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Text message-facilitated PC CDS is an effective, efficient way to reach patients across a range of clinical interactions, including preventive care and chronic disease management. Text messages also represent a low-cost, easily customizable, and automated way to support clinicians and patients in making informed decisions. This report provides practical guidance for implementing text message-facilitated PC CDS, and shares promising practices to engage patients in decision support. 

About the Report  

Based on a literature review and key informant interviews, this report summarizes guidance that stakeholders can use when planning, designing, implementing, and evaluating text message-facilitated PC CDS. 

The report also identifies six promising practices for implementing text message-facilitated PC CDS: 

1. Design interventions with adaptive text message capabilities.
2. Balance the use of protected health information with potential privacy risks.
3. Involve patients in codesign.
4. Identify opportunities to personalize the message.
5. Use behavioral science principles. 
6. Support bidirectional communication with patients. 

How To Use This Report  

Healthcare organizations and developers can use this report to implement and scale text message-facilitated PC CDS, using practical guidance and promising practices to improve patient engagement with PC CDS and, ultimately, health outcomes.  

Suggested Citation: Heaney-Huls K, Kawamoto K, Lobach DF, Jiménez F, Ryan S, Desai PJ, CDSiC Implementation, Adoption, and Scaling Workgroup, Dullabh PM. Implementation, Adoption, and Scaling Workgroup: Text Message-Facilitated PC CDS Implementation: Key Considerations and Promising Practices. Prepared under Contract No. 75Q80120D00018. AHRQ Publication No.  25-0068. Rockville, MD: Agency for Healthcare Research and Quality; August 2025.