By Brian Gilmore
Wireless text messaging is a natural outgrowth of paging technologies dating back to the 1950s, the 1980s, and 1990s. After years of hard work, the telemessaging industry has achieved what was once only a dream – wireless text messaging. A telephone message neatly typed into a computer in the call center appears almost instantly on the screen of any wireless device carried by the client, combining automated message delivery and notification. With the exception of message delivery confirmation, no further labor is required after the caller disconnects from the call center agent.
Over the course of the last seventy years, little has impacted the telemessaging industry more significantly then wireless text messaging. In many cases, the ability to deliver the entire text of a telephone message through automation reduces the call center labor cost per message by as much as fifty percent.
The process, procedures, and technology have all become so familiar to the industry that we essentially take them for granted. Yet there are challenges to be faced as changing technologies, competing business interests, and new governmental requirements threaten to disrupt the technology we depend upon so heavily.
Massive upheaval among wireless carriers: Most recently we have seen a tremendous proliferation of new options as wireless telephone service carriers bundled wireless text messaging into digital telephone handsets and rate plans. The six major wireless telephone carriers and a handful of regional carriers decimated the enormous subscriber growth of the traditional paging industry in the 1990s.
While the number of business users of paging services has increased steadily in recent decades, a handful of paging carriers sought to create nationwide paging networks. As a result, their market share grew at an astounding pace with increased consumer sales. When wireless telephone carriers rolled out their inexpensive digital services with bundled text messaging, millions of consumers canceled their paging service and signed up for a wireless telephone. Only MCI’s SkyTel Paging remained focused mainly on business sales.
The effect on the national paging carriers was profound. These carriers faced enormous customer losses and many went through bankruptcy reorganization. As of this writing, only four national paging companies survive in the US and their customer base is once again comprised mostly of business users. There are also well over one hundred regional and local paging carriers in the US, many of whom never had the resources or inclination to pursue the consumer market and many of which are today thriving by providing paging service to business subscribers.
Among wireless telephone carriers, the focus is largely on consumer sales, though each of the big six national carriers devotes substantial personnel and resources to business sales. One carrier, Nextel, focuses most of its sales efforts on the business subscriber. It is not by accident that the wireless carriers with the highest revenues per subscriber are SkyTel Paging and Nextel – both companies focus on business subscribers.
The reasons for the success of these two organizations is clear. While mass marketing techniques let carriers grow their consumer subscriber base at incredible speeds, business subscribers are more stable, do not change carriers as often as consumers, pay larger amounts each month, and pay more reliably than consumers. Business accounts are also less expensive to maintain and are thus more profitable according to wireless financial analysts.
Businesses choose various wireless text messaging solutions: The reasons that businesses choose paging or wireless telephones for employee communications vary widely. There are many reasons why certain businesses choose one technology over another including price, features, reliability, cost control, wireless coverage and penetration, safety ratings of devices, perceptions of service quality, and even the “coolness factor.”
Paging subscribership is now heavily concentrated in specific vertical industries including law enforcement, heavy industry, various trades and crafts, and other service organizations. The paging industry has focused heavily on these niches and worked hard to cater to their special needs. These industries provide intrinsically safe subscriber equipment and paging networks optimized to prioritize “code blue” messages for medical workers.
Without reliable ways to send wireless text messages, the telemessaging industry loses key advantages: Just as the telemessaging industry benefited in the 1990s from the widespread availability of alphanumeric paging technology, it has more recently benefited from the shift to wireless telephones with bundled text messaging features. In many cases, more clients’ employees are equipped with devices that can be used to deliver text messages than ever before. Frequently the devices are purchased and services are paid by the employee instead of their employer, our client. Employees are happy to receive text messages at no additional cost on their wireless telephone handset and our industry is the beneficiary.
But the wireless telephone industry will not continue to provide free text messaging. In Europe, Asia, and elsewhere the price of text messaging is increasing dramatically as paging businesses have faded. Consumers and businesses alike have come to rely on wireless telephone networks as their only reliable source for short text messaging. With voice prices fading fast under withering competition, wireless carriers are looking to increase their revenues from messaging services.
Already two of the big six wireless carriers have dropped Telocator Alpha Paging (TAP) dialup modem access. TAP was first adopted by paging carriers in the 1980s and was consistently used by every wireless text messaging provider in the US. TAP dialup modem service is so important to the telemessaging/dispatch industry that every telemessaging system manufactured since the 1980s supports TAP dialup for text messaging.
