Bulk Messaging


Introduction to Bulk Messaging

Bulk messaging is a great way to send out mass communication to all, or certain subsets, of your patients without having to individually message each one. To send a bulk message, follow the instructions below. Please note that you can only send bulk messages from the web Spruce version, not from the Spruce mobile app or Spruce mobile browser. 

How to Send a Bulk Message

There's a new way to select your recipients for a bulk message: via your Contact List.
Please note: Unlike sending a single message, sending a bulk message will not cause each conversation to appear unread in the inbox. If the included conversations were previously in the archived state, they will remain archived even after the bulk message is sent. If the conversations were previously marked as read, they will remain marked as read after the bulk message is sent. 
Additionally, you can only send bulk messages as SMS or secure messages. You cannot bulk message in fax, email, or note conversations.

Bulk Messaging from Your Contact List

1.  Create the list you want to bulk message: Click the "Create Filter" button at the bottom of your contact lists. Using that pop up, you can categorize your contacts using tags, invite status, etc. Once that list has been created, you can use it to send bulk messages.

2.  Select the contacts: To select only certain contacts, check the checkbox to the far left of each individual contact. To select all contacts displayed on the page, select the checkbox at the top of the Contact List (see image below).

3.  Define the channel and sender of your message: Once you've selected all the contacts to whom you want to send your bulk message, select the "Bulk Message" button. 

You'll need to choose which channel you'd like to send the bulk message in: SMS or secure message. What you choose may depend on whether your contacts have the Spruce app or not, as SMS messages do not require that your patients have the app. If you choose to send your bulk message as a secure message, then you will also be able to choose whether you want to send it in an existing conversation or to create a new conversation for it with each patient.

You'll also need to define the "Sender" of the message, i.e., what display name the patient sees the message coming from (your name or your clinic name). You may prefer to use your clinic name as the sender when you're sending general announcements that won't require much patient follow-up, and you may prefer to send the message from your personal name when you know you'll be the one responding to your patients' replies.

4. Compose your message: Once you've defined the channel and sender of your message, compose your message, add any attachments you want, and select "Send."

Lastly, here is a video overviewing this entire process.

Here is a video to see how to bulk message: 

Important Information for Bulk SMS Messaging

Spruce allows you to send bulk SMS messages (standard "text messages"), but there are several key aspects of this feature that you must understand in order to make sure that your messages are delivered as expected.

Above all, it is important to understand that SMS messaging is fundamentally less dependable than secure messaging, and this is beyond the control of Spruce or any other communication service. This stems particularly from the fact that SMS is tightly controlled by the major telecommunications carriers, and they have implemented significant defenses to combat spam text messaging. Any time you are sending multiple SMS messages, whether via Spruce or any other platform, you run the risk of your messages being blocked by phone network factors beyond your control.

If you want to bulk message large numbers of your patients—quickly, privately, and dependably—we strongly urge you to consider using secure bulk messaging on Spruce, rather than SMS. Secure messages will also allow you to know which patients have seen your messages, and when.

With that said, if you have messaging needs that will be best served by bulk SMS, please be aware that your bulk SMS messages:
  • Will be subject to telecom carrier regulations, which might include regulation of message content (e.g., banning references to the sale of federally prohibited substances) and enforcement of STOP words that will block future communication
  • Will be sent at an intentionally metered pace, to avoid tripping spam detectors—the longer your recipient list, the longer it will take your message to go out
  • May be blocked by a downstream telecom carrier—if this happens, we will do our best to report each blockage in the impacted conversation on Spruce
  • May negatively impact the ability of your practice to send individual, non-bulk SMS messages, if the major carriers flag your phone number as a possible source of SMS spam and decide to clamp down on all messages from it—this risk goes up with the length of recipient list length
Steps you can take to ensure that your bulk SMS messages are delivered:
  • Keep your bulk SMS recipient lists as short as possible
  • Keep each message shorter than 160 characters—beyond this, your message will send as TWO or more messages, each of which counts against your limit with the carriers
  • Use bulk SMS messaging sparingly, and preferentially use bulk secure messaging instead of bulk SMS—the less you use bulk SMS, the more likely it is to work when you need it
  • Provision a dedicated phone number on Spruce to use specifically for bulk SMS messaging—with this approach, any blockages you run into with bulk messaging won't also reduce your organization's ability to send important non-bulk SMS messages
  • Contact Spruce support in the Spruce app and request a toll-free number to use for bulk SMS—these numbers require a stricter verification process to obtain, and they cost a bit more, but they are significantly less likely to be subject to SMS blockage by the major telecom carriers
Avoiding SMS messaging limitations

When you use an application like Spruce to send SMS messages, you are doing what the major telecom carriers call " application-to-person messaging" (A2P messaging). Because this type of messaging has been abused for spam, the carriers have a low threshold to block such messages, and they also charge more to transmit them.

In most cases, Spruce absorbs any increased A2P messaging fees on your behalf, without raising your subscription price! 🙌

Spruce also works to prevent your messages from being blocked, by registering your organization with the major carriers so that you will be identified as a legitimate user of A2P SMS messaging. Please note that, if your organization makes heavy use of SMS or has 6 or more phone numbers, the telecom carriers will require you to complete a more thorough registration in order to avoid SMS message blocking.

Typical daily limits on A2P SMS messaging, by organization registration status (not Spruce plan):

Registration Type Spruce Phone Lines Daily SMS Limit*
Basic 1 to 5 3,000
Standard 6+ 6,000
Standard with "secondary" vetting 6+ 10,000+

*IMPORTANT NOTE: The "daily SMS limit" in this table refers to SMS message segments. Each SMS message segment can contain only 160 characters, so long messages will require multiple segments, each of which will count against your daily limit with the carriers.

In some cases, Spruce will automatically detect when your organization needs a more thorough registration and will prompt you for the necessary information. In other cases, we may reach out to you individually when a specific need arises. We also encourage you to reach out to our support team proactively, either in the Spruce app itself or via email to support@sprucehealth.com, to pursue a more thorough registration, if you know that you will have significant SMS messaging usage and you want to get ahead of potential blocking.

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