It is disappointing at best to read that the authors feel it appropriate to say that "[Google Translate] has the potential to routinely facilitate effective one-way oral communication between English-speaking physicians and Spanish-speaking patients with limited English proficiency," despite their own results showing accuracy reducing as the number of sentences increased. These results were themselves not derived from a robust methodology.
Researchers in Machine Translation have pointed out that flaws in sentence-level evaluations for some time (Läubli et al 2018) and the use of a single rater runs counter to known research on inter-rater reliability in the assessment of interpreting quality (Han 2015, Wang et al 2015). In addition, scoring a technological solution and suggesting future uses on the basis of a single dataset in only one language direction, under conditions that are not realistic, demonstrates a lack of familiarity with longstanding field research on the importance of interaction in medical interpreting (Wadensjö 1992, Clifford 2004, Baraldi and Gavioli 2015).
In light of the above evidence, it would seem that the use of Google Translate or any similar technology should not be suggested under any clinically important circumstances until such a time as each individual solution has been through robust testing, including field trials with patient feedback and tracking of patient outcomes. Any use of automated speech...
It is disappointing at best to read that the authors feel it appropriate to say that "[Google Translate] has the potential to routinely facilitate effective one-way oral communication between English-speaking physicians and Spanish-speaking patients with limited English proficiency," despite their own results showing accuracy reducing as the number of sentences increased. These results were themselves not derived from a robust methodology.
Researchers in Machine Translation have pointed out that flaws in sentence-level evaluations for some time (Läubli et al 2018) and the use of a single rater runs counter to known research on inter-rater reliability in the assessment of interpreting quality (Han 2015, Wang et al 2015). In addition, scoring a technological solution and suggesting future uses on the basis of a single dataset in only one language direction, under conditions that are not realistic, demonstrates a lack of familiarity with longstanding field research on the importance of interaction in medical interpreting (Wadensjö 1992, Clifford 2004, Baraldi and Gavioli 2015).
In light of the above evidence, it would seem that the use of Google Translate or any similar technology should not be suggested under any clinically important circumstances until such a time as each individual solution has been through robust testing, including field trials with patient feedback and tracking of patient outcomes. Any use of automated speech translation predicated on immediate cost savings should also take into account the fact that effect professional human interpreting is already known to significantly reduce overall healthcare costs (Flores 2005, Jacobs et al 2007).
Six years ago, Dr James T. Carlton and coworkers reported an unprecedented, tsunami-driven, transoceanic spread of marine organisms following the dramatic earthquake occurred in March 2011 in Eastern Japan (1). This really impressive spread of living organisms was greatly enhanced by micro-nanoplastics, which likely acted as “rafts” for them (1). Among the large number of (mostly) invertebrate species
affected by the aforementioned phenomenon, special emphasis should be also placed upon microbial pathogens, some of which are known to impact the health and conservation of free-ranging cetaceans (2). A paradigmatic example in this direction is represented by Toxoplasma gondii, a protozoan and zoonotic agent of major concern (3), which may also infect striped dolphins (Stenella coeruleoalba), with subsequent development of severe brain lesions leading to stranding and death (4).
Although a general consensus seems to exist on a land-to-sea flow as the most plausible mechanism through which T. gondii oocysts, similarly to other oro-fecally transmitted microorganisms, may gain access to the marine environment (2), this becomes questionable when dealing with striped dolphins and other T. gondii-susceptible species of aquatic mammals living in the open sea (5). In other words, how striped dolphins and other pelagic cetaceans may acquire T. gondii infection is still far from being understood. Consequently, among the different hypotheses drawn to explain this phenomenon,...
