Delivering emoji/icon-based universal health education messages through smartphones

Health information technology (HIT) refers to the comprehensive management of health information across computerized systems and its secure exchange between patients, health care providers, government, and others [1],[2]. A broad and consistent use of HIT can potentially improve the quality of primary health care, reduce medical errors, reduce basic health care costs, decrease paperwork, increase administrative efficiency, and expand access to affordable care. The World Health Organization has identified HIT as a tool with which to address health problems and transform quality of life [3]. India is a hub of IT-enabled service industries. Despite this tremendous potential, there is limited use of HIT in the public health sector as compared with other sectors such as banking, railway, tourism, and entertainment, which have embraced IT on a considerable scale [1]. According to the technology acceptance model [4], the speed of acceptance and dissemination of a particular technology depends primarily on its perceived usefulness and ease of use (Figure 1). England et al. [5] conducted a study which revealed that the complexity of health care organizations and their fragmented internal structure constrained their ability to adopt organization-wide IT. The authors concluded that both organizational and technological factors lead to the slow adoption of strategic IT. Open in a separate window Figure 1. Technology acceptance model [4]. Another important contributing factor to the limited use of IT in health care is the comparatively less revenue generation in the public health sector. For most governments, primary health care is an investment with no immediate return though there are obvious long-term benefits. Such myopic perception at the policy level may function as a barrier to the adoption of any technology [6]. Other reasons of low use of technology in health sector include language barriers, use of outdated technology, and lackluster appeal for the general public [1]. With use of the smart phones by general public increasing day by day, an important way of use of HIT is popularization of emojis, images, and icons are pictorial methods of expression as health-related communication. India is now considered a major mobile technology consumer [7], and communication through mobile phones is no longer limited to text messages. We communicate more with each other using emojis, images, and icons in chats or on social media. The inclination toward this pictorial mode of expression is quite natural. If we consider paleo-anthropology and the history of linguistic development, we can clearly see that Homo Sapiens have always used symbolic languages and wall paintings to communicate with each other (Figure 2). Even the earliest traces of language, dating back to the age of the caveman and woman, were also strikingly similar to icons, paintings, and symbols. These are still observed in tribal hamlets. The symbol/icon is thus a connecting link between our past and the present. Open in a separate window Figure 2. Similarity in symbolic communication earlier and now (Source-https://www.freepik.com/free-photos-vectors/design). Emojis, images, and icons help break the barriers of languages. Meanings of symbols are easily understood across the globe. Furthermore, images tend to have more appeal than text. As the saying indicates, “A picture speaks more than a thousand words. ” Interestingly, the written language (script) of some Asian countries (e.g., China, Korea, and Japan) are symbol-based. Apart from being linked with human emotions, Emojis, images, and icons can also be developed or tailor-made to appeal to the cultural norms prevalent in a society. One cannot ignore the strong influence of culture [6].