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It's Time to Turn in the Pager

Our middle-aged patients often laugh when they see a pager: They are old enough to know what it is, but young enough to see how anachronistic it has become.
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Sachin H. Jain, M.D., Pharmaceutical Executive
C. Ted Lord, M.D., Anesthesiologist, Spectrum Medical Group

While the tech and business worlds embrace modern marvels such as the cloud, interoperability, and real-time collaboration, our fellow medical professionals cling to a particular artifact of 1970s tech: the pager.

As physicians, we are continually faced with the limitations of this anachronistic technology. In a common situation, if a nurse wants to notify a doctor, he calls a phone number and enters the callback number. Minutes later, the doctor receives the page, responds by telephone, and the nurse explains the reason he paged. In a peculiar underutilization of the vast communication potential of networked computers, the nurse might also log into a website and type in the callback number or a brief alphanumeric message to achieve the same ends. That computer might be connected to extensive databases of patient information, clinical results and monitoring data, none of which is integrated with the paging system. Many hospitals even employ "page operators" solely to help people figure out how to contact clinicians by pager, despite the fact that these same clinicians spend their days surrounded by a multitude of networked computer systems, both personal and professional. We're using VHS tapes in a Netflix world.

Outside the hospital, anyone with a smartphone can connect with their entire network instantaneously through numerous apps. Our middle-aged patients often laugh when they see a pager: They are old enough to know what it is, but young enough to see how anachronistic it has become. One patient asked: "What's with the pager? Are you going to an '80s party dressed as a drug dealer?" Communication can now move seamlessly and in real-time. Fellow physicians: It's time for a hardware update.

We've all heard the arguments about why pagers are still in use. But this position often overlooks how newly-available solutions incorporate the strengths of pagers with many more benefits:

Reliability -- Hospitals have long claimed that pagers are more reliable than cell phones, as they don't depend on cell tower reception. However, this ignores a relatively easy solution. Many hospitals today can easily set up mesh networks, which act as their own private cell phone networks within the facility walls. Consider this the next time your mother's nurse wants to get ahold of the doctor immediately, because there is no way to know if a page that was sent has actually been received.

Security -- The Health Insurance Portability & Accountability Act of 1996 requires extensive requirements for privacy standards, and has long been cited as a supporting argument for pagers. However, many new secure text messaging services such as Cortext, MediGram, and Seratis are all also HIPPA compliant.

Cost -- While on the surface, pager hardware and services appear to cost less than mobile phones, the math can be deceiving. According to one study by the Ponemon Institute, health care professionals waste 45 minutes each day because of inefficient communications systems. These are precious minutes that should be spent with patients, and could equate to billions of dollars in lost productivity each year.

Ubiquity -- Often the biggest reason cited for keeping pagers is that they are widely used and well understood by the profession. But this points to a stubbornness that prioritizes familiarity over efficiency and common sense. Nearly all physicians also carry a smartphone, and would adapt to a new system -- particularly if it saves them time and frustration. Many already bemoan the telling juxtaposition of finding out immediately via text message when their credit card balance has been exceeded, while relying on cumbersome pagers to find out from a third party when a patient's health has deteriorated.

With the numerous advances in communications technology and the ubiquity of smartphones, pagers simply no longer offer the best way for physicians and hospitals to communicate. Doctors often get paged with issues that could have been answered by others within the hospital, or with questions that could have been addressed with a simple text message exchange.

Additionally, new technologies offer functionality that could prove crucial in decision making, such as organizing messages by patient, keeping the entire team up to date on a patient's status, notifying the sender when the message has been read, and notifying users when an attending physician is unavailable -- all advances that would be invaluable during an emergency.

While we should avoid overcomplicating the communications process, new technologies offer a more efficient, intuitive, and user-friendly way to stay connected to the hospital. And so, we challenge the medical profession: Turn in your pagers and join the 21st century.

Any views or opinions presented here are solely those of the authors, and do necessarily represent or reflect those of the companies in which they work.

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