Why doctors still use pagers (it's not what you thought)
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- Опубліковано 7 чер 2024
- Despite the existence of cell phones as powerful as computers, many doctors still rely on pagers that have basically been unchanged for decades. In this video, I explain why the pager is such an important tool for communication in healthcare.
(If it was what you thought, then I'm sorry I lied with the title)
0:00 Start
0:30 Bad cell service
2:11 Reliability issues
2:54 Emergencies
3:42 Unexpected benefits
5:23 Better alternatives?
Music:
Subtle Swagger by Ron Gelinas: / atmospheric-music-portal
The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
#Anesthesiology #Residency #MedicalSchool - Наука та технологія
I have to say, hearing my name pop up threw me for a loop, though I don't blame you for not taking my word for it! I work with NMR spectrometers (same tech as MRIs) and it's the same thing in my workplace - no phone reception in the building at all! It's doubly annoying when we need to get a two-factor auth code over SMS.
Omg!!! How did you find this video haha thank you for providing initial guidance on this matter
That's got to be fun to be watching UA-cam and hearing your specific username called out 😂 no zoned out listening today
This guy is an excellent anesthesiologist. I started listening to this video and within a minute I was fast asleep.
Please don’t bill me.
That'll be 6348.21.
LOL, that was a good one. but to be honest he's great, very interesting
Just said this on a similar video yesterday (so sorry if folks seeing again 😂) but another big piece of the pager for Hospitals (and a couple other industries) is because the technology is so understood/stable that pager companies are willing to provide SLAs (Service Level Agreements) that guarantee delivery within a couple minutes or they have to pay potentially large fines. Cell phones for example refuse to do that for either phone calls or text messages they both don't want to guarantee delivery at all and explicitly say that messages can take days to be delivered. In a crisis situation that's obviously unacceptable and the SLA guarantee is worth millions of dollars to some hospitals.
Ah yes, I work in web development and we have hefty SLAs for uptime. I’ve done minor work on EHR development and uptime SLAs are measured by the decimal percentage. For example: an SLA of 99.99% means that in 1 calendar year, your web service can only experience a CUMULATIVE downtime of 87.6 minutes (0.01%). I read somewhere that most EHRs and electronic health systems aim for six 9s of accuracy: 99.9999%. That’s 52 seconds spread across an entire year.
absolutely wild, but it makes complete sense.
@@jtw-r As it should be, it is the lives of patients at stake. I am actually surprised that pagers havent been abandoned for an even more forgiving and less reliable system given the economic environment of our times. It is surprising that greed hasn't overridden them.
Here in the UK it has become common to use DECT phones instead of pagers. These are actual phones however they work on a local network with access points (usually wall or ceiling-mounted) similar to Wifi but on a drastically lower frequency, which provides the same penetration benefits of pagers, and because they use access points they can actually be used in locations where even pager signal is poor.
The main benefit is they are actual phones as well so you can actually talk to other people using them, just using extension numbers. or if permitted by your organisation, they can call out to external lines. They are also encrypted ensuring the security of communications.
because they are simple devices (similar to your old Nokia style phones) they too have long battery life, and are immediately easy to use. with access for contacts lists ect.
Yep in my hospital all pagers were replaced with DECT.
DECT makes so much more sense nowadays I think. Also probably good to not rely on a public pager network but Instead have hospital-owned DECT network that can be designed to definitely have coverage everywhere. Pagers aren't magic and still can have dead spots somewhere In your building. Imagine building a new hospital and then realizing that there is some corner where your pagers might not work. With DECT you can just stick another base station on the ceiling and be done
Up until very recently I carried a pager as an operator of a wastewater treatment plant. The most frequent page I got was from the local hospital mistakingly paging my number, sometimes with some very personal medical information. I tried for years to get them to correct this, but I still kept getting paged several times per week.
Quick fix, leak the personal info to the local news. I'm sure it will get fixed real quick.
Good video! I'm sure you're aware of two other benefits of pagers. (1) They don't have to be tied to a person. They can be assigned based on a role. When someone comes on duty as part of the code team, they can have the active code team pager passed along to them. That very obvious action is far less prone to mistakes than some scheme for altering which personal cell phone is activated at every shift change. (2) When a pager goes off, its meaning is clear. When a cell phone rings or makes some sound, it's not that clear what is meant. In a cellphone system time is wasted checking to see that call or beep means.
As a hospital telecoms manager (just retired) I can not agree more.
I installed a bleep system upgrading from our old system just 5 years ago. It is essential
I installed a completely separate network for the Swissphone system as I don’t trust the IT network.
In the NHS we rely on speech for urgent commas over the bleeps
I like the fact that not only is the pager passed to someone the code team, but presumably they're actively taking it. You can't be given the pager without realising you have it, or expressing willingness to have it.
