New smart phone paging apps are promising emergency medical personnel the same fast, reliable service as pagers, which are the gold standard for emergency communication. As a result, some medical personnel are lobbying their information technology departments to do away with their pagers, saying they'd like to carry only one device.


But the cellular network should never be considered reliable, especially during a disaster. In fact, it is likely to be out of service just when it is needed most. There are numerous examples, from 2011 alone, that illustrate the shortcomings of the cellular network during a disaster.

Cell System Shortcomings

Consider the aftermath of the tornado that struck Joplin, Mo., on May 22. Some cellular systems in that area were off-line for up to four days. However, even though the paging transmitter and antenna on top of St. John's Regional Medical Center were blown off the building, Midwest Paging's simulcast network delivered uninterrupted service when it was needed most. The surrounding transmitters — thanks to the high-transmission power inherent in paging networks — continued broadcasting to medical personnel inside the hospital, as well as to first responders throughout the Joplin area.

Hurricane Irene slammed into the Northeast in late August, and the Federal Communications Commission reported that 6,500 cell towers and sites were damaged or disrupted as a result of the storm. Forty-four percent of the cellular network in the hard-hit state of Vermont, as well as 35 percent in Connecticut, 31 percent in Rhode Island and 25 percent in Virginia, were damaged. All of this cellular service disruption occurred just when communication for medical workers and first responders was most crucial.

It doesn't take a full-scale natural disaster to disable or impede cellular networks. Unexpected heavy call volume quickly can cause cellular networks to become jammed, resulting in disrupted voice communication and slow data services and text message delivery. On a local level, this happened following the Aug. 13 stage collapse at the Indiana State Fair. The rush of audience members to call loved ones jammed all nearby cellular carriers.

A larger-scale case of cellular network congestion and outages occurred following the 5.9 earthquake that shook the East Coast on Aug. 23. According to Jaime Barnett, chief of the FCC's Public Safety and Homeland Security Bureau, which is investigating these outages, " … these are the moments when mobile phone service is needed most — and disruptions put lives at risk.

These recent examples are hardly unique. During almost every major disaster in the United States over the past decade, local cellular systems were either quickly overloaded or disabled — proving virtually useless for emergency communications. In fact, most cellular carriers provide a disclaimer, cautioning users not to rely on their system for emergencies.

Paging Network Distinctions

Unlike a cellular network that sends a message from only one site at a time, a paging network sends the message over every transmitter in the network at exactly the same time. This is called simulcast technology. It's unique to paging and is significantly more reliable than the cellular networks used by smart phones.

Paging systems also have the distinct capability to set up a common group address in any pager so that the same message is sent and received at exactly the same time to as many people as needed. A hospital's STEMI and code teams generally are set up this way. Smart phone apps and short message service can't do that. Mass message delivery with cellular networks can result in a "daisy chain of different delivery times for each device, often measured in minutes, that can be critical for emergency medical personnel.

Paging networks also outperform cellular networks when it comes to broadcast power. Paging systems have up to seven times the power of cellular networks, translating into better signal penetration in buildings and more reliable message delivery. A single paging transmitter site typically covers 176 square miles, while a typical cell site covers only 10 to 15 square miles.

Being Fully Prepared

When disaster strikes, medical personnel are among the most crucial first responders. Health care organizations must ensure that communication is uninterrupted during a catastrophe — an objective that can be compromised severely by reliance on cellular networks.

Before you allow your staff to retire their pagers, remember that smart phone paging apps and short message service are only as reliable as the cellular or Wi-Fi network on which they operate. Consider all the facts, and the consequences, when selecting the technology that will support communications during a disaster.

Ted McNaught is the president of Critical Alert Systems in Westbrook, Maine. He was the founding president of the American Association of Paging Carriers, now known as the Critical Messaging Association.