Six years ago, Dr James T. Carlton and coworkers reported an unprecedented, tsunami-driven, transoceanic spread of marine organisms following the dramatic earthquake occurred in March 2011 in Eastern Japan (1). This really impressive spread of living organisms was greatly enhanced by micro-nanoplastics, which likely acted as “rafts” for them (1). Among the large number of (mostly) invertebrate species
affected by the aforementioned phenomenon, special emphasis should be also placed upon microbial pathogens, some of which are known to impact the health and conservation of free-ranging cetaceans (2). A paradigmatic example in this direction is represented by Toxoplasma gondii, a protozoan and zoonotic agent of major concern (3), which may also infect striped dolphins (Stenella coeruleoalba), with subsequent development of severe brain lesions leading to stranding and death (4).
Although a general consensus seems to exist on a land-to-sea flow as the most plausible mechanism through which T. gondii oocysts, similarly to other oro-fecally transmitted microorganisms, may gain access to the marine environment (2), this becomes questionable when dealing with striped dolphins and other T. gondii-susceptible species of aquatic mammals living in the open sea (5). In other words, how striped dolphins and other pelagic cetaceans may acquire T. gondii infection is still far from being understood. Consequently, among the different hypotheses drawn to explain this phenomenon, the existence of an alternate (mainly, if not exclusively) intra-marine biological protozoan's cycle has been also hypothesized (5). Since alternate cycles of a similar nature have not been demonstrated to occur, thus
far, for both T. gondii and many other protozoan and non-protozoan pathogens, it would be worthwhile to investigate whether tsunamis, seaquakes and (more in general) seawater movements may account for the dispersal into marine and oceanic ecosystems, also for very long distances, of T. gondii and other oro-fecally transmitted microbial agents, along with their (vertebrate and invertebrate) hosts.
Noteworthy, T. gondii has been additionally identified in several edible fish species sold on the market (6) and, since no clear-cut evidence is hitherto available, to the best of my knowledge, on fish susceptibility to this infection, such an alarming finding of public health concern provides further support to the assumption that T. gondii-contaminated micro-nanoplastics behaved as the likely infection’s vehicle
after having been eaten by fish. Indeed, an association in the marine environment of the zoonotic protozoan parasites T. gondii, Cryptosporidium parvum, and Giardia enterica with polyethylene microbeads and polyester microfibers has been recently
described, with more parasites adhering to microfiber surfaces as compared with microbeads (7).
In conclusion, while the herein hypothesized “T. gondii/micro-nanoplastics synergism” warrants further study, an integrated approach based upon the complementary “One Health” and “One Ocean, One Health” concepts/principles would be highly recommended (also) for elucidating the complex dynamics driving the mutual “animal/human host-parasite-foodweb interactions” within the marine
ecosystem.
References
1. J.T. Carlton, J.W. Chapman, J.B. Geller, et al. Tsunami-driven rafting: Transoceanic species dispersal and implications for marine
biogeography. Science 357, 1402-1406. DOI: 10.1126/science.aao1498 (2017).
2. M.-F. Van Bressem, J.-A. Raga, G. Di Guardo, et al. Emerging infectious diseases in cetaceans worldwide and the possible role of environmental stressors. Dis. Aquat. Organ. 86, 143-157. DOI: 10.3354/dao02101 (2009).
3. J.G. Montoya, O. Liesenfeld. Toxoplasmosis. Lancet 363, 1965-1976. DOI: 10.1016/S0140-6736(04)16412-X (2004).
4. G. Di Guardo, U. Proietto, C.E. Di Francesco, et al. Cerebral toxoplasmosis in striped dolphins (Stenella coeruleoalba) stranded along the Ligurian Sea coast of Italy. Vet. Pathol. 47, 245-253. DOI: 10.1177/0300985809358036 (2010).
5. G. Di Guardo, S. Mazzariol. Toxoplasma gondii: Clues from stranded dolphins. Vet. Pathol. 50, 737. DOI: 10.1177/0300985813486816 (2013).
6. A.M.F. Marino, R.P. Giunta, A. Salvaggio, et al. Toxoplasma gondii in edible fishes captured in the Mediterranean basin. Zoonoses Public Health 66, 826-834 (2019).