I've done a bit of on-call IT support, never with anything physical like a pager, we had some automated rota systems and I thought it would be good to make the person going on-call at least click a button to take the on-call responsibility instead of the system just assuming that they're ready to go on call because it's their turn. And then if they don't do it the previous person might stay on call for some extra time.
I mean, PagerDuty does both of those things. Not saying it’s great for a hospital network, just saying it does exist outside of traditional pagers
Those are easily addressed compared to the issues he mentioned in the video.
You can also have multiple pagers on the same phone number which provides redundancy.
I miss our pager system that has been replaced by regular cell phones. I liked that it was asynchronous communication. It gave you a moment to think about the page before calling it back.
Some of our guys were almost always "out of pager range" even though they lived where it was not a coverage problem.
Then, if you are on call decide if you are going to claim to have had a glass of wine or two....three if it is a shooting call.
There is likely another reason for shielding. Sensitive devices such as EKG, EEG, etc. can be interfered with by electromagnetic radiation from such things as cell phones. Pagers only receive but cell phones constantly "ping" or transmit their location even if the owner is not doing anything with it.
Probably 20 years ago yes. But the power output of modern Smartphones are not very high. The reason why cellphone service is pretty good these days is because service providers install 4G and 5G nodes everywhere. They haven’t used towers in a long time.
I have had EKG done on me with IPhone in pocket. I was at a cardiology clinic not in hospital basement so I had very good 5G signal.
we are always carrying our phones anyways
This is an outdated thought model. Shielding is very easy to implement, and many large devices have casings acting as Faraday Cages. And it's not hard to build a room as a Faraday Cage either. High frequencies used in some cell bands also don't penetrate walls well. Also, as the early part of the video mentions, many walls are already heavily shielded.
@@JasonB808 said " But the power output of modern Smartphones are not very high "
Power output is adjusted to be just high enough to hit the cell network. This is done to preserve battery life. If the phone is in a poor or zero reception area, the TX power will go to max. I've worked in metal buildings that block cell signals and the battery will be depleted in a day where as in normal conditions it would go a weak.
Doctor's offices and especially dentists still have 'no cell phone' signs basically on every other door and wall, but people just don't care and staff never says anything anyway. Seems cell signals aren't a problem.
As someone with a chronic health condition that frequently spends a lot of time in and around hospitals, it would be nice if hospitals put more Wi-Fi boosters in waiting rooms and hallways where patients often have to sit and wait for their turn to go in for a procedure. For the most part, there is good Wi-Fi on the wards, even if in some hospitals, you have to pay for it.
The only health condition YOUS have is Smurfitis. YOUS miss YOUS Smurf, Edgar.
My hospital system has a clinical and guest network at all times, and they need to use those boosters because we utilize MyChart Bedside tablets for a similar reason: the network enables us to provide a direct connection to the nurse’s station that can be differentiated from alarms and overhead announcements.
It was nice during the pandemic, because we do still have the bed-based call remotes for the TV and the phone for Food Services, so there is a backup system when we need to update or back up servers and network connections. For example, a patient like myself. who was in observation for sepsis post-operatively, who is alert, comfortable, and meeting milestones before discharge, I was able to still communicate my needs quickly and spend my time resting and staying mentally engaged. That made recovery that much easier.
In contrast, after my WLS, that hospital did not have the same tablet tech, so most of my time was either TV, sleep, taking a mandatory walk in the hall, or waiting for my phone to charge or connect. In both cases I recovered well, but the first one made me feel better upon discharge.
Ottawa hospital is great for that, there's free wifi in basically every room
As a cyber security professional, I can tell you the reason for that is healthcare IT is just insane when it comes to regulations and privacy. Hospitals are one of the hardest places to work as an IT professional. They’re also one of the most interesting. For example, hospitals often employ redundant networks in order to ensure that equipment is able to operate. Even if half of the building is missing it’s standard practice to have 2,3 or even 4 sets of net work back bone going through a hospital vertically. The thought is if there is a natural disaster or attack the hospital needs to operate regardless. As for your Wi-Fi issues hospitals employ tons of devices that connect to those networks or networks operating on similar frequencies to avoid instances of over saturation often times patient connectivity is overlooked or cut out of network capacity planing guest networks need to be isolated from official hospital networks and IT budgets run thin when meeting the demands placed upon the networks already in place. Most hospitals I have worked with do allow their staff to use the Wi-Fi in order to accommodate their needs. Not to mention rolling out a Wi-Fi network in a hospital is hard like was mentioned in the video a lot of hospital walls are shielded and the ones that are not are usually rebar reenforced concrete so they might as well be planing for Wi-Fi in that environment requires double or triple the amount of access points that are needed in a regular office building…. So the TLDR is hospitals are a pain to network and usually the budget was spen on making systems redundant and fail safe. In other words when working in a hospital every network component is at least 2…1 is none and two is one.
