Dear HIFA colleagues,
Thank you for all your contributions about informal use of mobile phones by health workers (including use of personal mobile phones for work purposes). https://www.hifa.org/sites/default/files/articles/2025-mHEALTH-INNOVATE-...
I would like to introduce Topic 4: What strategies could be used to help ensure that the healthcare system is not undermined when information is not formally shared and stored as a consequence of informal use?
In our systematic review we wrote:
'Informal digital strategies can also undermine the goals that formal digital strategies are designed to address, particularly if they are used instead of formal systems... Healthcare workers’ transfer of information away from these formal systems can lead to the development of parallel systems. This can cause problems with the continuity of information when healthcare workers change teams or institutions. This can also weaken governments’ and organisations’ opportunities to gain oversight, learn, and improve. The limited oversight of devices and information flows also poses concerns for cybersecurity, particularly in situations where data may be hacked or compromised beyond the control of the healthcare worker and requires timely resolution through a formal institution.'
Healthcare workers’ informal uses of mobile phones and other mobile devices to support their work: a qualitative evidence synthesis
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015705.pub2/...
Let's explore this issue. First, can anyone give an example where use of personal mobile phones by health workers has led to information NOT being recorded in formal systems? For example, do we know of instances where important information about a patient is exchanged through a personal mobile device but never reaches the formal system? Or do we know of cases where data is collected on a personal mobile phone but is not added to the formal system and is therefore lost?
Also, we consider that personal mobile phone use might 'weaken governments’ and organisations’ opportunities to gain oversight, learn, and improve'. To explore this aspect it would be helpful to understand what kind of data is most important 'to gain oversight, learn, and improve'. Can anyone help? And do we have examples where personal mobile phone use weakens opportunities?
The last point about 'concerns for cybersecurity' is interesting. Is this a major issue? Do we have any examples? To me this seems to be an issue that relates more to patient privacy and confidentiality rather than to undermining of the health system. What do you think?
We would be especially interested to hear more about the primary research in Uganda and what has been learned from the perspective of (a) health workers and (b) policymakers.
Looking forward to read your thoughts. Please send to: hifa@hifaforums.org
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org