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I take issue with a couple of the points made for pagers (and against smartphones).

Security: Pagers are hilariously insecure. It's all plaintext, and it's broadcast nationwide. All you need is $15 for an RTL-SDR dongle and you can receive and log everything. I've seen, first hand, pager messages with embarrassing medical information and the full patient name and address.

Reliability: Since pagers are one-way only, there are no built in means to check whether a page was received. If the doctor is out of range, the page is just silently lost. Cell phone range may be less but you can get an ACK.

Even old, time-tested technology is unreliable and leaks information when not used correctly. For example, I have a home phone number that's apparently similar to some doctor's phone number. In spite of the fact that my answering machine message states my name and phone number, I get lots of messages for the doctor, some of which include clinical details, e.g., "Dr. ___, Mrs. ___'s lab results are ___, what are your instructions?". Due to simple carelessness, I've receive private health information which I shouldn't have received, and the doctor failed to receive information that may have been critical to a patient's health. It would seem that a communication system designed for sensitive or critical information should include some kind of protocol that ensures (1) the device you reached is the one you thought you reached and (2) the device was able to store your message.
I carry a pager daily and agree with much of the article. It just _works_.

Other points: - A single AA battery lasts at least 1 month. - It takes a literal 2 seconds to pull out of clip, push button and read message. - ~75% of my pages contain a 5 digit internal phone extension for a return call. The rest might say "Smith in ICU bed 104 is going to CT", etc. Not exactly transmitting a lot of patient information. - There is a huge physician workforce of "old school" docs who would have a difficult time adapting to smartphone-based technologies.

I don't see a single texting app being able to successfully penetrate this space. Instead, I believe a more robust suite with a simple, slick UI with access to laboratory data, vitals, and dictated reports would be optimal. PerfectServe is one company that I know of that is actively working in this space.

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