I think hospitals have a finite amount of money and is spent where necessary for patient care, not patients entertainment
We use hospital issued VOIP phones. Everyone grabs one at the beginning of their shift (from a charging base) or if they are sitting at a desk all day they can log into a website that allows for messaging. If you’re on a code team, you click on that upon signing in and get appropriate RAP and code alerts that are hard to miss. It’s secure (as anything can be these days) and won’t work beyond the hospital Wi-Fi. There have been a couple of outages in the few years we’ve had them but in general, rather reliable.
We cant use that in Hurricane Territory...we can reasonably expect LONG power outages in certain areas of the facilities.
Another reason pagers are useful. A location can have it's own transmitter / paging system with antennas in the building. Some restaurants / stores use this to alert customers that their table or items are ready.
Correct in regards to network infastructure
But the systems installed in NHS Trusts MUST also carry speech communication paths for calling the trauma teams.
I dunno man, being at an L1 Trauma (and burn, and NICU)...we did just fine for decades with no voice @@robertbroadbent3038
Pagers are good for me turtle Edgar
Pagers use HIGHLY insecure protocols. The texts are sent in what is effectively plain text over the air. Not only can anyone intercept the message contents, but with $500 hardware, someone can actually send texts to any pager network.
Not any more actually. Dr Feinstein's pager (Spok T5) has encryption capabilities (cloud.spok.com/DS-AMER-T5-Pager-Security-Features.pdf).
This is true, in a broad sense, mostly because many hospitals don't want to deploy newer/more expensive hardware. However, both the back end and devices have become more sophisticated and secure. These newer systems encrypt from end to end and can be integrated with the org messaging systems like MS Exchange/Office 365, which also include other security futures. For example, should one of these pagers be stolen, an IT admin can disable the device. During my time in Incident Response for O365, these were some of the most interesting and intense cases I ever worked on, and I had no idea that pagers had joined the 21st century until I started this role. And now you do too!
Encrypted pagers are HIPPA compliant.
I use pagers in emergency services - and modern ones do not use insecure protocols.
This just isn’t an issue... most modern pagers aren’t that insecure anymore.. and even if they were, I have never heard of pager interceptions or whatever.. we use them (speaking from a first world country and no not USA) for pretty much all emergency services that have some kind of standby kind of shift. It’s reliable and very useful, these issues just aren’t a thing, even if they could be.
This is so cool. I've been working in hospitals for over 10 years and I never understood why pagers were still used. Thanks.
I am a field engineer for an OEM that manages a few hospitals telemetry system. They also run cellular service over our same system so I had to learn how to work on cellular as well. What you said about the walls and shielding is so true. Had a doc complaining they were getting calls in the CT. Well yeah there is not an antenna in the room and you are in a lead box. Would you like an antenna installed in the room. Just about every hospital here has Wi-Fi phones that can work better than pagers because a pager can still be blocked by a wall and encrypted pagers can get enough interference to scramble the message.
My Trust tried to switch to Wifi phones, but the coverage just wasn't good/reliable enough and they had to go back to the super-expensive, falling-apart pagers for now.
I could tell a story about a new IR machine (GE) that could shoot "up"...someone assumed the ceiling was shielded...it wasnt....
@@systemsbroken somebody got strangled by a lanyard on the floor above didnt they
My sister is a clinical engineer in charge of equipment orders/installations in hospitals who now works for an equipment company at many hospitals but she started out at a specific hospital dealing with different companies and I remember her having to borrow a bunch of equipment from a smaller offsite facility during the beginning of the pandemic when they had to create their own Covid ward and she was talking about the different communication systems they had in place then and pagers were still one of them, it was fascinating learning about some of the behind the scenes inner workings that you never think about as an outsider, thanks for sharing, great video!
Never thought about the frequency still plays a part in these situations. great video!
I’ve worked for a mobility provider on the pager side before, a couple decades ago. Way back when, before the age of cell phones, there were pagers called reflex pagers that you could receive AND send a response from. The original Blackberries used that service as well. Was a pain to program into the system though. Many steps, involving a network ghost pager to be linked and all that. The systems were old DOS based programs. Very NOT user friendly. Fun times!
Precisely why the pager died !
Interesting to note. I have worked as a maintenance engineer at several hospitals throughout British Columbia, Canada and they have all had excellent cellular reception. Even on the second floor where the imaging suite was located and in the basement where the maintenance shop was located. Maybe things are designed differently up here.
Even hospitals in Australia still use pagers, though some are planning phasing them out, due to the fact of no encryption, and how easy it is to decode messages
I don't think info like "Cardiac attack floor 2 room 5" should be encrypted. And any other sensitive should not be used through paging system
where I work the pages are just a phone number for someone to call you back on
There are pager systems out there that support encryption, mostly used by EMS and fire service. Yes, they are more expensive, and yes you lock yourself in with one manufacturer, but that might be worth the advantages of pagers.
