Notification Automation: Enhancing Communication with Twilio

Introduction #

Public health units (PHUs) safeguard community health, and part of this role involves providing time-sensitive notifications such as health advisories, service updates, and individual test results. Traditionally, these notifications have relied on manual processes - phone calls, mailed letters, or emails - which can be time-consuming and prone to delays. As public health demands grow, automation offers a scalable solution to improve efficiency and consistency of service.

This article explores how PHUs can modernize their notification systems by introducin automation, with a focus on our first planned use case: automating well water testing result notifications with Twilio.

Notification in Public Health #

PHUs handle a wide range of communications, such as:

• Health alerts to community partners.
• Follow-up requests for lab results, case management, or outbreak investigations.
• Reminders for immunization clinics.
• Internal communications to keep staff informed of urgent updates.

Currently, many of these notifications are created and sent manually - requiring staff to track lists, draft messages, and ensure they go out on time. These methods are familiar and often effective, but they come with limitations.

Manual notifications take time. A public health nurse might spend hours each week making follow-up calls. Letters can be delayed or lost. Emails may go unread. When staff are stretched thin (i.e. during busy seasons or public health emergencies), these delays can affect service quality and public safety.

These challenges aren’t unique to one region or service. They reflect a broader need for tools that support timely, reliable communication - without adding to staff workload.

Why Automation #

Automation offers a way to handle these important (but repetitive) tasks more efficiently, delivering the same information securely and promptly - without requiring a staff member to initiate each message.

Notification automation could support public health work by:

• Saving time: reducing time spent by staff on drafting and sending notifications.
• Reducing errors: removing human error from the equation.
• Ensuring timely delivery: sending notifications as soon as an event triggers response and avoiding manual delays.
• Improving accessibility: supporting delivery of notifications in multiple formats (e.g. email, SMS, phone call).

This could look like automatically notifying staff of new lab results when received, or distributing a standardized health alert across multiple channels.

For public health, timing and clarity can be critical. Exploring notification automation is one way we can strengthen our ability to respond to public health needs while making the most of our staff’s time and expertise.

Case Study: Well Water Testing Result Notification #

In many parts of Ontario, residents rely on private wells for their drinking water. Public Health Ontario labs offer free testing to help identify contaminants like E. coli and coliform. Their presence in a sample suggests that fecal contamination and surface water, respectively, are entering a well, and can make the water unsafe to drink¹.

This testing is a small but important facet of well water quality. Funded by the province, PHUs organize water testing kit distribution and collection nodes - and they also play a role in addressing issues, such as directing next steps for adverse water results.

After a wellwater sample is submitted, results are typically delivered by mail - a process that can take days and often depends on staff availability.

This is where automation can make a difference. In the planned pilot, once a lab uploads a test result to the provincial system, our browser automation process will be able to retrieve it.

Based on these new results, a notification can be automatically sent to residents with adverse water quality results. The message - delivered by SMS or robocall - lets them know their result is ready and advises the well owner of where to find information about next steps. Twilio handles the delivery, using its API to connect to the resident’s phone and send relevant information and resources based on the test results.

A diagram of the Twilio notification workflow is shown below.

Conclusion #

The goal is not to replace human involvement where needed, but to reduce delays and free up staff for more complex tasks. For residents, it means faster access to important health information. For PHUs, it’s a step toward modernizing service delivery and improving community health outcomes. With Twilio’s flexible and secure platform, PHUs can streamline communications and ensure residents receive timely, accurate information. The well water testing notification pilot is just the beginning, opening the door to broader applications across public health services.