SIGNL4 can be considered as an alternative to Twilio. It’s a mobile alerting platform. Typically there are other use cases, it’s primarily focused on incident management and team communication, but it could potentially be used for sending text alerts or push notifications to patients as well. I guess it also depends on your exact budget and how old the patients are as they would need to download an app.
Checkmk is great for home lab monitoring. It’s got secure, flexible agents for Docker and more, making data reporting easy and customizable. Plus, it has visually appealing dashboards and graphs that help in visualizing monitoring data.