> ## Documentation Index
> Fetch the complete documentation index at: https://docs.decodahealth.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Messages

> Message patients through the secure patient portal instead of texting, and let patients reply from their portal.

Secure messages let you reach a patient inside the patient portal rather than by
text. The patient signs in to read and reply, so the conversation stays behind
their portal login instead of sitting on their phone as a plain text message.

You send and read these messages from the same **Chat** inbox you already use
for texting — there's no separate screen to learn.

## Switch a conversation to the patient portal

Each conversation is either sending by text or sending through the portal. You
choose per conversation, and the choice sticks until you change it back.

<Steps>
  <Step title="Open the conversation">
    Go to **Comms > Chat** and select the conversation.
  </Step>

  <Step title="Find the channel label above the message box">
    Just above where you type, a small label shows where your next message will
    go: **SMS** or **Secure patient portal**.
  </Step>

  <Step title="Click it to switch">
    Clicking the label switches the channel. In portal mode the message box
    shows a lock and a highlighted border, so you can tell at a glance that
    you're writing a secure message.
  </Step>
</Steps>

<Note>
  Switching the channel only changes where **your next message** goes. It doesn't
  move or hide messages you already sent, and the patient can always reply — their
  replies come back through the portal.
</Note>

## What the patient sees

Patients open **Messages** in their portal sidebar. They see one combined
timeline of everything the clinic and patient have exchanged, with each entry
labelled by how it arrived:

* **Portal** — a secure message
* **Text message** — a text
* **Email** — an email
* **Phone call** — a call that took place

Patients type a reply at the bottom and can attach files. Their replies always
come back through the portal, and land in your Chat inbox alongside everything
else.

## How patients find out about a new message

A patient won't see a secure message until they sign in, so the portal sends a
short heads-up that doesn't include anything private — just a note that there's
a new message waiting and a link to sign in.

Patients choose how they're told. In their portal **Profile**, under **Message
notifications**, there's a **Notify me by** setting with three choices:

* **Text**
* **Email**
* **Both**

New patients start on **Text**.

<Note>
  If a patient has chosen **Text** but the clinic can't text them — no phone
  number on file, they've opted out of texting, or their number is a landline —
  the heads-up goes to their email address instead when the clinic has one.
</Note>

If you send several messages before the patient opens the conversation, they get
one heads-up, not one per message. And if the patient already has the portal
open when you send, they aren't pinged at all — the message simply appears in
front of them.

## When a patient has no phone number

Patients with no phone number on file can still use secure messages — that's the
main reason to use the portal instead of texting. Their conversation appears in
your Chat inbox like any other, and you reply the same way.

## Knowing the patient got it

Underneath each secure message you send, the conversation shows what happened.

* **Notification sent by text message** — the heads-up went out. Click it to
  read exactly what the patient received.
* **Patient was NOT notified** in red — nothing reached them. Click it for the
  reason, such as no phone number on file or the patient having opted out of
  texting. Follow up another way.
* **Seen** — the patient has opened the conversation and read your message.

## The patient's message button

Patients don't have to be on a particular page to message you. A message button
sits in the bottom corner of every portal page, with a red count when they have
unread messages from the clinic. Clicking it opens the conversation over
whatever they were looking at, and the count clears once they've read.

## Photos and documents

Both sides can share files in a secure conversation.

Patients can attach photos and documents — including PDFs — up to ten per
message. Photos appear as small previews they can click to enlarge, and
documents open in a viewer without leaving the page. If they pick more than ten
files, the portal keeps the first ten and tells them to send the rest
separately.

## Profile pictures

Patients can set their own profile picture from their portal **Profile** page by
clicking their photo. Pictures appear beside each message in the conversation,
so it's clear who is speaking. Patients who haven't set one show their initials.