. This view can be minimized by clicking on the arrow in the upper right hand corner of the panel. Similar to other panels in Instinct, the Chat panel can be pinned to stay in place as you move through different areas of Instinct.
In the upper left hand corner of the panel, the number of new Chat messages will display in a blue circle next to Client Chat.
Messages appear in chronological order, with the most recent messages at the top. Any messages that have not been read will show a blue dot to the left of the client’s name or phone number.
Once a message has been read by any staff member, that message will be considered read for all. To change a message back to an unread state, click on the 3-dot menu next to the client’s name/phone number and select Mark as Unread.
To filter by unread messages, click on the 3-dot menu next to the search box and select Show Unread Only. To see all messages, click on the 3-dot menu again and change the filter to Show all messages.
📱Sending a Message
During the initial setup, Twilio will assign a unique phone number to your practice. This is the phone number that your clients will see when they receive a message from your practice.
To send a message to a client, simply click on the Find/Start Chat button or search for a client in the search box. A chat message window will display to the right of the chat list.
If there is no message history with the client, No Messages Yet will display when the client is selected. If any messages have been sent/received from the client, they will display in the panel.
Enter your message in the Type a Message… field and click the orange arrow to send a message to a client.
Outbound messages to the client will display in blue and will include:
- The date and time the message was sent
- The initials of the user who is sending the message
📲Receiving Messages
Clients will be able to send messages to your practice by sending a text message to the phone number provided to your practice by Twilio (not the practice’s business number).
When an incoming message is from a phone number that is associated with an existing client, the client’s name will be displayed.
Phone numbers will be displayed if they are not associated with an existing client or if the phone number is associated with more than one client. When there is more than one client associated with a phone number, hovering over the info icon will display which accounts share that phone number.
Clicking on the 3-dot menu next to the phone number in the chat thread panel will allow you to select associated accounts giving you easy access to select an account to edit.
In the message thread, inbound messages from the clients will display in gray and will include:
- The date and time the message was received
- The initials of the client (not present if more then one account is associated to a phone number)
🚫 Message Errors
If a message is not sent successfully, it will display in red on the chat messaging screen.
🚨There is currently no option to resend a failed message. The message will have to be sent again.
🔎 Viewing messages in the Comm Log
When viewing the Comm Log for a patient, any messages that are linked to the owner or the owner’s alternate contacts will be displayed in the Client Chat section of the Comm Log.
Since messages are linked to the phone number associated with the client, if the phone number is changed, existing messages will still be viewable in the Comm Log; however, a tooltip message will say that the following contacts are no longer associated with this phone number and the Type a message field will no longer be active in Client Chat.
📁 Archiving Alternate Contacts
If there is an alternate contact that is no longer associated with the client account, you can click on Archive This Contact if there has been messaging to/from that number, or Remove Contact if there has not been messaging to/from that number.
When a contact is archived, messages to and from the phone number will still display in the Chat Panel and in the Comm Log, but the phone number will no longer display the contact name that it was initially associated with.