[Background: Since 2022 HIFA is supporting mHEALTH-INNOVATE, an international research consortium exploring how health workers use their personal mobile phones to support their work. HIFA is the main platform for sharing experience and expertise on this topic. Your inputs over the coming days and weeks are crucial and will feed into high-level policy discussions at WHO. See https://www.hifa.org/news/mhealth-innovate-exploring-healthcare-workers-... ]
Some of the healthcare workers in our secondary research (systematic review) were concerned about the legal implications of using their personal phones informally. For example, some wonder if they could be punished for offering advice to patients and colleagues through informal channels such as WhatsApp. One pharmacist in the UK asked the following question:
“[What if] someone answered and that was the wrong answer, but no one corrected you, and if something had gone wrong with […] the case, who would take the responsibility for that? Because officially you weren't on‐call on that day, you were just helping [….]” (Rathbone 2020, in Glenton 2024).
The above quote is not easy to interpret and I was unable to find it in the original source (Rathbone 2020). One interpretation is that the subject is asking a question to another health worker, who gives incorrect information leading to a negative health outcome. May I ask our systematic reviewers if this interpretation is correct, and did they come across other examples in the review? I would expect, for example, that breaches of patient confidentiality would be important.
One response to the use of WhatsApp (or email, or other written communication) is perhaps to say that the same 'rules' apply to written communication as they do to oral communication, with the additional point that written communications constitute a temporary or permanent record of the communication that is potentially verifiable in the case of an investigation. That said, WhatsApp uses end-to-end encryption which can prevent scrutiny by third parties - also you can configure WhatsApp to 'disappear' messages after 24 hours. This means that it is possible to have (for example) breaches of patient confidentiality that leave no written evidence.
I understand from the informal 12-page review https://zenodo.org/records/15011500 that concerns were expressed also by health workers in our primary research in Uganda, although I do not have further details. Please could our primary researchers add further information on this? According to our review, these concerns were not replicated by policymakers/managers, which is also interesting.
QUESTION: In your setting, do you or other healthcare workers have concerns about the legal implications of using personal mobile phones for work purposes? What is the nature of these concerns?
Many thanks, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org