Use of smartphone-based instant messaging services in medical practice: a cross-sectional study

Use of Instant Messaging Software in a German Hospital-An Exploratory Investigation among Physicians

Internationally, evidence exists that physicians use instant messaging services for communication tasks in everyday clinical practice However, there are only few data on physicians in Germany in this regard. Therefore, at the initiation of our project "DocTalk-Dialog meets Chatbot: Collaborative Learning and Teaching in the Process of Work", we conducted a stakeholder survey with an exploratory research approach. The aim was to gain initial insights into use of instant messaging software and attitudes towards data security and advantages and disadvantages before implementing a data-secure in-house messaging platform. N = 70 physicians at Charité-Universitätsmedizin Berlin completed an exploratory questionnaire with closed and open-ended questions. Quantitative data were analyzed using descriptive statistics and qualitative data using thematic analysis. The use of messenger software was not widespread in the sample studied. Physicians most frequently used face-to-face contact for communication. On average, up to ten instant messages were exchanged per day, mainly among colleagues, to answer mutual questions, and to send pictures. With a high awareness of privacy-related restrictions among participating physicians, advantages such as fast and uncomplicated communication were also highlighted. An instant messenger solution that complies with the German data protection guidelines is needed and should be investigated in more detail.

Surgery remember@: an innovation to reduce surgical cancellations

The use of mobile phones has dramatically increased all over the world. Such revolution in the communication amongst individuals has a great impact in patient care, supporting their self-management and promoting shared responsibility with health services. Given that improved communication facilitates compliance with scheduled procedures and reduces surgical cancellations, the current work aims to develop a communication tool named Surgery Remember@ to mitigate surgical suspensions due to patient absenteeism. The present article is a study of technological production divided into four chapters: literature review; analysis of the hospital administrative profile; software development; and process mapping for software implementation. Taking into account that in the last three years the problem of absenteeism was the main cause of institutional surgical cancellations; the development of Surgery Remember@ endeavours to reduce surgery cancellations, improving efficiency and reducing costs. It is known that sending messages three days before the surgical procedure makes it possible to replace patients in the event of cancellations, optimizing the human and material resources in the operating room. The confirmation of the pre-aesthetic consultation is also positive, for it allows the verification of perioperative assistance improvement. Hence, besides being viable and easy to implement, the software developed allows the addition of other features based on user requirements, proving to be an asset to reduce surgery cancellations.

WhatsApp in Clinical Practice-The Challenges of Record Keeping and Storage. A Scoping Review

The use of WhatsApp in health care has increased, especially since the COVID-19 pandemic, but there is a need to safeguard electronic patient information when incorporating it into a medical record, be it electronic or paper based. The aim of this study was to review the literature on how clinicians who use WhatsApp in clinical practice keep medical records of the content of WhatsApp messages and how they store WhatsApp messages and/or attachments. A scoping review of nine databases sought evidence of record keeping or data storage related to use of WhatsApp in clinical practice up to 31 December 2020. Sixteen of 346 papers met study criteria. Most clinicians were aware that they must comply with statutory reporting requirements in keeping medical records of all electronic communications. However, this study showed a general lack of awareness or concern about flaunting existing privacy and security legislation. No clear mechanisms for record keeping or data storage of WhatsApp content were provided. In the absence of clear guidelines, problematic practices and workarounds have been created, increasing legal, regulatory and ethical concerns. There is a need to raise awareness of the problems clinicians face in meeting these obligations and to urgently provide viable guidance.

Adapting non-medical applications for medical use: Ethical limits, coverage, and validation

The widespread adoption of smartphones and other mobile devices amongst healthcare providers opened new possibilities arising from the use of non-medical apps, social media, meeting platforms, and non-medical devices with intended medical purposes, thus expanding the communication and imaging chat systems between these professionals and their patients, as well as amongst healthcare professionals. However, adapting non-medical applications, social media, videoconference platforms and devices for medical use present potential limitations, barriers, and risks, which should be fully recognized to reduce crossing the fine line between ethical and unethical. In the herein study, we analyse the ethical limits, coverage, and validation of non-medical applications adapted for medical use. Level of evidence: IV (evidence from well-designed case-control or cohort studies).

