JMIR Publications

ABSTRACT

Background:

Health professionals in low and middle resource settings have limited access to up-to-date resources for diagnosing and treating illnesses, training medical staff, reviewing newly disseminated guidelines and publications, and preparing data for international disease reporting. A concomitant difficulty in high resource settings is the need for continuing education and skills up-training in innovative procedures on unfamiliar social media platforms. These challenges can delay both patient care and epidemiological surveillance efforts. To overcome these challenging, health professionals have adapted WeChat Groups to implement timely, low-cost, and high-quality patient care.

Objective:

The primary study aim was to describe the processes taken by medical professionals across their diverse physical and virtual networks in adapting a bottom-up approach to collectively overcome resource shortages. The secondary study aim was to delineate the pathways, procedures, and resources/information sharing implemented by medical professionals using an international publicly available popular social media app to enhance performance of facility-based procedures and protocols for improved patient care.

Methods:

In-depth interviews, observations, and digital ethnography of WeChat Groups communications were collected from medical professionals in interconnected networks of healthcare facilities. Participants’ WeChat Groups usage and observations of their professional functions in interconnected networks were collected from November 2018-2019. Qualitative analysis and thematic coding were used to develop constructs and themes in NVIVO. Constructs incorporated descriptions for the implementation and uses of WeChat Groups for professional connections, healthcare procedures, and patient care. Themes supporting the constructs focused on the pathways and venues used by medical professionals to build trust, to establish and solidify online networks, and to identify requests and resource sharing within WeChat Groups.

Results:

There were 58 participants (male 36, female 22) distributed across 24 healthcare settings spanning geographical networks in south China. Analysis yielded 4 constructs and 11 themes delineating the bottom-up usage of WeChat Groups among clinicians, technicians, nurses, pharmacists, and public health administrators. Participants used WeChat Groups in collectively training hospital staff in complex new procedures, processing timely diagnoses of biological specimens, staying abreast of latest trends and clinical procedures and symptoms, and contributing to case-reporting for emergent illnesses and international surveillance reporting. An unexpected strength of implementing clinical, training, and research support on a popular app with international coverage is the added ability to overcome administrative and geographic barriers in resource distribution. This advantage increased a network’s access to WeChat Groups members both working within China and abroad, greatly expanding the scope of shared resources.

Conclusions:

The organic, bottoms-up approach of repurposing extant social media apps is low-cost and efficient in timely implementation for improving patient care. WeChat’s international user base enables medical staff to access widespread professional networks across geographic, administrative, and economic barriers, with potential to reduce health disparities in low resource setting.