A Clinical Trial Evaluation of Pager vs Smart-device Efficacy in an Academic Hospital Setting

Introduction: Health care delivery is contingent on efficient communication among providers. We hypothesized that using smart-device two-way communication would result in faster provider responses when compared with alphanumeric paging among resident physicians in an academic medical center. Methods: Resident physicians were given an Apple iPad Mini smart device with a Health Insurance Portability and Accountability Act-compliant smart-device two-way communication application. Patient care messages were randomized for transmission via smart-device two-way texting or standard one-way paging. Physician response time was recorded as the primary outcome measure. Results: The study was halted after participation of the first 24 residents due to safety concerns. A technical glitch was identified in which the smart devices automatically powered off to conserve battery life. The first 72 smart devices to first 37 pager communication response times were similar (8 vs 6 minutes, p = 0.43). In analysis of responses within 5 minutes of communication (the time smart devices powered off), smart-device responses occurred significantly faster (1 vs 2 minutes, p < 0.05) but the response frequency was less in the smart-device group (33 vs 62%, p < 0.05), and thus the study was ended early due to safety concerns. Discussion: Based on our initial findings, smart devices have potential to improve communication but technical issues must be addressed prior to usage as the sole means of communication.