Opinion of Patients and Healthcare Professionals on the Value of Integrating Emojis into Healthcare Communication
Authors: Dahlström Ester , Noyes Essex Margaret , Blakeman Karin Hygge , Weibull Caroline 
Published: January 2024

Introduction: Ability to discuss emotions can significantly strengthen the patient–Health Care Professional (HCP) relationship and improve outcomes. Communication barriers impede this relationship and limit the ability of HCPs to provide patient-centered care. Emojis are a universal language that has the potential to overcome these issues and are particularly suited for describing emotions.
Aim: This 3-phase feasibility study aimed to collate current opinions around the utility of emojis in patient–HCP communication.
Methods: In phase 1, a survey was conducted between September and October 2021 among members of the War On Cancer digital platform community (patients, friends, family, and others interested in the study) to determine how they used emojis in their personal and healthcare communications. In phase 2 (February 2022), selected patients were individually interviewed via zoom (9 questions; 30–60 minutes) to evaluate their current use of emojis in text-based communications, situations where emojis might and might not help them express themselves to HCPs, and emotions represented by different emojis. In phase 3 (February 2022), invited HCPs were individually interviewed face-to-face or via Zoom (6 open-ended questions; 30–45 minutes) to evaluate their current use of digital communications and emojis with patients, insights on the findings from phases 1 and 2, and overall thoughts on using emojis in patient communications.
Results: The phase 1 survey had 290 respondents aged 15–84 years from 22 countries. The majority used emojis to express emotions in personal conversations and were positive about using them in HCP communications. In phase 2, 8 patients aged 30–70 years from the UK, US, and Sweden were interviewed. All used emojis in personal communications and a minority had used emojis to communicate with their HCP. Most interpreted emojis similarly, yet participants had varying views on when and how they should be used with HCPs, mainly because of the potential ambiguous interpretation. Some noted a lack of healthcare–adapted emojis. Participants identified 4 situations where emojis could be useful in HCP communication: emotional preparation before a visit, follow-up after a visit, situations with a language barrier, and to replace numeric scales for strength of emotion. Emojis were considered less useful as a substitute for face-to-face meetings, in serious situations, and when expressing serious emotions. In phase 3, 5 HCP volunteers (2 clinicians, 3 nurses) aged 30–45 years from the US and Sweden were interviewed. All communicated digitally with patients through electronic medical records or other platforms, sometimes only one-way (HCP to patient). No HCPs had used emojis directly with patients, noting that some platforms prohibit it. HCPs agreed with the scenarios identified in phase 2, further suggesting emojis may be most helpful for patients with poor literacy or who have difficulty expressing emotions.
Conclusions: The findings of this survey and interviews demonstrated that both patients and HCPs recognize potential advantages in using emojis within healthcare conversations. Further research is required to determine the optimal settings in which emojis can be used to improve communications between patients and HCPs, and the associated clinical value.