No pagers in NZ, we have a personal and ward phone system. Just a regular cell phone. The only place I have encountered poor reception in the interventional radiology suites (as you would expect).
I watched a video here on youtube where some pager service providers don't even encrypt the info being send to your pager.
So someone with the right knowledge and know how can fact see the info that is being sent in the area.
I'm a chaplain. At our hospital we also respond to rapid response, codes, trauma, etc to take care of family, staff and check on patient when stable. Everyone just has an iphone on the hospitals network so it works everywhere. It tells you what you're notification is right away so you know what it is and where you're going.
Bless you for being a chaplain, first of all. I am mainly a receptionist but I’m on our H.E.R.Team and Disaster support team so I have needed to take BLS, 30-Second Triage, Stop The Bleed, Decontamination, and Psychological First Aid training. Of all of those, PFA was the most straightforward but most stressful of them all.
Our chaplain team uses their phones as well, but they also have a central office near the ER and other wards, so PA announcements and such are just as effective.
in the hospitals I worked in, only old doctors remember the old classics pagers. For years it's been some kind of phone (from a nokia style phone to a smartphone style) that are used as pagers and to call each other and also consult some files. Never had connection problem with these, even in the radiology second underground, always had network for the classic pager function, calling and internet.
sometimes the old ways are the best. I understand the idea of reliability being so important and ease of use is a great bonus
I work in a heavy industry(pulp mill) in Northern Canada and until about 8 years ago pagers were still used to get a hold of someone if they didn’t have a portable radio or near a phone and the as stated pagers are extremely reliable and durable especially when it’s -30c outside. However 8 years ago a cell tower was erected on our property so pagers were relegated to the dust bin.
They still have their uses today in multiple industries and are used more than people think.
There is push to talk radio system that uses the cell network. It acts like a regular hand held radio once members are entered to the system and offers the benefit of private comm that a regular radio does not. If you are near most any cell tower, you have comm, the down side is radio to radio comm isn't possible. Try the vid Talk Across The World With These Radios!
Ringway Manchester
Hi Dr. Feinstein you did a very good explication on why a pager is reliable. As a long time hospital employee that has a technical background on items like this in hospitals I just wanted to add that it’s very easy for a hospital to retransmit a pager signal in the facility via a hospital owned transmitter. Most paging system also has the ability to send its signal out twice to increase its reliability. If the pager gets the first signal it will ignore the second to keep it from going off twice. There is also one downside most staff do not understand about pagers. If for some reason you need to have 2 pagers at one time for call coverage the pagers should be worn one on each side of your hip. Having them next to each other can cause interference with each other and actually block one or both from getting a signal reliably.
Interesting fact: the pager system in use in my country is, in addition to the groups one would expect (police, emergency care, etc.), used to control street lights
Thank you for your service.
I agree! It's then major reason for pagers in special situations! I haven't experienced much issues with cellular things, but it has been slow around Christmas Eve and our national day of May 17 (som years ago though)
I work in a major hospital in ID. Our clinicians all use pagers. We have 5 services and rotating Fellows. Pagers are easier to hand off and less administrative work ( for me) sooooo I do appreciate them.
So, it's exactly what I thought. Thank you!
You nailed it as to why pagers are still being used. I chuckled at a few of the "experts" chiming in with comments. One of the first misconceptions is that pagers work on the same networks as cell phones...Wrong. They are independent of cellular networks and can deft have coverage where cell phones do not. The other misconception is that all pagers are insecure....Wrong. For sensitive information, Encrypted secure pagers are now available. In fact, the Spok T5 that the doctor is using is available in a secure format where if the message is intercepted, it would be all garbled.
Thank you for sharing your video for electronic safety.
That observation on resistance to new tech is spot-on. It's called technological inertia and it's a major challenge, especially in information technology. Hearing that some of the old guard quit, rather than learn a new system, seems right in line with this tendency. It's very cool that pagers are very old tech that still has a very important purpose in our modern world, though!
As somebody working in an organisation with a huge inertia, although not as critical as a hospital (a "millionaire" library, we have ~6 mln items), in general, I know, I see howit's not bad to transition to new technologies, they are often obviously better. But such a transition costs a lot (a lot!) of money, both in pure purchases and in work hours (hundreds and sometimes thousands, depending on the change). And there will be fails and adaptation pains, nobody enjoys that (as a patient, I remember clinics transitioning to electronic patient cards - it was a mess for years!). Any new instrument, technology, technique must be measurably better by a solid margin for an enterprise to decide to transit. And, again, money; a minor but expensive improvement - nobody would pay for that.
