How We Test Medical Alert Pendants

Medical Alert Systems: Our Testing Process

There are dozens of medical alert companies on the market, and all of them offer similar services for relatively the same cost, give or take a few dollars each month. So how did we separate the best medical alert services from the simply mediocre? For starters, we developed tests and evaluations (which we describe below) for each of the three parts to the service that you should consider: the medical alert system, the monitoring center and the company. The logic is simple: The best medical alert systems must excel in each of these areas.

Part One: The Medical Alert System

The medical alert system is the actual device that you install in your home or wear around your neck. In many cases, half a dozen other medical alert companies use the same device. For example, six of the 20 companies we reviewed use the MyTrex MXD3G device, and five use the MobileHelp CBS2-01 model. As such, the difference in technology is often not enough to distinguish one company from another. That said, all of these devices fulfill the same purpose: to call for help in an emergency.

Part Two: The Monitoring Center

We learned through our testing and research process that most medical alert companies outsource their monitoring center duties to an independent monitoring center. While there are benefits when a company owns and operates its own monitoring center, as ADT and GreatCall do, contracting with a third-party isn’t necessarily a bad thing. For example, Rapid Response is a popular monitoring center used by several medical alert services, and they were the recipient of the 2016 Central Station Call Center of the Year award.  

Part Three: The Company

Because so companies use similar (or identical) hardware and contract with third-party monitoring centers, the company itself is often the only thing that separates one medical alert system from another. The company is responsible for developing a useful, resource-heavy website, setting competitive prices, writing the terms and conditions, and handling the sales and customer service. If you’re looking at two companies that both use the MyTrex MXD3G device and contract with the Rapid Response call center, then your deciding factor can only be how the company presents itself.

Setting Up Our Tests

While we considered over 70 companies, we brought 21 medical alert systems (from 20 different companies) into the Purch Lab for testing. Of these, 16 were in-home systems and five were mobile systems. Six of the in-home systems used the MyTrex MXD3G base unit and five used the MobileHelp CBS-01. The remaining systems used hardware that was unique to each company.

We set up an account with each service under the same name (Frank) and didn’t tell any of the companies that we were reviewing their system. This was to ensure that we didn’t receive preferential treatment.

Emergency Response Time

Our first test measured the time it takes the monitoring center to respond to an emergency activated by the pendant. These tests were straightforward. We pressed the button on the pendant at the same time we started a stopwatch. Once an operator started talking, we stopped the stopwatch and recorded the time in a spreadsheet. We tested the response rate at various times of day over the course of a week to account for potential fluctuations in call traffic.

From these tests, we learned that most medical alert systems are consistent. For example, if a service answers the call in 54 seconds in the morning, the same service will likely answer an afternoon call in about 54 seconds. Few services deviated from this pattern.

On average, the call response time in our tests was 69.58 seconds, with many companies breaking the 60 second mark. However, the fastest response times were only about 20 seconds. While a minute and ten seconds doesn’t seem like long, it feels much longer, especially in an emergency. Imagine having suffered a fall where you’ve broken a bone. Would you prefer a service that answers before you’ve stopped swearing or one that answers after you’ve gone into shock?

Pendant Reliability & Distance

With an in-home medical alert system, if the pendant can’t effectively communicate with the base unit, you’re not going to get help. As such, this was one of the important tests we did – making sure each system could reliably call for help.

We tested the pendant’s communication in a two-bedroom apartment and actively looked for line-of-sight issues that could potentially block the wireless signal from the pendant to the base unit – on the floor behind the couch, next to the fridge, in the shower, under water in the bathroom, in the closet, in the furthest bedroom, and more. You get the idea – every potential trouble area we could find, we tested.

And what did we discover? Every pendant we tested was 100-percent reliable. We simply could not find a line-of-sight area that caused any problems. This is good news, of course, because it means you don’t have to worry about having several rooms between you and the base unit if you fall.

To test the distance of each device, I ventured into the hallway while another tester stood by the base unit. In these tests, we measured how far I could roam from the apartment before the pendant failed to contact the base unit. Longer distances mean you could, for example, go outside or into your garden and still have the security of the medical alert system.

It’s important to note a second reason that one tester stayed near the base unit – he was able to assure the monitoring center that we were fine. If you accidentally activate an emergency and the monitoring center personnel are not able to communicate with you (if you’re beyond the speakerphone’s range, for example), they will assume you need help and will send emergency responders. This is why you may want to consider a mobile system if you enjoy walks or working in the garden. Mobile systems use two-way devices that don’t have a wireless range (aside from your local cellular network), so if you accidentally hit the button, you can always assure the operator that you’re fine.

Fall Detection Pendants

Fall detection pendants typically come as an add-on, costing $5 to $10 extra per month. And like the base unit models, many companies use the same hardware. Among the 16 in-home base units we reviewed, there were only four different brands of fall detection pendants.

