On March 12, CommonTime published the results of an independent, 6 week research project into the use of consumer instant messaging (IM) apps in the NHS. In a 22 page report, Instant Messaging in the NHS: An exploration of the relationship between consumer messaging applications and modern healthcare delivery, CommonTime revealed a shocking disparity between the needs of frontline staff and expected practice.

Specifically, the report highlighted that the widespread adoption of instant messaging apps to supplement official communication channels is, in many ways, a sign that NHS staff themselves are being driven to innovate faster than the Trusts they represent. However, it was also noted that as this behaviour continues to grow year-on-year (driven primarily by new entrants to the workforce), so too does the risk from accidental or malicious misuse.

From the sample of 800 NHS staff across all major Trust types and divisions, research participants were able to recall instances of colleagues; accidentally sending patient information to non-clinical staff, sharing ‘pertinent’ patient details on social media and sending patient photos to others for ‘entertainment purposes’. So common, in fact, are issues pertaining to instant messaging that the research found 1 in 50 NHS staff have been disciplined for their use of IM at work.

Ultimately, the report concluded that NHS Trusts face a stark, uncomfortable choice – maintain a fragile norm until a catalyst for widespread adoption or rejection of instant messaging is found, or provide staff with the technologies they need in order to deliver the high standards of care expected of them.

Media Reaction and Opinion

In a roundup of global health tech news, Business Insider linked these findings to a McAfee report which stated regular NHS data breaches could be attributed to a lack of compliance & best practices.

Meanwhile, the British Journal of Healthcare Computing, InfoSecurity Magazine & National Health Executive among others focused on the numerous security and patient confidentiality concerns that sharing sensitive data in this way leads to. An article published in Nursing Standard included a response to the report’s claims from RCN ehealth lead Ross Scrivener, who reminded nurses risk their registration if they share confidential information inappropriately or post pictures of patients without their consent.

In Ireland, The Medical Independent built upon the research, discussing the organic growth of instant messaging apps in healthcare environments and how regulators are playing catchup to common practice. The article also reported that the Health & Safety Executive will soon be going to tender for a secure, compliant solution that can be used as a consumer IM replacement.

Elsewhere, comments from leaders in digital healthcare had a common theme – the need for interoperability & integration into electronic patient records in alternatives before widespread adoption could take place.

Rowan Pritchard-Jones, Chief Clinical Information Officer of St Helens and Knowsley Teaching Hospitals NHS Trust said, “For me, the ability to prioritise tasks with the detail of IM is helpful to clinical staff and therefore a driver for use above pagers. The drawback remains that such detail of care never makes it into the patient record. Increasing numbers of EPR vendors are creating solutions to support secure messaging as well as recording these tasks in the patient record. It will be critical that Trusts ensure their infrastructure can support mobile devices working in this sophisticated way.”

Martin Wilson, Trust Clinical Lead for IT at The Walton Centre Foundation Trust stated, “The obvious gap in using a proprietary IM app is the IG concern, but also the inability to integrate with other clinical systems / EPR. Personally I would also like to see such an app developed in partnership with the NHS, preferably on an open source model, to allow standardisation and wider NHS sharing.”

To address the issues highlighted by this research, health tech media and digital leaders, CommonTime are developing a healthcare-oriented instant messaging solution with full EPR integration capabilities, as well as support for custom workflows, bots and pager alerts. Read more about Clinical Messaging here.

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