The nurse pool gets the task, assigned by a workflow in GoHighLevel the moment a patient asks for a callback, with a deadline and an escalation. The bottom line: a callback request about results is a patient safety item, so it needs an owner and a due time, and nothing about the result itself should travel by text.
Why results need a process
A study of 5,434 patient records from 23 primary care practices, published in the Archives of Internal Medicine, found that 7.1 percent of clinically significant abnormal results had no documented notification of the patient, with a range from 0 to 26.2 percent across practices. The authors found that practices using simple processes to manage results had lower failure rates, and that having an electronic record did not reduce failures without those processes. The federal 21st Century Cures Act final rule now requires providers to give patients access to their electronic records with limited exceptions, which can mean patients see results in the portal before anyone calls. A survey of 8,030 respondents found that 74 percent accepted learning cholesterol results online first and 57 percent accepted it for strep throat, while most preferred in person for cancer results (54 percent) and miscarriage (53 percent). A callback request is often a patient trying to understand what they have already read.
How requests arrive, and where they go
| Request channel | What happens |
|---|---|
| Phone menu option for results | Message box, then a workflow creates a nurse task |
| Voice agent | Takes a name, number, and callback request, with no clinical discussion |
| Chat or web form | Collects a callback number and creates a task |
| Text reply asking about results | Stop on Response, task for the nurse, and a generic automatic reply |
Build it in GoHighLevel
GoHighLevel's actions list includes creating internal tasks and assigning a contact to a user, and its Wait steps and If/Else branches support a deadline and an escalation.
GoHighLevel's help portal says accounts are not HIPAA compliant by default, and that HIPAA Compliance is a paid upgrade, $297 a month as an account wide add on, that must be enabled for the agency and then configured for the sub accounts that need it. Third party guides add that the add on provides a business associate agreement, encryption, audit logging, and multi factor authentication, that the practice also needs its own agreement with the agency, and that GoHighLevel itself recommends avoiding protected health information in SMS and email even with the add on. Whether the AI features are covered by the agreement is a question to put to HighLevel in writing before any patient data reaches them.
- Add a results callback option to the phone menu and the web form, and train the Voice AI agent to take a message only.
- Build a workflow that starts from a tag, Results callback requested, added by those channels.
- Add Assign to User for the nurse on duty, or the nurse pool, and Add Task due the same business day, with the patient's number and the date of the request.
- Send a generic confirmation: a nurse will call you back during office hours, and for an emergency call 911.
- Add a Wait and an If/Else on the tag Called back, and alert the practice manager if it is missing after 4 business hours.
- Have the nurse document the call in the chart, and add the Called back tag.
- Never include a result, a test name, or a diagnosis in a text.
Worked example
For example, a practice that gets 60 results callback requests a month creates 60 tasks. If 6 of them are not answered inside four hours, the escalation catches those 6 (60 times 0.1) before the patient calls again or goes elsewhere.
Mistakes to avoid
- Putting results in a text. Use a callback or the portal.
- A task with no owner. Assign it to a person or pool.
- No deadline. Same business day is a sensible default.
- No chart documentation. The call belongs in the record.
How this was handled before
A message slip went to the nurse's tray or a shared inbox, and the nurse called when results were reviewed. The 2009 study of failure to inform patients showed how often that process missed a result. Portals now put results in the patient's hands first, which makes the callback a conversation about what they have already seen.
What to measure after launch
Track requests, time to callback, escalations, and requests answered the same business day. Review escalations weekly and adjust staffing.
Check before you switch it on
US text messages sent from a standard 10 digit number need A2P 10DLC registration. The HighLevel support portal says registration is required for texts to US recipients from 10 digit long code numbers and that toll free numbers do not require it. HighLevel's opt in guidelines also say a person cannot be forced to agree to text messages in order to submit a form, so keep the consent box optional. One compliance guide separates informational texts, which need documented consent, from marketing texts, which need prior express written consent. Ask your attorney which category your reminders fall into. Have your medical director approve the response times and the escalation path. This is general information, not legal advice.
Questions people ask
How often are abnormal results not communicated?
A study of 23 practices found 7.1 percent of abnormal results had no documented notification.
Should results be texted?
No. Keep texts generic and give results by a call, a visit, or the portal.
Who should the task go to?
A nurse or nurse pool, with a same business day deadline and an escalation.
Ready to try it yourself? Start a GoHighLevel account here.
You can also see this in action in our GoHighLevel capabilities demo.