Mobile Alert Systems: Comparison Testing
Written By: Richard Caro. Last Updated: Sat, 11/24/2018 - 11:19.
After weeks of testing multiple different "mobile alert systems" (personal emergency response systems), here are the results. We looked at appearance, ease of use, speed to respond when we pressed the "help" button, how well the "location capability" worked in various different locations, battery life, sound quality, price, and more. While none of the products was "perfect", several worked rather well. But some fell short. If you are thinking of buying one of this class of products, please read this before deciding which one to buy.
As part of our research project into "which medical alert system should I buy?", we set out to do a comparative evaluation of products in the "mobile, monitored, go anywhere" class of medical alert systems (personal emergency response systems). These are medical alert systems that work anywhere there is cell coverage, and which have a professional monitoring service that responds when you press the emergency button.
You can learn more about this research project, the team doing the work, our medical alert system selection tool, deep dive analysis of individual products and other analysis here. For those unfamiliar with medical alert systems, we also created a short tutorial and an online workshop, both of which you can access from our Medical Alert Systems: Selection Guide.
Update Q4 2018
Since the original evaluations described below were conducted, some of the products have been replaced or updated. We have updated the appropriate sections of the analysis below to identify where such changes have taken place.
We have also updated the Recommendations section, so it reflects our recommendations as of the end of 2018.
The most significant change has been that the GreatCall Splash has been replaced by the GreatCall Lively Mobile. We believe this to be a product with similarly strong performance to the Splash.
The Philips Lifeline GoSafe, and the various versions of the MobileHelp Duo continue to be available.
We have updated the content below to bring it into line with the state of things at the end of 2018.
There have been some additional noteworthy products that have entered the market recently. In particular, there is a handful of products we think of as "Smartwatches that work like medical alerts". We recently published a comparative evaluation of those products, and that is worth reading as well as the study below which deals with more conventional mobile medical alerts.
Table of Contents
- The different products we tested
- Different feature sets
- Test protocol
- Testing results
- Special issues
The mobile alert systems we tested
The two criteria for the products we analyzed in this portion of the research were that they:
- work everywhere there is cell coverage; and
- are "monitored" (ie a professional responder recieves the alert rather than friends, family, or a direct call to 911).
Our selection tool identifies 20 products that meet these criteria. However, many of these are actually the same product, sold under different names by different distributors (it is rather confusing). We focused on products available in the USA, chose one example of each of the products that are resold by multiple distributors, eliminated a handful of products based on their feature set, and narrowed down our selection for testing to 5 hardware products (corresponding to 11 of the products on our list) and 3 "Apps" for a smartphone. See more about how we selected the mobile medical alert products for testing here (3).
The hardware products we studied were as follow (links go to the detailed analysis of each product by our analyst team. We include links on the product analysis pages to the company websites so you can learn more, or purchase the products if you wish):
- "Splash" from GreatCall; [Now replaced by the GreatCall Lively Mobile].
- "GoSafe" from Philips Lifeline;
- "Premium Guardian" from Medical Guardian (a rebranded version of the Numera "Libris"). [Medical Guardian no longer sells this product. However an updated version of the Numera Libris is now sold by LifeFone as the LifeFone At-Home & On-the-Go GPS, Voice in Necklace. It is also sold by Alert1, and likely various other vendors];
- "At Home & On-the-Go GPS" from LifeFone (a rebranded version of the MobileHelp "Cellular Duo"). Variants of this product are available also from other vendors.
- "Kelsi" from Alert1 (a rebranded version of the Freeus "eResponder"). [no longer sold by Alert1 in the form we evaluated here, but it is still available from ResponseLink ("MobileMedical Alert")].
We also included these monitored "Apps":
Important, differentiating mobile alert features
These products have many similarities but some important differences.
All of these products are designed to "work anywhere" (at least anywhere there is cell service). All involve some type of "wearable" that you carry with you at all times. When you activate the alert (or the built in fall detector in some cases activates the alert), a person in a call center responds and helps you (calling 911 if need be). And in each case, that responder can talk directly to you through the wearable and you can talk back to them.
