Rotations · Escalation · Equity
On-call scheduling software that answers the 2am question
On-call scheduling software builds and publishes the rotation that says who is covering right now, and what happens if they do not answer. It manages first, second and backup call, tracks the fair distribution of nights, weekends and holidays, and gives anyone who needs to know a way to find out without a login.
From $99/month per location · No sales call · No card to start
At a glance
- On-call scheduling software publishes who is covering right now, and defines what happens if they do not answer.
- It manages first, second and backup call, and publishes the whole chain in order, so escalation is a glance rather than a search.
- A public who's-on-call board answers the 2am question without an account, an app, or a call to the switchboard.
- Equity tracking counts nights, weekends, holidays and call per person, and shows the count to the people carrying them.
- $99–$249 per location per month, published, with a 14-day trial and no card required.
How do I publish who is on call?
The board that answers the pager question. Someone needs the on-call physician at two in the morning; they are not going to install an app, and they are not going to ask you for a password.
MedAligna publishes a who's-on-call board on a revocable public link: who is covering right now, who is second, who is backup, and how to reach them. No account, no app, no phoning the switchboard. That single page is the reason a piece of software built in the pager era still gets a thousand searches a month: the need never went away, and most modern tools forgot to serve it.
The link is a token you can rotate or revoke at any time, so it is shareable without being permanent, and it never appears in a search engine.
What happens when the first person does not answer?
Escalation is a chain, not a name. A rotation that names one person is a rotation with a single point of failure, and everybody discovers that on the night it matters.
The chain is there before anyone needs to start it. First call, second call, backup: each rotation carries its own escalation order, and the public board shows the whole chain in that order. When the first name does not answer, the caller is already looking at the second, which beats any paging workflow that begins with finding the right phone list.
And because the board is a revocable link rather than an app, it works for the person actually placing the 2am call: a ward clerk, an answering service, a partner practice. Nobody needs an account to find the next name.
How is on-call equity tracked?
Equity, so the rota stops being an argument. Nobody minds carrying their share; what people mind is a rota where nobody can prove what their share was.
MedAligna counts on-call blocks, nights, weekends and holidays per person over any trailing window, and shows the count to the people carrying them, not only to the scheduler. Holiday memory is explicit: it knows who worked the last Christmas, so the next one is assigned against a record instead of a recollection.
When someone says they always get the bad weekends, the answer is a number rather than a conversation.
Which nights does an on-call system actually change?
First call does not pick up
The on-call physician's phone is on silent. In most departments the caller now goes hunting: who is second call, and is the list taped to the desk even current?
The board publishes the chain, not just the name: first, second and backup in order, always the current version. The caller tries the next name from the page they are already on.
The list on the wall is stale
The rota changed at four o'clock: a swap moved second call. The printed list at the ward desk, and the copy the answering service keeps, both still show yesterday's chain.
The board is a link, not a printout, so there is exactly one copy and it is always the published truth. Rotate or revoke the token and every old bookmark stops working at once.
'I always get the bad weekends'
It is said in every department, and it is sometimes true. Nobody has the numbers, so it is settled by whoever is most persuasive.
A count per person, over any trailing window, visible to the people carrying the calls. The conversation becomes a number.
How to choose on-call scheduling software
Eight questions worth asking any vendor in this category, including us. At least one of them is a question we do not answer well, and we have said so rather than leaving it out.
01Can someone check who is on call without logging in?
This is the whole job. If the answer requires an account, the answer will be obtained by phoning somebody instead, and your software has been routed around.
Where MedAligna lands: A revocable public link, no account, never indexed. Rotate or revoke the token at any time.
02What happens if the first person does not answer?
A rotation that names one person is a single point of failure, and you find out on the night it matters.
Where MedAligna lands: First, second and backup call, published in order on the board: the caller tries the next name from the page they are already looking at. Nothing about the chain lives in anybody's memory.
03Does it page people automatically: push, SMS, phone?
Push notifications are unreliable in ways that are invisible until they fail, particularly on iOS, where they require the app to have been installed to the home screen. SMS is the usual fallback, and some tools sell the whole chain as automation.
Where MedAligna lands: No. This is the criterion we fail: MedAligna does not send pushes or SMS pages. Our answer to the missed page is the published chain on a board that needs nothing installed on the caller's side. If automated paging is a hard requirement, we are not your tool, and we would rather you knew before the trial than after.
04Is equity tracked, and by whom can it be seen?
An equity report only ends the argument if the people arguing can see it.
Where MedAligna lands: Counts of nights, weekends, holidays and call blocks per person, over any window, visible to the staff carrying them.
05Does it integrate with your paging or alerting system?
Some hospitals run dedicated clinical alerting platforms, and duplicating the escalation logic in two systems is a recipe for a missed page.
Where MedAligna lands: We do not integrate with paging platforms, and we do not send pages ourselves: on the caller's side, the published board is the answer. Enterprise gets webhooks, so schedule and on-call changes can be forwarded into whatever alerting you already run. If deep paging integration is a hard requirement, say so and we will tell you honestly whether we fit.
What is an escalation window, an acknowledgement, or backup call?
- First / second / backup call
- The escalation order for a rotation. First call is contacted initially; second and backup are the ordered fallbacks when there is no response.
- Escalation window
- How long an unacknowledged notification waits before the next channel or the next person is tried. Too long and the page is missed; too short and everyone is woken.
- Acknowledgement
- An explicit confirmation that the on-call person has received the request. Delivery is not acknowledgement: a message that arrives on a silent phone has been delivered and has not been seen.
- On-call equity
- The fair distribution of call across a team, counted over a trailing window. Needs to include holidays and weekends separately, because those are the ones people actually resent.
- Public on-call board
- A login-free page showing current coverage, for the people who need to know and do not have accounts: switchboard, other departments, referring physicians.
Questions people actually ask
- What is on-call scheduling software?
- On-call scheduling software, often just called an on-call scheduler, builds the rotation of who is covering outside normal hours, manages first, second and backup call, escalates when someone does not respond, tracks the fair distribution of nights, weekends and holidays, and publishes the current on-call to whoever needs it.
- Can people see who is on call without logging in?
- Yes. A revocable public board shows who is on call right now, who is second and who is backup, on a link that needs no account and never gets indexed by search engines. You can rotate or revoke the token at any time.
- What happens if the on-call person does not respond?
- The escalation order is published beside the current name: the board shows first call, second call and backup in order, so the caller tries the next name without hunting for a phone list. The chain is data rather than memory, and it is the same answer for everyone who looks.
- Does it track on-call equity?
- Yes: on-call blocks, nights, weekends and holidays per person over any trailing window, including who worked the last occurrence of each holiday. The report is visible to the people carrying the calls, which is what makes it credible.
- Who sets the rotation up, and what does on-call scheduling software cost?
- You set it up, in an afternoon, and it costs $99, $149 or $249 per month per location, published, with a 14-day trial and no card. Import your people from a CSV, define the rotation and its escalation order, and share the board's link. There is no implementation project and no sales call, so the first rota is built by the person who understands the rota. On-call rotations and the public board are on every tier.
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Stop being the person who knows
A public on-call board, an escalation chain that actually escalates, and equity everyone can check. Fourteen days free.