Pagers combine effectiveness, low cost, simplicity, and solid reliability, nothing yet can compete.
I work in high tech and we use cell phones for many things, but I still really like pagers for on-call *because* they're different. Being able to pass it around, to leave it with staff when you go see a performance, to know the battery is fine for weeks, to be confident when it goes off it's actually important, etc. They're really great for the "rare but important" communication use in a way that cell phones aren't.
Thanks for the video Max 🌹
I work in a hospital pharmacy that was formerly the nuclear pharmacy. Our walls and ceiling are filled with lead--zero cell service but the code pagers still work fine. Actually when i step out and go to the bathroom my phone vibrates with all of the texts and emails that i've been sent throughout my shift.
The pager doesn't need to transmit back to the base station - saves on battery and can be used near sensitive equipment that might not like a cellphone next to it.
When I got my first cellphone the battery life was so poor it was expected that it would only be turned on to make a call or when one was expected. It came with a free pager with 'lifetime service'. I've still got the same cellphone service (subject to some updates to number and hardware). But the pager doesn't work any more. :(
Bay tires are batteries for bears. in the same way that you MAY understand the Copenhagen interpretation of Quantum Physics, qubits are negatively affected by both observation and interaction. They are also the product of a VERY SMOOTH HEAD. Its a fact that there are more horseflies, and more horsefly species, in Canada compared to more temperate regions. Bears are under pressure to evolve a SMOOTH HEAD to deter flies. It’s also very elegant and soft.
In Germany, doctors in hospitals have DECT telephones. DECT is a separate frequency band in Europe. The hospitals are equipping their buildings with DECT telephone radio. There is WiFi for patients. You then have to book a weekly plan, but that's cheap.
Cell phone reception depends on how Telekom supplies it from outside. But there are no longer patient telephones at the beds.
It’s almost like you read my mind as I was watching your video about trauma on-call. My question at the time was “where can you even get a pager these days?”
In the UK the hospitals have wi fi for connection to provide signals for mobile phones. At the same time all the equipment used for patient observations work via wi fi to send the observation data to the patient records. No more charts on the end of beds. If you are in a major teaching/research hospital there are multiple wi fi channels for particular users including the Department of Health visitors, university researchers etc. to give the doctors and others plenty of bandwidth.
U.S. hospitals do this too but as stated in the video the building materials that hospitals are built with plus the shielding i.e. lead lined walls and glass along with copper mesh lining will block the Wi-Fi and cell signals very easily. The radio frequency pagers use can transmit further and easier.
I love your videos. I learn so much
Noti gang 💯💯
Only way to start my day
I always enjoy your UA-cam channel 😊
That's exactly what I thought. And even though the signals are at a lower frequency (and go through more materials), hospitals still often have internal pager signal repeaters.
Our Corporate Headquarters building had multiple internal antennae, fed by coax that wound through the building. During my time in Phoenix we never had a problem with the coax or antennae. Good thing - access was spotty at best.
I work in a UK hospital and everything you've said is the same here too, with one essential difference...... NOBODY calls them pagers here.
*Everyone* calls both the devices and the messages 'bleeps'!
Work in the UK to, and interestingly, I've never worked in a hospital where our bleeps get messages! I've only recently became aware that its even a thing! It's always just a number to call back, or the bleep yells out a MET call or Trauma call or cardiac arrest message and location.
"beeper" is a common US slang term for "pager".
One mustn't forget that many of the hospitals out there were also built in earthquake country, some hospitals are designed to be tornado and hurricane resistant, and of course some of them were built to be resistant to the effects of the detonation of truck bombs and nuclear weapons... Note I said "resistant"I did not say bomb proof. Many of these factors go into the design and building and placement of a hospital within a community or a region.... I have some background in civil defense.... Pagers work between 150 and 154 MHz and in various parts of the 800/900 maga Hertz range., Depending where you're at, who the carriers are and several other factors.. the best pagers frequencies for penetrating most standard construction would be the pages at work between the 150 and 154 megahertz range, although with the proper wave guides you can set up a building to accept all standard pager frequencies no matter what the frequency range is....
just remember not send each other passwords using them as pagers usually use plaintext and anyone can receive them. So while you might not have privacy issues from big companies, you do have them from anyone with a $20 usb dongle. Also, "SOS only" means you have reception, its just not your carrier.
I had noticed pagers being carried a while ago, and I had always thought it had more to do with HIPPA. However, I was unaware of several of the facts discussed in this video... which make more sense than my initial thought.
Here was my thought process... Seeing as I never noticed anyone with their phone out (not a very big sample size though, mind you), the thought was that phones were forbidden to be out while on the floor, and the pager was used in place of the phone. If someone needed paged, then it could be done easily while not having to worry about a cell phone accidently sharing information about a patient, either by the microphone or camera. Then, by using pagers, no one could make an argument about needing their phone.