All of these products communicate to the responder via the cellular network. The hardware products all include the components to do this in the product itself, and they do NOT use your cell phone or your cell minutes, or require you to worry about the cellular connection. The "Apps" run on your smartphone, and use your cellular carrier.
The obvious differences between these products are:
- whether or not they have built in automatic fall detection;
- whether or not they have built in location capability (GPS);
- battery life (time between recharging — all have a rechargeable battery);
- the cellular network on which they operate.
Price is also a very important differentiator. And our testing uncovered some additional unexpected differences.
"Pendants & buttons"
|Philips Lifeline GoSafe||Yes||GPS||1-3 days||$859||AT&T|
|Medical Guardian Premium Guardian
(rebranded version of the Numera Libris)
|LifeFone At home, On-the-Go GPS
(rebranded version of the MobileHelp Cellular Duo)
|Alert 1 Kelsi
(rebranded version of the Freeus eResponder)
|No||No (2)||3 months||$547||T-mobile|
Apps on Smartphone
|GreatCall 5Star||No||GPS||1 day||$180||Your smart-phone carrier|
|LifeFone Mobile Alert||No||GPS||1 day||$84||Your smart-phone carrier|
Philips Lifeline Response App
|No||GPS||1 day||$168||Your smart-phone carrier|
Notes: some of the products have automatic detection of falls as an optional extra. The pricing reflects this. "no auto-fall" means the price of the system without the auto-detection capability for falls. "incl. auto-fall" means the price including this auto-detection capability.
Our comparison test protocol
Over a period of two months I routinely wore some or all of these products during my daily routine. I learned which ones were convenient to use and which were not, although that is quite subjective. Every now and again I sat down at some location where I thought I would want to be sure the products worked, and one after the other I pressed the alert buttons and waited for the responder to come on the line.
In each case, I timed how long it took between when I pressed the button and when the responder started talking.
When I spoke with the responder, I explained we were testing the system, and asked them to tell me "where I am right now?". Typically, they were able to give me a street address and exact GPS coordinates. I cross checked these with my map.
I carried out this routine on 20 occasions in 15 different locations, mostly in the San Francisco Bay area, but once on a roadtrip to Sacramento and several times in Tahoe City. The locations ranged from out on a trail during a small walk, to on the seventh floor of the parking garage I use to go to evening events downtown. I included both indoor and outdoor locations, and tried to select the locations based on where I would expect people's everyday routine to take them.
Results: three months of mobile medical alert evaluation
The responders were uniformly friendly and pleasant. I did not have any bad experiences with any of the responders. I would be happy thinking they were a resource for an older adult about whom I cared.
"Works everywhere"?: The cell networks
In our testing in the San Francisco Bay Area we saw very few problems due to cell network coverage. However, in areas where one or other of the carrier networks has better coverage than others, this could be an important differentiator. As you hone in on a specific product, check that the carrier it uses (see table above) has good coverage where you want to use the product. Many observers of the telecom industry in North America identify AT&T and Verizon as the top two carriers for coverage, but T-mobile is investing heavily to catch up.
All the hardware products had fairly good response times. The Apps also had good response times, except when they failed completely (see below). However there were some significant differences if one feels that minutes matter.
At one extreme, the GreatCall product had very fast response. The responder was usually talking to me within less than 15 seconds of my pressing the button. At the opposite extreme was Philips Lifeline. Their responder typically came on the line after well over a minute. The other products fell in between these extremes, mostly in the range of 30-60 seconds.
- GreatCall Splash: (average: 16 seconds; Max: 53 seconds; Min: 5 seconds; N=19)
- Medical Guardian Premium Guardian: (average: 44 seconds; Max: 72 seconds; Min: 24 seconds; N=14)
- LifeFone, At Home & On-the-Go GPS: (average: 62 seconds; Max: 120 seconds; Min: 20 seconds; N=13)
- Philips Lifeline GoSafe: (average: 91 seconds; Max: 146 seconds; Min: 66 seconds; N=13)
The results in this section were a bit surprising. The big picture is that (at least out of doors) most of the products know where you are most of the time. But they are far from "perfect".
