Yesterday I read an article in the Guardian regarding Doctors using Snapchat to send patient scans to each other, which I thought was a controversial concept. The sourced report says NHS clinicians sending scans using photo messaging app is “clearly insecure, risky and non-auditable”.
The article also stated that a panel of health and tech experts has found, concluding the “digital revolution has largely bypassed the NHS” which I personally thought was a contradiction. You can read the whole article here: https://www.theguardian.com/technology/2017/jul/05/doctors-using-snapchat-to-send-patient-scans-to-each-other-panel-finds
I put this concept to three of our experts at Ideal Health to get their opinions and I think each have valid points to be considered:
Jill De Bene Delivery Manager:
The digital NHS is already here, more than 11 million people have signed up to patient on line and 1 million of these view their records every month. There are 1000’s of health apps in use which are improving the health interaction for both the patient and the clinical staff. More can be done but we do have to make sure health care is safe and I would want to see how we can guarantee that the doctor has the right scan for the right patient and also how secure is snap chat against a cyber attack?
At Ideal we are working with Trusts to expand their digital journeys and use of digital tools and equally important talking to patient groups (i.e. diabetes groups) about what they want from digital health to help them manage their health and wellbeing. So we do not agree the digital revolution has bypassed the NHS. There is lots to do but let’s remember the lessons of retail banking. 50 years ago the ATM revolutionised this sector but the banks continue to engage with its customers to see what is needed to provide a range of engagements which includes face to face and digital. Health needs to talk to patients and engage with clinicians to see what they think will really revolutionise the way we deliver health and respond in a safe and joined up way. IT has to be aligned to where the overall delivery of health and social care is going.
Tas Hind IM&T Consultant:
I think that the concept of using an instant messaging platform is an excellent idea as it enables quick access to the information that the doctors may need about the scans and saves time looking for a machine and logging onto it, finding the patient and so on. It also means that urgent requests can be sent to the person that needs to respond to it and be alerted via their phones. These are all valuable minutes in a doctor’s daily routine that can be saved and better spent caring for the patient.
However, there are drawbacks as there will be a need for the receiving device to have sufficient high level resolution to view the scans and make decisions that are clinically safe. It also means that the doctor is inundated by messages from various sources and how do you distinguish these from personal messages. I cannot imagine doctors walking around with multiple devices to receive information that is personal on one and professional on another. What happens if the doctor is on leave or off sick? How does the sender make sure that the information has reached the right clinician without delay? In addition patient data that is exchanged will need to be highly secure and we cannot afford it to be sent inadvertently to the wrong person or hacked into and get into the wrong hands.
Martin Bell – Independent Consultant
There have been a few articles in recent days about the sharing of patient information over ShapChat and Whatsapp and such like. Conversations about patients, medical details, images – and a view that at best these touch the boundaries of regulation, if not crossing them.
The challenge is to balance the effectiveness of the technology and its ease of use, with the rights of the patients not to have their data used in the wrong way and the NHS’s need to manage its systems and governance appropriately – but without holding back the enthusiasm of clinicians to use technology, which is at their fingertips.
A few thoughts for consideration:
- Is information shared patient identifiable?
- Do users know where this data might flow, in terms of the countries that data might end up in?
- Have they discussed usage with their CIO, CCIO or Medical/Nursing Director to get a steer?
- How is essential information recorded back into the patient record?
- How do users know that information shared on such apps has been removed by the app providers after use?
- Are there social media/app policies in place to cover such usage?
The clinicians concerned might also ask themselves:
- If it was my data, would I happy be happy?
- If my patient found out, would they be happy?
- If the CQC, ICO or other regulator found out, what might happen?
These are all important questions. However, there are constructive alternatives.
The features of Snapchat and Whatsapp are available through commercially provided, safe, UK housed applications that offer all the same features, but with the discreet protection of being “bounded” to a single organisation or community, and with all the necessary NHS data protections one would want.
NHS organisations can use these in a safe, cloud based way, or even implement them as local “on site” solutions.
Exploring the growth of these applications might be a way to achieve that balance that I mentioned earlier – without dampening enthusiasm – or putting patient information at risk.
I think the main thread from all of our experts is that Cyber Security is of prime importance! What are your thoughts?