Manage Two-way Conversations

Last updated 1 day ago

This guide explains how two-way conversations work in Subflow and how to respond to incoming patient messages from the Conversations inbox. Patients reply to your SMS messages directly from their phones, with no portal or app to log in to, and every reply lands in a single inbox where you can read it and reply using a saved template or free-form text.

How it works

Two-way conversations connect every SMS exchange between Subflow and a patient into a single, ongoing thread. The key things to know:

Patients reply to Subflow messages from their own phones, just as they would to any other text message. There is no portal to log into and no app to install.
Every patient reply lands in the Conversations inbox as a new unread message, regardless of whether the original message came from a workflow, a broadcast, or a team member.
Inside a conversation, the platform distinguishes automated messages (sent by a workflow) from messages sent by a team member, so you can quickly see who said what.
Your replies use the same SMS channel as the patient. Anything you send from the conversation reply box goes to the patient as a standard text message.

✏️ If the conversation involves protected health information beyond logistics or general guidance, switch the conversation to Secure Chat before continuing the exchange.

The Conversations inbox

The Conversations area is in the Messaging side menu, under the Conversations heading. The sidebar groups conversations into six views, described in the table below.

Sidebar section	What it shows
Inbox	All active conversations across all patients. The number next to the label shows the total number of conversations in your account.
Unread	Only conversations that contain at least one unread message. The number next to the label shows how many conversations have unread messages, so you can focus on what still needs a reply.
Scheduled	Messages queued to be sent at a future time but not yet delivered.
Favorites	Conversations that have been manually marked as favorites for quick access.
Snoozed	Conversations that have been temporarily set aside and will reappear in the inbox later.
Archived	Conversations that have been moved out of the active inbox to keep the list clean. Archived conversations are not deleted and can be restored.

Inside any of these views, the conversations list shows each thread with the patient's initials, name, the date of the last activity, and a preview of the most recent message. A blue indicator on the left of a conversation card means it contains an unread message.

Reading a conversation

Click any conversation in the list to open the full thread on the right. Within the thread, message style and metadata help you distinguish automated workflow messages from those sent by a colleague.

Automated messages are sent by a workflow node (for example, an intake reminder triggered when a patient reaches a stage in their care plan). The thread labels these as automated messages so you can see they were not typed by a person.
Staff-sent messages show the name of the team member who sent them. If a colleague replied to a patient earlier, you can see who it was before sending a follow-up.
Patient replies appear as inbound messages in the thread, in chronological order with the rest of the exchange.

Respond to a conversation

The reply box at the bottom of the conversation has a toolbar from which you can insert a saved template, add dynamic fields, or attach a file before sending.

Open Messaging from the main navigation, then select Inbox under the Conversations heading.
Click the conversation you want to reply to. The full message thread opens on the right.
In the reply field at the bottom, write your response. You can:
- Type a free-form message directly into the field.
- Access Templates in the toolbar to load a saved message template as the starting content. You can edit the template after inserting it.
- Click Personalize to insert a dynamic field that pulls the patient's contact data or form responses into the message.
- Select Attach to include a file, form, course, or meeting link in the reply.
Send or schedule the message:
- Click Send SMS to send immediately. The message appears in the thread and is delivered to the patient as a standard text.
- Click the downward arrow next to Send SMS to schedule the message for a later date and time. The message appears in the thread with a scheduled indicator showing the planned send time instead of a delivery confirmation.

💡 If you frequently reply with the same content, save it as a message template. The template can then be inserted with one click from the Templates button.

Now that you know how to manage two-way conversations, check these related articles to make the most out of this feature.

Create a Message Template: Save a reusable SMS message you can insert into a conversation reply with one click.
Use Secure Chat: Switch a conversation to encrypted web chat when discussing sensitive health information.
Create an SMS Broadcast: Send a one-to-many text message to one or more segments when a single message needs to reach a group.
Messaging in Subflow: Review the differences between SMS broadcasts, email campaigns, two-way conversations, and templates to choose the right tool for each message.

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