WhatsApp-Based Record-Keeping System in a Private Neurosurgical Clinic Chain

Abstract

Background The demanding nature of neurosurgical practice requires a reliable system for documentation and record-keeping. The cost of electronic health record systems can limit their availability in low- and middle-income countries. That is why less expensive and easily accessible technological alternatives should be sought. In this article, we describe our adopted system for medical record-keeping based on WhatsApp (Meta Platforms, Inc., Menlo Park, CA). Methods In our chain of six clinics, each clinic has its record-keeping WhatsApp group dedicated to sharing medical data of outpatients following up in that specific clinic and of inpatients cared for in hospitals in its area. After each encounter, our surgeons share smartphone-captured pictures of their patients' medical data on the WhatsApp group of the related clinic. The medical data are then categorized and stored by the secretary on the clinic's computer to be accessed at any time for record retrieval. Discussion Our five years of experience with the WhatsApp-based record-keeping system with medical records of 11,729 patients proved to be reliable, cost-effective, user-friendly, and efficient, and it positively impacted patient care. Responsible behavior, security precautions, and regulating policies are essential to protect patient confidentiality. Conclusion Our system can be an inexpensive alternative to the electronic health record system in small healthcare facilities. It can help physicians practicing in low- and middle-income countries to improve medical records documentation, thereby improving patient care. There is a need for policies to regulate the use of instant messaging applications in professional medical communication.

Keywords: documentation; electronic health record system; neurosurgery; record-keeping; whatsapp.

Figure 1. An illustrative example of medical data shared on a record-keeping WhatsApp group.

A brain CT shared to "Irbid clinic records" WhatsApp group. The picture was captured by the treating surgeon, who evaluated the patient and examined the CT on the picture archiving and communication system (PACS). A message with the patient's name and the encounter's type and date is sent to the group to help in the later categorization of the medical records. Note WhatsApp's disclaimer, "Messages and calls are end-to-end encrypted. No one outside of this chat, not even WhatsApp, can read or listen to them." Yousef Odeibat is one of the authors of this article, and his name is used for illustrative purposes. Brain CT reproduced from File:001 Arteriovenous Malformation CT axial 01.png - Wikimedia Commons. Accessed: April 7, 2023.

Figure 2. An illustrative example of categorization and storage of medical data on the clinic’s computer.

Using the WhatsApp desktop application, the shared pictures of medical data are downloaded, categorized, and stored in a folder with the patient’s name “Yousef Odeibat” and a subfolder of the encounter’s type and date “Admission 1-4-2023.” Note that this patient has a previous encounter in the clinic; medical data from that encounter can be found in the subfolder “Clinic visit 25-2-2023.” Medical data are categorized in a hierarchical structure of nested folders and subfolders. Yousef Odeibat is one of the authors of this article, and his name is used for illustrative purposes. Brain CT reproduced from File:001 Arteriovenous Malformation CT axial 01.png - Wikimedia Commons. Accessed: April 7, 2023.

Figure 3. Flowchart of the WhatsApp-based record-keeping system.