Each of them was off by a block or two at least once. If you can talk to the responder, and are alert, this may not matter. But if you are confused or have become unconscious, this could be important.
- The Philips Lifeline GoSafe and the Great Call Splash were within a block most of the time (90% of tests).
- The MobileHelp Cellular Duo (Lifefone At Home, on the Go) was within a block in 76% of tests, but on 3 of 13 occasions was off by more than 10 blocks.
- The Numera Libris (Medical Guardian Premium Guardian) was within a block in only 50% of tests, and on 6 of 14 occasions was off by more than 10 blocks.
As best I can tell, the errors occured after I moved from one location to another. I suspect the products that erred most may update their GPS readings less frequently than those that are more often correct. Typically, the error involved the responder thinking I was at some location I had been at maybe 15 or even thirty minutes before.
The other challenges I found were that indoors, on several occasions all the systems were unsure where I was. In several instances, they were so unsure as to be not useful as locators.
When I simulated hurting myself on the seventh floor of the downtown parking garage, the systems all knew I was within a block or two of where I actually was. But none of them would have known which floor I was on (GPS does not know about height). This would make finding me tricky if I could not speak. (See below for a special feature in this regard by the Philips Lifeline GoSafe).
Responder training and services
In this analysis we have not tried to cover the differences between the responder call centers that each of these systems uses. We plan to cover this in a later piece of research. Details that we currently think will be important differentiators for some people include: multi-language capability; level of responder training and certification; call center redundancy; whether or not the responders offer additional services beyond emergency response; and how well the companies protect and keep private the data they are collecting.
Battery life and ease of charging
The Kelsi (Freeus eResponder) stands out with respect to battery life and convenience, with a 3 month time between charges. The reason it can do that, of course, is that it does not include features like GPS or automatic fall detection.
The other products are all designed with the idea they need to be charged every day or two. There are some differences (see table) but they are modest. In general, I think one would want to plan on a routine in which they are charged daily.
While all the products have a light that tells you if charging is needed, the Philips product talks to you and is quite personable, and reminds you exactly when and how to charge it.
There is a very important subtlety in regard to charging. For the GreatCall Splash and the Philips Lifeline GoSafe, it is the pendant itself that needs to be charged daily (or maybe every second day). This is not at all inconvenient, and you can charge it by the bed at night. However, it does mean that while you are charging the pendant you most likely are not wearing it, and that could be just the time you need it. Philips Lifeline makes a point that you can charge the pendant while wearing it, but we did not think that was at all realistic.
In contrast, for the MobileHelp Cellular Duo (LifeFone At Home & On-the-Go) the pendant has its own battery with a very long life (18 months, according to the manual). The thing that needs daily charging is the portable base station. And while that is charging, the pendant / wearable continues to work just fine, communicating with either the main base station or the portable base station depending on how things are set up. This makes it far more likely that one would keep the wearable on 24/7, and for many that may be a decisive factor!
It is important that you can clearly hear the responder when they call you back through the wearable after you press the alert button. The Philips Lifeline GoSafe stands out in this respect. It is very loud and very clear. At the opposite extreme, I found the Kelsi (Freeus eResponder) noticeably scratchy and faint and hard to hear. In between these extremes, I thought all the other hardware products had quite adequate sound quality. In noisy places I needed to put them near my head. If I were hard of hearing I would definitely favor the Philips Lifeline product in this regard, although I think the other products are quite acceptable.
Ease of use, Appearance, and Wearability
The main problem with this whole class of products is that they are all quite ugly and they scream "I am old and frail and need help". Many of the older adults in our Explorer circles dislike that aspect of them, and we are frequently told this is a reason people don't wear them.
