My post about replacing pagers with smart phones generated some great comments. Please read them for insight into the debate.
Several of the comments brought up what I think of as nurse messaging tools, a subject I wrote about last summer. Companies I see in this space are Voalte, Vocera, EXTENSION, AmCom (now part of USA Mobility), and PatientSafe. These tools, which include integration with hospital alarms and patient call, are extremely valuable for patient care, but were not what I intended in my last post.
My post was specifically motivated by companies that — from a marketing perspective, at least — seem to be focused on growing a network of physician users to enable secure doc-to-doc communication. All of these companies speak to the convenience of replacing pagers with personal smart phones.
I see this as separate and distinct from in-facility tools that employees pick up when they arrive for a shift. I could be wrong, but I can’t really imagine doctors carrying around dedicated devices from Voalte or EXTENSION or PatientSafe.
Second, the list of secure messaging companies in my last post was not meant to be an exhaustive list, just all the companies that I’ve heard about over the last 6-12 months. Somebody e-mailed to let me know about OnPage, a company that was new to me. I think OnPage is industry agnostic when it comes to secure messaging — which is how I saw TigerText when it first launched — and I don’t think that is necessarily the right approach to getting into healthcare. If you know of other companies, please let me know.
Third, reader Dave Dillehunt brought up an interesting point:
Because traditional paging technology is dying, and customers are leaving in favor of their smartphone texting apps, the industry is now milking what revenues they have left and are no longer repairing / replacing damaged / failing paging towers / equipment.
I hadn’t thought of this, but it makes sense as the pager industry is shrinking, though it’s still a billion-dollar industry in the US. Does anybody have any specific data on worsening pager networks or coverage?
Fourth, Dave went on to say:
While cellular coverage is sketchy as well, technologies that send out through both cellular and wi-fi are a good start and probably provide better coverage than the current (worsening) paging coverage.
Several other comments did not agree with this, siding with my belief that pager coverage is still more reliable. Is there good data specific to healthcare that compares message reliability and latency between cell phones and pagers? Also, I don’t really know all the technical details about why pagers are more reliable – strength of signal, protocols used for communication, multicast. If somebody wants to submit a guest post detailing the technical differences, please e-mail me below.
Fifth — and this was a great point that I hadn’t even considered – physician reader Laura wrote:
One final benefit of the beeper is that it is much less interruptive when engaged in an important conversation or procedure.
This is so true. It happened twice today while I was at the hospital with one of my kids. Attendings were talking to us, got paged, glanced at the pager, and handed it off to a resident to call back, all without breaking the conversation or seeming distracted.
Sixth, based on personal experience today. I couldn’t have made this last part up. Ironically I’m dealing with connection issues at the hospital as I’m writing this. My daughter is here getting IV meds and a full workup (full = ID + ENT + rheumatology + thorough derm mom) for her recurrent parotitis.
My wife just left the room to go to work on another floor of the hospital. Before she left, told me to put her pager number into my phone because she wanted to know if the docs were doing any more blood draws (it’s rather traumatic for our daughter.) She said she has no connection on her phone at the hospital, so I should just page her. I promise I didn’t prompt her. We are both Doximity users, so I guess that would have been an alternative, but pager was just the default because it’s reliable and habitual.
Also, I should note that the nurses here carry pagers, but I know the hospital just started a trial of a new smart phone communication system (I’m not sure which one.) Something else I found interesting from this experience — the iOS address book has "Pager" as an option for phone numbers.
I plan to write a another post on this later in the week. Please let me know if you want to weigh in on this either by e-mailing me or commenting below.