Zithulele Hospital, Eastern Cape Department of Health, Mqanduli; and Department of Family Medicine, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa.
S Afr Med J. 2021 Feb 1;111(2):171-175. doi: 10.7196/SAMJ.2021.v111i2.14453.
There has been a steady increase in the use of electronic media and instant messaging among healthcare professionals, where it has been almost universally adopted in the workplace. The use of WhatsApp and its perceived benefits in healthcare have been extensively studied; however, there are concerns regarding the potential for ethical breaches in confidentiality through shared electronic patient information.
To identify the usage characteristics and incidence of shared patient information with WhatsApp use in a team of medical doctors in an unobserved and unregulated setting.
We conducted a retrospective cross-sectional content analysis of WhatsApp messages (n=3 340) among a team of 20 doctors in a South African district hospital over 6 months. All messages found within this time period were allocated unique identifiers. The text and image messages were thematically grouped into four categories, i.e. clinical care, resource allocation, social and administrative. Messages that contained patient-identifying information were included in the analysis.
Of a total of 3 340 messages sent, 220 (6.6%) contained patient-identifying information. Of these, 109 (3.3%) contained non-anonymised patient information, while in 111 (3.3%) messages, the information was anonymised. The likelihood of sharing patient identifiers was proportionally much higher in shared images (odds ratio (OR) 5.1; 95% confidence interval (CI) 3.2 - 8.2; p<0.0001) compared with text messages, and in messages that related to clinical care (OR 9.3; 95% CI 2.2 - 38.8; p=0.0023) compared with those sent for resource allocation, and social or administrative purposes.
Non-anonymised patient identifiers were found in 3.3% of messages, constituting the potential for breaching patient confidentiality. While WhatsApp groups have significant utility in co-ordinating aspects of clinical care, resource allocation, as well as social and administrative functions, the safe use of WhatsApp should be promoted to ensure that patient confidentiality is maintained.
电子媒体和即时通讯在医疗保健专业人员中的使用稳步增加，几乎在工作场所普遍采用。WhatsApp 的使用及其在医疗保健中的益处已经得到了广泛研究；然而，人们担心通过共享电子患者信息可能会违反保密性。
在南非一家地区医院的一组医生中，在未被观察和不受监管的环境下，确定 WhatsApp 使用的使用特征和共享患者信息的发生率。
我们对南非一家地区医院的 20 名医生团队在 6 个月内使用 WhatsApp 消息（n=3340）进行了回顾性横断面内容分析。在此期间内找到的所有消息都分配了唯一标识符。文本和图像消息被分为四个主题类别，即临床护理、资源分配、社会和行政。包含患者识别信息的消息被纳入分析。
在总共发送的 3340 条消息中，有 220 条（6.6%）包含患者识别信息。其中，有 109 条（3.3%）包含未匿名的患者信息，而在 111 条（3.3%）消息中，信息是匿名的。与文本消息相比，共享图像中的患者标识符共享的可能性要高得多（优势比（OR）5.1；95%置信区间（CI）3.2-8.2；p<0.0001），与资源分配、社会或行政目的相比，与临床护理相关的消息（OR 9.3；95% CI 2.2-38.8；p=0.0023）。
在 3.3%的消息中发现了未匿名的患者标识符，构成了侵犯患者保密性的潜在风险。虽然 WhatsApp 群组在协调临床护理、资源分配以及社会和行政功能方面具有重要的实用价值，但应推广安全使用 WhatsApp，以确保维护患者的保密性。