Like I said, I had a small sample size and the things discussed in the video make a lot more sense than that thought process I just explained.
When I was on the SWAT team we used pagers also. During a natural disaster or terrorist attack or any type of situation where cell service might be unreliable they definitely became handy.
Also the reliability, drop a phone and it could break. you drop a Motorola pager and it will keep working.
I work in a hospital and Anesthesiologists are absolute life savers!
Your reaction to the ringer reminds me of my reaction to my insulin pumps beeps and chimes. That stuff haunts me lol
That and it's super easy to hand off the pager to someone else. Whoever has the pager, has the pager. Some dumb app might not do handoffs correctly and is a pain in the butt besides.
Yes, the ring tone of the pager.
It would increase my heart rate when the pager would go off.
Sometimes you would hear the same sound on some music, evoking the same response.
I set up my own pager network using a raspberry pi and mmdvm hat on an amateur radio 70cm frequency, it doesn’t have any significant range, but does work well around the house 😊
This was actually quite interesting. I how it comes up on trivia night some day
Just FYI, the shielding in MRI rooms isn’t mostly for the magnetic field. It’s so the extremely sensitive equipment doesn’t have any outside EM radiation interference at all. The strong magnet aligns molecules in your body but the sensing equipment still has to be extremely sensitive and tuned precisely for it to work correctly. The rooms are faraday cages for that reason. Also, most of the hospitals I’ve worked in have cellular repeaters these days, so most of the time the phones work, even in the basement. But the hospital usually has to have an agreement with a major provider like AT&T to put them inside.
MRI machines use the magnets to align the molecules, but RF (radio) pulses to actually create the images. Outside interference would reduce the image quality.
I had to research various imaging modalities while studying to be an X-Ray tech. I didn't complete the degree, but learned a fair bit about the technology.
DECT - as many others already wrote. In Europe pagers phased out some time ago (10-15 years or so) and have been mostly replaced by DECT-Phones.
It is what I thought. I was responsible for maintenance and administration of our company (a Fortune 100 electric utility) pagers in the Metro area. Our 21 story corporate headquarters building had an internal pager antenna system that ensured service to every room in the building; I presume most hospitals do as well. A paging terminal in the four story building where I primarily worked covered the city around CHQ. Altogether, we had three paging terminals that covered the Metro area and one that covered our nuke plant.
The hospital my wife works at has their own, proprietary cell phone network and their own proprietary cell phones that only work in the building. When you clock in and take report from the doctor/nurse that you are relieving you take the phone for that position and swap the better for a fully charged one.
They work everywhere on the hospital campus except in the MRI chamber.
Hi Doc; Med student here interested in either gen surg or anesthesia and I wanted to see if you ever had this dilemma? Thanks.
There are also rooms in some hospitals where you have to put your phone in airplane mode or let it outside completely to make sure not accidentally disabling airplane mode, because some devices in some clinics can be interrupted by the signals from cellphones. And then you can of course not be reached, pagers on the other hand don't send any signals out, so they can be used literally everywhere, if the room is shielded too much they might not receive the message, but at least you can´t forgot to turn it back on when leaving because it doesn't has to be turned off at all :)
One of the reasons I've a pager for myself even though not working in those areas. You can use it everywhere even on places where you are not allowed to use your phone for security reasons. And there are of course more places then just hospitals where this is the case.
In my homeland last pager service ended 2010 and actually never got the popularity. Actually pagers came here just after cell phone and this communication was even more expensive, than SMS.
I have never seen a pager in my life. Nowadays you can have 4G signal in every hospital and wifi is usual everywhere.
I was a hospital phlebotomist and missed when they took our pagers away and gave us COWs instead. We eventually got a messaging system inside the EHR which was nice, we made a group chat of all phlebotomists on staff that shift.
I work in MR in our hospital, and we have decent WiFi coverage down there, so I've never had an issue with not being able to use messaging (we use Voalte) but still, nothing makes you jump like a pager, so I understand why they still get used 😂 On the other hand though, with messaging, you can see that the message has been sent and seen, whereas with pagers, you have no idea that the message has been received
Ah Voalte…We use it too, though it’s also just as easy to punch the 4-digit extension to who we need to reach. But the number of times I’ve seen IT send alerts about “Voalte interruption”…
I work in an ED in Australia, and some nurses and doctors still carry pagers. I know other specialties do too.
Lower frequency, but higher dB thorough the frequency. That's how it can communicate through large wall.
Pager can support both FHSS & DSSS spread spectrum.
FHSS setting is more likely to be more reliable through large wall.
