Tso Lai Sze
Global Health & Medical Humanities Initiative, Massachusetts Institute of Technology, Cambridge, MA, United States.
Center for Health & Human Development Studies, Sun Yat-Sen University, Guangzhou, China.
JMIR Med Educ. 2022 Jul 29;8(3):e26419. doi: 10.2196/26419.
Health professionals in low- and middle-resource settings have limited access to up-to-date resources for diagnosing and treating illnesses, training medical staff, reviewing newly disseminated guidelines and publications, and preparing data for international disease reporting. A concomitant difficulty in high-resource settings is the need for continuing education and skills up-training in innovative procedures on unfamiliar social media platforms. These challenges can delay both patient care and epidemiological surveillance efforts. To overcome these challenges, health professionals have adapted WeChat Groups to implement timely, low-cost, and high-quality patient care.
The primary study aim was to describe the processes taken by medical professionals across their diverse physical and virtual networks in adapting a bottom-up approach to collectively overcome resource shortages. The secondary study aim was to delineate the pathways, procedures, and resource/information sharing implemented by medical professionals using an international publicly available popular social media app (WeChat) to enhance performance of facility-based procedures and protocols for improved patient care.
In-depth interviews, observations, and digital ethnography of WeChat Groups communications were collected from medical professionals in interconnected networks of health care facilities. Participants' WeChat Groups usage and observations of their professional functions in interconnected networks were collected from November 2018 to 2019. Qualitative analysis and thematic coding were used to develop constructs and themes in NVivo. Constructs incorporated descriptions for the implementation and uses of WeChat Groups for professional connections, health care procedures, and patient care. Themes supporting the constructs focused on the pathways and venues used by medical professionals to build trust, to establish and solidify online networks, and to identify requests and resource sharing within WeChat Groups.
There were 58 participants (males 36 and females 22) distributed across 24 health care settings spanning geographical networks in south China. Analysis yielded 4 constructs and 11 themes delineating the bottom-up usage of WeChat Groups among clinicians, technicians, nurses, pharmacists, and public health administrators. Participants used WeChat Groups for collectively training hospital staff in complex new procedures, processing timely diagnoses of biological specimens, staying abreast of latest trends and clinical procedures and symptoms, and contributing to case reporting for emergent illnesses and international surveillance reporting. An unexpected strength of implementing clinical, training, and research support on a popular app with international coverage is the added ability to overcome administrative and geographic barriers in resource distribution. This advantage increased a network's access to WeChat Groups members both working within China and abroad, greatly expanding the scope of shared resources.
The organic, bottom-up approach of repurposing extant social media apps is low cost and efficient for timely implementation to improve patient care. WeChat's international user base enables medical staff to access widespread professional networks across geographic, administrative, and economic barriers, with potential to reduce health disparities in low-resource settings.
中低收入资源环境中的卫生专业人员获取用于疾病诊断和治疗、培训医务人员、审查新发布的指南和出版物以及为国际疾病报告准备数据的最新资源的机会有限。高资源环境中一个与之相伴的困难是需要在不熟悉的社交媒体平台上进行继续教育和创新程序的技能提升培训。这些挑战可能会延误患者护理和流行病学监测工作。为了克服这些挑战，卫生专业人员利用微信群实施及时、低成本且高质量的患者护理。
主要研究目的是描述医疗专业人员在其不同的实体和虚拟网络中采用自下而上的方法共同克服资源短缺所采取的过程。次要研究目的是描绘医疗专业人员使用一款国际公开可用的热门社交媒体应用程序（微信）来加强基于机构的程序和协议的执行以改善患者护理的途径、程序以及资源/信息共享情况。
从相互关联的医疗保健机构网络中的医疗专业人员那里收集对微信群通信的深入访谈、观察和数字人种志资料。从2018年11月至2019年收集参与者对微信群的使用情况及其在相互关联网络中的专业功能的观察资料。采用定性分析和主题编码在NVivo中构建结构和主题。结构纳入了对微信群用于专业联系、医疗保健程序和患者护理的实施及用途的描述。支持这些结构的主题侧重于医疗专业人员在微信群中建立信任、建立和巩固在线网络以及识别请求和资源共享所使用的途径和场所。
58名参与者（男性36名，女性22名）分布在中国南方跨越地理网络的24个医疗保健机构。分析得出4个结构和11个主题，描绘了临床医生、技术人员、护士、药剂师和公共卫生管理人员对微信群的自下而上的使用情况。参与者利用微信群对医院工作人员进行复杂新程序的集体培训、及时处理生物标本的诊断、了解最新趋势以及临床程序和症状，并为突发疾病的病例报告和国际监测报告做出贡献。在一款具有国际影响力的热门应用程序上实施临床、培训和研究支持的一个意外优势是增加了克服资源分配中的行政和地理障碍的能力。这一优势增加了一个网络接触国内外微信群成员的机会，极大地扩大了共享资源的范围。
重新利用现有社交媒体应用程序的有机的、自下而上方法成本低且效率高，可以及时实施以改善患者护理。微信的国际用户基础使医务人员能够跨越地理、行政和经济障碍接入广泛的专业网络，有可能减少低资源环境中的健康差距。
