Real-Time SMS Patient Engagement at Enterprise Scale for a Global Pharmaceutical Leader

Adobe Campaign  |  Conversational SMS  |  Managed Services  |  Healthcare & Life Sciences

Overview

For more than four years, Celerity has partnered with one of the world's largest pharmaceutical companies to design, build, and manage a real-time SMS engagement program supporting patients on two of its flagship medications — a weekly injectable and a daily oral therapy in the diabetes and weight-management category. What began as a managed support engagement has grown into the client's most business-critical patient communication channel, powered by a fully custom real-time architecture built on Adobe Campaign.

Problem Statement

The client needed a way for patients to sign up for prescription savings cards and enroll in long-term medication support programs entirely over SMS — in real time. A patient texting a keyword to a short code expects an immediate reply; the client's requirement was a response within five seconds, and ideally under two. Anything slower and patients abandon the signup flow, directly hurting conversion and savings-card activation.

Beyond the signup moment, the program needed to sustain engagement over the long haul: support journeys running 300 to 360 days, medication reminders scheduled to each patient's preferred day and time, messages delivered at appropriate hours in the patient's local time zone, and interactive elements such as surveys, motivational content, and on-demand keyword commands. All of this had to run at enterprise scale, across a regulated healthcare environment with double opt-in, HIPAA consent capture, and insurance eligibility screening built into the conversation flow.

Out-of-the-box marketing platforms were not designed for this. The core challenge was true bidirectional, conversational SMS at sub-5-second latency — a fundamentally different problem from one-way campaign sends.

Solution Proposed

Celerity architected a custom real-time SMS engine within Adobe Campaign that orchestrates the full patient conversation end to end. When a patient texts a keyword to the program's short code, the message travels from the carrier network through an SMS aggregator into Adobe Campaign, where Celerity's custom logic processes the response, determines the next step in the journey, and returns a reply through the aggregator to the patient's device — all within seconds. The solution encompassed:

A guided conversational signup flow handling double opt-in, HIPAA consent, insurance screening (including Medicare and Medicaid qualification), and savings-card activation — supporting both new card generation and activation of existing physical cards via kit codes.

A real-time API integration with the client's savings-card fulfillment provider, with request payloads structured in collaboration with the client's IT organization, so eligible patients receive their savings card during the conversation itself.

Long-running support journeys of up to a full year, with patient-selected medication reminders (down to a specific day and time), time-zone-aware delivery derived from the patient's zip code, first-name personalization, in-journey surveys, and keyword-triggered content such as motivational messages.

An aggregator-agnostic architecture. Over the life of the program the client has changed SMS aggregators multiple times; because Celerity designed the integration layer to be vendor-neutral, these transitions occurred without rebuilding the core system.

Challenges and Roadblocks

Native platform limits under load. The initial implementation, built on Adobe Campaign's native workflow functionality, could not handle production traffic and failed under load at first launch. Celerity's engineers re-architected the entire real-time layer using custom JavaScript libraries, bringing response times to under two seconds — well within the client's five-second ceiling.

A failed platform migration that validated the architecture. The client later invested significant effort — alongside Celerity and its own marketing operations and IT teams — in migrating the program to Adobe Journey Optimizer (AJO), Adobe's next-generation journey platform. Testing revealed that AJO, designed for one-way event-triggered messaging rather than conversational back-and-forth, could not receive and process inbound SMS responses fast enough: replies took one to two minutes, with inconsistent performance. Platform capabilities for this use case had not been transparent up front. Adobe committed to enhancing AJO for the client's requirements, but with no progress materializing, the program remains on the proven Adobe Campaign architecture — underscoring the value of the custom-built solution.

Regulatory complexity. Every message in the program passes through the client's legal and promotional review processes, requiring an operating model that can absorb continuous content and flow changes without disrupting the live system.

Execution

Celerity built the program from the ground up and has operated it continuously since 2022 in a managed-services model designed for efficiency. Celerity owns the complex real-time processing layer — the components only its engineers can build and maintain — while the client's marketing operations team manages routine cadence workflows using standard Adobe Campaign functionality, keeping specialist hours focused where they create the most value.

The engagement is continuously evolving. Current work includes extending the signup flow to let patients specify their medication format (pen versus pill) as the client consolidates its product line, with Celerity updating the real-time logic while the client's team adapts the downstream support-journey workflows. Celerity has also become the client's de facto center of expertise: the team's knowledge of the program runs deeper than any internal resource, and Celerity serves as the first call for troubleshooting and platform questions across the Adobe Campaign environment.

Business Outcomes

• A fully custom real-time engine on a platform not built for it — sub-2-second conversational SMS achieved within Adobe Campaign, meeting a latency requirement that even Adobe's newer journey platform could not satisfy.

• Real-time savings-card enrollment — patients activate prescription savings during a single text conversation, removing friction from a moment that directly drives medication access and conversion.

• Sustained engagement at scale — support journeys of up to 360 days, with personalized medication reminders, time-zone-aware delivery, and interactive content serving a large national patient population.

• A four-plus-year strategic partnership — the program has been in continuous operation since 2022, with the client repeatedly expanding scope and relying on Celerity as the system's primary knowledge holder and troubleshooting partner.

• Resilience through change — multiple aggregator transitions and ongoing regulatory-driven content updates absorbed without disruption, thanks to vendor-agnostic architecture and a flexible managed-services model.