7. E. Zhang, M. Kim, L. Rueda, et al. Association of zoonotic protozoan parasites with microplastics in seawater and implications for human and
wildlife health. Sci. Rep. 12, 6532. https://doi.org/10.1038/s41598-022-10485-5 (2022).
We read with interest the article by Kulkarni et al. [1], which highlights the advances in EKG pattern-recognition to help screen and identify patients with early-stage chronic diseases, particularly type 2 Diabetes (T2D).
While we recognize the rationale behind the inclusion criteria of the DISFIN study, the included population has a high insulin resistance-diabetes prevalence. However, it is important to note that the participants have a uniformly low A1c value and the time of exposure to hyperglycemia and treatment regimens are unknown. [1] These two variables are essential to consider since both have been described to have a direct relationship with micro and macrovascular complications that could impact EKG features and, thus, the performance of this model. [2]
Kulkarni et al. [1] do not clarify time since diagnosis of pre-diabetes or T2D and what treatment regimen each patient is undergoing. We ponder if patient classification based on the time of diagnosis, level of hyperglycemia and treatment regimen could help us better understand the onset and biological mechanisms behind EKG feature changes that help better identify subjects with hyperglycemia in all of its spectrum from pre-diabetes to T2D.
When choosing the ML technique, we noticed that the authors used a K-Fold Cross-Validation scenario for the six candidates. In our opinion, this may result in inconsistencies and skewness on the “K” folds of subsets of the dataset,...
We read with interest the article by Kulkarni et al. [1], which highlights the advances in EKG pattern-recognition to help screen and identify patients with early-stage chronic diseases, particularly type 2 Diabetes (T2D).
While we recognize the rationale behind the inclusion criteria of the DISFIN study, the included population has a high insulin resistance-diabetes prevalence. However, it is important to note that the participants have a uniformly low A1c value and the time of exposure to hyperglycemia and treatment regimens are unknown. [1] These two variables are essential to consider since both have been described to have a direct relationship with micro and macrovascular complications that could impact EKG features and, thus, the performance of this model. [2]
Kulkarni et al. [1] do not clarify time since diagnosis of pre-diabetes or T2D and what treatment regimen each patient is undergoing. We ponder if patient classification based on the time of diagnosis, level of hyperglycemia and treatment regimen could help us better understand the onset and biological mechanisms behind EKG feature changes that help better identify subjects with hyperglycemia in all of its spectrum from pre-diabetes to T2D.
When choosing the ML technique, we noticed that the authors used a K-Fold Cross-Validation scenario for the six candidates. In our opinion, this may result in inconsistencies and skewness on the “K” folds of subsets of the dataset, mainly because of the imbalance in the dataset. We would favor using a Stratified K-Fold Cross-Validation, an extension of the regular K-Fold Cross-Validation. This technique avoids such inconsistencies by maintaining the class-ratio of the data while generating the “K” subsets of the data. Thus, the same class distribution occurs when these “K” folds are concatenated to form the final complete dataset. Also, using Synthetic Minority Oversampling Technique (SMOTE) may result in an increased overlapping of classes and can bring in additional noise. For this, we suggest combining SMOTE with an undersampling technique, specifically Edited Nearest Neighbour (ENN), which removes the data points on the class boundary, increasing the separation between classes and reducing possible bias.
References:
1.Kulkarni AR, Patel AA, Pipal KV, et alMachine-learning algorithm to non-invasively detect diabetes and pre-diabetes from electrocardiogramBMJ Innovations 2023;9:32-42.
2.Stratton, I. M., Adler, A. I., Neil, H. A., Matthews, D. R., Manley, S. E., Cull, C. A., Hadden, D., Turner, R. C., & Holman, R. R. (2000). Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ (Clinical research ed.), 321(7258), 405–412. https://doi.org/10.1136/bmj.321.7258.405
For home manage in the territorial context in which I work, the Covid19 patient is advised to have a thermometer and oximeter , possibly also check blood pressure and blood sugar (if previously monitored ).
