# Instagram and WhatApp in Health and Healthcare: An Overview
## 3 WhatsApp  
A number of studies have examined the usefulness of WhatsApp in clinical decision-making and patient care. [PERSON] et al. [27] tested WhatsApp to verify if it facilitates communication, enhances learning, and improves patient care (and maintains privacy). They conducted focus groups of surgeons over the periods from March 2013 to July 2015 and September 2014 to July 2015 through a 'WhatsApp Surgery Group'. Patients signed consent and information-release forms to let team members communicate clinical data using WhatsApp. A total of 1053 images were used with an average of 78 images for each patient (range 41-143). One hundred twenty-five hours of communication were recorded, generating 354 communication events. An expert surgeon received the highest number of questions (\(p\), 0.001), while residents asked clinical questions (\(p\), 0.001) and were fastest to respond (\(p\), 0.001). In their conclusion, they described WhatsApp as a low-cost and fast technology with the potential of facilitating clinical communications, enhancing learning, and improving patient care whilst preserving their privacy. Another study by [PERSON] et al. [28] looked at whether group discussion and reminders via WhatsApp or Facebook were effective in preventing smoking relapse for those who had stopped smoking. They conducted a randomized controlled trial allocating recent quitters who had completed eight-week treatment reporting abstinence for at least seven days to WhatsApp (\(n=42\)) or Facebook (\(n=40\)) and a control (\(n=54\)). Groups participated in two-month online group discussions on WhatsApp or Facebook, which were moderated by trained smoking cessation experts and receiveda self-help booklet on smoking cessation. The control group only received the booklet. The primary outcome was two- and six-month relapse rates. WhatsApp was found to be effective in reducing relapse, thanks to enhanced discussion and social support. Inactive discussion in Facebook might have attributed to lower effectiveness. [PERSON] et al. [29] tested the use of WhatsApp in laboratory management by forming multiple laboratory groups. Thirty-five members used the service for three months and responses were taken on a scale of 1 to 10. Significant improvements in communication were seen in sharing photographic evidence, information about accidents, critical alerts, academic activities and directives. An increase in the load of adding information to the application and some disturbance in routine workflows were documented, but the benefits outweighed the minor hassles associated with the use of WhatsApp. Research by [PERSON] et al. [30] analyzed WhatsApp as a communication method among emergency surgery teams in a London hospital. All emergency surgery team members (\(n\) = 40) who participated in their study used WhatsApp for 19 weeks. Initiator and receiver of communications were compared for response times and communication types. Safety events were reported. More than 1100 communication hours covering the details of 636 patients were logged, resulting in 1495 communication events. The attending started the most instruction-giving communication, while interns asked the largest number of questions (\(p\) < 0.001). The resident was faster to respond compared to intern or attending (\(p\) < 0.001). Participants felt the app helped to _\"flatten hierarchy\"_ amongst students, residents and experienced consultants, enabling them all to actively contribute to discussions without inhibition. [PERSON] et al. [31] evaluated the frequency of use, advantages and disadvantages of WhatsApp in clinical discussion groups. An online survey was created and sent to a convenience sample made up of members of three WhatsApp dermatology groups. The survey looked at individual activities, satisfaction with app, and perceptions regarding platform. Sixty-one (61) dermatologists completed a survey; 38 males and 23 females. Ages of participants ranged from 26 to 57 years.