CareMessage keeps communities healthy by reaching out to patients by text

Vineet Singal saw firsthand how difficult it is for low-income families to treat ongoing medical issues or practice preventive care. With the help of Twilio SMS, Voice, and Lookup, he created the CareMessage web platform, which exchanges ongoing communications with clients via text or voice calls based on the patient’s preferred communication method.


1.5 million

Messages sent in 12 months


Appointment reminders sent by Los Angeles health center, 12,000 appointments booked in one day

In 2008, Hurricane Ike ripped through the Gulf Coast, causing $37.5 billion in damage and displacing thousands. While helping displaced residents at a free health clinic in the hurricane’s aftermath, Stanford undergraduate Vineet Singal identified a problem that can be found nearly anywhere in the U.S.—low-income families’ medical care often began and ended in the office. Most families didn’t have the support they needed to treat ongoing medical issues or avoid behavior that could put them at risk of illness.

One problem was particularly thorny: Healthcare providers lacked the ability to advise patients efficiently and reliably once they left the clinic. The providers spent valuable time crafting tailored messages, but once they hit “send,” they had no visibility into delivery statistics or response rates, which are critical to measuring the success of medical outreach campaigns.

Twilio Products

  • Programmable SMS
  • Programmable Voice
  • Lookup


  • Appointment reminders, interactive voice response (IVR)


“With lower socioeconomic communities, if you build a smartphone app, you’re alienating 50% of the population. Text messaging is the fastest and easiest way to reach this community.”

Cecilia Corral, co-founder and VP of product, CareMessage

Tracking message delivery with Twilio

Years later, Vineet called upon his experience to found CareMessage, a web platform that connects healthcare providers to patients through text messaging and voice—the communications channels that are most familiar to patients. After initially working with another communications company, Vineet switched to Twilio’s Programmable SMS and Voice to power CareMessage’s delivery system, and he relied on Twilio’s Lookup feature to help track call statistics.

The Twilio APIs work in harmony. For instance, let’s say a CareMessage client sends a series of text messages to encourage at-risk patients to get cancer screenings. Using Programmable SMS and Voice, the client can easily segment its target groups, select which number it should contact, and determine whether phone or text is a more reliable contact method.

When CareMessage clients import numbers, the numbers are automatically sorted via Twilio Lookup to determine which ones are landlines and which ones are mobile devices. Using Twilio, CareMessage determined that over 25% of users had only a landline, information that helped clients send communications more efficiently.

Prior to using Twilio, CareMessage team members used a different API provider to get information on their users’ numbers. The solution didn’t scale with CareMessage’s success and user growth. It was too expensive and unreliable. The Twilio platform gave them a more intelligent way to manage their customer outreach, and the platform’s per-minute and per-message pricing model meant they didn’t have to pay for software or solutions they didn’t use or make a costly up-front investment.


Skyrocketing response rates

Twilio Lookup allows CareMessage clients to avoid paying for texts that will never be delivered to a landline and enables them to pivot to a cell phone. CareMessage also uses a Twilio-powered fallback to automatically call patients who do not respond to text messages. The targeted outreach has dramatically increased response rates for its clients.

Another CareMessage customer, a federally qualified health center (FQHC) in the Los Angeles area, sent appointment reminders to more than 50,000 patients who had either previously missed appointments or hadn’t been to the FQHC for a while. In one day alone, the FQHC saw 12,000 appointments booked.

More and more CareMessage customers are using SMS outreach to increase member retention, which is evident in the volume of Twilio-powered messages that CareMessage sends. In the past 12 months, CareMessage sent close to 1.5 million SMS messages.

By using a simple medium of communication tied to a powerful platform, CareMessage delivers the best of both worlds. Patients get timely messages in the medium they prefer and are most familiar with. CareMessage clients get the insight and scale they need to run outreach campaigns.


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