The history and future of pagers: an opinion piece

March 10, 2023

Since its first use in a New York City Hospital in 1950, pagers have and still – today – continue to play an important part for doctors and staff in hospitals.  

Their affordability and “deeply entwined in legacy systems” status makes them a cornerstone of communications amongst healthcare workers. 

However, as our healthcare facilities – and indeed the way we work – become more digitised for better connectivity and faster delivery of patient care, the limitations of pagers as a form of communication in hospitals are becoming more evident:  

  • Inefficient workflows: research has shown that one-way communication paging systems offer no ability to answer back with the same immediacy and efficiency as a mobile device. The time wasted in communicating adds up as a burden on the healthcare system, especially when the answer back could be a simple yes or no response.
  • Insecure and inaccurate data: anecdotes of nurses writing patient notes on their scrubs and Australian healthcare providers reporting massive data breaches from pagers also highlight the need for a better, more accurate and effective way to communicate patient information.
  • Limited ongoing network support: moreover, wide area paging systems are effectively not available anymore since our major telecommunications providers stop supporting this in early 2022.  


So, how can healthcare leaders and their IT team support their hospital workforce to continue using their cost-effective paging systems today, whilst also preparing for a modern, connected ecosystem for next generation digital hospitals?  

We look at all viable solutions to suit the differing and common circumstances faced by Australian healthcare facilities. 


The history and – current – status of pagers  

In providing these solutions, the Olinqua team appreciates the cost barriers to many Australian hospitals that prevent them from moving completely away from pagers in favour of a unified communications system that offer other digital solutions for its workforce and operations.  

Through our innovation towards smarter, safer, and better healthcare, and working within the digital health space for over a decade, we have been well placed to understand the evolution of paging technology and the future of pagers.  

Paging – or messaging to use a broader term – can be said, like most technological evolutions, to have matured through several stages since its inception.  

Paging 1.0 may be described as those early days, when a simple nudge prompted the bearer to ring a pre-determined number to talk to the switchboard operator to find out the nature of the call-to-action. 

The move towards Paging 2.0 may be summarised by some enhancements to that initial capability – whereby a pager now had a small screen to display a numeric value, offering slightly more flexibility to the previous simple “nudge.” In the years following, alpha-numeric paging was also introduced, enabling the sending of text characters to the devices so actual meaningful instructions or requests may be passed to the target recipient(s). 

The advent of Paging 3.0 was the early 1990s. As technology improved, pagers became smaller, screens became larger and, the supporting systems improved and advanced. The appearance of middleware boosted this further, adding in significant enhancements, particularly in alarm integration whereby increasingly external systems – nurse call, fire panels etc. – were connected for automated alerting to devices. 

Paging 4.0 is now taking hold, with far deeper business-relevant workflow and integration becoming both possible but also necessary. The advent of things like the Internet of Things (IoT), and the opportunity to enable deep integration to core business and infrastructure, to enable intelligent automated decision-making and notify other actors where required (be it machine-to-human or machine-to-machine).  This is the future of pagers.

The middleware platforms that have grown over the last ten years offer some ability in this space, but most follow an identical pathway – integrate to low level and high-level external systems, and apply some basic business rules, usually: 

  • “If the alarm is <location> and the time is <time> then send a message(s) to <people>.  

There are usually escalation rules based on time delay to acknowledgement or closure of the alarm source. Often a broad protocol or integration layer – allowing connection to a growing set of external systems exist – but in the main, they are all doing the same “alarm-in-and-alert-out” core service. In NSW Health, this basic capability is now known as an MIE (Messaging Integration Engine).  


Looking beyond a paging solution  

Today, implementing a “modern” paging system or “modern” middleware system into your facility is going to create another message-centric tool that just replicates what your last paging system did, but with nicer interfaces, more integration opportunities etc.  

It is a like-for-like situation.  

What that misses, is the opportunity to explore how the entire business may use not only that capability, but tack onto it the wealth of related, relevant, and important other data sources, events, systems, people, roles, and the myriad additional actors in a modern, complex business of a healthcare facility.  

It is the fact that all these discrete players are connected and leveraging this tech, that provides the entire business with enhanced operational capacity. It is like the central nervous system, linking all the individual parts together. 

Is traditional paging going to be with us for a while yet?  

Yes, it will – it remains a solid, reliable, and effective way to broadcast data to a lot of people at once. Paging is embedded still in health around the country.  

However, that does not mean you need a traditional paging system! Look towards the future of pagers.

With the digitalisation of hospitals, the emergence of EMRs (Electronic Medical Record), and other advances, your communication platform should be broad enough to both support legacy technology but also offer you the gateway into both new and emerging communication technology, while accessing new and emerging technology elsewhere in the business. 

It should truly support the Internet of Things, offering connectivity into emerging edge devices that can provide business data for systems and people to act on. It should support the changing core infrastructure within “smart buildings.”  

It should be a transformational platform that supports your technology choices, both legacy and future, and enable your environment, people, supporting infrastructure and business units to benefit. 


Paging solution options for the future  

Through our work in over 80 healthcare facilities across Australia, team Olinqua appreciates that not every hospital is able to choose a complete solution to transition pagers to a unified communications and collaboration system for the whole business.

We also know that supporting where your hospitals’ paging journey is at is very important for the future of pagers.

That is why, we at Olinqua are pleased the following two options that we believe can support any stage of a pager communications journey:

A future proof solution: IGNITE for unified communications and Collaboration

IGNITE offers a transformational platform that supports connectivity of all systems to create automated notifications and alerts to pagers, whilst also opening opportunities for asset trackingenvironment monitoringmobile duress, and workflow management for the whole business.

“Modern” Paging System via Messaging Integration Engine

For healthcare facilities with resources to just focus on improving the user interface and increase integration options, Olinqua’s Messaging Integration Engine acts as a powerful middleware platform to connect into more hospital systems than any other competitor platform.

Read more on these two solutions in our follow-up article: A Seamless Transition from Pagers to Unified Communication, or get in touch below to hear it from one of our paging system experts: