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To Page Or Not To Page

That is the question....or is it?  Over a year ago, when we decided to build SmartPager, we took a critical look at the market and the companies in this space.  We quickly realized that although the opportunity to revolutionize healthcare communications with modern technology is vast, there is a simple reason why the pager has survived over the decades and several generations of 'smart' devices.

Before the current generation of Smartphones dominated by Google and Apple, there were Palm Pilots, HandSpring Visors, Treos, BlackBerries, and of course the ever prolific SMS.   The Pager survived all of these onslaughts for several reasons:

1. Network Coverage - A single pager tower can span a range of over 60 miles and the signal can penetrate to the depths of a hospital.

2. Simplicity - A device so simple that not much can go wrong.  Two or 3 buttons and a simple LCD alphanumeric display.

3. Battery Life - A pager can last for several days on a single charge.

When we started talking to our potential customers, we saw a few recurring patterns that cast some doubt on this legacy paging technology.

1. Network Coverage Issues
One of our first customers in Arizona had to switch to an SMS based solution after recurring outages caused by the fact that the one pager tower serving their whole area had gone down.  The problem with relying on a small number of towers is that it increases the likelihood of an all-out outage in the event that there is a single radio with an issue.  On top of that, the paging industry has been bleeding revenues since the advent of SMS, thereby limiting their ability to roll-out and fix tower issues within an acceptable time frame for their health care customers. 3G and in-building WiFi network coverage is rapidly growing, and it's time to leverage them.  Most of the hospitals we talked to have 99%+ WiFi coverage.

2. Too Simple!
Healthcare delivery models are getting more complex and have evolved beyond the pager model.  We live in an on-demand world, and while the medical world has had trouble keeping up, our observation is that it's turning a corner.

A communication model needs to be immediate, but more importantly responsive.  One-way messaging does not support the new healthcare paradigm.  Messages need to be tracked, escalated, and prioritized so that the receiver can make the correct decision.

In the words of one of our customers-  "Why should I drop an exam for a patient because I receive a message for a non urgent opinion?"  With a pager, doctors often don't know the nature of the message and how quickly it needs to be responded to.

Another issue that commonly recurred centered around confirmation of message receipt. Some of the paging networks can verify that a message was delivered, but most of them can't.  Even worse, how do we know when a message has been read or replied to? How is this measured, and who is responsible to assess this responsiveness on a regular basis?

3. Inconvenient

Being able to determine the priority of an issue and react accordingly is difficult to do when you have 8 characters of text. Since 87% of US Physicians carry a Smartphone, why should they carry a second device? Our Orthopedic customers love the fact that we can actually show them an Image.   The process before we deployed SmartPager for one particular customer was to have an ER physician verbally describe an image over the phone to a specialist after receiving the page.  Such an approach is not only time consuming, but more importantly extremely error prone and could lead to the wrong opinion on handling a patient.

We have no doubt that there will be ongoing debates about the Pros and Cons associated with pagers vs. other approaches.  But we also have no doubt that critical medical communications has turned a corner and now is the time to start moving away from 'Page and Pray' approaches.

We'd love to hear from you about your thoughts, and please do take a peek at what we're working on here at SmartPager.

blog, pager replacement