OhMD and Twilio: Empathetic AI-powered patient communication at scale

Challenge

OhMD came to Twilio to build a scalable, HIPAA-compliant voice assistant to automate routine patient calls without losing the human touch. They also needed a way to unify product usage data across systems to better understand customer engagement and identify churn risks.

Solution

OhMD used Twilio ConversationRelay to launch Nia, a voice AI assistant that handles common patient calls with real-time streaming and human-in-the-loop escalation. They also leveraged Twilio Segment Connections to unify data, enabling deeper insight into provider engagement and operational health.

Let’s be honest: We expect everything to be instant now—shopping, streaming, even chatting with customer support. Yet, calling your doctor’s office in 2025? Still a maze of menus, hold music, and marathon wait times.

Patients dread it. Clinic staff are challenged by it. Too many calls mean less time for real care on both sides.

That’s why OhMD stepped in, bringing healthcare communication into the modern age with a HIPAA-compliant platform built for today. Forget portals, phone trees, or long-winded booking. Just text and connect. Fast, secure, pain-free.

With Twilio powering voice, automation, and smart workflows behind the scenes, OhMD lets medical practices streamline everything, without losing the human touch. More meaningful care for patients. More sanity for staff.

Because getting help from your doctor should be as easy as ordering a pizza, and you deserve nothing less.

OhMD’s journey began in the era of patient portals and app-based messaging. “Back in 2014, it was an acceptable amount of friction to ask patients to download an app,” says Ethan Bechtel, CEO and Co-founder of OhMD. “At some point, we realized that patients should just have access and communicating with their practice should be simple.”

OhMD pivoted from app-based workflows to a text-first model, using SMS as the conduit for simple reminders and secure, encrypted conversations. Their goal was to make patient access as seamless and intuitive as possible. “The more invisible we are to the patient, the better we are at delivering our service,” says Bechtel. “The patient shouldn't even know that OhMD exists.”

As demand for smarter, faster communication grew, OhMD needed a partner that could support their next phase of growth; one that included voice automation, deeper analytics, and the ability to scale AI-powered interactions across thousands of practices.

When Twilio launched its HIPAA-eligible offering, OhMD saw the opportunity to go beyond text. They leveraged Twilio’s ConversationRelay to build Nia, an AI-powered voice assistant that acts as a first responder to inbound patient calls.

Unlike traditional methods that route every question to a staff member, Nia uses real-time streaming and speech recognition to handle common interactions like scheduling, prescription refills, and FAQs, while escalating complex needs to human staff. The result is a hybrid model that uses automation while making space for empathy and supporting compliance.

One of Nia’s first use cases was appointment scheduling. Traditionally, this process involved back-and-forth between the patient and receptionist. Today, Nia gathers all necessary information and packages it for a human to finalize. This can cut the time involved from multiple minutes to as low as one minute. “The closer we got to one minute, the better it felt to the people using it,” Bechtel says.

Beyond speed, ConversationRelay gave OhMD full ownership of the experience. Twilio handled the telephony, infrastructure, and reliability so OhMD’s engineers could stay focused on building the unique layers that made Nia special.

OhMD didn’t stop at building Nia. With Twilio Segment Connections, they also began centralizing usage data from across systems like Vitally and Dreamdata. These insights power OhMD’s customer health scores, expansion strategies, and in-product marketing.

“Today, we’re using Segment to feed key metrics such as message volume, video minutes, and feature usage into our customer success platform,” says Bechtel. “It’s pretty simple, but it’s critical to helping us understand what success looks like for our customers.”

Broadcast message volume, for example, is a leading indicator of engagement. The more messages a practice sends and receives, the more calls they avoid and the more time they save. With Segment, OhMD can quantify that value in real time.

Looking ahead, OhMD plans to expand its use of Segment to better understand user profiles and target the right features or services to the right people at the right time. This will help customers get more from the platform and unlock new opportunities for upsell and retention.

Since adopting Twilio ConversationRelay and Segment, OhMD has achieved major wins:

• Built and deployed Nia in weeks, not months, accelerating time to value

• Improved self-service first time call resolution by an expected 60%, giving live agents back their time

• Enabled as low as one minute appointment flows, improving patient satisfaction

• Established a scalable model for AI voice, with human-in-the-loop control

• Centralized engagement metrics, giving success teams a clearer picture of patient health

And the impact continues to grow. OhMD projects Nia will handle over 55 million patient interactions in 2026—proof that the right AI doesn’t replace care, it enhances it.

OhMD’s mission has always been about access, removing the friction between patients and the care they depend on. As new technologies like Rich Communications Services (RCS) emerge, the company sees an even richer future ahead.

“RCS gives us what we always wanted when we started building OhMD, which is to actually allow for a rich patient experience that doesn’t require a login, a password, and a portal,” says Bechtel. “What’s most exciting is being able to reach patients that are difficult to reach with technology that’s already in their hands.” 

Unlike traditional SMS, Twilio RCS enables branded, interactive messages that let patients confirm, cancel, or book appointments with just a tap. OhMD is currently testing carousels and action buttons with a growing group of health practices. The next version of the platform gives customers the power to create RCS templates themselves. 

“A lot of the excitement from our customers is around brand recognition.” Bechtel explains. “Texting is a noisier channel than it used to be, and RCS allows you to separate yourself and put your brand in front of the patient.”

In Twilio, OhMD found more than a vendor; they found a partner who shares their vision for more human, accessible healthcare. From Voice AI to RCS messaging, Twilio’s unified suite of tools helps OhMD’s customers move fast, scale smart, and keep care at the center of every interaction. 

“We don’t start from scratch anymore,” says Bechtel. “We start with the Twilio documentation, because chances are there’s already a workflow or tool that gets us most of the way there.” 

The future of healthcare communication isn’t on the way. It’s already here. And with Twilio, OhMD is building it, one message, one call, one minute at a time.