As the world’s most popular messaging app, Whatsapp allows users to share information quickly and easily with limited data usage. End-to-end encryption gives users a sense of security when sharing private information through the platform. An increasing number of doctors are turning to WhatsApp to consult with colleagues. But does the app provides a suitable means of communication for the medical community in terms of security and medical practice standards?
A new medical communication is needed
The pager has remained the physician’s ‘faithful friend’ for decades, and as many as 85% of doctors still communicate using outdated legacy pager systems. But as technology has progressed far beyond the simple pager, physicians desperately need a more nuanced form of communication. WhatsApp provides a tempting alternative to waiting for an email response or paging a senior consultant, especially for residents and junior doctors who might need expert consultation in real-time.
Not surprisingly in today’s world, 98.9% of physicians own a smartphone. In fact, smartphone use has a higher rate among doctors than the general population, where smartphone ownership stands at approximately 72%. Still, those numbers do not reveal whether or not doctors use their phones, in a professional capacity.
Using smartphones for clinical duties
Despite the high percentage of smartphone ownership among doctors, it remains the only professional community to still regularly use pagers. However, that trend has started to shift. The vast majority of doctors are already using their smartphones to conduct clinical business and 92.6% of physicians surveyed found their smartphone very useful or useful in carrying out their clinical duties. (The rate decreased significantly among nurses, with only 53.2% finding their smartphones useful or very useful for their professional duties. This discrepancy likely results from the difference in professional duties.)
When using their smartphones for communication, 64.7% of physicians rely on SMS as their preferred method, with the remaining third using web-based applications, such as WhatsApp and Facebook messenger.
Implications for WhatsApp usage among doctors
This has significant implications for professional standards in the medical field calling into question the level of patient confidentiality, whether shared images maintain a high enough standard for remote diagnosis or second opinion and how such methods affect the flow of information between physicians.
Research into the use of WhatsApp for junior doctors found that over a third of communications were seeking advice or support. Creating groups for collective communication easily pooled information among physicians. Because messaging groups involve both junior and senior doctors, 80% of responding junior doctors felt that it improved relationships between the grades of doctors, breaking down traditional barriers and giving them greater access to expert advice.
Is WhatsApp good enough for medical usage?
Messaging apps have the advantage of instant image sharing. A recent study revealed that 80% of clinicians used WhatsAppfor obtaining a second opinion or remote consultation for neonatal chest radiographs. Based on this data, the study then assessed the accuracy of viewing images sent by messenger compared to on a computer screen. Neonatologists first looked at n images on a smartphone before viewing the same images two months later from a computer to compare diagnosis. Then, another group looked at the images on a computer screen before viewing them again two months later on a smartphone screen. The study found that WhatsApp was indeed reliable for preliminary interpretation of neonatal chest radiographs (p=0.88 for diagnosis and p=0.94 for disease severity.)
Patient security – the biggest concern
WhatsApp and other instant messaging apps offer doctors a convenient way of communicating between themselves and a good first line of communication for consultation. However, serious issues arise when it comes to the security of patient data. Although encryption technology used by some instant messaging apps prevent the interception of messages between devices, that information does not stay protected on the actual smartphone. Anyone with access to the device can see that data. While most physicians using messaging to discuss patient cases take precautions to remove any identifying information, there still remains a significant risk to information security.
For physicians based in the USA it is important to know that WhatsApp is not HIPAA compliant.
HIPAA also requires access controls to be implemented. As messages can be see by anyone with access to the phone can view the messages without any additional passwords being requested, WhatsApp does not fulfill this HIPAA requirement. HIPAA also requires audit controls preventing deleting patient data. Users can easily delete messages from common apps, which does not comply with Messages can easily be deleted from commonly used apps, not complying with this aspect of HIPAA.
The EVA System – A solution to the medical messaging challenge
Physicians clearly need a form of instant messaging that will allow the free flow of information to streamline the clinical process. Although such communication has tremendous benefits, the risks for patient security must be overcome.
A number of companies have started creating a solution to this issue. One company has side-stepped some of the potential issues by embedding a messaging and image sharing app directly into a medical device. The EVA System colposcopy solution combines a handheld colposcope with an online portal that stores patient information and images in a fully HIPAA compliant platform.
Clinicians using the EVA System can send images to colleagues for remote consultation directly from the device. The consulting physician either receives the images to their own EVA device or receives notifications on their smartphone. They can then view the images, offer their input and have the results returned in real-time while the patient remains at the point of care.
As a fully HIPAA compliant system and portal, clinicians can use the EVA System with the assurance that all patient information remains stored and protected with maximum security.
The world of medicine is defined by innovation and the search for new solutions to provide ever better treatment. The time has come for the medical community to embrace the same level of excellence and efficiency in their communications. Custom solutions created to fit the specific needs of physicians are the answer in the long term.