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Comment by medymed | Hacker News Reader

I love pagers. Sometimes I carry three for three different hospitals.

There is no risk of malfunction due to automatic software updates when the software does not update. There is no chatty distraction of text platforms. Functionality is not affected by changes to volume or mute status as it might be on a heavily used phone. The wavelengths used reportedly have better penetration deep into buildings with shielded areas like around MR machines. They are bulky, and it would be hard to forget that one is on call when they are strapped to the waistband/belt.

When the pager goes off, it doesn't bother other people because they either don't know what it is or know it's a medical issue and is acceptable.

The major problem is that I constantly 'hear' my pager going off when other devices beep in a roughly-similar fashion even when I'm not wearing it and my heart starts racing, so I have to change the ringtone frequently to de-Pavlov myself.

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You're absolutely right about the various advantages of pagers over cell phones.

On the other hand, all of that medical information goes over the air in plain text. It is trivial to capture and decode POCSAG [1], requiring less than $100 of hardware: a Raspberry Pi 3 has enough horsepower to handle the 2 RTL-SDR's needed to capture both the 929MHz and 931MHz bands.

Modern security simply demands that pagers go away (or at least be heavily modified). This is not a theoretical concern [2][3].

[1] https://github.com/pvachon/tsl-sdr

[2] https://www.rtl-sdr.com/art-installation-eavesdrops-on-hospi...

[3] https://openprivacy.ca/blog/2019/09/09/open-privacy-discover...

Unfortunately, it's pretty hard to get all the security benefits of modern technology without the distraction, the sloppy user interface, the complexity (and attack surface) and user hostility -- in a word, without the incredibly poor design -- of modern technology.

A pager-like device with proper encryption isn't extraordinarily challenging. But planned obsolescence or selling ads is pretty hard to do with this sort of technology, so despite plenty of interest from users, there's not that much interest from companies.

To be fair it generally costs money to send a page. It's the expectation of free messaging that creates the need for advertising - unless people are willing to go back to the days of paying per message.

Have you ever used Signal?

Maybe I’m living in the 1970s but I always assumed pagers just showed a phone number and you were supposed to call back?

No, you can definitely send a text message to them, they just don't have the ability to send anything back.

the most basic pagers can only receive callback number. More advanced ones have additional features to display text messages as well.

Except for the 2-way ones

What next? 2-way voice communication!? ;)

If you can send a sequence of digits, you can also send a sequence of letters (a text message) using the same technology.

Does the paged text typically contain information that can identify the patient?

https://www.kansascity.com/news/business/health-care/article...

"An information technology worker from Johnson County recently told The Star about the issue after he stumbled across hospital pager information while playing with an antenna, which he bought to get TV channels on his laptop computer. With a simple program, the antenna picks up radio signals that can be digitized.

Except instead of picking up local TV stations, he started seeing things like this, with the patient's and doctor's names included:

RQSTD RTM: (patient's name) 19 M Origin Unit: EDOF Admitting: (doctor's name) Level of Care: 1st Avail Medical Diagnosis: TONSILAR BLEED, ANEMIA, THROMBOCYTOPENIA

It was the personal patient data of a 19-year-old man, broadcast across the airwaves for anyone to read. And it was coming from a local hospital, which was sending the message to a doctor on a pager."

I looked into some of such cases in Germany, there the answer was definitely yes. Names and addresses, coupled with extremely sensitive medical information.

I'd imagine it to be trivial to also send malicious signals and jam the system.

That sounds like any radio frequency though. Alao a great way to get the FCC knocking on your door sooner or later.

True you could create a trash beacon for any frequency, but as you said it'd be very "loud". Disrupting service with seemingly innocent messages would be much harder to detect though

Oh I see, you're suggesting a very specified attack. Sounds like a smaller scale Stingray or something, but for beepers.

Edit: Yeah I'm not entirely familiar with interference detection, but I would always suspect some HAM somewhere will figure it out and report it.

>the 2 RTL-SDR's needed to capture both the 929MHz and 931MHz bands.

