Medicine and Messages – The Hindu


During COVID, WhatsApp revolutionized healthcare delivery when lockdown and travel restrictions were in place

As I walked into the patient’s exam booth, I noticed him hastily taking a picture of his x-ray in his smartphone. The x-ray was hanging upside down and I instinctively corrected it and asked her to take a picture. The gentleman shyly took a picture and said, “My sister’s son is a medical student and I wanted to show him my x-ray.”

Lately, each medical record is photographed by patients on their smartphones as it serves as a ready repository and calculator. As I was asking a patient about his background, he would pull out his smartphone, proudly open his gallery and scroll up and down the thousands of images a few times and show some of his previous doctor visits. Apart from being stored, the images are also sent via WhatsApp to family members and friends. Among the many recent technological advancements of the past decade, WhatsApp would stand out as a creator of disruptive innovations. It has permeated every part of our lives. I notice that it has brought about significant changes in the way health care is practiced and delivered.

Since time immemorial, it has been common for patients to miss their old prescriptions and previous exams when they come in for an exam. They let out a sheepish smile, scolded their partners or pretended to ignore such prescriptions. Some patients tried to remember medications based on their size and shape (“a big yellow pill and another small round white pill, doctor”). With the advent of WhatsApp, we can now easily retrieve reports, either from the patient’s phone gallery or from someone at home clicking on an image and sending it on the spot.

For surgical patients, assessing a surgical wound requires a keen eye and sound judgment. Previously, patients would panic if there was swelling or slight drainage from the wound and would come to the clinic even at odd hours. It was a strain on the health system as well as undue stress on family members. Now, via WhatsApp, in doubtful cases, patients send photos of the wound from several angles and sometimes a video, which facilitates decision-making. In a huge country like ours, this has been a boon for enabling health care to reach even the most remote villages.

During the COVID pandemic, WhatsApp revolutionized healthcare delivery when lockdowns and travel restrictions were in place. Patients from faraway towns and villages consulted doctors through this app. Assessment of the urgency of a clinical situation could be made via WhatsApp and immediate treatment initiated. Patients who needed long-term prescriptions received new ones without having to leave their shelter. Follow-up X-rays to assess recovery from the disease and regular blood tests for long-standing kidney, heart and liver disease were carried out at nearby labs and reports were checked by their usual specialists elsewhere via WhatsApp. This allowed continuity of health care without allowing disease or COVID to steal someone’s health.

Communication between members of the healthcare team has also improved considerably after the advent of WhatsApp. The team’s decision-maker cannot be ubiquitous, and x-rays and scanned images, blood investigation reports, patient wound status, and changes in vital signs can be sent to team members. team for immediate assessment and decision. This increases the efficiency levels of junior members and helps them spend their time on other productive work instead of waiting to discuss the situation in person with senior doctors. For senior consultants too, fast and effective communication allows them to sort and plan management. The collective wisdom of team members is also sought as these situations are discussed in a WhatsApp group which ensures the best possible treatment for a patient. Previously, a face-to-face multi-disciplinary team meeting was held once a month and now via WhatsApp this happens effectively anytime, anywhere with a click of a button.

It often happens that colleagues from the same specialty share images of a complex medical situation to plan a surgical treatment. It can be a doctor from a small village discussing the situation with a specialist in a subway. Through WhatsApp, the complete history, clinical images and x-rays can be shared and discussed, through which a safe treatment plan can be drawn for the patient. The need for patients to travel long distances to seek specialist medical advice is therefore diminishing. It is also a common situation where non-physician friends, relatives and medical colleagues from other specialties comfortably share their images via WhatsApp seeking our advice to ensure that the treatment they have been advised is proceeding as expected. .

Like any other technical innovation, the free use of WhatsApp in medical practice has its pitfalls. Patient anonymity is lost in the senseless transfer of images between groups. This leads to a violation of the patient’s privacy regarding his health issues. We’ve seen pictures of celebrities with their fans during the pandemic, and I don’t know if they were aware of it. Second, doctors’ prescriptions, opinions, X-rays and other reports are shared via WhatsApp for opinions, judgments and mockery. Since medical science is not exact and no doctor is perfect, this throws further strain on the already stalled doctor-patient relationship. Third, despite rapid progress in medical innovations, the practice of medical science remains an art with complex human relationships and emotional attachments. Too much reliance on images and messages alone cannot replace the direct doctor-patient encounter and personalized care. Often the reports do not fully reflect the actual physical condition of the patient.

Despite these minor quibbles, WhatsApp has completely transformed the way we deliver and practice healthcare over the past few years. I hope this will improve further by leaps and bounds in the years to come, leading to effective, ethical and empathetic care for people.

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