Clinical Image Sharing

What’s up with WhatsApp for healthcare messaging?

WhatsApp doesn't cut it as a health messaging app. We take a deep dive into some of the compliance concerns and workflow limitations of WhatsApp.


The social media platform WhatsApp is becoming the go-to messaging solution for healthcare providers as clinicians embrace digital solutions to improve communication and workplace efficiencies. The benefits of a real-time communication solution in healthcare is huge. WhatsApp clearly has some advantages when compared to other traditional modalities used by clinicians.

WhatsApp as a medical messaging app – the good:

  • More secure than SMS texting.
  • Allows group communication between Android and iOS users, in stark contrast to SMS.
  • Allows new users to be easily added to group conversations, in stark contrast to email.
  • Is networked focused – allows users to readily connect with other users on the network.

WhatsApp as a medical messaging app – the bad:

Despite these apparent benefits compared with legacy solutions of paging, fax, SMS, and email, there are a number of issues with using WhatsApp as a real-time messaging solution for healthcare providers:

  • Lack of read receipts. Let’s face it, communication in healthcare requires precision and accountability. Don’t you want to know if the recipient of your message has at least seen your message even if he/she hasn’t responded?
  • Lack of dedicated workflows for healthcare. Sophisticated healthcare communication demands more than just a simple messenger which is all WhatsApp really is. How about patient-centric communication that provides dedicated workflows to manage clinical handover between practitioners, e-referrals, and multi-disciplinary team collaboration? Foxo provides these workflows in a simple to use interface accessible on desktop and mobile.
  • Lack of accountability. Healthcare communication also demands transparency, audit trails, and accountability. Foxo keeps a running log of user activity. As patient information traverses users and is modified, Foxo publishes a time-stamped log relating to user activity. This running ledger ensures accountability and transparency are front of mind, making the platform truly unique and encourages a professional environment through an intuitive easy to use interface.
  • Lack of formatting. Clinical information is easily lost within deep message threads, this rapidly compounds as more users are added to a message group. The nature of real-time messaging often severs critical information from a clinical case. Foxo creates a unique environment that promotes real-time messaging and collaboration while contextual communication is maintained.
  • Non-compliant with privacy legislation. Data handling (including storage in overseas servers), security workflows, or lack thereof compromise WhatsApp’s ability to fit the bill as a healthcare messenger. Clinicians have a number of responsibilities when handling sensitive health information and risk fines for non-compliance. These considerations include:
    • Data sovereignty
    • Ensuring clinical images that could readily identify a patient are not stored on personal mobile devices.
    • Having controls to prevent unauthorised access (1).

Use of WhatsApp in overseas healthcare markets

A number of health jurisdictions have banned the use of WhatsApp for clinical communication purposes. In the UK, it’s use is not considered concordant with the recommendations outlined in the latest NHS guidelines (1). In the USA, WhatsApp in not considered HIPAA compliant (2). HIPAA provides the regulatory framework around which personal health information is managed in the United States (3).

How is secure clinical communication playing out in Australia?

In Australia, the need for sophisticated mobile communications is evidenced by the growing use of non-sanctioned, unsecure third-party messaging apps that have surfaced broadly throughout Australia as well as more globally. In a recent survey in Victorian hospitals, communication app usage was widespread, however, largely consisting of WhatsApp in 85% of instances (4).

The recently announced plans to merge the messaging platforms of Facebook, WhatsApp and Instagram further raise privacy concerns around how sensitive personal information is handled on such social media platforms and should be front of mind with all health professionals considering utilising such platforms as a clinical communication tool. User beware!

A secure messaging solution for health professionals

Health professionals need a purpose-built, secure communication solution, not a repurposed solution designed for different industries.

We believe the best solution is for health providers is Foxo – a dedicated, encrypted messaging app designed specifically for health professionals. Powerful workflows foster realtime communication and collaboration across the entire healthcare team.


Suggested reading:

Clinical images and personal mobile devices- a guide for medical students and doctors. Australian Medical Association.

References:

1. Information governance considerations for staff on the use of instant messaging software in acute clinical settings. Version 1.0 Mistry, K, Nov 2018.

2. https://www.hipaajournal.com/whatsapp-hipaa-compliant/

3. https://www.hipaajournal.com/hipaa-compliance-checklist/

4. Nikolic, A et al The Use of Communication apps by Medical Staff the Australian Healthcare system.: Survey on Prevalence and Use JMIR Med Inform 2018 Jan- March; 6 (1): e 9

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