Smart-phone based telemedicine: Instant messaging application as a platform for radiographic interpretations of jaw pathologies

Objective

To evaluate the reliability of WhatsApp in comparison to the images viewed on a workstation monitor (gold standard) for the identification and interpretation of radiographic images of jaw pathologies.

Methods

150 panoramic radiographs were screened for the assessment of jaw pathologies in the workstation monitor. The radiographs were sent to two observers (Observer A and B) via WhatsApp® Messenger which were viewed independently on smartphones. A structured proforma was prepared to evaluate the radiographs for the presence or absence of various radiographic pathological characteristics.

Results

The reliability of WhatsApp for observers A and B concerning various characteristics like vital structures, pathological fractures, periodontal ligament widening, and root resorption indicated almost perfect agreement (0.8-0.97). The Kappa coefficients for WhatsApp for observers A and B for pre-categorized radiographic impressions were 0.95 and 0.97 which indicated almost perfect agreement.

Conclusion

WhatsApp based expert teleradiology consultation can be a suitable and effective alternative for radiographic interpretations.

Academic use of smartphones among medical students in Pakistan

This study examined the use of smartphones as an academic tool amongst medical students from a developing country context. The study also aimed at identifying the perceived benefits and barriers to using smartphones in medical education. A cross sectional survey was administered to the students from nine medical institutes in Pakistan. A structured questionnaire was self-administered to 270 students from MBBS program. Data were analyzed using SPSS 23. All the respondents owned a smartphone. They used smartphones to browse the Internet to find medical information (100%), to share educational material (90%), and to take notes (79%). Easy and speedy access to information and improvement in study skills were the major benefits, while limited wireless access, small screen, and lack of awareness about medical resources were the main barriers. The students had a positive attitude towards smartphone as an academic tool. Smartphones use is likely to increase with the emergence of new developments in terms of design, medical apps and educational resources.

Netiquette: Ethic, Education, and Behavior on Internet-A Systematic Literature Review

In this article, an analysis of the existing literature is carried out. It focused on the netiquette (country, date, objectives, methodological design, main variables, sample details, and measurement methods) included in the Web of Science and Scopus databases. This systematic review of the literature has been developed entirely according to the Preferred Reporting Items for Systematic Reviews (PRISMA). The initial search yielded 53 results, of which 18 exceeded the inclusion criteria and were analyzed in detail. These results show that this is a poorly defined line of research, both in theory and in practice. There is a need to update the theoretical framework and an analysis of the empirical proposals, whose samples are supported by students or similar. Knowing, understanding, and analyzing netiquette is a necessity in a society in which information and communication technologies (ICT) have changed the way of socializing and communicating. A new reality in which there is cyber-bullying, digital scams, fake news, and haters on social networks.

Development and validation of a Smartphone Impact Scale among healthcare professionals

Objectives

Smartphone overuse is prevalent among healthcare professionals. There is no standard scale that can measure the impact of smartphone usage on healthcare professionals. This study aimed to develop and validate a tool, the Smartphone Impact Scale (SIS), that can effectively measure the use of smartphone among healthcare professionals.

Methods

We developed a generic instrument to study the impact of smartphone usage among healthcare professionals. A total of 1436 healthcare professionals from various regions of KSA participated in this study through an online questionnaire-based survey. The psychometric properties of the SIS were developed using content validity index (CVI), factor analysis, internal consistency, and test-retest reliability analysis.

Results

A 23-item scale was selected for reliability and validity analysis. The average CVI was found to be 0.824. The internal consistency with Cronbach's alpha value was 0.91, and test-retest reliability was 0.85. The Cronbach's alpha values for Factors 1 and 2 were 0.875 and 0.803, respectively. The confirmatory factor analysis indices were as follows: root mean square of approximation = 0.0710, comparative fit index = 0.861, Tucker–Lewis index = 0.845, and the coefficient of determination = 0.969. The correlation between two factors was 0.66. After factor analysis, we developed a final questionnaire with 23 items.

Conclusions

Our SIS showed a three-factor structure and appropriate psychometric characteristics. Due to its adequate reliability and validity, SIS can be conveniently used to evaluate the impact of smartphone usage on healthcare professionals.