Concerns about use of WhatsApp for sharing preanesthesia evaluation form among anesthesiologists.

Sir,

First and foremost, I applaud the team on this novel use of WhatsApp for sharing preanesthesia evaluation form among anesthesiologists.[1] In many institutes, it is a common practice where the preanesthesia checkup (PAC) is conducted in the preoperative assessment clinics, where the anesthesiologists are usually posted by rotation. In this scenario, it is quite common that the anesthesiologist clearing the patient for surgery and the anesthesiologist anesthetizing the patient may be different as pointed out by the authors. Some of the points that I wish to point out with regard to this are as follows:

Many government and corporate hospitals, catering to various surgical disciplines, have large anesthesia department. The surgical patient load in these hospitals may also be large. Some of the patients may have similar sounding names. In this scenario, there may be confusion if all the PACs are put up in the same group in WhatsApp. What I suggest, if I may, is that smaller groups be made on WhatsApp according to the different surgical disciplines and these PACs may be forwarded accordingly. Furthermore, it cannot replace the final evaluation of the patient just before anesthetizing the patient[2]

The patients who may be seen and cleared in the preoperative assessment clinics may also not come up for surgery immediately. Generally, an anesthesia visit 1 day before surgery is advisable even if the patient has been examined previously. This helps us to evaluate any new symptom or sign as also take the opportunity to allay patient anxiety. Forwarding the PACs from this preoperative visit may serve better than from when the patient has been cleared previously

One last concern that comes to mind is the maintenance of confidentiality and patient privacy. Generally, the PACs and perioperative records are scanned and kept in the medical records section or hospital data management systems. However, forwarding these on WhatsApp may breach the right to confidentiality accorded to the patient and may make the anesthesiologist liable to litigation.[3]

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Conflicts of interest

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