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. 2022 Jun 17;19(12):7462.
doi: 10.3390/ijerph19127462.

An Audit and Survey of Informal Use of Instant Messaging for Dermatology in District Hospitals in KwaZulu-Natal, South Africa

Christopher Morris  1 , Richard E Scott  1   2 , Maurice Mars  1   3
Affiliations

An Audit and Survey of Informal Use of Instant Messaging for Dermatology in District Hospitals in KwaZulu-Natal, South Africa

Christopher Morris et al. Int J Environ Res Public Health. .

Abstract

Background: In KwaZulu-Natal (KZ-N), South Africa, recent reports have indicated that spontaneous use of smartphones has occurred, providing access to specialist dermatological care to remote areas. This informal use has raised a number of practical, legal, regulatory, and ethical concerns.

Aim: To assess the nature and content of WhatsApp messages sent to dermatologists, to determine the referring doctors' reasons for, and satisfaction with, their interactions, as well as their knowledge of legal, regulatory, and ethical requirements.

Methods: A retrospective study of WhatsApp messages between referring doctors and dermatologists, as well as a cross-sectional survey of doctors working at district hospitals in KZ-N who used IM for teledermatology.

Results: Use of IM (primarily WhatsApp) for teledermatology was almost universal, but often not considered 'telemedicine'. Few referring doctors were aware of South Africa's ethical guidelines and their requirements, and few of those who did followed them, e.g., the stipulated and onerous consent process and existing privacy and security legislations. No secure methods for record keeping or data storage of WhatsApp content were used. A desire to formalize the service existed.

Conclusions: Based upon these findings, it was proposed that a number of described steps be followed in order to formalize the use of IM for teledermatology.

Keywords: HPCSA; WhatsApp; guidelines; instant messaging; legal; regulatory and ethical concerns; teledermatology.

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Conflict of interest statement

The authors declared no potential conflict of interest with respect to the research, authorship, and/or publication of this article.

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