The simple urinalysis is not mentioned: it is cheap and can be performed at home.
In fact, through a strip that is immersed in urine, after 1-2 minutes we can obtain about 10 parameters.
They indicate not only kidney damage (presence of proteins, red blood cells, white blood cells, nitrites for urinary infections) but also important systemic metabolic indices.
The values of pH, urinary density, glycosuria and ketonuria indicate whether metabolic decompensations, dehydration, etc. are in progress; finally, also bilirubin and urobilinogen, for what concerns the liver or eventual haemolytic anemia.
I say this because unfortunately Covid19 can also compromise not only the kidney system, as well as a series of complications with a sneaky onset, not always quickly diagnosed.
There remains the problem of the stripes packaging, not available individually, from which a single dose will have to be obtained.
But it is probably a problem that can be overcome
Dear Editor,
We read with great interest the paper by Clement et al. With the advancement of technology, the digital consultations got a lot of attention in a good way and become more useful during the pandemic for both patients with disability as well as the normal patients. Though, some people still prefers to see the doctor face to face for more self-satisfaction. The digital consultation still have a long way to go for its acceptance within people specifically who are not used to and just begin.
As we know that telemedicine or video consultation can be used if you want to have look at a patient in care home, are working in a remote practice or the patient is bed bound. It saves patients an unnecessary trip to the practice, and the practitioner may have time freed up to see the sickest patients first. [1] Under the COVID-19 pandemic situation, people have to beware of the existence of such approaches to consultations, during the pandemic people were afraid to go to the hospital or clinic to have a treatment or appointment with doctor, especially for the aging population.
In Taiwan, the COVID-19 case raised up to hundreds local cases per day since Mid of May 2021 and the situation is going up to stage 3, the ministry of the health in Taiwan announced that people should prefer to use the digital consultation or telemedicine services to prevent the patients hospital visits and infection spread. Taiwan has a well-structured Health IT infrastructure an...
Dear Editor,
We read with great interest the paper by Clement et al. With the advancement of technology, the digital consultations got a lot of attention in a good way and become more useful during the pandemic for both patients with disability as well as the normal patients. Though, some people still prefers to see the doctor face to face for more self-satisfaction. The digital consultation still have a long way to go for its acceptance within people specifically who are not used to and just begin.
As we know that telemedicine or video consultation can be used if you want to have look at a patient in care home, are working in a remote practice or the patient is bed bound. It saves patients an unnecessary trip to the practice, and the practitioner may have time freed up to see the sickest patients first. [1] Under the COVID-19 pandemic situation, people have to beware of the existence of such approaches to consultations, during the pandemic people were afraid to go to the hospital or clinic to have a treatment or appointment with doctor, especially for the aging population.
In Taiwan, the COVID-19 case raised up to hundreds local cases per day since Mid of May 2021 and the situation is going up to stage 3, the ministry of the health in Taiwan announced that people should prefer to use the digital consultation or telemedicine services to prevent the patients hospital visits and infection spread. Taiwan has a well-structured Health IT infrastructure and the digital consultation services were provided before for certain services but now it has a great advantage in the pandemic situation where it is not only helpful for the aged care patients or patients with diability but also for normal stable patients.[2]
It helps unnecessary hospital visits as well as continued social distancing with proper delivery of healthcare services. However, there are some challenges in the remote systems where the patients are not familiar with the digital technology usage and in that circumstances the video consultations services could be a problem such as in elderly care .[3]
References:
[1] Kathy Oxtoby. (07 July, 2020) The rapid rise of digital consultations since Covid-19. News, https://www.gmjournal.co.uk/the-rapid-rise-of-digital-consultations-sinc...
