Doctors and nurses using smartphones in hospitals raises data risks

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Doctors and nurses in the UK are routinely using their own smartphones – including apps and messaging systems – for patient care, according to a new survey of frontline staff.

Published in the online journal BMJ Innovations, the survey found doctors and nurses were most commonly using their smartphones to communicate with colleagues, but many had also sent patient data via their device.

The researchers behind the survey raised concerns that this practice could lead to highly sensitive and confidential data being disclosed - currently a major concern as the NHS moves towards electronic patient records and greater reliance on digital technology.

As the use of smartphones is so engrained in everyone's daily life, the researchers have not suggested that smartphone use by healthcare professionals be banned, but do suggest that data encryption and active strategy to protect digital security are needed in healthcare providers.

More than 6,000 clinical staff at five different hospitals of varying sizes in London were asked to complete a questionnaire about the use of portable devices and mobile health apps in the workplace.

The results are based on the responses of 287 doctors and 564 nurses from different specialities.

Virtually all the doctors (99 per cent) owned a smartphone, and almost three out of four (73.5 per cent) said they owned a tablet device. The equivalent figures for nurses were 95 per cent and just under 65 per cent, respectively.

When asked about the usefulness of smartphones for carrying out clinical duties, more than 92 per cent of doctors and over half (53 per cent) of the nurses stated these were 'very useful' or 'useful'.

Most (94 per cent) of the doctors used their smartphones while at work to communicate with their colleagues, compared with under a third of nurses (28.5 per cent). Half of the doctors used their smartphone instead of a traditional bleep.

Almost eight out of 10 of the doctors (78 per cent) and just over a third of nurses (35 per cent) had downloaded a medical app to their device, with almost 90 per cent of the doctors and two thirds of nurses saying that they used these apps as part of their clinical work.

One in three of the doctors who owned an app used them daily, compared with around one in five (22 per cent) nurses. The apps included drug formularies, medical calculators, and those for disease diagnosis and treatment, reference and education, documentation and drug preparation.

When asked if they had ever sent patient data over their smartphones using SMS (short message script), app-based messaging, such as WhatsApp, and picture messaging using their smartphone camera, many respondents said they had.

Almost two thirds of the doctors had used SMS (65 per cent); a third had used app-based messaging; and almost half (46 per cent) had used their phone's camera and picture messaging to send a photo of a wound or X-ray to a colleague.

The corresponding figures for nurses were much lower – around 14 per cent, 6 per cent and 7.5 per cent, respectively.

Doctors were significantly more likely to send clinical patient data using all these methods. Perhaps of greatest concern was that 27.5 per cent of the doctors believed they still retained clinical information on their smartphones.

A substantial proportion of respondents wanted to be able to use their own devices at work. And many (70 per cent) of the doctors and over a third (37 per cent) of nurses wanted a secure means of sending patient data to colleagues using their own smartphone.

Fully secure messaging services for smartphones are not yet available in the UK, added to which the data are unlikely to be encrypted, say the researchers. They urge NHS organisations to make sure their staff understand the potential risks of sharing patient information via their unsecured smartphones.

"The results provide strong evidence that healthcare organisations need to develop policies to support the safe and secure use of digital technologies in the workplace and that strategies are needed to secure further innovations in digital health," the researchers concluded.

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Linda Banks

8 October, 2015