A single R820T can do about 2.56MHz bandwidth, which is enough to handle both bands simultaneously.

I can attest that notifications which doesn't force you to take immediate, real-time action has productivity and may be even mental health benefits.

I have struck an old android wear watch to the front of the computer desk just to see the notifications from my smartphone. So when the notifications arrive, I can see it on the watch like a pager and it has cut my need to touch the smartphone for notifications which could potentially lead into a rabbit hole.

Yes a smartwatch on hand can do these as well, but reaching to it will likely lead to smartwatch rabbit hole. I use the smartwatch on the desk as read only, no actions.

> The major problem is that I constantly 'hear' my pager going off when other devices beep in a roughly-similar fashion even when I'm not wearing it and my heart starts racing, so I have to change the ringtone frequently to de-Pavlov myself.

Yup. I've got very, odd, sounds for all my "paging" needs. It's the only way to stay sane.

Play this in the right place in a British or Irish seaside village and about 5 people will immediately jump up and run out the door! https://www.youtube.com/watch?v=8EYfOxeBV7M

I’m a big fan of them for technical on-call for those reasons, plus the better battery life. Much more reliable than cell phones.

How does pagers deal with dead spots? Since they seem to only be receivers it would be hard to guarantee delivery? I Googled a little and understood that it works a little different than cell towers, in that every tower transits the same message at the same time, a little similar to how FM-radio works.

Interestingly enough it seems like 5G will operate in a similar fashion, albeit a little more modern, where at least the client can talk to multiple towers at the same time and send and receive from multiple towers as well.

In typical use the person being paged makes direct contact with the sender once the page has been received. It's better than guaranteed delivery, in that the direct contact from the recipient closes the loop "completely", and guarantees that the message has not only been delivered but also read, understood and acted upon. The attempt to page continues until the contact has been made.

It's an old technology but it works. Large parts of the world are still installing new paging networks as their old ones reach end of life. Part of my day job is designing the equipment for such networks.

Er, no - verbal confirmation of delivery, in the event it succeeds, is not better than guaranteed delivery; it is strictly worse. If the message gets dropped you have no way of knowing - you might be waiting forever.

Er, no - Nobody waits forever. People are not computers stuck in a for loop waiting for input.

If a response isn't received in an expected amount of time, then the sender takes the appropriate action.

People are far better at dealing with faults than any automated mechanism.

It doesn't. I owned such a thing in an area where the reception was poor back in the 90s. It just meant that it wasn't very useful, because I usually didn't get the messages.

I believe they don't? The most basic types of pagers are receive only device just like a FM radio is. The network is supposed to be sufficiently loud and clear and practical, and that's it.

For me the advantage of the pager, is that it is loud, much louder than a mobile phone and easy to hear outdoors in traffic. I have found though an iPad is equally loud, if not louder but is a lot bigger and less robust. For my use if someone can come up with a way of making a mobile phone alert to the same volume, I'd move to that as in any case I have to acknowledge the page on an app and the monthly service fee on the pager is four times what I pay for my mobile service.

You might want to look for smartphones targeted to gamers, which usually have loud speakers, or buy a Bluetooth ringer amplifier and carry it with you.

Its too loud for me, but the vibration motor in mine is also incredibly, boneshakingly loud. It's impossible to ignore, which is great. My iPhone and apple watch are basically silent compared to it, especially when walking or doing anything laborious.

I'm surprised your pager is so expensive. Mine is around $6/mo through my employer.

It’s the first time I’ve read about Pavlov. What are you referencing if I may ask?

https://en.m.wikipedia.org/wiki/Ivan_Pavlov

Pavlov famously rang a bell while feeding his dog, eventually demonstrating that the dog would salivate at the sound of the bell alone, showing an adaptive link between stimuli and subconscious response.

https://en.wikipedia.org/wiki/Classical_conditioning

https://en.wikipedia.org/wiki/Pavlov%27s_Dog

Building reach is much less important when you have a higher level protocol on top and can check for message receipt (and can ack or people can call you as a last resort).

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