How can doctors safely communicate in the SARS CoV2 era? Dr Michael Watson examines some options for this critical need.

Now more than ever, outstanding communication between health professionals is needed to help us to problem solve, innovate and adapt to the threat of the SARS CoV2 virus.

I think there is a real need for a multifunction mass communication platform i.e. a secure unified communication platform that includes all doctors. This platform should be funded and controlled by doctors to benefit all doctors, their patients and our whole society.

In addition to a unified communication platform there also needs to be a plethora of small, boutique ICT applications which promote highly specialised information sharing and gathering amongst specific groups of health care professionals.

Government responses to the SARS CoV2 threat (the “social distancing” regulations) have resulted in the prohibition of many traditional forms of doctor communication such as face-to-face clinical meetings (including morbidity and mortality meetings) and scientific and clinical conferences where doctors have been able, in the past, to share important stories (case studies and research) that help us all to learn from our experiences.

We are now forced to use electronic media to meet and to discuss confidential clinical cases. Many doctors have turned to free email and video conferencing applications. Many of these applications lack the security features necessary for safe discussion of clinical cases and raise legitimate concerns about patient privacy.

They also lack the sophistication to allow for the extremely high level and ultra-efficient communication needed to combat this virus.

Of even greater concern to me is the use of mass social media platforms whose servers are based outside of Australia and have a track record of data breaches.

I would encourage doctors to consult with their medical defence organisations before using these forms of free mass electronic social media to discuss their patients. Whilst they are free and easy to use, it is disrespectful to our patients to discuss confidential information in an online forum where privacy is questionable.

If we look to the ICT marketplace to find a mass communication platform which is multi-functional, secure and has servers in Australia, we can either look at pulling together pieces from multiple different sources or a single integrated solution.

There are many excellent stand-alone platforms which provide outstanding individual services such as commercial business grade video conferencing on its own or dedicated file sharing platforms, but there are currently very few secure, fully integrated business grade solutions that are available at affordable prices.

Having researched this extensively when setting up a telehealth business in the past, the product that now stands out to me is Microsoft Office 365.

Many doctors already use Office 365 in some form. Office 365 gives us the potential right now to allow for secure connectivity between doctors. It is just a matter of catalysing this connectivity.

My organisation Valued Voice is currently exploring options to help facilitate the connectivity of doctors and I would greatly value people’s thoughts on this. There are many ICT and social media gurus in our profession, so now is the time to share your ideas!

What values do we need?

Of course, in any system there must be a way to ensure that people work together to promote the common good. In the traditional model this has been achieved through lengthy legal agreements with vast numbers of rules and regulations which can stifle the communication process.

I believe we only need one rule. Everyone must live the value of Respect (empathy and compassion i.e. understanding and kindness). This means Respect for each other, for our patients, for our whole society (including our society’s leadership) and most importantly respect for ourselves.

Respect is NOT political correctness (a series of artificial rules to try to dictate some form of ‘ideal’ conforming behaviour). Respect is a genuine heartfelt desire to try to understand how others feel, and to be kind to them.  Respect allows for genuine mistakes and it promotes people’s better understanding of human behaviour so we can all work together to help each other be safe and feel safe.

Respect means respecting people’s individual privacy, their individual rights and their human dignity.

What would be the ideal system?

I have used the Office 365 platform as an example (there may be others out there, but this is one I have researched in depth) and propose three levels of communication;

  1. An emergency channel (similar to a mayday channel or Channel 16 on marine radio). This function could be filled using email. Email should be reserved for critical communications about emergency situations and for key updates on the SARS CoV2 situation. Your email box will NOT be full in this new ideal system as it will only be for critical communications!
  2. A health business channel which is for collaborative health communications of a semi-urgent or elective nature on health-related topics. This type of communication could principally use Microsoft Teams. Collaborative groups are readily established with file sharing, video conferencing and many other sophisticated business tools to promote high level, efficient collaboration on health issues.
  3. A secure doctor’s social media platform. The mainstay of this could be Yammer which is a sophisticated and secure social networking tool which will allow doctors to share information of a private nature, debrief on personal experiences or organise virtual social groups (many of whom used to meet in person but are no longer lawfully allowed to do so with the new social distancing regulations). I think this type of social communication will be essential for the health and wellbeing of doctors in the coming months and years.

How do we catalyse doctor communication?

Through the use of champions, of course!

I think we need to recruit moderators and leaders who will help to bring doctors together to promote high level, respectful communication. Once started, groups of doctors will naturally recruit and select their own facilitators or moderators and form new groups.

Moderating communication?

In my experience, groups of ethical individuals (such as doctors) will almost always auto correct their communication behaviours in favour of Respect. This is particularly true when we have respectful and respected moderators.

Freedom of speech and freedom of scientific ideas should be promoted within this ideal system and the bullying of individuals who are trying to respectfully put forward alternate viewpoints should not be accepted.

Respectful questioning of the policies of the day is a healthy part of our democracy and should be encouraged. However, public disclosure of scientific conjecture should be discouraged so all communications within this ideal health communication network should be held in the strictest confidence.

A simple written agreement which reminds people to behave in a respectful way towards each other, our patients and society as a whole would be an essential feature of the network.

The ICT nuts and bolts?

There are also many boutique ICT platforms being developed to help fight the SARS CoV2 virus. I have seen some spectacular enhanced surveillance tools, plans for the development of SARS CoV2 related clinical decision support software and patient monitoring tools and many, many more. It is ripe for more investigation.

Who is Valued Voice?

Valued Voice is a public health advocacy organisation. We aim to promote the health (the broadest WHO definition) through the promotion of the value of Respect. I have found that promoting Respect has solved many seemingly insoluble clinical and public health problems and I think that respectful communication is at the heart of the solution to this new deadly virus.

Where to from here?

If you are interested in helping to promote respectful communication between doctors, please call me on (08) 9386 3839 or email me at . I will keep you updated on the progress of this exciting idea!