JMIR Publications

ABSTRACT

Background:

Instant messaging (IM) is used in routine clinical communication via secure, electronic health record–integrated tools and, in practice, also via ad hoc consumer apps. In crisis and disaster contexts (eg, pandemics, natural disasters, mass-casualty incidents, or large-scale IT outages), reports describe IM supporting time-critical coordination. However, no synthesis maps how IM is used across crisis and disaster response scenarios and what experiences, barriers, and facilitators are reported.

Objective:

This protocol describes the methods for a qualitative scoping review that will map and synthesize qualitative evidence on real-world IM use to support continuity of medical care under constrained conditions during crises and disasters.

Methods:

We will conduct a qualitative scoping review guided by Arksey and O’Malley, Levac refinements, and the JBI. The research question and eligibility criteria are structured using PICo (Population, Phenomenon of Interest, Context). Searches will be conducted in PubMed/MEDLINE, Scopus, and Web of Science Core Collection (WoS) for records published from 2010 to the date of the final searches using a clustered Boolean strategy; search reporting will follow PRISMA-S and the review will follow PRISMA-ScR. We will include qualitative studies and mixed-methods studies with a substantial qualitative component, and qualitatively relevant grey literature with transparent, traceable methods (appraised using AACODS). Eligible IM tools include secure clinical messengers and improvised/consumer apps when used in real-world crisis care contexts; purely simulated scenarios without real-world transfer and records without empirical data will be excluded. Two reviewers will independently screen titles/abstracts and full texts; disagreements will be resolved by discussion. Data will be charted in a standardized extraction matrix with targeted verification of a subset of charted records by the second reviewer. Synthesis will combine structured evidence mapping with reflexive thematic analysis of empirically grounded qualitative findings. Methodological rigor of included qualitative studies will be appraised using the JBI Critical Appraisal Checklist for Qualitative Research to inform interpretation.

Results:

Results:

As of July 2026, feasibility testing and piloting of the search strategy have been completed; the final database and grey literature searches have not yet been conducted. Following publication of this protocol, full searches and dual screening will be initiated, with data charting and thematic synthesis beginning after study selection. Completion of the scoping review is anticipated in the first half of 2027.

Conclusions:

This protocol provides a transparent framework for a scoping review that will generate an evidence map and thematic synthesis of IM use to sustain continuity of medical care during crises and disasters, including reported use patterns, actors, barriers, and facilitators, to inform preparedness planning, clinical workflow design, and governance for secure messaging under emergency conditions. Clinical Trial: None