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Comparison of secure messaging application (WhatsApp) and standard telephone usage for consultations on Length of Stay in the ED: A prospective randomized controlled study
Open accessAbstract
Summary: Objective: Consultation, the process of an Emergency Physician seeking an opinion from other specialties, occurs frequently in the Emergency Department (ED). The aim of this study was to determine the effect of secure messaging application (WhatsApp) usage for medical consultations on Emergency Department Length of Stay (ED LOS) and consult time. Methods: We conducted a prospective, randomized controlled trial in the ED using allocation concealment over three months. Consultations requested in the ED were allocated into two groups: consultations requested via the secure messaging application and consultations requested by telephone as verbal. Results: A total of 439 consultations requested in the ED were assessed for eligibility and 345 were included in the final analysis: 173 consultations were conducted using secure messaging application and 172 consultations were conducted using standard telephone communications. The median ED LOS was 240 minutes (IQR:230-270, 95% CI:240 to 255.2) for patients in the secure messaging application group and 277 minutes (IQR:270-287.8, 95% CI:277 to 279) for patients in the telephone group. The median total ED LOS was significantly lower among consults conducted using Secure messaging application relative to consults conducted by telephone (median dif: -30, 95%CI:–37to-25, p<0.0001). The median consult time was 158 minutes (IQR:133 to 177.25, 95% CI:150 to 169) for patients in the Secure messaging application group and 170 minutes (IQR:165 to 188.5, 95% CI:170-171) for patients in the Telephone group (median dif: –12, 95%CI:-19 to-7,p<0.0001). Consultations completed without ED arrival was 61.8% in the secure messaging group and 33.1% in the Telephone group (dif: 28.7, 95% CI:48.3 to 66, p<0.001). Conclusions: Use of secure messaging application for consultations in the ED reduces the total ED LOS and consultation time. Consultation with secure messaging application eliminated more than half of in-person ED consultation visits. Gulacti U, Lok U. Comparison of secure messaging application (WhatsApp) and standard telephone usage for consultations on Length of Stay in the ED. Appl Clin Inform 2017; 8: 742–753 https://doi.org/10.4338/ACI-2017-04-RA-0064
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“reported that participants allocated to the intervention group were probably either admitted to hospital or discharged in slightly less time from the emergency department (median difference −12 minutes, 95% CI −19 to −7; 345 participants; moderate‐certainty evidence) (Gulacti 2017; Analysis 8.1).”
From Mobile technologies to support healthcare provider to healthcare provider communication and management of care (2020) · cites this paper as Gulacti 2017
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“Gulacti 2017 reported that there were no technical problems during the course of the trial (Analysis 10.1).”
From Mobile technologies to support healthcare provider to healthcare provider communication and management of care (2020) · cites this paper as Gulacti 2017
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“One trial reported that participants seen by emergency physicians allocated to the intervention group probably had a shorter length of emergency department stay (median difference −30 minutes, 95% CI −37 to −25 minutes; 345 participants; moderate‐certainty evidence; Analysis 9.1, Gulacti 2017).”
From Mobile technologies to support healthcare provider to healthcare provider communication and management of care (2020) · cites this paper as Gulacti 2017
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“Gulacti 2017 assessed the use of a messaging system for communication between emergency physicians in the emergency department and physicians working elsewhere in the hospital, excluding consultants who did not own a smartphone with a secure messaging service.”
From Mobile technologies to support healthcare provider to healthcare provider communication and management of care (2020) · cites this paper as Gulacti 2017
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Cited by
Gonçalves-Bradley, D. C., J Maria, A. R., Ricci-Cabello, I., Villanueva, G., Fønhus, M. S., Glenton, C., Lewin, S., Henschke, N., Buckley, B. S., Mehl, G. L., et al. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012927.pub2 · Cited by 145
Lee, M. S., & Nambudiri, V. E. (2020) · Applied Clinical Informatics · doi:10.1055/s-0040-1719181 · Cited by 15
Metadata
- Authors
- Lok, U., & Gulacti, U.
- Venue
- Applied Clinical Informatics
- Publisher
- Georg Thieme Verlag KG
- Published
- 2017-07
- Volume
- 08
- Issue
- 03
- Pages
- 742-753
- ISSN
- 1869-0327 (ISSN-L)
- PMC
- PMC6220693
- OpenAlex
- W2738201146
- Semantic Scholar
- d970ff8ae5759520506cec87666fe6f4e27b4738
- Cited by
- 39
- References
- 29
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 5 · 2022: 4 · 2021: 9 · 2020: 8 · 2019: 4 · 2018: 1
- FWCI
- 4.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Applied Clinical Informatics (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Adiyaman Üniversitesi
- Topics
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Technology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- secure messaging, interprofessional consultation, emergency department length of stay, consultation time, telephone consultation, telemedicine, emergency department efficiency
- MeSH terms
- Emergency Service, Hospital, Female, Humans, Length of Stay, Male, Middle Aged, Prospective Studies, Referral and Consultation, Telephone, Time Factors, Computer Security, Text Messaging
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