'Paging Dr. Unreachable' – Why Physicians Are Ditching Pagers in Favor of HIPAA-Compliant Phone Apps

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Physicians will be the first to admit that they're sometimes hard to reach with a pager. This "send-and-wait" clinical messaging scenario of paging is old school, with patient care quality and HIPAA compliance suffering as a result.

The page signal itself takes too much time – from 15 seconds to one minute depending on the type of pager. The person sending the page doesn’t know if the intended recipient received the signal, and the pager doesn't alert senders or intended recipients if an attempt to communicate failed. Meanwhile, workflow is interrupted as clinicians wait – sometimes in vain -- for needed feedback; pager messages also cannot include patient names or patient data to comply with HIPAA.

About 80% of hospitals in the United States still use pagers as they continue clinical communication with familiar but outdated technology. In Canada, the three largest telecom companies soon will no longer support pager networks, a development sealed when the largest of this trio announced it will stop pager support at the end of 2021. In the United Kingdom, the National Health Service mandated that all trusts’ hospitals must stop the use of pagers for non-emergency clinical communication by the end of 2021. Replacement options include “smartphones and apps” (Gov.uk, 2019).  

The onset of Covid-19 in 2020 led to pagers being replaced with new clinical communication technologies in health care delivery and response. Pager replacement led to increased use of instant messaging via smartphones and other digital communication tools. Many physicians replaced the pager and introduced updated technologies for clinical communication and HIPAA compliance; smartphones worked “for rapid collective sense-making and to facilitate strategic and operational decision-making” (Tham, Lu & Teo, 2020).

Six Reasons for Physicians to Ditch the Pager

Communication delays interrupt not only workflow but quality and timely patient care. Here are six reasons why it’s time to ditch the pager.

1. Clincian burnout: Multiple, non-urgent pages can “disrupt patient care, reduce efficiency and contribute to burnout” (Storino, et al., 2021). Non-urgent pages also contribute to alarm fatigue and noise in clinical areas.
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2. Outdated infrastructure: As hospitals and health systems invest in digital and mobile communication technologies, pagers and other outdated infrastructure march toward obsolescence. “Health care practitioners now have smartphones and need communication tools that are much more capable of doing richer, contextual and relevant communication” (Best, 2021).
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3. Not HIPAA-compliant: The HIPAA Security Rule “effectively ended alpha numeric paging in medical facilities,” a change where “medical professionals are abandoning pagers in favor of personal mobile devices.” The rule calls for administrative, physical and technology protections for electronic exchange of patient health information. (HIPAA Journal, 2018). For clinicians who simply must page, they cannot share personal health information about their patients.
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4. Delayed transmission times: Pagers vary in the time they take to transmit to a call. Some take a minute to connect while another model with a faster response time may transmit in as little as 15 seconds. This limited functionality matters to any clinician or health care professional who needs information immediately.
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5. Unreported missed calls: The pager doesn’t know and doesn’t report when a call fails. For example, a nurse pages a physician whose pager isn’t turned on, or the page doesn't go through due to connection issues within the hospital or other location. The nurse who sent the page assumes the intended recipient received the message and waits for an answer.
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6. Multiple pagers in use: Physicians and residents often use physician-specific pagers rather than a single-service pager, a system that results in workflow interruptions with multiple pages sent to each pager. Pagers cannot communicate the urgency or importance of the message, nor can pagers indicate missed or repeated messages. (Witherspoon, et al., 2019). This hit-or-miss messaging system leaves clinicians uninformed due to missed pages or challenged to manage multiple return calls from each pager in use.

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Hypercare Provides Immediate Pager Replacement

The Hypercare smartphone app can immediately replace a pager with its pager replacement functionality that is HIPAA-compliant and designed for health care workflows. This feature generates a custom phone number linked to an on-call schedule or an individual provider so that call back numbers always get to the right person.

To ensure pages always reach the right person on call, the Hypercare pager replacement solution sends pages as Stat messages that bypass the Do Not Disturb functionality on the smartphone. The pager replacement feature provides a direct line to the intended recipient of the page, simplifies the messaging process, and eliminates disruption in communication between clinicians.  

"As a surgical subspecialist, I require a quick and efficient paging system to deliver patient care," said Dr. Joel Cooper, a vascular surgeon at Royal Victoria Hospital. "Our group had previously paid hundreds of dollars per month for an outdated paging service. We were excited to switch to Hypercare, which costs a fraction of the price, and allows for a more accurate and modern way to communicate among our team and deliver care. The transition to Hypercare was easy and the app has been more reliable and functional than our previous service. We have been very happy with this product."

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Book a demo to learn more about Hypercare's pager replacement.

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References

Best J. Slow death of the bleep: why hospital pagers won’t die. BMJ, March 31 2021;372:n684

Gov.uk Government News. Health and social care secretary bans pagers from NHS. February 23, 2019.

HIPAA Journal. HIPAA compliance and pagers, 2016: updated 2018.

Storino A, et al. Paging patterns among junior surgery residents in a tertiary care center, Journal of Surgical Education, Sept.-Oct. 2021;78(5):1483-1491.

Tham K, Lu Q, Teo W. Infodemic: what physician leaders learned during the COVID-19 outbreak: a qualitative study. BMJ Leader, December 2020;4(4):201-206.

Witherspoon L, et al. Is it time to rethink how we page physicians? Understanding paging patterns in a tertiary care hospital. BMC Health Services Research, 2019;19:992.