Mobile Devices and Messaging Apps in Radiology On the Rise
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Sharing diagnostic images on messaging apps raises privacy and security issues.
We use mobile devices and messaging apps to share our locations, photos of our family, and travel updates. So why not diagnostic images? Common messaging apps like WhatsApp are incorporated almost routinely into the radiology workflow in the United Kingdom, Netherlands, and Germany, according to Dr. Erik R. Ranschaert, Mol/BE of University Hospitals Leuven, Belgium. And this increasing transmission of medical reports and images via smart phones and tablets is raising security and ethical issues, he explained in a presentation at ECR 2018.
Medical images on mainstream apps
Dr. Ranschaert cited a study at the University Hospital Limerick (UHL) in Ireland in 2017 that “found that 100% of respondents have a WhatsApp account and that 100% have an active ‘group chat’ used for clinical medicine at UHL.” (1)
Radiologists, physicians, and other healthcare providers are attracted to the app for the same reason we use it for social: the ease of transmission of text, images, and videos; and group chat. But instead of sending a video of their child playing football, some radiologists and physicians are using WhatsApp to send a radiograph of a patient to another healthcare provider for their opinion. Sometimes, the advice is needed to inform a diagnosis or treatment in an acute setting. “What’s more important in an emergency situation?” Dr. Ranschaert asked the audience. “The patient’s well being or privacy?”
WhatsApp isn’t the only consumer service being used. A report prepared by Google-owned Deep Mind reported that UK physicians are “using ordinary apps like Snapchat to share medical photos of their patients.” (2) And let’s not forget about Twitter. A popular hashtag for interventional radiology is #IRAD. Post a medical image and a question with that hashtag and you are likely to receive numerous responses.
Why the quick adoption of messaging services by radiologists and physicians? Because they are intuitive and efficient. Among the benefits cited by Dr. Ranschaert are: quick communication and decision making, less experienced team members can seek help when they need it, and the ability to collaborate with peers. The benefits are hard to dispute.
Security and ethical issues of mobile device technology
Yet of course there are concerns. The feedback you are receiving on your #IRAD post might be from someone with no medical education. And possibly you are transmitting personally identifiable information (PIA) about the patient along with the image of their lung. Also, the data remains stored on your mobile device, opening the door for others to access the data.
The Deep Mind report stated, “They (clinicians) may use Snapchat to send scans from one clinician to another or camera apps to record particular details of patient information in a convenient format. It is difficult to criticise these individuals, given that this makes their job possible. However, this is clearly an insecure, risky, and nonauditable way of operating, and cannot continue.”
The study at UHL in Ireland found “a total of 97% of surveyed doctors routinely send sensitive patient information on instant messenger without acquiring patient consent.”
Asking radiologists, physicians, and other healthcare providers to abandon the benefits of the apps is not an option, said Dr. Ranschaert. What’s needed instead are secure services that replicate the ease and functionality of messaging services like What’s App. He gave several examples including Kanta, Tiger Text, and Siilo. For example, only registered healthcare providers can use Siilo which has 50,000 users. It provides end to end encryption of data and deletes it after a set time.
Regulators also are taking note, issuing guidelines – and some blockades – on messaging services. The NHS says WhatsApp should never be used for sending information in a professional healthcare environment. Similarly, Dutch legislation says WhatsApp does not meet their medical standard.
Meeting regulatory guidelines is, of course, required. But Dr. Ranschaert also reminded attendees that it is ultimately “the responsibility of the radiologist to securely use mobile devices in the best interest of the patient.”
What is your opinion about using messaging apps for sharing clinical data? Does your facility have a policy in place? We’d love to hear about it. Contact me at firstname.lastname@example.org or on WhatsApp!
#mobile #radiology #ECR2018
Katie Kilfoyle Remis is the Digital Media Manager at Carestream Health.
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