Will social media banish the bleep? An analysis of hospital pager activity and instant messaging patterns.

Pagers or ‘bleeps’ have been used for intra-hospital communication for over 30 years but are time inefficient and antiquated. To investigate how social media has affected the use of pagers we compared pager activity with instant messaging patterns over a 6-month period in a large, UK, teaching hospital. In 2017, it was estimated that 10% of the world’s pagers were used in the UK National Health Service at an estimated cost of £6.6 million/year (a figure which does not include network costs or cost incurred by inefficiency).1 This antiquated technology is associated with a number of issues. Pagers are typically associated with substantial time inefficiency,2 a quarter of pager messages are unnecessary3 and 65% interrupt patient care.4 Understandably, therefore, pagers are not popular with doctors.2 In response to these shortcomings, the UK Health and Social Care Secretary has called for the health service to ‘#purgethepager’.5 Instant messaging on the wards either takes the form of informal, non-condoned usage via social media platforms such as WhatsApp (which are not designed for communication of patient information), or hospital-provided applications that are specifically tailored for clinical use. In 2018, a large university hospital introduced one such application, Medxnote, a mobile encrypted instant messaging application. After initial pilots, Medxnote was made available to all employees of the Trust in 2018. Pagers continue to be in use which provides a unique opportunity to assess the impact of a new technology on traditional patterns of hospital communication. ### Data collection Message logs between 12 November 2018 and 30 April 2019 were provided by Medxnote. Logs included a unique, anonymised identifier for the sender and recipient(s) of each message …