It's not just the medical shielding... Houston has a "tunnel system" that runs between many of the downtown buildings... There are restaurants and shops there and because it is air-conditionined, people will use it to go to lunch even though walking on the street is (nearly always) a shorter distance... Even back in the days of analog cell phone days (which had better signal reception than the newer digital frequencies), our support people usually could not be contacted when in the tunnel system... As such, they would have a cell phone and a pager and notifications would go out on both of them -- pager text (or just number, depending upon whether the pager accepted text), SMS text to the phone, email, and an automated voice call... The on-call person was bombarded with the various notification methods and it definitely got their attention...
With that title you've invited me to guess at the start, I'm going with same reason you still fax things. It's secure and no one really feels like making a replacement
I worked in a hospital years ago. There was a lot of IT infrastructure tied to the systems too. I think the pagers did have some guaranteed receipt confirmation, as well as logging infrastructure to show when the page was sent, received, etc. And leased lines directly to the pager providers for ~instant sending without relying on public networks (imagine natural disasters and all of the phone networks are tied up)
I work as a clinical research coordinator at a cancer center, and everyone in my role that has any direct contact with patients also has pagers. We get paged when a blood sample or tissue specimen is ready to pick up, either by a specific code or a call back phone number if there is a question. We get phone calls on a desk phones sometimes too, but the pagers are handy for the simplest stuff, because we know the labs/specimens are coming and where to go to get them, so a page is faster than even a short phone call unless there is some question we need to answer. I do feel almost "unworthy" of the pager - I'm not rushing off to save anyone's life, although I am BLS (basic life support) trained. Funny enough we also are generally expected to wear white coats when we talk to patients, no reason given (and no they don't say Dr. on them unless someone is a doctor), but I suppose because it makes us look more trustworthy or science-y or something...
Some hospitals have issued phones they give to staff that have a proprietary messaging system installed on it. Voalte.
Its nice, but you don't always want 2 way communication. Sometimes a concern is low priority (like needing an order for a laxative) and responding would distract from something high priority (needing to respond to a heart attack).
Also 2 way communication leaves behind a record of the conversation that can be brought up. So it kind of acts like an axillary med record document. So clinicians may not want to leave a paper trail where the wrong wording (but correct intention) might get them into hot water later.
Drug Dealers still use Pagers too.... they are DYI Anesthesiologists, dispensation drugs..
Modern buildings have systems called DAS, which allows the building to be penetrated by radio waves including cell phones, but primarily for first responders.
We use them in Maryland for fire/ems in addition to regular fire pagers
I carry a pager for work also but for a different reason, phones, Bluetooth, 2 way radios etc are not allowed in the building at all.
Thanks for talking about this a lot of people don't realize that a pager works better and faster than calling you and because phones just don't work. I have a separate question I was wondering how do feel when anesthesia doctors sedate patients for elective surgery and the patient the doctor to please wait but the doctor sedates the patient without knowledge. How do feel about it? I felt it was rude and unethical for doctors to do that because caused PTSD after the fact.
Up here in Canada cell antennas are typically installed within public health facilities so you're always covered despite being 3 levels underground 🎉
Where in Canada? In Ontario we still use pagers for the main form of communication in my hospital which is s major teaching hospital.
I'm an RN working at the new hospital built in Vaughan next to Canada's Wonderland but prior to construction I was working at the Richmond Hill Hospital and both hospitals issue staff Motorola or similar type cellphones for internal use but both hospitals do in fact have civilian full 5G telecommunications throughout the hospital through the use of indoor cellular antennas. These look like little off-white cones protruding from the ceilings.
Regarding privacy... pager usually is unencrypted. Everyone with an SDR radio and the right piece of software can read all pages on the air
You have to certify every SW update for medical use. Basically impossible to keep up with smartphone update frequency.
We use pagers in Antarctica too. No cell coverage at all on the research stations, but running a pager system is easy.
I swore when you brought up other means of communicating you were going to show us some elaborate banging on the pipes technique! I mean why have a settings change to one with a bright red pipe if it wasn't going to be used for something?!
Here in Germany, the fire department still uses a pager but digital and it's more modern. They get some text on the display about the call. Having frequencies only used by emergency services is pretty important and having a device that is very robust, is also important.
There are options to bring cell service down there. There are repeaters that could relay the signal down there. The reason that they don't want cellphone signals down there to stop interference, is not a good one, because just banning phones would be better. Phones, especially 2G, crank up their signal to the maximum, to get a reception. You still have phones that try to ping a basestation but at maximum power. When they get a bit of a station, it does the whole handshake stuff and when they are really on the edge, this happens a lot. It's better to have a reception. 2G is phasing out but phones still have it.
I think the reason is, they don't want people on their phones and doing phone calls in areas where it need to be quieter. My experience is, people don't care for rules and the personell doesn't have the time to enforce it. Without a reception, they can't use their phones. But when the hospital has wifi even for visitors, well then there is no reason to not just relay some cell network into the basement.