The GreatCall Splash stands out a bit in a good way here, as it looks like a pager or other type of consumer electronics, and is not too noticeable. The Premium Guardian (Numera Libris) rides on the belt and is unobtrusive but ugly. The Kelsi (Freeus eResponder) is a smallish black rectangle and is also quite innocuous. And of course, the Apps don't require you to carry anything but the phone.
The Splash, Kelsi, and Premium Guardian are all pretty easy to use with a single large button to press in case of emergency.
I found myself in two minds about the remaining two products with respect to ease of use and wearability. The LifeFone At Home & On-the-Go (MobileHelp Cellular Duo) includes an extra component. It belongs to the "portable base station" flavor of product. As such, it is quite a bit more clunky than the other products. But it has a big benefit. Namely, it works both out and about, as well as at home, where it connects via its home base station. And the wearable itself can be quite a bit smaller than in the case of the "all in one" products that make up the rest of the list.
The Philips Lifeline GoSafe has a number of very cool extra "features", that an engineer like me definitely admires (see below). In terms of look and feel it very much telegraphs "I am a medical product". It is white, very nicely ergonomic, and comfortable to wear under the shirt. It has a very nice positive feel when you press the button. And all in all, it feels like a piece of german engineering. But it definitely says "I am old and sick and I need help".
The final wearability issue has to do with whether you would wear each of these in the shower. I think one would be much less likely to wear a Splash or a Kelsi or a Premium Guardian in the shower, although they say you can.
Weight of the pendants
|Product name||Weight (oz)
|Philips Lifeline GoSafe||2.1|
|Medical Guardian Premium Guardian
(rebranded version of the Numera Libris)
|LifeFone At home, On-the-Go
(rebranded version of the MobileHelp Cellular Duo)
|Alert 1 Kelsi
(rebranded version of the Freeus eResponder)
NOTES on weight:
- This was done with our kitchen scale. I expect the relative weights to be accurate. The absolute numbers may be off a bit. I did not try and calibrate the scale.
- The MobileHelp weight refers only to the pendant (the fall detection version). It also requires the portable base station of course, which weighs an additional 2.4 oz. However, this weight goes away when you are at home, and when out and about I am assuming it goes either on your belt or in your purse, and is not too bothersome as a result.
Finding you when GPS fails
After testing these products I have the opinion that you don't want to fall and hit your head inside, in a large multistory building. With one exception, the responders explained to me that if the GPS was not giving a good reading and they could not talk to me, that would be a problem.
The exception is the Philips Lifeline GoSafe product. When I discussed this issue with the responder from Philips Lifeline, they explained to me that the pendant contains a very loud siren, and that if they get an alert and don't know where I am and can't talk to me, they will activate the siren to help the emergency responders track me down. This struck me as an excellent solution to the fact that GPS is not perfect.
At home connectivity
Each of these devices works wherever there is cell coverage. Some people have poor cell coverage in some parts of their house, and all but two of these products will not work in those places, because they rely solely on cell coverage to communicate to the responder.
Both the Philips Lifeline GoSafe and the MobileHelp Cellular Duo (LifeFone At Home & On-the-Go) products include a type of dual functionality. When they are away from home they use the cell network to communicate, as do the other products. But when they are "at home", they communicate via a base station in the house. The communication between pendant and home base station uses a more robust type of wireless communication than the cell network, and is much less likely to have dead spots. So these two products are a bit more "perfect" than the others, in terms of working at home in areas where cell reception is bad.
Planes and the "off button".
Most of these products have an "off button". The Kelsi (Freeus eResponder) does not have an "off button", that I could find. Some of the vendors claim that when going on an airplane you need to turn the pendants off, and this would not be possible with the Kelsi. I have not verified whether the airlines do indeed care about this.
Problems with the Apps
I had high hopes for these three Emergency Response Apps. When they worked, they worked well. The main issue, common to all Apps, is that to activate them you need first to navigate the lockscreen of the phone, and find the App, and wait for it to open — and then press the button. Some of our Explorers think this is too complicated to do in an emergency. But some think it would be fine.
