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OhMD and Klara (now ModMed Patient Engagement, powered by Klara) are cloud-based clinical patient communication platforms that enable ambulatory medical practices, health systems, and clinical research sites to conduct two-way SMS text messaging, asynchronous care coordination, digital intake collection, and browser-based video telehealth while maintaining compliance with the HIPAA Privacy and Security Rules (45 CFR Parts 160 and 164). Alongside unified clinical communication suites such as Spruce Health and hospital clinical messaging systems such as TigerConnect, OhMD and Klara replace unmonitored front-desk telephone queues with structured, auditable messaging threads synchronized directly into the electronic health record (EHR).
What Is OhMD? Core Architecture, Nia Voice AI, and EHR Integrations
OhMD is a HIPAA-compliant patient communication and conversational automation platform designed to let patients reach their care team or clinical trial coordinator using standard mobile text messaging (SMS) without downloading a proprietary mobile app or remembering a patient portal password:
- Two-Way SMS & Encrypted Thread Routing: Patients text the clinic’s existing landline or toll-free telephone number. OhMD routes the inbound message into a shared, role-based clinical team inbox where nurses, medical assistants, or schedulers can triage requests, attach lab orders or PDF educational packets, and escalate clinical questions to physicians.
- Nia Conversational Voice AI & Call-to-Text Deflection: To eliminate front-desk telephone bottlenecks and voicemail transcription backlogs, OhMD provides Nia, an automated conversational voice AI assistant that answers inbound patient phone calls, captures the structured reason for calling (such as prescription refill requests, appointment scheduling, or symptom updates), and converts the interaction into an actionable text thread in the OhMD inbox.
- Automated Broadcasts, Digital Intake, & App-Free Video Visits: Supports bulk SMS broadcast campaigns (preventive screening recalls, flu clinic notifications, or clinical trial recruitment outreach), pre-visit digital intake forms, and one-tap WebRTC browser video telehealth encounters launched directly from an SMS link.
- Bidirectional EHR Chart Archival: Integrates via HL7, FHIR R4, and vendor APIs with Epic, Oracle Health (Cerner), Athenahealth, eClinicalWorks, DrChrono, Practice Fusion, and Veradigm so that completed patient text conversations and photo attachments can be pushed into the patient’s permanent medical chart with a single click.
What Is Klara (ModMed Patient Engagement)? Asynchronous Care Workflows
Klara—acquired in 2022 by Modernizing Medicine (ModMed)—is an asynchronous patient engagement and team collaboration platform widely deployed across dermatology, ophthalmology, orthopedics, gastroenterology, plastic surgery, and multi-specialty ambulatory groups:
- Unified Omnichannel Patient Inbox: Centralizes SMS text messages, web-chat widget inquiries, transcribed voicemails, digital registration forms, and post-procedure follow-up photo uploads (such as surgical incision or dermatology lesion checks) into a single patient timeline.
- Native ModMed EMA & Multi-EHR Synchronization: For practices running ModMed EMA, Klara operates as the native patient engagement engine, automatically synchronizing appointment schedules, patient demographics, and chart notes. For practices on Athenahealth, NextGen Healthcare, Greenway Health, or eClinicalWorks, Klara connects via bidirectional scheduling and clinical document interfaces.
- Automated Pre- and Post-Visit Cadences: Triggers rule-based message sequences tied to specific appointment types or CPT procedure codes—delivering pre-procedure bowel prep or fasting instructions, collecting insurance card photos, and sending post-visit care instructions without manual staff intervention.
How OhMD and Klara Handle HIPAA-Compliant SMS Texting Under 45 CFR § 164.312(e)
A critical regulatory question in healthcare informatics is how any platform can use **SMS (Short Message Service)** in compliance with the HIPAA Security Rule’s Transmission Security standard (45 CFR § 164.312(e)(1)). Standard carrier SMS traverses cellular signaling networks unencrypted, can be viewed on a locked phone screen, and is not covered by telecom carrier Business Associate Agreements.
Under HHS Office for Civil Rights (OCR) guidance on patient right of access and confidential communications (45 CFR § 164.522(b) and § 164.524), both OhMD and Klara implement a dual-mode security architecture that lets practices match the communication channel to the sensitivity of the clinical content:
- Mode 1 — Encrypted Web-Session Link via SMS (Full End-to-End TLS Encryption): When a clinician sends a message containing Protected Health Information (PHI)—such as lab results, diagnostic images, or clinical instructions—the platform sends a generic, zero-PHI SMS notification containing a secure HTTPS link. Clicking the link opens a mobile browser session encrypted via TLS 1.2/1.3 where the patient verifies their identity (typically by entering their date of birth or a one-time passcode) to read and reply inside a HIPAA-compliant encrypted vault.
- Mode 2 — Direct Two-Way Standard SMS With Logged Patient Consent: Because HHS OCR permits Covered Entities to communicate with patients via unencrypted email or SMS if the patient requests it after being warned of the security risks, OhMD and Klara automate an initial SMS Opt-In & Risk Warning Workflow. Before two-way plain SMS is enabled, the platform sends an automated disclosure explaining that standard text messaging is not encrypted and logs the patient’s affirmative opt-in consent (with timestamp and phone number) in the audit trail.
Comparison: OhMD vs. Klara vs. Spruce Health for Clinical & Research Teams
When selecting a patient messaging platform for an ambulatory clinic or a decentralized clinical trial site, informatics teams compare four architectural dimensions:
| Evaluation Dimension | OhMD | Klara (ModMed Patient Engagement) | Spruce Health |
|---|---|---|---|
| Primary Architectural Focus | Direct two-way SMS texting, Nia conversational voice-to-text AI, and broad multi-EHR chart sync | Automated pre-/post-visit specialty workflows, web-link secure messaging, and native ModMed EMA integration | Full cloud VoIP phone system (PBX replacement), secure app/SMS messaging, and e-fax in one app |
| Default Patient Messaging Experience | Supports direct two-way native SMS (with logged HIPAA consent) as well as encrypted chat links | Primarily uses SMS magic links opening an app-free, DOB-verified encrypted mobile web thread | Supports both secure Spruce mobile app messaging and consented standard SMS |
| EHR Integration Depth | 85+ EHR systems via FHIR/HL7/APIs (Epic, Athenahealth, eClinicalWorks, DrChrono, Practice Fusion, Veradigm) | Deepest native integration with ModMed EMA; also integrates with Athenahealth, NextGen, Greenway, and eCW | Integrates via webhooks/API and manual/automated PDF export to ambulatory EHRs |
| Clinical Research & Trial Site Utility | High utility for SMS cohort recruitment broadcasts, visit reminders, and quick adverse-event triage | Strong for protocolized pre-visit instructions, photo diary uploads, and surgical/dermatology follow-up | Ideal for study coordinators needing dedicated study phone lines, call recording, and participant texting |
