Wanted: a WhatsApp alternative for clinicians
BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k622 (Published 12 February 2018) Cite this as: BMJ 2018;360:k622
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As a 'young person' I am hardly surprised at the high number of physicians using Whatsapp to communicate in the healthcare setting. If you were to look at other businesses around the world, I am sure you will find that many, if not the majority, use Whatsapp or similar programmes to communicate with each other instantly. However, they will not be as concerned with information governance and patient confidentiality as we are. I am encouraged to read that there are companies out there who have or are developing apps that can be used safely.
The idea of instant messaging in the NHS is not a new one though. In GP practices, SystmOne has a comprehensive instant messaging service which is used regularly throughout clinics. It enables doctors, nurses, admin staff etc to ask general or specific questions about a whole variety of things, ranging from rota changes to medical advice. This enables quick communication without interrupting consultations, therefore saving on time; something that is precious in a GP. A more 'mobile' version of this system would be a godsend in a hospital from quick easy communication with no hierarchical barriers.
Having said that, there are many technologies in the NHS that are very 'behind the times' and need updating as well. You can imagine the derision when I had to ask how a fax machine worked, and questioned whether it was appropriate to be sending referrals through them? My qualms were confirmed when I heard horror stories of patient's confidential details being sent to the wrong hospital, GP surgery, or even to places outside the NHS. Medical students will be well acquainted with the 'fear of the bleep'. I reckon that at this stage, the biggest fear is not what is happening at the other end of the telephone line, but the prospect of having to figure out how to display the correct number to call! Surely a whatsapp-like system would be nothing but an improvement than this for routine communications within the NHS.
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The General Data Protection Regulation (GDPR) is due earlier than you print. It becomes binding in the EU on May 25th 2018.
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Very well and comprehensively stated. It is absolutely not surprising that a consumer technology has caught on among health professionals ; in fact , usage in healthcare and emergency- crisis situations may rank as one of its top utilities. As ones , who posed questions on use of mobile phones in ICU (1) , the cycle now appears to have taken one full circle. Pro-pagers may now appear 'conservative and non - progressive ' viewed contextually. Communications within the clinical units , departments, and investigative services in an institution setup along with referral components undeniably have undergone a profound change for the better ; sharing images and laboratory data has facilitated speedy and timely actions in favour of patients and proved to be an enormously useful academic tool . Pre.informed with do' s and dont's (2) , and "GDRP " regulatory provisions in place , there could be hardly any concern left. However , one elementary and important health concern does deserve attention beyond clinical settings ; the addictive potential , attention sapping and neuro.energy sucking effects of modern technology are becoming apparent for the human race , with necessity to log - off , and doctors are humans too. Dr ME Yeolekar , Dr AM Yeolekar, Mumbai. References : 1. Yeolekar M , Sharma A. Use of mobile phones in ICU - why not ban. J Association of Physicians of India. 2004 , 52 :311-13. 2. NHS digital. The do' s & dont's for individuals on the use of instant messaging software in clinical settings. https :// digital.nhs.uk /information -governance-alliance /resources / technology. Google Scholar
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WhatsApp is a fantastic tool for modern medicine and is a brilliant example of physicians filling in the gaps of systems suffocated by bureaucracy and over reliance on outdated technology (why am I still sending faxes?). As mobile comminications take off and smart phones are ubiquitous within the hospital, it is almost at the point where it can be argued it is in our patients best interest to embrace these technologies. Instead of running scared behind knee jerk reactions of data protection we as physicians, the NHS, BMA and GMC should be proactively seeking to mitigate these concerns via actively trying to provide solutions that fill these niches within our system. Instead, doctors and other healthare professionals are being forced to expose themselves in order to improve their team communication and, in turn, improve patient safety.
People fret over the ''unsecure'' nature of WhatsApp communication; what is so '''secure'' about the multitude of physical copies of patient lists that are printed everyday and stored in scrub tops that seemed designed to fling their contents at the slightest jiggle? I suspect that the quandary is that it is much easier to blame the maligned foundation year trainee for losing a scrap of paper rather than for the system to accept responsibility for creating a modern, integrated healthcare solution.
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Interesting article, but there is a third way; rather than continue with a service where data is moved out of the protection of UK and EU law, or have to spend to build or buy a new service, why not work with WhatsApp or similar to create an NHS-friendly service.
The large tech companies such as Whatsapp/Facebook already have the technology and scale to deliver a service easily. Only small modifications would be needed to keep the messages of registered NHS users within the UK and in a way that is compliant with healthcare data governance. NHS Digital are warming to such cloud storage (https://digital.nhs.uk/article/8497/NHS-Digital-publishes-guidance-on-da...) and could help with the governance of it all.
Best of both worlds, users get a familiar user experience and reassurance that their data is as safe as any other NHS service, the big tech companies get some income and a case study in helping patients get better care.
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Legislators must be wary of preventing important and useful improvements as a response to hypothetical risks.
The internet is international. Is it really proportionate to ban services such as WhatsApp because of laws that forbid patient data being saved on a server in the USA?
Of course there are potential risks; but we have to be proportionate, and crude, blanket bans may prevent practices (possibly including the use of WhatsApp) which overwhelmingly improve patient safety.
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WhatsApp for social communication, but not about patients
I'm glad to see the focus is shifting towards modernising communication in medicine, yet can't help but feel some interactions should still exist within a regulated platform and not involve individual phones. WhatsApp is a logical way to communicate with other doctors - ideal for covering rota gaps and arranging social meetings - yet this doesn't allow for input from other healthcare professionals . Instead, efforts should be made to modernise how the system runs overall. In our hospital, we have recently integrated electronic handovers and worklists for out of hours shifts. Nursing and medical staff add patient-specific tasks to a virtual worklist on an online patient management system. The on-call doctor can use their unique login on any hospital computer and see patients that need to be reviewed or tasks that are required (such as cannulation), then tick them off once completed. When covering 10 wards at a time, between two doctors, we have found this an extremely useful way to prioritise tasks and share the workload, without using our own phones.
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