I almost missed a very important phone call a couple of weeks ago because I was using Nabla for dictation and it muted the ringer. I had no way to know the call was happening except that I happened to glance at my phone; I didn’t hear something but was shifting my gaze back to the monitor screen as I was checking something while reviewing results with a family. That is BAD. WORSE happened today, because my phone is my primary work communication device, and I use a phone app as my pager. I missed one urgent nurse message, one phone call, and 2 pages for the same issue as many as 6 minutes before a sudden dry cough made me step out of the room and I checked my phone while sipping water. I was quite lucky that the page from the infusion center was not a 911 page for a patient anaphylaxing…..because as the attending on service, I am the one designated to be ready to RUN there when needed. This is absolutely URGENT feedback for the phone app: recording by Nabla needs to be able to be audibly interruptible by specific notifications/apps that I can control—I need to get those urgent messages via phone call, the paging app, our secure messaging apps (more than one, because some of us on staff also provide on-call coverage at a different campus that uses a separate secure texting app. And if I was a brittle insulin-dependent diabetic, I would need my continuous glucose monitor app to also override/interrupt. This kind of variation in what are the key items for permitting interruptions is what that needs to be under the control of the end user—not just a campus-wide standard. and… I would not be so bothered by this if it weren't for the excellent work of the noble team that finally made this a really useful app even for our complex and comprehensive Rheumatology visits, which completely baffled earlier version of the app. There is still plenty of room for improvement because the app does not understand the difference between signs and symptoms (physician observed findings being reported in the interval history and review systems and patient reported symptoms are being reported in the physical exam from time to time, still... but less often and few enough that it's now feasible to edit them out rather than being so many that it's simply not worth the hassle of using the app at all.
