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If there is a lack of alert, how do I know my loved ones are OK, versus the app being down?

Answering hard questions like that is the difference between a product that is ready for the marketplace, and a hobby toy.

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There is certainly a log of triggers that the subscriber can access. Any suggestions on how to make that distinction?

I would go back to the beginning, ask yourself "what level of false negatives am I willing to tolerate", and architect the system's reliability around maintaining that rate.

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