Spruce Bulk (Broadcast) Messaging: Send Messages to Many Patients at Once (Communicator Plan)

Types of Bulk Messages

There are 4 different types of bulk messages you can send using Spruce:

1. Bulk SMS Text Message
2. Bulk Secure Message
3. Bulk Email
4. Bulk Spruce Invitation

How to Send a Bulk Message

You can use a Contact Filter to send a bulk message to a specific list of contacts or you can individually select contacts from 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 sending the bulk message. 

Sending a Bulk Message Using a Contact Filter

Sending a bulk message using a Contact Filter allows you to create a custom list of contacts who will receive your bulk message.

Prepare a Custom Contact Filter List

To create a custom Contact Filter to send your bulk message to, navigate to your contacts tab and do one of the following:

1. Create a contact filter list of contacts that you want to bulk message. You can read more about contact filtering here.
2. Upload a list of contacts that you want to bulk message. You can read more about importing contacts here.

Create a New Bulk Message

Now that you've prepared your Contact Filter list, the next step is sending the message. 

Navigate to your "Bulk Messages" tab, then click the "New Bulk Message" button. From there, select the type of bulk message you want to send, then enter all of the required information. This includes which Contact List to send the message to (select the filter you created from the dropdown menu), how the message should be delivered, the message delivery date and time, and the content of the message. When you've finished, press the button at the bottom of the dialog to send or schedule your new bulk message.

Sending a Bulk Message by Selecting Contacts  

Navigate to the "Contacts" tab and select the contacts you want to send the bulk message to by clicking on their initials or profile photo. Once you've selected all the contacts, click the "Bulk Message" button. Select the type of bulk message you'd like to send and configure your message.

Scheduling a Bulk Message

One powerful way to use bulk messaging is to schedule a bulk message for delivery at a future date and time. When creating your bulk message, under Delivery Date & Time, select "Schedule Delivery," then choose a future date and time for your message to be sent. Some common use cases for scheduling a bulk message include:

1. Sending an invite to Spruce to a new group of patients joining the practice on a future date
2. Sharing information about a new program/initiative at the practice when it launches
3. Reminding patients of their appointments that day/week

Please note that for scheduled messages, any contacts who have been added to a Contact Filter before the delivery date will be added to the recipient list.

Bulk Messaging Video Walkthrough

Monitoring the Status of a Bulk Message

In the "Bulk Messages" tab, you can monitor the status of any bulk messages. This is helpful to track any bulk messages that you have scheduled for the future, any that are currently in progress, or any that have fully completed sending. 

The Queued tab displays bulk messages that are in the process of being sent or that are scheduled to send at a future date. Scheduled bulk messages can be edited at any time before their scheduled send date and time. 

For bulk messages that are in the process of being sent, you can pause the sending of the messages. Once a message has been paused, it can be resumed or canceled. 

And if you make a typo, you can edit the message contents of a bulk message while it is paused. The updated message will be sent to the remainder of the recipient's list. 

Lastly, you can view all completed bulk messages in the "Completed" tab. Clicking on the message will show you the details of the 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 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 the major telecommunications carriers tightly control SMS and have implemented significant defenses to combat spam text messaging. Any time you send multiple SMS messages, whether via Spruce or any other platform, you risk 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 let you 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.
• Messages may be throttled by carriers, such that messages deliver at a slower pace than you might otherwise expect. 
• It 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.
• It 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 the recipient list.

Steps you can take to ensure that your bulk SMS messages are delivered:

• Keep your bulk SMS recipient lists as short as possible.
• If possible, keep each message shorter than 160 characters—beyond this length, your message will count as TWO or more messages with the carriers, even if it eventually displays as one message for your recipients.
• 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.

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 uses SMS heavily or has six or more phone numbers, the telecom carriers will require you to complete a more thorough registration to avoid SMS message blocking.

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

*IMPORTANT NOTE: This table's "daily SMS limit" 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 contact 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.

If a contact has multiple phone numbers, the system will use the below logic to determine which numbers to text:

• First, the engine sorts the contact's phone numbers by label:

  1. "mobile", "personal", "cell", "iphone"

  2. "primary", "main"

  3. "home"

  4. every other label except for "work"

  5. "work"

• Then the engine checks whether conversations exist for all of the contact's phone numbers, and picks the conversation that's sorted first in the above list, in case there are multiple conversations.
• Then, if no conversation exists, the engine picks the phone number that's first in the priority list and creates a new conversation.

Important Information for Secure Bulk Messaging

Secure bulk messages will only be sent to contacts with a Spruce account. Contacts that have not yet created an account will not receive the message. If you wish to invite patients to connect using the Spruce app, send a bulk Spruce Invitation instead. 

Determining Which Secure Conversation Receives the Bulk Message

If your organization uses multiple Spruce Links, it's important that the message gets delivered to the right patient conversation. Under the "Secure Message Delivery" section, the "Deliver Message To" field allows you to decide how to deliver the message. The options for delivery are:  

• Any available, secure conversation - In this option, the system will first try and deliver the message to conversations with the Spruce link you selected. Then, it will try to deliver the message to any existing secure conversation with the recipient. A new secure conversation with the selected Spruce link will be created if no existing conversation exists.
• Only conversations with the selected Spruce Link - In this option, the system will only deliver messages to conversations with the selected Spruce link. A new conversation will be created if no conversation with that Spruce link exists for the recipient.
• A new conversation - This option will create a brand new conversation with the recipient and the selected Spruce link that's separate from any existing conversations. 

Frequently Asked Questions

How do I send a mass text message to patients in Spruce?

Bulk (broadcast) messaging on the Communicator plan lets you compose one message and send it to a selected group of contacts. 

Are there requirements before sending bulk messages through Spruce?

Yes. Practices must complete a one-time 10DLC registration for $19.50, which registers your number with carriers and is required for SMS delivery.