Chris Netherton, M.D.

The role for instant messaging apps in acute care


NHS England has issued its first set of guidelines for the use of instant messaging apps during emergencies. This is a very positive move which will help to improve patient care.

I am sure that this initiative by the NHS will be warmly welcomed by clinicians and staff in our hospitals. It recently emerged that nearly half of all NHS staff were regularly using these apps in order to carry out their day to day work, but that the majority of trusts did not have any policy in place to govern their use.

This new guidance gives clarity to our medical professionals and allows them to use their professional judgment to make safe and effective use of this technology in a way that benefits patients. It recognises that patient safety is enhanced when medical staff have the ability to communicate patient information quickly between teams.

The value of messaging apps has already been proved ‘in the field’. They have been a huge help in dealing with large-scale emergency situations, such as the terrorist attacks in London and Manchester, as well as the Croydon tram crash. During the Grenfell Tower fire, a major incident messaging group was set up to coordinate the response of the team at Imperial College Healthcare NHS Trust.

Messaging apps also played an important role when the NHS was hit by the WannaCry virus. When NHS staff found they were locked out of their computers, they used apps to communicate with each other and help cope with the crisis.

The new guidance recognises the need for this type of software but does not endorse any specific tool. It states that standalone apps such as WhatsApp should only be used when the local NHS organisation doesn’t provide a suitable alternative.

The guidance includes clear instructions for the protection of patient confidentiality. Staff can only use messaging tools and apps that meet the NHS encryption standard and have user verification and password protection. Message notifications on the device’s lock screen must be disabled. Staff must not allow anyone else to use their device and they must be able to remotely wipe any messages, should their device be stolen or lost.

The guidance also stresses the prime importance of the medical record. It is vital that these are fully maintained and comprehensive. Therefore, any clinical advice that is received by a messaging app should be transcribed and attributed in the medical record as soon as possible and then the original messaging notes should be deleted. This procedure will help ensure that no important information is left on anyone’s device.

I think it is a real step forward that our medical staff have now been empowered to use this new technology and that clinicians have scope to use their initiative on how it can best be applied. At Microtest, through our work on patient record software, we have seen the impact that fast and secure sharing of critical information has on patient care, so we can appreciate the value of this initiative.

It is for this reason that Microtest is so committed to improving the interoperability of systems, so that clinical software systems used across different parts of the NHS can ‘talk to each other’ and streamline patient care. For years we have been at the forefront of developments in interoperability. Microtest was the first IT supplier to sign up to GP Connect and the first to develop, design and deliver a purpose-built GP Connect solution. Our new clinical system, Open Evolution, has been designed to take full advantage of the new era of interoperability. As well as being the most advanced clinical system, it will provide for business continuity during communications failure and deliver full mobile use of key system features.

Our goal is to help medical professionals in the NHS achieve more with their time and deliver improved, integrated patient care through the application of new technology. We are constantly looking at ways in which we can improve the ‘toolkit’ they can use to do their job.

For doctors and emergency care services, the use of messaging apps is a very welcome addition to that toolkit.