E-mail is fading, but direct messaging has caught fire—and it could be HTM’s solution to rapid interaction with customers and vendors

What’s the best way to handle the follow-up after a repair, or pin down a hard-to-reach vendor? After an initial equipment problem is fixed, our attention often shifts to the next crisis, which can leave the end user—our customer—hanging. Similarly, we may find ourselves on the receiving end of this problem when new or upgraded equipment is installed. It is often difficult to get the attention of our vendors to answer questions or resolve urgent issues.

So how can we in healthcare technology management (HTM) briefly shift our focus to update our customer before we tackle our next task, or get a quick answer from a vendor when we need one?

Increasingly, the answer is direct messaging. Electronic platforms have theoretically made communication easier than ever, but it can still be difficult to do it effectively. Direct messaging offers the immediacy of e-mail while avoiding the other problems e-mail brings, like messages that get caught in spam filters or buried in inboxes.

Use of this communication tool among the general population is growing rapidly, especially internationally. In the United States, there is growing support for HIPAA-compliant instant messaging in healthcare settings, but these solutions tend to be costly and hospitals have been slow to adopt them. By leveraging existing social media and messaging platforms like Facebook instead, HTM professionals can place themselves on the forefront of the direct messaging trend and make our own jobs easier. But the concepts below will require an open mind, and a little bit of creative engineering.

Who Are Our Customers?

HTM customers include anyone who has the responsibility for coordinating patient care equipment in a healthcare facility. A customer might be an equipment technician on a patient care unit or a nursing manager in an acute critical care unit. For new equipment installations, the customer could be a fellow employee at the vice president or chief operating officer level.

In the past, many facilities have focused the on number of repairs completed, without emphasizing follow-up communication to the customer. That time used to be considered a waste, but in recent years there has been a shift towards superior customer service in most business models, especially in the healthcare arena.

Following up helps you reassure your customers that their concerns have been addressed, and alerts you if any remaining problems exist. As hospitals increasingly look for ways to cut costs, it’s important to demonstrate the value that HTM brings to each facility. Notifying a customer that you have solved their problem is a key way to do that.

Evolution of Hospital Communication

Communication has always been critical in the hospital environment, although the methods have changed over time. Before the advent of computers and pagers, typed letters and three-part hand-written memos were the primary form of internal written hospital communication. This was a time-consuming task that often took hours or days to complete. The invention of the early form of the pager allowed on-call techs to check in with the hospital operator for emergency after-hours service calls. Alpha-numeric pagers later increased the efficiency of this process.

For a long time, paper repair tickets, phone calls, and voicemails sufficed as a method to inform our customers about a critical repair or parts ordered for a noncritical piece of equipment. But in today’s fast-paced culture, we often struggle to communicate with our customers. Busy C-suite executives are often away from their desks, and many employees now screen calls, letting messages go to voicemail.

Over time, e-mail too has become a problem. When instant communication first became possible, many thought it would be the solution for all communication problems. Initially, e-mail was used as an efficient method to connect with our customers. But the volume of e-mail has gradually grown to a point where messages are left unread or skipped altogether. Reader behavior has also shifted to scanning rather than reading e-mail messages. Many e-mails are sent but never received in the recipient’s inbox. In some cases, firewalls, permissions, and the hospital’s spam filters catch the e-mail before it ever arrives in the recipient’s account.

If e-mail is no longer reliable as a primary mode of communication, what, then, will take its place?

The Rise of Direct Messaging

The origins of direct messaging date back to the mid-1960s, when it was primarily used to message users that were connected to the same mainframe computer. It progressed to various systems, including bulletin board systems, an early form of the chat room.

The general public was first introduced to messaging on a large scale in 1997 via AOL’s real-time Instant Messenger. By the early 2000s, some corporations had started using direct message platforms for internal communications.1 With the advent of social media, direct messaging became even more popular with the general public.

