Duke University

Increasing likelihood of clinician success by automating workflow

Duke University and BennettLab help patients manage weight loss by automating participant workflow with Twilio Voice and SMS

Duke University


Research study participants

8 months

of work automated with Twilio

Making weight loss high tech

Helping Americans lose weight remains one of the major challenges of the 21st century. Nationwide, over two-thirds of adults are overweight, and the rates are higher among socially disadvantaged populations. Recent figures show that obesity rates are higher among African American women (49%), compared to their non-Hispanic white counterparts (31%). To combat this epidemic, it will take more than fad diets and relying on individuals to change their lifestyles. It will take creative innovation and a population-relevant, holistic approach. This is what Dr. Gary Bennett and his research team at Duke University realized when they launched Shape,

a series of weight loss studies that combine the newest evidence in weight loss with the latest web and telephony technologies to create personally-tailored weight loss programs for obese women.

Dr Bennett and his team were looking for a program that would help them leverage the web, IVR, and text messaging to improve the efficacy of their weight loss studies, as well as lower its cost in order to extend its reach. Twilio powers the underlying communications platform for outbound/inbound calls and text messaging.

The low cost and unending flexibility of Twilio make it possible for programs like this to be leveraged from 200 participants to 20,000. This means that it could be easily and quickly implemented in communities all over the country.

Dr. Gary Bennett Professor of Psychology and Neuroscience

Dispatching volunteers with Twilio-powered messaging 

The research team selected Twilio because it enabled them to quickly and easily integrate voice and SMS capabilities into the underlying technology used to power Shape. Prior to using Twilio, the research team had a proprietary system to help with the automated outbound calls. The phone system could not be linked with the study database, which made for greater challenges during the course of the study and during data analysis. In addition, the research team could not make changes to the system once it was built, so it could not implement proactive measures to support their participants. “We had to create lots of workarounds, which put stress on our staff and participants, and made fixing issues mid-stream more difficult.”

With Twilio’s flexible cloud platform, the web development team at Duke was able to implement an automated outbound calling system for study participants – without having to learn proprietary telecommunications technologies. The experience of building the system was so easy for the development team, which today consists of just three people, that after 8 months of executing automated outbound phone calls, they implemented a call back system for their participants in the event a participant missed an outbound call. This new feature made it more convenient for participants to interact with the system, which led to higher usage rates. Twilio’s capacity and flexibility made it possible to link a number of different systems to it, and the BennettLab team quickly realized that the possibilities were endless with regards to data collection and usage tracking, two crucial issues for researchers.


The research team also leverages Twilio SMS reminders and notifications to participants in the program. Study participants can also send inbound SMS messages to the research team to provide status updates about their weight loss progress. This gives participants an easy and efficient way to interact with the research team while they are on the go, allowing this program to be widely used among anyone with a cell phone and text-messaging capabilities. “The low cost and unending flexibility of Twilio make it possible for programs like this to be leveraged from 200 participants to 20,000. This means that it could be easily and quickly implemented in communities all over the country.”

Using Twilio, Dr. Bennett and the Duke research team are leveraging cloud and telephony technologies to better help their research goals, and more importantly, helping their participants lose weight. The team has seen increased call response, and has humanized the interaction of their participants with the automated system. The ease and flexibility of Twilio allowed the research team to expand its communication capability beyond simple outbound calling.