Other than this, the GreatCall 5Star App worked well. It opens easily, has a nice big red button to press, and when pressed it connects to the same responder as did the Splash. The GPS seems to work a bit better on the phone than on the stand alone devices, with slightly fewer errors.
In contrast, I consider both the other two Apps to be unusable!!
See my detailed reviews of each App for my discussion of why exactly that is the case. But the short summary is this.
- More than 50% of the time, in my testing the Phillips Lifeline App froze before it reached the button you need to press to summon help.
- The LifeFone App works quite well when you activate it. However, instead of a big obvious button to press when you open it, it has a very tiny little icon at the bottom that is almost unreadable (by me at least). In an emergency I don't think you would figure out what to press.
Conclusions: comparison tests
Best of Breed: Mobile Alert Systems
Of the products we tested, we think the Philips Lifeline GoSafe, the GreatCall Splash, and the various products that are equivalent to the MobileHelp Cellular Duo (we bought the LifeFone version) represent the best of three different "breeds". We think the right one depends on the type of life circumstance a person has.
An App on a smart phone is a fourth "breed" of product in this class, with the GreatCall 5 star App being best of breed in our opinion. If you are interested in medical alert "apps", see: Best Medical Alert App: Bake-off.
The GreatCall Jitterbug 5 phone represents a fifth "breed" — a conventional clam shell phone, with a red emergency button on it. This is a popular alternative, but we did not try and evaluate competitors to that product in this analysis.
The Philips Lifeline GoSafe represents the gold-plated Mercedes of these products, in terms of emergency response. The performance seems excellent in all aspects that we tested, except speed of response. It has notable advantages (siren; loudness; ergonomics; home base station). However, it sends the unambiguous message that one is a "patient" (it looks like a medical product). It is not a lifestyle type of product at all. And it costs the most of the products we looked at.
The GreatCall Splash [replaced by the GreatCall Lively Mobile] is more of a lifestyle product. It seems to work very well. It has some imperfections as an emergency response system (would not work in a room with poor cell coverage at home; less loud; no siren; would you really shower with it?). But many people will find the combination of performance and price hits the sweet spot. In addition, it comes with a range of extra "services" that go beyond traditional emergency response, and which may be very useful to some people (including 24/7 access to a doctor or nurse, and a web-based application to connect the older adult with family and friends). And if speed of response is important to you, this product has by far the best response time.
The MobileHelp Cellular Duo product (and the numerous rebranded versions in our database — we bought the LifeFone At Home & On-the-Go) is a less sophisticated implementation of the Philips Lifeline GoSafe concept — a system that uses a base station while at home, but works via cell network when out and about. It is clunky, needing an extra portable base station. But if you normally carry a purse, or don't mind having a pouch on your belt, that may not matter.
The big advantage of the MobileHelp product (and its rebranded derivatives) over the GreatCall Splash is that it should work well everywhere at home if you have poor cell reception, and you can wear a small pendant or watch-type button (with a long battery life) as the wearable — which might lead to wearing it more often. An advantage of the MobileHelp product compared to the Philips Lifeline GoSafe is price. And the wearable can perhaps be less obtrusive in some cases if that is important.
The other big advantage of the MobileHelp product, compared to both the Splash and the GoSafe, is that the MobileHelp wearable has a battery with a long life (over a year). This is because the part that needs frequent charging is in the portable base station (daily charging), whereas for the Splash and GoSafe it is in the pendant.
If you want an Emergency Response App for your smartphone, the only one we recommend in this class (monitored alerts) is the 5Star App made by GreatCall. The others fell short of what we consider adequate performance.
Less desirable alternatives
The Numera Libris (and the numerous rebranded versions in our database — we bought the Medical Guardian Premium Guardian) seemed to work well much of the time. But they are very similar to the Splash, have poorer performance (especially GPS) and cost more, so they did not make the "best of" list.
