Key Takeaways
- Referral SMS is scarce-slot inventory: failed DLR means a wasted MRI minute.
- Queued is not “the patient has the address.”
- Priced by devices and SMS send volume. You use your own phone and operator SMS credit. Free is 300 SMS lifetime, 1 device.
- Keep results-portal OTP off the referral-reminder SIM.
- Call tree for failed DLR before you release the next day’s specialist list.
- Minimal clinical content — a building and a clock, not a diagnosis.
Summary
Scenario 86 is referral and imaging logistics, not generic “appointment reminder.” DLR decides whether a scarce slot was even announced. Service pricing is based on device count and total SMS sent through the gateway. You need a working Android phone with a SIM and SMS credit from your mobile operator. Operator message costs are yours—we do not sell carrier SMS balance.
Releasing tomorrow’s MRI list while last night’s texts are still queued is how you waste a machine-hour and still blame “no-shows.”
You host the coordinator MSISDN. Aggregators abstract the radio — Twilio vs Android SMS gateway.
Key takeaways
- Referral SMS is scarce-slot inventory: failed DLR means a wasted MRI minute.
- Queued is not “the patient has the address.”
- Priced by devices and SMS send volume. You use your own phone and operator SMS credit. Free is 300 SMS lifetime, 1 device.
- Keep results-portal OTP off the referral-reminder SIM.
- Call tree for failed DLR before you release the next day’s specialist list.
- Minimal clinical content — a building and a clock, not a diagnosis.
Related reading
SMS delivery reports, DLR overview, two-way SMS inbox, HHS HIPAA privacy.
Context
Referral coordinators text building, floor, and arrival window. Imaging centres bill idle time. The SIM can be out of credit at 06:20. DLR is the board, not a vanity graph.
Free (300 SMS lifetime, 300 contacts) is one specialty clinic pilot.
Core scenario guidance
Do not mark the EHR “informed” on enqueue. Gate that flag on delivered, or on a completed call after failed DLR.
Isolate results-portal OTP. A wellness campaign must not sit in front of a login code for imaging results.
Referral DLR meaning
| DLR | Meaning | Action |
|---|---|---|
| Queued overnight | Slot not yet communicated | Do not mark “informed” in the EHR |
| Submitted | Clinic SIM tried | If stuck, pairing + airtime before 07:30 |
| Delivered | Handset got a text | Still not attendance — offer a map link only |
| Failed | Slot at risk | Call tree; do not five-resend loops |
Cost and ownership
Priced by devices and SMS send volume. You use your own phone and operator SMS credit. Failed retries still spend airtime. Name who tops up the coordinator SIM.
Multi-site imaging: one radio per site at 07:00, not one HQ phone for three postcodes.
Operations
07:15 board: failed DLR on tomorrow’s list, unpaired minutes, spare charge. After OEM updates, canary a coordinator mobile.
YES/NO confirmations need an inbox owner before the first slot. Unread NO is an unused magnet.
Security and compliance
No modality + suspected diagnosis in one SMS. Time, site, how to cancel. Keep OTP bodies out of shared chat.
EHR webhooks must verify signatures. A forged referral event is a privacy and airtime incident.
Decision guide
Ship when coordinators refuse to release lists on queued-only. Delay if DLR is “IT’s dashboard.” If no handset ops, CPaaS for referrals and honesty about cost.
Checklist
- Informed flag gated on DLR or call.
- OTP isolated from wellness.
- Call tree for failed set.
- Minimal clinical template.
- Inbox owner for YES/NO.
- Airtime before specialist days.
- Spare at coordination desk.
- Webhook HMAC on.
- 07:15 board named.
- Developer Center for DLR payloads.
Next steps
Read delivery reports, device and SMS volume pricing, SMS API documentation.
Deep dive: production hardening
Coordinator phones in coat pockets sleep. Desk charge only.
Dual-SIM remap: results OTP must not hop to the reminder slot.
No auto-reply thank-you into a portal 2FA thread.
Holiday catch-up lists must pace. Fair-use still applies.
Deep dive: scaling and failure modes
Health systems scale by device per campus. Uncapped platform volume is not extra 07:00 radios.
Carrier outage: second operator SIM only helps if it is topped up.
Avoid “unlimited SMS” titles. Free and Developer still cap SMS.
Deep dive: integration discipline
Idempotency on referral_id + offset. EHR retries are common.
Feature-flag new templates. Canary coordinators before a 400-slot week.
Priced by devices and SMS send volume. You use your own phone and operator SMS credit. Live fields in Developer Center.
Specialist-slot board
07:15: failed DLR only — call those patients before releasing overflow slots.
Do not resend the whole day’s list because two were queued. Fix the radio, then the failed subset.
Delivered + patient denies receipt: treat as number quality; offer a voice path.
Abort: pause wellness, keep portal OTP, run the call tree. If that sentence is missing, you have a webhook.
Related product pages
Jump to the live product docs for this topic—not another long-form article.
- SMS delivery reports (DLR)Delivery status tracking
- transactional SMS for orders and alertsEvent-driven messages
- SMS webhook integrationInbound and status events
- SMS API documentationLive endpoint reference