In recent years, global use of direct messaging has skyrocketed. The number of people on direct messaging apps worldwide is expected to exceed 1.4 billion in 2015.2 In China, the WeChat application has 549 million monthly active users.3 The platform is now used not only to send direct messages but to arrange travel, make purchases, and perform a host of other functions. WhatsApp, a cross-platform, international mobile messaging app, now boasts 900 million monthly active users worldwide.4 And in the United States, all the major social media platforms have a direct message feature, including Twitter, LinkedIn, Instagram, and Facebook, which owns WhatsApp.

With about 600 million monthly active users around the world,3 Facebook Messenger has emerged as one of the tech world’s success stories. And it keeps growing. This past spring, the company introduced Businesses on Messenger, a feature that allows users to send direct messages to businesses.5 In a recent article for the UK edition of Wired magazine,6 editor David Rowan quoted Facebook founder Mark Zuckerberg on how the new features will affect how users interact with various companies: “Messenger would also, he revealed, let users communicate with businesses just as if they were friends—through simple conversation threads that would let them ‘make a reservation, buy something, change shipping information…’” The new tool stores all conversations with a company in a single thread, removing the problem of searching for a specific e-mail in an overstuffed inbox.

Applications for HTM

New tools like Facebook Messenger could prove to be useful as an alternative method of communication with our vendors, particularly those on the other side of the world.

I recently saw how response times can vary among different communication methods in a nonhealthcare context. I was looking for an electrical schematic for my personal Simplicity riding lawn mower. When I was unable to submit a traditional information request via the company’s Web site, I went to the Simplicity Facebook page and sent a direct message requesting the schematics. Within 2 hours, I received a reply with a 5-page attachment.

I made some other initial tests with medical vendors via their Facebook pages. Although a message sent to Zoll Medical was never answered, a message to Philips Healthcare was answered by the company’s India office on a weekend in just under 3 hours. Several other medical companies didn’t yet have the message feature offered.

This approach will require some further experimentation and testing, but it could help improve customer-vendor relations. Instead of using e-mail, text, or phone to communicate with a vendor next time, I encourage you to be open-minded and try out a global direct message platform. Mainstream companies are also increasingly integrating direct messaging components into their proprietary apps. Soon, medical vendors may join them.

A similar approach could work well in a hospital setting by allowing HTM professionals to continue to engage with our customers even after a repair is completed. Clinical messaging platforms designed for physicians average $100 to $200 per provider per year,7 making them impractical for HTM. At present, my local research has shown that some HTM professionals are using Lync or Jabber for internal nonclinical direct messages inside the hospitals.

But what if technicians could send nonclinical messages via Facebook Messenger, Skype, FaceTime, or another nonhealthcare platform in order to follow up on repair work? As Businesses on Messenger proves, Facebook is no longer just for social conversations.

Best Practices

Ready to take the plunge and give direct messaging a try? There are a few tips to keep in mind before reaching out to your customers for the first time.

Build trust first. If you’re contacting a customer for the first time, you may want to do your first meeting in person or over the phone. Once you’ve established a rapport, ask the person, “Is it OK if I direct message you from now on?”

Keep it brief. No one wants to scroll through a 1500-word update in a small chat window. Use your messages for quick updates or calls to action: “We’re still waiting on that part” or “Call me when you have a minute.”

Use plain, professional English. Don’t confuse a situation by resorting to online acronyms your customer might not understand. Avoid emoticons, since not all platforms accept them—what looks like a happy face to you could come through to your customer as a blank box or foreign characters.

Feel the fear, and do it anyway. Don’t be shy about reaching out to higher-ups. Most people would rather know what’s going on. It takes only about 5 to 10 seconds to send a direct message, and it’s another “touch” to remind your customer how you’re helping him or her.

When contacting a vendor via direct message for assistance, similar rules apply. Clearly state your problem and what you’re requesting, but get to the point. It’s also a good idea to include another way of contacting you, such as your phone number or email, in case the company has restrictions on the type of information they can include in a direct message response to a customer.

