Use of WhatsApp in Pediatric Surgery Division of General Surgery Department: Is it Worthwhile?

Sir,

Many of the Government Medical Institutes in India do not have a separate Pediatric Surgery Department. Hence, a pediatric surgeon, if appointed, works in the General Surgery Department. In case of a single pediatric surgeon, he/she may not be at call every day. In such a situation, the available option is the telephonic communication. The smartphone is a new technology that combines mobile communication and computation in a handheld-sized device.[1] We attempted to evaluate the role of WhatsApp multimedia service in the management of pediatric surgical patients in a center with single pediatric surgeon.

Any event, i.e., the need of requiring consultation for the management of pediatric surgical patient was uploaded on the WhatsApp group created for this study. It comprised all the consultants of the Surgery and Radiodiagnosis Department, along with the residents. Everyone perused the event; however, the advice regarding the diagnosis and management was given by the pediatric surgeon. It was supplemented with a telephonic communication to avoid any time lag.

The patients were evaluated by the pediatric surgeon on the next working day. During 20 months, there were 119 events requiring consultations. Of these, the pediatric surgeon had to go immediately in person for 17 times (14.28%). All the diagnoses made on the basis of the pictures were correct. The management as per the diagnosis and need was adequate.

Besides acute emergency, after the primary management by the residents, definitive management was done on the next working day.

WhatsApp Inc., was founded in 2009 by Brian Acton and developed by Jan Koum.[2] Electronic data transfer has seen various modifications over a period of 30 years. Taking clinical pictures and sending via personal computers have been evolved as pictures taken by smartphones and transferred to other smartphones.[34]

We observed that primary patient management appeared to be quick. The patients could be separated into emergency or elective type [Figure 1]. A general surgeon with limited exposure to pediatric surgery may not be able to diagnose specific conditions. The WhatsApp group may help them in such a situation.

Figure 1

(a) A 2-day-old neonate having a sacrococcygeal teratoma. This was not an acute emergency; hence, it was advised to attend outpatients’ clinic the next day. (b) Showing clinical picture and X-ray of 4-month-old patient having abdominal distension due to intestinal obstruction. The picture was taken on a LED view box. The immediate management for resuscitation was informed to the concerned residents. The patient was operated in the same night by pediatric surgeon

The use of smartphone in the clinical field has increased; however, the use of WhatsApp has been reported in only one study.[3] Moreover, there has been no study on the use of WhatsApp in the management of pediatric surgical patients. The literature ascribes certain benefits to it like the creation of user groups, easy image transmission, record archiving, and decreased the possibility of misinterpretation of the words such as 15 instead of 50.[5] The possible disadvantages may be poor 3G services, delivery report to the desired surgeon, costly smartphone, medicolegal implications, and patient's confidentiality.[5]

To us, the only disadvantages appear to be 3G services and medicolegal issues. Thus, the use of WhatsApp may be helpful in the management of the pediatric surgical patients, especially in pediatric surgery division or General Surgery Department. Further studies in this regard at other centers may substantiate our efforts.

FINANCIAL SUPPORT AND SPONSORSHIP

Nil.

CONFLICTS OF INTEREST

There are no conflicts of interest.