1. Pager Be Gone! Using Free Software as a medical communication platform. Susan Rose MSN RN

2. YIKES! Returning a call from a page can be a frustrating experience for the nurse as well as the doctor!.

3. OR Nurse States how she would like to use cell phone communication instead of pager: "One example is the use of texting, which officially we are not allowed to do. 30 seconds to text a Surgeon with a lab result or just “Ready in O.R.” as compared to 10 minutes or more to page him and wait by the phone for an answer is not a good use of the circulators time, or the surgeons."

4. Smart phones in Pittsburgh Mercy Hospital instead of pagers! Consulted cardiologist - perfers smart phone ekg for urgent consutls: "In the digital age, it's sort of archaic to rely on conventional fax technology." http://www.washingtonpost.com/wp- dyn/content/article/2009/05/18/AR2009051802234.html

5. Linux.mce.com This is an open source program that works on mobile devices. It also allows you to view your home remotely 58 open source communication example, with the name of the propriteray software it would replace. http://itmanagement.earthweb.com/ osrc/article.php/3904271/58-Open- Source-Replacements-for- Commercial-Communications- Apps.htm

6. PidginPidgin "The universal chat client," Pidgin lets you keep in touch with friends on 17 different IM networks. Others are:Adium aMSN KopeteAdiumaMSNKopete Miranda IM

8. When available...

9. This messesage suggests that he can chat by video in his virtual VIDYO office space.

10. "Please do not call on any phone or leave phone messages on any numbers for me regarding anything important and please only send emails if you are actively checking your own emails regularly during the day (hopefully on a mobile device) If you dont hear back promptly please just assume I am not available at this time..no need to call paging operators or overhead paging services, no need to leave voice messages,etc) You can also check my calendarYou can also check my calendar" MOST EFFICIENT WAY TO REACH ME: Google Talk (abarbash@gmail.com). I use online video conferences for most professional meetings, EMAIL (Routine) or TEXT Message (urgent) with a number I can reach you if needed, and a time to contact that works best for you. I prefer not to get un- scheduled phone calls in general.

11. The goal of urgent messaging is immediate care in person or by video if they specialist is far way. Although video communication can be done through gmail, Dr Barbash prefers to go from google chat or text to low cost Vidyo or Citrix GoToMeeting. The cost is low, the picture resolution is much better than google video, and both provide a high reliability, 7-24-365 supported platform which is essential for healthcare transactions.

12. In conclusion: 1. Pagers are being replaced by smart phones. 2. Google chat and gmail is a very viable system to talk to others instantly because it is free and and has the most name brand recognition. 3. You can set great personalized away ( or even here ) messages on it. 4.The end goal is better patient outcomes via more timely assessment and treatment decisions.