Hi, I’m Josephine Namitala, a PhD candidate on the mHealth-Innovate project. I am registered at the University of Oslo, I serve as one of the primary researchers based in Uganda. My doctoral research focuses on Work Package 2, which involves an in-depth exploration of the informal use of mobile phones by health workers and managers in Uganda. In addition to this focus, I have also participated in the other work packages within the project.
Topic 3: What strategies could be used to address the potential for informal mobile phone use to undermine patients’ privacy and confidentiality and the legal implications of informal use for healthcare workers?
To address the potential for informal mobile phone use, especially when it comes to undermining patient privacy and confidentiality, as well as the legal implications for healthcare workers in Uganda. It is important to review guiding policies on the informal use of mobile phones and train healthcare workers on proper use of mobile phones, especially around the storing and sharing of patient data from one person to another, even when we know that the intention is many times to serve the best interest of the patients. Findings from the primary study in Uganda revealed that at times healthcare providers capture photos/videos of rare diseases using their mobile phones and share them with fellow healthcare providers via WhatsApp for quick consultation in order to garner technical guidance from colleagues for quick action. In the process of seeking advice from fellow health workers on certain health conditions, sometimes health workers do not blur images of patients as they share the pictures, which contravenes patients’ privacy. This therefore calls for training of health workers on proper use of these mobile gadgets. These strategies must be grounded in Uganda's legal, ethical, and health system context. For instance, there is an urgent need to develop, disseminate and enforce clear national guidelines on informal mobile phone use within the healthcare system.
The Ministry of Health (MoH), in collaboration with the National Information Technology Authority-Uganda (NITA-U) and health workers’ professional associations, should develop clear national policies governing the ethical and legal use of mobile phones for clinical purposes. These guidelines should specify what type of patient data can be shared, who can access it, and under what circumstances and, if possible, include clauses about data storage, retention, and deletion guidelines on healthcare workers’ personal devices. Alternatively, they can also train and support healthcare providers by focusing on real-life examples (e.g., case studies of breaches), emphasising the Data Protection and Privacy Act (2019) of Uganda. But also train on consent procedures for sharing patient data, including the use of mobile phones. Because many times, in a bid to support the patients, some healthcare workers acknowledge that, at times, they are more interested in saving lives and erroneously forget to seek consent from the patients.
Health facility managers working together with fellow facility staff should develop internal policies or by-laws on mobile phone use, including designated communication channels (e.g., WhatsApp groups for work vs. personal use).
Secondly, the data indicated that a number of healthcare providers were not aware of the ethical and legal implications related to digital communication. This highlights the urgent need to integrate digital ethics and patient confidentiality into ongoing Continous Professional Development (CPD) or Continuing Medical Education (CME) programmes. Such training could play a critical role in raising awareness and fostering a culture of responsible mobile phone use, considering that mobile phones have become an unavoidable component of the healthcare system.
I believe it is important for the relevant line ministry to involve healthcare workers in a participatory policy-making process on mobile phone usage within the health system. Top-down policies often face resistance or low uptake by the people who are supposed to use them. It is therefore critical and important that the line ministry involves frontline health workers in the development of mobile phone use guidelines to reflect real-world/work challenges, encourage ownership and incorporate different feedback mechanisms to continuously improve policies on the ground. It is crucial and significant that the line ministry includes frontline health workers in the development of mobile phone use guidelines.
Kind Regards,
Namitala Josephine
Those who wait upon the Lord shall never be put to shame. I believe and trust. Amen
HIFA profile: Josephine Namitala is an assistant lecturer at Makerere University, Uganda. jnamitala24 AT gmail.com