A Resident-Led Innovation in Communication: Introducing WhatsApp Communities in a Large Internal Medicine Residency Program

TL;DR

This paper introduces WhatsApp Communities as a free and effective communication tool for a large internal medicine residency program, improving organization and reducing unnecessary messages.

Contribution

The study demonstrates the successful implementation of WhatsApp Communities in a residency program, reducing undifferentiated notifications and improving communication.

Findings

Residents showed high satisfaction with the organization, timeliness, and informativeness of WhatsApp Communities.

Undifferentiated patient-care notifications were reduced by 97% using the new platform.

A CMR-led intervention significantly reduced inappropriate sharing of patient health information.

Abstract

Introduction

Effective communication is critical in healthcare. Despite the availability of secure messaging applications, widespread adoption has lagged due to costs and clinician preferences. WhatsApp is a popular free messaging platform that is frequently used in healthcare settings, although its use raises concerns regarding the safety of patient health information. In recent years, WhatsApp has launched a feature called WhatsApp Communities (WAC), which allows for structured communication in large groups. We identified this as a valuable tool to improve communication and collaboration in our internal medicine residency program.

Methods

At the start of the new academic year, we transitioned from a single WhatsApp group chat to a WAC platform with multiple sub-group chats. After six months, we surveyed residents using a five-point Likert scale to assess satisfaction with the new platform. We also defined and measured instances of "undifferentiated patient-care notifications" (messages sent to all residents but only truly intended for a specific cohort of residents) and compared how often they occurred in the legacy single chat versus the new WAC platform. Finally, we implemented an intervention to eliminate inappropriate sharing of protected patient health information on the platform.

Results

Approximately half (57 (47.5%)) of all residents completed the survey. Satisfaction was high: 48 (84%) were satisfied with the new platform’s organization, 49 (87.5%) with its timeliness, and 54 (95%) with its ability to keep them informed. Thirty-four (92%) residents who had used the prior single group chat preferred the newer platform. "Undifferentiated patient-care notifications" were reduced by 97% (from 204 instances to six). A chief medical resident (CMR)-led intervention yielded a statistically significant decline in the inappropriate sharing of patients’ protected health information (PHI).

Conclusion

WAC significantly improves communication in a large internal medicine residency program. It is an effective, zero-cost communication platform, which makes it especially attractive to programs with limited resources. The sharing of PHI remains a concern but can be effectively addressed through targeted orientation and moderation by CMRs.

Figures