# Instagram and WhatApp in Health and Healthcare: An Overview
## 1 Introduction  
The rise of smartphones, tablets and mobile apps is an important development in health and healthcare, particularly social apps that provide learning and collaboration opportunities to busy health professionals and peer-to-peer support and health education for the general public [1; 2]. Effective use of smartphones is part of how doctors and patients communicate in the 21 st century. The latest social media trends point to social networking services and mobile tools, such as Instagram [3] and WhatApp [4], as a viable medium for sharing and discussing clinical cases and medical and health knowledge.  
In 2006 and 2007, the first and third authors published two highly accessed and cited reviews of social media applications in health and healthcare [5; 6]. Since then, a growing number of social media and networking services have been introduced and have grown popular in the health and healthcare arena, joining the more established and older services in the social media toolbox, such as Facebook, Twitter and LinkedIn. This paper focuses on two social media and networking services that were launched in 2010, namely Instagram, a photo- and video-sharing service, and WhatsApp, an instant messaging client. Both services are currently (as of April 2016) subsidiaries of Facebook, Inc., California, USA. The article examines the available research evidence and reports into their uses in health and healthcare and the main issues that are involved in such applications.  
Photo-sharing and messaging apps are part of the mobile revolution. They change how text, audio and visual information are shared and communicated within social networks. In medicine, Instagram and WhatsApp are finding a niche among health professionals that use hospital-specific and dedicated accounts and groups on these platforms to communicate and encourage social and mobile forms of learning.  
Instagram and WhatsApp are free and easy-to-use apps that facilitate all sorts of clinical and non-clinical exchanges, and can also support mobile learning. WhatsApp user base reached one billionin February 2016 [7], while Instagram's monthly active user base is expected to reach 520 million by the end of 2016 [8]. Facebook (the parent company) is currently exploring business models to monetize the two services [8], learning from the successful and innovative revenue generation models implemented by WeChat [9], WhatsApp's direct Chinese competitor (e.g., ordering a taxi or paying for goods and services directly from the platform).  
Instagram is available as an app for the Android and iOS platforms [3], but can also be accessed from any Web browser on desktop PCs and notebooks, thanks to its Web-based user timelines functionality, e.g., the Instagram timeline of the US CDC (Centers for Disease Control and Prevention [10] and Figure 1).  
Figure 1: The US CDC (Centers for Disease Control and Prevention) timeline on Instagram, as captured on 15 April 2016 [10].  
Instagram users can easily share photos and videos with text captions and hashtags on their timelines. Timeline visitors and followers can 'like' or comment on timeline posts. Instagram Direct lets users send private messages to single contacts or groups.  
With WhatsApp, users can send text messages, and share video and voice messages and images over the Internet to their personal and professional learning networks. WhatsApp's Group Chat feature lets users chat and share content with up to 256 people at once. WhatsApp's Broadcast Lists are saved lists of message recipients that a user can repeatedly send broadcast messages to without having to select them each time. Available for the Android, iOS and Windows Phone platforms [4], the app is tied to the user's cellular mobile number, but can also be accessed from any Web browser on desktop PCs and notebooks (Figure 2), once an account has been created via the app on the user's smartphone. The service has recently implemented end-to-end encryption to protect user privacy [11], making it even better suited to clinical applications.