Challenges and the Future

Despite the potential offered by this technology, there are still hurtles to overcome. Some businesses have disabled the direct message feature on their company Facebook pages, preventing customers from contacting them. But for those that allow it, Facebook has started listing companies’ average response time8 to encourage Facebook page owners to respond more quickly. Although some companies might not have the direct message option, it would be worthwhile for biomeds to check their Facebook page first before spending hours on the phone with customer service. Asking vendors whether they have a direct messaging option would also be a valid question to include during the purchasing process.

In addition, hospitals concerned about patient privacy and cybersecurity may be reluctant to allow internal direct messaging, whether over social media or a clinical messaging platform. Moving forward will require cooperation between administration, technicians, clinical engineers, and IT, which could be slow in coming.

However, it seems the healthcare arena is gradually coming around to this new technology. In a recent article on direct messaging for Healthcare IT News, editor Mike Miliard reported that there is “growing use and appreciation for the secure, email-like method of data exchange.” But, he acknowledged, “there are still challenges to be ironed out—related to technology standards, cost and workflow—before it sees broader acceptance.”Current discussions of direct messaging are mostly geared toward use in the clinical environment. But once it is accepted there, it will most likely transfer to the technical arena.

Now is the time to get ahead of the curve. By familiarizing ourselves with this growing technology, biomeds can take the lead on improving communication without compromising efficiency. That can help us become more visible across our facilities and ensure that HTM plays a central role in their future.

So how about it: Will direct messaging become the next tool in your toolbox?

Dave Meeker is a former biomed and social media business strategist at Bringing Technology to You LLC. For more information, contact chief editor Jenny Lower at [email protected].


1. Petronzio M. A Brief History of Instant Messaging. Mashable. http://mashable.com/2012/10/25/instant-messaging-history/#yjn7BfwRIEqp. Published October 25, 2012. Accessed November 19, 2015.

2. Mobile Messaging to Reach 1.4 Billion Worldwide in 2015. eMarketer. http://www.emarketer.com/Article/Mobile-Messaging-Reach-14-Billion-Worldwide-2015/1013215. Published November 11, 2015. Accessed November 19, 2015.

3. Kosoff M. This Chinese messaging app is taking the country by storm—and Facebook should pay attention. Business Insider. http://www.businessinsider.com/wechat-why-it-dominates-china-2015-8. Published August 10, 2015. Accessed November 19, 2015.

4. Rao L. WhatsApp hits 900 million users. Fortune. http://fortune.com/2015/09/04/whatsapp-900-million-users/. Published September 4, 2015. Accessed November 19, 2015.

5. Franklin L. Introducing Messenger Platform and Businesses on Messenger. Facebook. https://developers.facebook.com/blog/post/2015/03/25/introducing-messenger-platform-and-businesses-on-messenger. Published March 25, 2015. Accessed November 19, 2015.

6. Rowan D. Facebook Messenger: inside Zuckerberg’s app for everything. Wired. http://www.wired.co.uk/magazine/archive/2015/11/features/inside-facebook-messenger. Published October 12, 2015. Accessed November 19, 2015.

7. Terry K. How to get started with Direct messaging. Medical Economics. http://medicaleconomics.modernmedicine.com/medical-economics/news/how-get-started-direct-messaging. Published April 1, 2015. Accessed November 19, 2015.

8. Kokalitcheva K. Facebook adds new ways for users to exchange private messages with businesses. http://fortune.com/2015/08/05/facebook-business-messages/. Published August 5, 2015. Accessed November 19, 2015.

9. Miliard M. Direct messaging finding stride, despite hurdles. Healthcare IT News. http://www.healthcareitnews.com/news/direct-messaging-finding-stride-despite-hurdles. Published June 25, 2015. Accessed November 19, 2015.

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