Cell phones

Where pagers haven't gone extinct yet

July 16, 2013: 11:19 AM ET

One field still counts on them.

By Verne Kopytoff

I'm not dead yet.

I'm not dead yet.

FORTUNE -- Pagers seemed like a fabulous invention in the years before mobile phones. To reach someone, all you had to do was call their number, enter your contact information, and hit the pound sign to send. The pager's owner, alerted by a symphony of beeping, would then return the call. Mobile phones, of course, eventually drove the technology to near-extinction.

But pagers, in fact, continue to thrive with one critical constituency: the medical industry. Yes, many doctors and nurses still carry pagers instead of -- or in addition to -- smartphones. It is an odd reality for a field that otherwise prides itself on using cutting-edge medicine and sophisticated machinery to save lives. For communication, at least, many people in the medical field are stuck in the 1990s.

The reasons are many. "Doctors are creatures of habit," says Ronald Gruia, an analyst with Frost & Sullivan. But he also argues that many hospitals hang onto the outdated technology to save money. Equipping staff with smartphones and installing technology to guarantee cell phone service inside cavernous medical buildings is expensive.

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Pagers reached their zenith in 1994 when there were over 61 million in use. Their numbers have since dwindled to around five or six million today, according to Gruia. His estimate is an educated guess. Officially, Frost & Sullivan stopped tracking the pager market in 2006 because of, well, its irrelevance.

Despite their obsolescence, pagers do have some advantages. They're small and light enough to carry in a pocket or on a belt. They also don't need to be charged. Instead, you just pop in new batteries. Convenience is a relative term, however. Pagers have no address book, for example. They also lack a way to easily identify those who page you unless the sender includes a name in the message. And nobody is working to improve them.

Such inefficiency comes at a price. Pagers and other outdated communications systems cost hospitals $8.3 billion annually in lost productivity and increased patient discharge times, according to a recent survey by the Ponemon Institute, a technology research organization. The survey, based on responses from 577 healthcare professionals, found that doctors, nurses, and others in the health care field waste around 45 minutes daily because of inefficient communications systems.

Additionally, hospitals take longer to discharge patients -- 101 minutes, on average -- than otherwise necessary, the survey found. By using secure text messaging, hospitals could cut that time by half, most of the respondents said.

Granted, the survey, like many of its kind, should be taken with a grain of salt. The financial losses are extrapolated from a relatively small sample of respondents. Furthermore, the survey was paid for by Imprivata, a company that provides hospitals with software for accessing patient files from both computers and mobile devices. There's an obvious incentive to make the problem seem bigger than it really is to drum up business.

At Alta Bates Summit Medical Center, in Berkeley, Calif., 1,000 out of 4,500 employees have pagers. Carrying one is as much a part of the job as wearing surgical scrubs and plastic gloves. Teri Schlessinger, telecommunications manager for the East Bay region of Sutter Health, the hospital's parent, disputed any suggestion that pagers are relics of the past. Instead, she called them just one of several communications tools employees use. "Certainly, everyone would like to just be able to depend on one device, but we can't do that," Schlessinger says.

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Cell phone signals don't necessarily reach the bowels of big concrete buildings like hospitals. Moreover, during emergencies like earthquakes, cell phone service can get overloaded. Pagers, it turns out, are far less prone to such technical problems. In fact, hospitals still cite their comparative reliability as their reason for continuing to use the technology. After all, doctors can't afford missing important calls. Patient lives are at stake.

In addition to pagers, a private internal communication system, called Vocera, plays a key role in communications at Alta Bates. Employees are given devices resembling smartphones that they clip to their clothes or dangle from their necks. All they have to do is press a button to activate the device, say the name of the colleague they want to reach (voice recognition technology looks them up), and then wait to be connected.

Alta Bates does not give smartphones to staff. Nevertheless, many people bring their personal phones to work. Schlessinger said the hospital is looking at ways to improve cell phone reception in the hospital.

Reception problems are relatively easy to solve and have been for years, analysts say. One option is setting up what are called mesh networks, essentially private cell phone networks, inside facilities to guarantee coverage in hard-to-reach places. Relying on the nearest cell phone tower to provide coverage is unnecessary.

In general, hospitals tend to be slow in adopting new technologies, says Brent Iadarola, another analyst with Frost & Sullivan. Digital medical records are another technology that has long been available, but many hospitals are only just now switching to them. With smartphones, the shift is similarly delayed, he adds. "To still be in the pager environment is to be in the Dark Ages," Iadarola says.

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