The Freeus eResponder (and various rebranded versions — we bought the Alert1 Kelsi) has far lesser functionality than the other hardware products we evaluated (no fall detection, no built-in location capability), and is not cheaper. The only reason that would be a best choice would be if battery life were especially important.
Recommendations: Best Mobile Medical Alert
The best of breed products listed in the conclusions above all seem good, and we think different types of people will choose different "breeds". The central focus of our research project is to help people decide which "breed' will work best for them. You can learn more about which breed would be right for your lifestyle in the other parts of our guide (see green button below).
If you want a single, simple, go-anywhere pendant, and don't mind charging it each night, we recommend either the GreatCall Splash [replaced by the GreatCall Lively Mobile] or the Philips Lifeline GoSafe.
But if charging the pendant worries you, and you don't mind having two things to take with you when you go out (or you don't need fall detection and you want the rather nice, small, watch-style button in the very top image on this page) then we recommend the MobileHelp Duo product.
In choosing between the Splash and the GoSafe, price is a factor. In addition, we think the extra services of the Splash and its lifestyle focus and decent appearance will appeal strongly to one group of people. And the Splash has the fastest response time.
For those who don't want the extra services of the Splash, don't care about the price or the medical appearance of the GoSafe, and want as near perfection of emergency response as possible (except for response time), then we would recommend the Philips Lifeline GoSafe.
View our detailed product reviews (and find links to the manufacturer websites)
See the recommended product listings at the bottom of the page and in the side bar (if you are reading this on a big screen).
In the table above we estimate a rough total annual cost for each product. The products typically come with some up-front fee, and a monthly fee, but we think comparing annual total cost is a good way to have a single number to compare.
The pricing here is based on the prices we actually paid (in Oct, Nov or Dec 2015), but modified to reflect the lower prices we could have got if we signed up for an annual plan. In reality, we typically signed up to pay by the month, which costs a bit more. In some cases there are specific features you can add for additional cost, but we ignored that for the purposes of comparison — except for fall detection which we called out in a separate column. In our product analysis pages, we include links to the company websites where you can see the latest prices. Use the table above only as a guide please.
(2) GPS and location
The Kelsi does not have any built-in way to know where it is. The vendor explains that after you talk to the responder, if the responder calls 911, they can use the 911 locating technology to find you. As discussed in our detailed review of the Kelsi, this is better than nothing but falls a long way short of the locating capability of the other products in this list.
(3) Product selection background
The way the emergency response industry works is that a handful of companies make actual hardware products that are then remarketed under a variety of different names by a much larger group of resellers. This is why, when you look at our selection tool and search for products by characteristics, you see a number of identical-looking products with different names, from different vendors. Thus the results above apply to a broad range of products from different vendors.
We did not test the GreatCall Jitterbug, although it gets excellent reviews, simply because, as a cell phone with built in emergency button, it is a little different from other products in this analysis. It uses the same 5 star response service as both the Splash and the 5 Star App, both of which we did study.
We also left out for now two products that seemed slightly less good on paper but which would be worth testing. These were the "Sentry Pal" from LogicMark (also sold as the "MobileGuard" from OnGuard Alert); and the iHelp Alarm from Medical Alarm Concepts. You can see the product analysis sections for these two products to learn more.
Finally, we like the look of the Limmex emergency watch and the Everon PERSmobile (both are in our data base if you are interested), but they are not available in the US and for now we left them out of the analysis.
For each of the products we reviewed, you can read detailed, hands-on test results in the detailed product analysis for that product. We also have included some desk analysis for all the other products in our database. You can access all this material through our main report home page here.
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Comments, Questions, Discussion
The team is led by Dr. Richard Caro, PhD physicist and co-author of a recent guide to home sensor systems for older adults.
Our advisory panel contains clinicians and aging services professionals with extensive experience in working with the older adult population that uses these medical alert systems. Professional competencies in the team include social work, physio-therapy, and nursing, and experience operating independent living communities.