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HealthLeaders – Texting Drives 600,000 Patients to Engage in COVID-19 Vaccination Scheduling at Hartford HealthCare

The initiative helps Connecticut to be a leader in the percentage of population that has been vaccinated.


Continuing a recent trend of avoiding the requirement to download mobile apps, and instead simplifying patient engagement via text and simple web pages, Hartford HealthCare helped lead the charge that allowed the state of Connecticut to have one of the highest COVID-19 vaccination rates in the nation.

The health system, based in Hartford, Connecticut, uses a platform from Upfront Healthcare that powers text-messaging engagement between patients and providers.

During the push to vaccinate the Hartford HealthCare community, the health system sent out 1.5 million texts, and 600,000 people engaged with the texts and pursued COVID-19 vaccinations, says Barry Stein, MD, MBA, FSIR, FACR, RPVI, vice president, chief clinical innovation officer, and chief medical informatics officer at Hartford HealthCare.

“I don’t think you could do any other campaign where people could reach 600,000 respondents in one shot,” Stein says.

The key success factor was keeping the technology simple, and that meant not requiring registering or logging into a traditional web site, visiting a patient portal, or downloading a mobile app. Instead, patients simply click on a text message on their mobile devices and engage by answering a set of questions that leads to scheduling a first or second COVID-19 vaccination.

Responding to the texts sent patients to specially built, simplified “micro sites” that allowed them to schedule their vaccination visits.

“We had a partner [in Upfront] that had the technology knowhow to send the message out in a seamless, provocative way,” Stein says. “We had a message from Hartford HealthCare: ‘We’re here for you, we understand.’ We collected the information in a seamless way. And we delivered everything we had promised simply and easily. From the consumer standpoint, it looked so easy.”

Hartford HealthCare utilized patient engagement technology from Upfront to get past limitations in logic and artificial intelligence that kept the mission from being completed solely using its Epic electronic healthcare software, Stein says.

“We had a partner [Upfront] that was extraordinarily agile,” Stein says. “Every day, we were meeting for 15 minutes, making sure everything was fine. And quickly, we rolled this out.”

The average number of engagements per patient was 4.3, according to Carrie Kozlowski, chief operating officer and co-founder of Upfront.

“They just loved that [the text] was unobtrusive and it was easy,” Stein says. “We were engaging them across all the steps of the vaccine, so informing them, reminding them of their first dose, making sure they didn’t skip their second dose, all the way through that experience.”

Asked how the rest of the population engaged with vaccination resources, Stein says “not every patient in Connecticut belongs to Hartford HealthCare. There are other alternatives that exist.” Among those were pharmacies and mass vaccination sites set up by the state and other governmental agencies.



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