Doctors find a cure for dangerous miscommunication through secure app

● Going to a state hospital in SA can be daunting — not only do patients have to contend with long queues but the ability of their doctors to access health records and communicate adds to the challenges faced by patients.

At Charlotte Maxeke Johannesburg Academic Hospital, however, poor communication and lost or unfiled patient information are becoming a thing of the past.

For the past four years orthopaedic surgeons at the hospital have been using Signapps, a mobile messaging platform that enables doctors to communicate with each other regarding patients and procedures.

Lipalo Mokete, a consultant surgeon at the orthopaedic surgery unit at Charlotte Maxeke, said he was initially approached by a junior doctor who told him they could make processes more efficient and communicate better in the hospital by using WhatsApp.

“I was sceptical at the time, so I thought OK, there are medical, legal and ethical issues but let’s give it a bash,” said Mokete.

It soon became clear that they had to find a secure platform that complied with regulations.

“We really felt very quickly that our patients were getting the best care. But we always felt uncomfortable that we were using WhatsApp,” said Jurek Pietrzak, an orthopaedic surgeon at the hospital.

Pietrzak explained that constant communication in the team is important due to the complexity of the procedures they perform, which requires them to keep a close eye on their patients.

When Pietrzak’s friend sent him a picture of his son’s elbow, saying he had hurt it when he fell but was quickly discharged, Pietrzak realised that, instead, the boy needed surgery to have pins inserted.

A conversation after the surgery about the challenges of secure communication between doctors led to Pietrzak’s friend introducing him to Andrew Davies, the former COO of now defunct chat app Mixit, which at its height had about 10-million users.

“We were approached by [Mokete and Pietrzak] who work at Charlotte Maxeke [as] orthopaedic surgeons,” said Davies, who is now the CEO of Healthcent, a health-tech company. “And they had started to use WhatsApp to coordinate the care of patients and it solved a very fundamental problem for them.”

Fast forward to 2019 and the app is being used in 25 private hospitals and five private practices.

In the public sector, it is used by doctors in Edendale Hospital in KwaZulu-Natal, the Red Cross Children’s Hospital in Cape Town and also at Chris Hani Baragwanath Hospital in Johannesburg.

Through the app, doctors are able to share information on patient cases, seek advice on procedures and devices quickly, carry out patient handovers and keep patient records.

Up-to-date patient records have become especially important in the face of the growing number of medico-legal cases the government is facing.

“With us, communication is paramount; if you get communication wrong, you are going to mismanage patients, you are going to get medico-legal issues,” said Mokete.

Pietrzak said research had shown that 60% of all medico-legal problems were down to miscommunication.

In SA, the department of health has seen a surge in medical negligence claims, which reportedly increased from R28.61bn in 2014/2015 to R80.4bn in 2017/2018.

Mokete and Pietrzak said doctors can only sign into the app using their Health Professions Council of SA registration numbers. A doctor who is using the app has to vouch for newcomers and invite them, in order for them to gain access to the app.

The information the doctors share on the app is not stored on the phone, and is instead stored on Signapps, which also enables the doctors to take pictures, which are also stored directly on the app.

If their phones get stolen or lost, doctors can remotely access the app through a computer and delete it from there.

People who are not medical practitioners cannot be part of any of the groups on the app.

We really felt very quickly that our patients were getting the best care Jurek Pietrzak Orthopaedic surgeon