Fall detection works by using accelerometers to detect when you’ve had a fall and signal the base unit automatically to call for help. They are built for scenarios where you may not be conscious or physically able to push the button, such as if you’ve had a heart attack or a stroke, or you’ve passed out from low blood sugar.

It’s important to note that every fall detection pendant comes with a disclaimer that it does not detect 100 percent of falls, simply because it’s next to impossible for it to tell whether you’ve face-planted into a tile floor or accidentally dropped the pendant in the kitchen. Likewise, fall detection pendants have been known to go off when the wearer rolls over in bed. This sensitivity made it difficult to test the fall detection accurately. In fact, we constantly set them off when we weren’t trying to by simply moving items around on a table.

We first tried to test the fall detection units by simulating a variety of falls, including falling backwards onto a mattress. However, none of these simulated falls set off the alert. We then dropped the pendants from heart’s height (about 4.5 feet). Many of the companies claimed that this wouldn’t work because the devices are calibrated to know the difference between someone falling and someone dropping the pendant. That said, nearly all the fall detection pendants consistently activated when dropped from this height.

After performing these heart-height tests, we wanted to see how sensitive these accelerometers were at detecting even shorter falls. We dropped the pendants from 12 inches off the ground, assuming that only the most sensitive would recognize a fall at this height. However, we were wrong, as most pendants recognized the short fall. After this, we dropped them again at a height of 6 inches. At this point, many stopped recognizing the fall while a few consistently activated.  

In all our testing, we were looking for the sweet spot – devices that weren’t too sensitive, but not so deftly calibrated that they would only recognize a fall down a flight of stairs.

In most of mobile systems we tested, the fall detection features hit that sweet spot just fine, but with the in-house units, there were variations. We preferred the tear-drop shaped pendants like the ones used by Alert1 and Medical Alert because these recognized falls instantly and weren’t too sensitive.

Speakerphone Evaluation

Whenever we communicated with the monitoring center, we paid close attention to the quality of the device’s speakerphone. We quickly learned that the quality of the speakers differs vastly from one unit to the next, and this makes a difference, as the speakerphone is the only way you can communicate your emergency, or lack thereof, to the operator.

We rated each call’s quality from one to five, with one representing the garbled mess of an awful drive-thru speaker and a five representing a clear voice. We also rated the volume, looking for speakers loud enough to fill a room, but without distortion. It’s worth noting that the volume changed dramatically from one call to another, even on the same device, so we suspect that the operators have some control over the volume. We also found that sometimes the calls had strange beeps and honks – a mixture of someone hitting the keypad on a phone call and a dial-up modem trying to connect to the internet. In other words, these noises were not only confusing, but very distracting and often interfered with the call. If you were suffering from a legit emergency, these noises wouldn’t be comforting at all.

After cataloging the ratings, we compared each system and gave it a quality grade. The MyTrex models were inconsistent – some fared well in the evaluation while others were a distorted mess in one call and clear on the next. The MobileHelp models were more consistent, and nearly all of these devices received A ratings. The mobile units suffered from a lack of volume, but not in clarity. You won’t experience any distortion with these, but you may have to hold the device to your ear to hear the operator.

Monitoring Center Evaluation

We evaluated our interactions with each monitoring center. We listened to accents, regional and foreign, that were thick enough to cause communication issues. We evaluated the operator’s demeaner. Did they seem bored and uninterested or did was there some energy and interest in their voice?

We also recorded whether or not the operator assumed we were “Frank” – our account owner – or if they asked for a name. While this may be a minor distinction for some, it represents a potential security issue. For instance, imagine someone was in your home uninvited and you press the help button. If the operator responds with “Hello Frank, do you need help?” the intruder simply needs to say “No, I accidentally hit the button.” But if the operator asks for your name and is given the wrong name in response, then the operator knows something is up and can send help. Granted, this isn’t a scenario that is likely to happen very often, but it is something to keep in mind. And it’s one reason we favored operators that didn’t simply assume they were talking to was the account owner.

It’s important to point out that every operator that we spoke with was exceptionally professional. However, that doesn’t mean we didn’t pay close attention.

Sales Aggressiveness Evaluation

We’ve heard stories and read accounts of medical alert companies being a little too aggressive with their sales tactics. These concerns are somewhat supported by the design of many of the websites, which are set up to funnel you to a salesperson by requiring you swap personal info for free brochures or to call a toll-free number to learn even the most basic information about the service.

A skilled salesperson can easily sway a consumer into making a purchase that isn’t in their best interest. Therefore, we wanted to evaluated the aggressiveness of each service’s sales team. First, we talked to the salespeople from the perspective of a son looking for a medical alert system for his elderly mother. These calls were what you would expect – every company’s sales team believes their service is the best way to protect your loved ones. Most avoided tough questions, like whether their service contracted out the monitoring centers to a third party, but every salesperson we talked to was respectful. We would not recommend any service that might potentially cross the line with taking advantage of an elderly person.

