Uchunguzi (Journal Watch/ Montre de Journal) March 2017

Without the need for expensive videoconferencing equipment or computer networks, doctors in the developing world have found practical use for WhatsApp Messenger in clinical and administrative settings because the service is ubiquitous, free and easy to use. This study reviewed the literature on WhatsApp in clinical practice, to determine how it was used, and users’ satisfaction. It revealed that the service was widely used in intradepartmental communication across a range of aspects, including second opinion, changes in treatment plans, sharing of X-rays and photographs, scheduling of academic meetings, and sharing of educational materials such as papers. There was a report of the use of WhatsApp for one to one telemedicine referrals to improve time to reperfusion in patients with ST segment elevation myocardial infarcts. Some of the advantages noted included an improvement over voice only communication, less disruption than a pager, reduced need to be in hospital, a computer was not required, was faster than email, permitted immediate response, reduced clinical incidents, reduced consultation time, increased level and improved supervision, flattened hierarchy, involved more senior staff in decisions, encouraged junior doctors to seek help, and improved team perception of effectiveness. The disadvantages included frequent interruption, disparity in the sense of urgency, it worsened professional relationships, lead to unprofessional behaviour, required staying online 24 h a day, was not part of the medical records, possible issues of privacy and confidentiality and risked reducing the autonomy of registrars. The ubiquity of WhatsApp, its simplicity, low cost and improved encryption make it an attractive proposition for developing telemedicine services for emergency care in resource constrained settings