Even subway lines do this. When I had my first cellphones, I had zero reception but at some point I had full reception, except in one spot. This was 10 years ago and they probably upgraded their relays for 4G and maybe even 5G now.
I kind of miss the days of pagers. Then there was many years where I had a cell phone AND a pager.
Yep, as a former employee of "Spok", but back when it was PageNet/Arch Wireless/USA Mobility....we all knew there was a base set of users (First Responders/Medical personnel) that would ALWAYS need a 1 way/2 way pager. And it's because the reception for 1 way/2 way paging is more available in deep dark areas of buildings where your cell stops working.
I just love your videos!
@1:19 - while the MRI has a strong magnetic field, that's not actually why the room is shielded. Making all your hydrogen atoms "spin & sing" involves using pulsed RF powers of the order of a few kilowatts - That kind of transmitter leaking into the outside world would interfere with the wider use of radio in a hospital and nearby area. The main reason however is that the received echo signal from those protons is very weak, and would be drowned out by all the RF noise from our normal environment, the computers outside the MR room etc. Guaranteeing the best image quality requires a very 'radio quiet' environment for the MRI machine to operate in.
Next time you're in a MR room, take a look at the door seals - that's one of the key places where special attention is paid to make sure RF is kept out the room and vice versa.
Aw Doc. You said the pagers predate your own birth. That one hit hard. And painfully. ☹️ And although pagers do not predate my own birth, but Bridge Over Troubled Water does by a few days, … I’ve only just started my career. 😐 I did not feel old until pagers……
don’t beat yourself up about it, i myself am part of the "born after pagers" generation and still in med school. A good fraction of my med school year consist of non traditional applicants that either started another career or worked as nurses/surgical technicians beforehand. Talking to them, they also sometimes get a little self conscious about the fact that they are just starting over, but i honestly have nothing but respect for them. I see a level of dedication to their goals of helping others as future physicians that I’m not sure i could muster. I admire the courage of putting up with that uncomfortable perspective of starting over surround by younger people for achieving their dream. No judgement in the slightest, be proud of yourself!!
I am in the Civil protection and I can confirm than during the almot 3 months I had one pager at home, the battery symbol didn't change muche
I work for a hospital and my job is to maintain the paging system. The pagers are super reliable
It was exactly what I thought.
Pagers make sense in hospitals as they are a passive receiver. I'm guessing the medical equipment manufacturers also filter 800mhz frequenecies in their manufacturer. Also fewer repeaters are needed to cover a given area.
Speaking as a former paging system technician I would have to add a coup[e data points...Paging systems use higher power than two-way and MUCH higher power than cellular systems. That said, there is often still a problem in places like hospital basements and we have had to find ways to boost the signal in problem areas by installing equipment in the hospital.
Different kind of pager in use here BUT i can confirm this same phenomenon. Was at my local hospital for my wife (all good, no worries) and my phone at less than 0 service but my FD pager went bananas for a crash. Ours operate similarly but without phone #s, just are programmed to alert when certain frequencies are broadcast on certain channels
The big question I have is, who sends those messages, and how do they send them?
What did they use before pagers? Did they just call doctors over the PA system like the cliche you always see in movies and TV shows where they're always calling doctors to different areas of the hospital over the loudspeaker and it annoys the patients?
prob med students running around to find the doctors LOL
Doctors on call had to inform the hospital switchboard of where they could be reached even as they moved from place to place. While traveling (car phones were very rare) they would call in from time to time for messages. If they went to the theatre they would leave their seat number with the box office, and the hospital could have them fetched by an usher. All of this was well established and familiar to all locations where people gathered.
@@danielfeenberg8094 What about when they were actually working within the hospital, though? That's what I was asking about. I guess there, they would just use the PA system, right? I'm talking about situations where they just need to call the doctor from one area of the hospital to another.
One useful thing about the pager was that you could activate the signal tone yourself, look a the pager, then leave a useless meeting pretending you were needed elsewhere.
Interesting… in spain we use cheap smartphones and ive never encountered any coverage issue, can be a pain because you end up carrying up to 3 smartphones in your pocket 😅
But im still left wondering why staff dont carry radios
Underrated reason for pagers being still very useful: When it rings, you know it's important.
That pager is always on even when your smartphone is off or silent. And you never have to configure it.
If they page you, there actually is an important and urgent reason for that. It won't ever be mom, your ex or accounting waking you after a night shift for stuff that seriously could wait. So you have no incentive to turn it off and then forget to turn it on again.
This is also great for things like going to the symphony, where they traditionally have a way to leave the pager and they'll get you if it goes off. That only works when it *only* goes off for something critical.
One other point, many hospitals own the paging transmitter which is installed within the hospital. They don't have to pay a fee to another company. The do have to either self maintain the system or pay a company for that service.