Next, we filled out personal information forms to get the free brochures or to request a sales person contact us. Then we recorded the number of times they tried to contact us in a week and evaluated the messages that they left. We considered any attempt to call use more than once a day as being too aggressive. In a few cases, the salesperson left a voicemail and a text message on the same day, but none of the services we evaluated tried to contact us too often.

Terms & Conditions Evaluation

Nobody likes to read the terms and conditions. In fact, very few people ever do. But we did. We pored over the seemingly endless legalese of all these services to look for any red flags or clauses that could potentially be worrisome for the consumer. We also looked at how long each document was – some exceed 6,000 words, while most hovered around 2,000 words.

The following are common clauses you should be aware of:

Liability, Indemnity
Every company ensures that they aren’t held liable for anything that happens to you or your loved one, even if it’s the result of a failure on the service’s part. To put it plainly, if your loved one dies because their system failed to work properly or there was an issue with the monitoring center, the company cannot be held liable.

In fact, if someone else brings a lawsuit against the company for such reasons, you are required to defend them. This is called the indemnity clause. It’s a common clause with most terms and condition contracts in all types of industries, so there’s very little chance that you’ll be subpoenaed to defend the company if another consumer sues them.

Maximum Payout Clause
While every company ensures in CAPITAL LETTERS that they cannot be held liable for any damage or harm caused to you, nearly every company also has a clause that states how much the maximum payout can be if they are somehow held liable. These maximum payout clauses range from a general refund of what you’ve paid to $1,000.

Product Damage Costs
Most companies (though not all) have a clause stating the amount you’ll owe if you damage the hardware. Most of companies purchase the units from a manufacturer and lease the equipment to you when you sign up for service. So, when you cancel, they expect the unit to be returned in working order so that they can lease it to someone else. Despite being little more than a simple speakerphone that would retail for around $30, the lifetime revenue potential of every unit is in the thousands of dollars, which is why the damage costs range from $350 to $500.

In some cases, the damage costs for the fall detection pendants is also specified. For example, Medical Guardian lists the damage cost for their fall detection pendant at $150.

Fees Associated with False Alerts
Based on our experience testing, and after talking to several CEOs of third-party, monitoring centers, we know that a false alert is far more common than an actual emergency. Perhaps you rolled over on your pendant or accidentally dropped it. As mentioned earlier, we set often set off false alerts just in the process of moving things around in the lab. It happens.

However, if it happens too much, you can get charged for any of the fees associated with it. This is an understandable clause. False alerts potentially take emergency responders away from actual emergencies, and third-party monitoring center can charge the company a fee if you’re monopolizing their operators. These clauses simply pass the responsibility of those fees to you, which is understandable. Unfortunately, the language is typically vague, so there’s no way of knowing what constitutes abuse of a monitoring center or to what extent you might be fined.

Cost Evaluation

Perhaps the most important evaluation of all, we looked closely at how the companies price their hardware to ensure you get the best product at the best value. To understand the cost evaluation, it’s important to understand how these companies structure their product packages. Typically, there are three packages – a base, a mid-range and a premium. We compared the costs and features in these packages, including add-ons and bulk payments, and graded the value accordingly. That said, we recognize that prices can change frequently. This evaluation represents a snapshot comparison of the market over the span of a few months.

Base Package
The base package of every company is the most affordable option available. It typically features a landline unit, which means that you have to have a working landline in your home or apartment.

However, not every company’s base package requires a landline. For example, GreatCall and RescueTouch only have mobile (or on-the-go) units. The base packages they offer simply don’t have as many features as their mid-range and premium packages.

The average month-to-month cost for a base package is $30.07. This doesn’t account for potential discounts for AARP membership, Veterans discounts or bulk payments.

Mid-Range Package
Most mid-range packages use cellular devices. The only difference between these devices and those with the base package is that the systems connect to a cellular network instead of a landline. The average cost for these packages is $36.80 per month.

Premium Package
The premium package is the most expensive package available and usually features a mobile with GPS tracking features. These are ideal for seniors that are active because you’re not tied to an in-home system; you can get help anywhere you go. The average cost of these packages is $43.13 per month.

With most services, the fall detection is an add-on option that adds between $5 and $10 to your monthly payments. Since fall detection pendants are wildly inconsistent, we placed only a little value on services that offered the add-on for less.

Bulk Payments

Every medical alert company we reviewed allows you to cancel anytime, so you don’t have to worry about being locked into a long-term contract. However, one of the ways these companies try to separate themselves from others is by providing bulk payment discounts. For example, you can pay for an entire year and save up to $10 per month or pay semi-annually or quarterly for similar discounts. In other words, if you’re looking at 10 companies that cost $29.99 per month, you’ll likely find that some that provide bigger discounts on their bulk payments.

On average, the savings per month on these discounts was $3.90. That adds up to a savings of over $46 in a year. With some companies, the discount is barely worth mentioning while others, like Alert1 and MobileHelp, allow you to save up to $10 per month if you pay in bulk.