Chatting with a patient
Open a real-time chat thread with a patient via the patient portal.
Overview
Patient chat is async messaging through the portal — better than SMS for back-and-forth, better than email for speed. Patients see clinic messages in their portal Inbox; staff see them in Chat.
Prerequisites
- Any clinical or front-desk role
- The patient has a portal account
- The patient has opted in to chat (Patient → Profile → Communication preferences)
Steps
Open Chat. Top nav → Chat (or "More").
Find or start a thread. Sidebar lists existing conversations. Search by patient name; if no thread exists, + New conversation → search the patient.
Type and send a message. Type into the bottom box. Enter sends; Shift+Enter for new line.
Attach files. Click the paperclip — image, PDF, or document. Patient sees the attachment inline in their portal.
Refer to a patient artifact. Type / for shortcuts: /appt to attach a recent appointment, /invoice for an invoice, /rx for a prescription. The recipient sees a preview card.
Mark sensitive. Toggle the lock icon to mark messages sensitive — they require the patient to re-authenticate before viewing.
Track read receipts. Each message shows sent/delivered/read status. Read happens when the patient opens the thread.
Mute or pin a thread. Right-click the thread in the sidebar — Pin to keep at top, Mute to suppress notifications.
Expected outcome
- A
ConversationandMessagerecord exist - The patient sees the message in their portal Inbox
- Read receipts update bidirectionally
- The thread persists indefinitely; full audit log applies
Troubleshooting
| Symptom | Likely cause | Fix |
|---|---|---|
| Patient doesn't appear in search | They have no portal account | Cannot chat without portal; offer SMS instead |
| Messages not delivering | Patient opted out of chat | Their preference; respect it |
| Attachments fail | File over 25 MB | Compress and retry |
| Read receipts stuck on "delivered" | Patient hasn't opened the thread yet | They'll see the message when they next sign in |
| Old conversation gone | Archived after 12 months of inactivity | Search "Archived" tab |