Pinehurst Medical Clinic (PMC) provides leading-edge, compassionate primary and specialty care in the Sandhills region of North Carolina, offering 16 locations and more than 150 providers. We have built a nimble, data-driven patient engagement engine that supports its success as an accountable care organization (ACO). As an ACO, the organization is responsible for managing cost and quality across defined patient populations. PMC partnered with QliqSOFT to operationalize patient engagement at scale, using automated campaigns, chatbots, and secure one-on-one patient texting to reach the right patients with the right message at the right time.

“This work demonstrates how thoughtful, targeted communication can transform patient engagement — driving better health outcomes, improving efficiency for our teams, and supporting long-term success in value-based care,” said Melissa Kuhn, Chief Operating Officer for PMC.

From one-off outreach to an agile engagement engine

PMC initially used digital engagement for specific value-based care priorities: confirming physician attribution, closing care gaps such as blood pressure management, and capturing updated insurance information when payers changed. Operations and clinical leaders — not IT — create and deploy campaigns aligned with organizational goals, and adoption ramped quickly. Each campaign is treated as a learning opportunity, where patient responses inform ongoing refinement of message design, workflows, and staffing.

The result is this scalable engagement playbook that accelerates outreach, shortens interaction time, and supports better clinical and financial performance in value-based arrangements.

Start with small, intentional populations

PMC targets small, intentional patient segments with highly personalized communications that map directly to value-based priorities. Initial campaigns focused on three areas: blood pressure management, confirming physician attribution, and obtaining new insurance cards from affected patients when a payer terminated coverage. Each text used PMC branding and specific, patient-friendly language to build trust and encourage patients to click the secure URL and engage.

The insurance card campaign is a standout example: because it referenced the payer termination directly and presented a clear action for patients, we achieved an almost 100% success rate. This demonstrated that tightly scoped, highly relevant outreach to a clearly defined population can outperform broad, generic communications.

Learn from unengaged patients

PMC takes a proactive approach to understanding non-responders and opt-outs. For selected campaigns, staff call patients who did not participate or who opted out to ask why, treating these conversations as qualitative research rather than failures. Patients reported not understanding the message or were worried that the text might be spam, underscoring the importance of trust signals and clear context.

We then iterated message content and links based on this feedback. One critical change was personalizing the URL, so it reflected PMC rather than a third-party vendor, which significantly improved opt-in rates and trust. We also streamlined campaign wording to match the terminology of other familiar tools within the organization, so messages felt consistent with communications patients already knew and trusted.

Treat timing as a clinical operations lever

Campaign timing emerged as a major driver of patient engagement and staffing efficiency. We found that the bulk of patient responses arrive within the first two hours after a campaign is sent. This insight led us to adjust staffing. We assign two team members to handle patient inquiries and secure chats during this critical window, ensuring patients receive rapid responses.

Over time, we also discovered that certain times of day consistently produce stronger engagement. Links sent around lunchtime (between 10:30 a.m. and 11:30 a.m.) and late afternoon (around 3:30 p.m.) generate the best response rates. These patterns help operations leaders schedule outreach — and staff up to respond — during the windows when patients are most likely to engage.

Equip staff to validate safety and legitimacy

Because digital outreach can raise concerns about spam and fraud, PMC recognized that staff need to be ready to reassure patients in real time. Before any campaign goes live, we conduct extensive staff education, so employees across the organization can confidently confirm that a text or secure link is legitimate.

We also established a designated verification phone line for patients to call to confirm that a message originated from the organization and was sent by PMC. This simple safety net increases patient comfort with digital outreach.

Clean up your population lists

An unexpected insight from our campaigns was that many opt-outs came from people who were no longer truly part of the organization’s patient population. Some had moved away, changed primary care providers, or otherwise disengaged from PMC. By removing these individuals from future campaign lists, we provide a more accurate view of patient engagement rates tied to our accountable population.

Embed self-scheduling into digital journeys

To close care gaps efficiently, we incorporate links to patient self-scheduling tools directly into the secure text experience. During the chatbot interaction, patients can access a self-scheduling link to book an appointment without waiting on hold or navigating a portal login.

Before routing to staff, the chatbot collects key context, such as why an appointment has not been scheduled. This information shortens call times and allows staff to quickly determine the right next step.

Protect quality by capping concurrent conversations

We have also developed guardrails for staff who manage secure texting conversations. While team members appreciate the efficiency of the digital platform, they have found that handling more than three simultaneous conversations increases the risk of errors. PMC guides staff to manage no more than three active chats at a time.

The secure texting dashboard displays key patient demographics and context alongside each conversation. This helps staff keep track of who they are speaking with, why the outreach is occurring, and what actions are needed, even when managing multiple conversations.

Moving faster than phone tag

Frontline teams report that digital outreach lets them deliver messages faster and to more patients than traditional call-based workflows. Once a patient engages, a full interaction can often be completed in about three minutes. This speed translates to more care gaps closed and fewer missed opportunities.

This efficiency is especially important in value-based care models, where timely blood pressure checks, medication reconciliations, post-discharge follow-ups, and preventive screenings can directly impact quality scores and shared savings. Our experience shows that digital engagement can make these touchpoints more achievable within existing staffing constraints.

What’s next for PMC’s digital engagement

We continue to expand use of the digital communication platform as our value-based portfolio grows. Key initiatives in progress include deeper EHR and workflow integrations to streamline staff work.

We plan to develop an inbound digital program targeting high-risk patient populations, starting with COPD and CHF. Patients will be able to reach out directly to their nurse during acute issues via secure digital channels, rather than relying solely on phone calls or urgent care. This inbound capability supports earlier intervention, reduces avoidable ED visits, and strengthens patients’ trust that they can access help when they need it.

PMC’s playbook demonstrates how a practical, data-driven approach to patient engagement can translate directly into better performance on value-based contracts.