The alternative is sending an email message to a wireless telephone. However, many telemessaging call centers continue to have mixed results with mitigated success delivering short text messages to digital handsets via email. But even email access is threatened by the increasing scourge of Unsolicited Commercial Email (UCE or spam). Indeed, Nextel recently instituted “white list” restrictions on many subscribers, requiring the subscriber to pre-authorize the addresses from which they will receive email on their handset.
Email also suffers from other drawbacks as it is a “connectionless protocol” meaning that the email message is sent but no confirmation of its receipt is received until later, if at all. Earlier standards like TAP provided instant acknowledgment of message receipt by the wireless network. The problem is compounded by the tendency of Internet Service Providers to constrain bandwidth on the transfer of email as well as a widespread perception that timely email delivery is not critical to customer satisfaction. Finally, email suffers from another malady that makes its use inappropriate for many medical service messaging applications: clear text email is an inherently insecure messaging medium.
HIPAA raises security issues: The 1996 Health Insurance Portability and Accountability Act (HIPAA) was finally implemented in Spring of 2003 by the US Department of Health and Human Services (HHS). Telemessaging companies and call centers serving medical service providers embraced their responsibility under the Privacy Rule of HIPAA and many entered into Business Associate Agreements (BAAs) contractually obligating themselves to protect certain information known as PHI (Protected Health Information).
Because the task of protecting PHI is so enormous, there are few clear guidelines under the Privacy Rule to guide the Telephone Answering Service (TAS) acting as a contractual Business Associate (BA). One thing is clear; PHI must be transmitted by “secure means” under the law.
Since the earliest reviews of HIPAA issues there has been concern and consternation about how to securely deliver PHI from a call center to a healthcare worker in the field over a wireless text messaging network. None of these networks were built with high security of text message data in mind.
Consequences and motivation: A demonstrated failure to keep PHI secure means HHS sanctions for clients. Both criminal and civil liabilities can apply depending upon the circumstances. Clients are also at risk of unwelcome negative publicity and patient litigation. For telemessaging call centers, a failure to keep PHI secure may result in civil liability to their client under the BAA and the certain possibility that the relationship with the client will be at least damaged or possibly destroyed. For wireless carriers there are also no provisions for HHS sanctions under HIPAA, but natural market forces are widely expected to drive medical services customers who are concerned about demonstrating their own compliance with HIPAA toward carriers who offer security for PHI that must be transmitted to wireless devices.
Telemessaging compliance with the HIPAA Security Rule: It has become clear that telemessaging companies acting as BAs must find secure means to deliver PHI to their medical clients wirelessly or they risk losing the convenience. More importantly, these companies may also lose the tremendous labor cost savings afforded by the use of wireless text messaging networks.
Some companies have adopted makeshift means to comply with their obligations under HIPAA. These include solutions as simple as using pre-agreed codes instead of symptoms, prescriptions, or other medical data when transmitting to wireless devices. In other cases they are not transmitting PHI in any form, opting instead to have the physician or other health care worker call an agent by telephone to receive the PHI. However, these stopgap measures eliminate much of the fundamental value delivered by text paging and drive up labor costs for a telemessaging call center. Better, more comprehensive solutions are needed.
[Read part two of this article or download the entire document.]
Telemessaging Wireless Forum
ATSI, the Association for TeleServices International, is creating a new online meeting place for professionals in the telemessaging, call center, and wireless industries including paging and wireless telephony. One of the initial focuses in the new Telemessaging Wireless Forum (TWF) will be wireless text messaging as it relates to the telemessaging industry and its clients.
There will be Web forums where telemessaging employees can find valuable information from all major wireless carriers regarding the accessibility of their text messaging networks — dial-up numbers, modem and other configuration settings, standards for email addressing, and other protocols supported. ATSI is asking all major wireless carriers to provide special technical support through the TWF to assist telemessaging employees working to get text messaging implemented on client pagers and handsets. Other call center owners, managers, and employees will be on hand as forum participants and moderators to assist as well.
Other TWF forums will focus on other topics including alternative solutions for text messaging, interaction with various telephone handsets, pagers and devices like wireless Palm, Pocket PC, and RIM Blackberry units and the impact of HIPAA on wireless text messaging.
[From Connection Magazine – Jan/Feb 2004]