[2] Chien-Hao Lin, Wen-Pin Tseng, Jhong-Lin Wu, Joyce Tay, Ming-Tai Cheng, Hooi-Nee Ong, Hao-Yang Lin Image, Yi-Ying Chen, Chih-Hsien Wu, Jiun-Wei Chen, Shey-Ying Chen, Chang-Chuan Chan, Chien-Hua Huang, Shyr-Chyr Chen. A Double Triage and Telemedicine Protocol to Optimize Infection Control in an Emergency Department in Taiwan During the COVID-19 Pandemic: Retrospective Feasibility Study. J Med Internet Res. 2020 June 23;22(6):e20586. doi:10.2196/20586
[3] Yi-Yin Lin, PhD and Chin-Shan Huang, PhD. Gerontology Institute, Georgia State University, Atlanta, Georgia. Adult and Continuing Education, National Chung Cheng University, Chia-Yi, Taiwan. Aging in Taiwan: Building a Society for Active Aging and Aging in Place. The Gerontologist. March 12, 2015; No. 2, 176–183 doi:10.1093
The high incidence of sensitive patient data exchanged between physicians via Whatsapp and iMessage evidenced in this study demonstrate potential violations of the new General Data Protection Regulation (GDPR) due to come into effect in May 2018. The GDPR outlines specific requirements for the processing and storage of data of which patient data is arguably the most sensitive. Breaches are expected to generate fines of up to 4% of annual turnover or 20 million euro – for authorities such as the NHS and HSE, this is potentially catastrophic.
Images of Xrays, blood results or wounds, taken via the mobile device in a doctor’s pocket, can be streamed via the famously insecure Apple iCloud in the USA, and suggested for potential upload to social Apps such as Facebook by default. Such material shared via Apps such as Whatsapp are downloaded by default to the image gallery on a smartphone and streamed between all networked devices, whether the recipients open the message or not. Such images can contain EXIF data, such as geographical co-ordinates, date, time, make and model of device etc. Such images are required to be encrypted and stored securely with the patient’s medical notes.
It cannot be overstated that ‘free’ communications solutions such as iMessage, WhatsApp, Signal, Secure Chat etc. are not free at all - if cash is not being paid for an App, the data of the clinician and patient is the commodity being paid for the functionality. Typically Apps have...
The high incidence of sensitive patient data exchanged between physicians via Whatsapp and iMessage evidenced in this study demonstrate potential violations of the new General Data Protection Regulation (GDPR) due to come into effect in May 2018. The GDPR outlines specific requirements for the processing and storage of data of which patient data is arguably the most sensitive. Breaches are expected to generate fines of up to 4% of annual turnover or 20 million euro – for authorities such as the NHS and HSE, this is potentially catastrophic.
Images of Xrays, blood results or wounds, taken via the mobile device in a doctor’s pocket, can be streamed via the famously insecure Apple iCloud in the USA, and suggested for potential upload to social Apps such as Facebook by default. Such material shared via Apps such as Whatsapp are downloaded by default to the image gallery on a smartphone and streamed between all networked devices, whether the recipients open the message or not. Such images can contain EXIF data, such as geographical co-ordinates, date, time, make and model of device etc. Such images are required to be encrypted and stored securely with the patient’s medical notes.
It cannot be overstated that ‘free’ communications solutions such as iMessage, WhatsApp, Signal, Secure Chat etc. are not free at all - if cash is not being paid for an App, the data of the clinician and patient is the commodity being paid for the functionality. Typically Apps have access a range of material on the users’ smartphone, including contact lists (to access and download), calendars (to read and amend entries) email, SMS, iMessage etc. (to read and send communications to those in the contact lists without notifying the owner), microphone (to access and record) and location (to track). If we are being ‘cost aware’ is access to a doctors diary, address book, email, digital messages, microphone and location/movements actually a cost worth paying?
The danger posed by lost phones is indeed alarming, and the importance of thoroughly cleaning devices before they are upgraded or discarded cannot be overstated either.
Security and data protection must be a central concern, not only for health service administrators, but for clinicians who understand that confidential patient data is no trivial issue. Patients disclose intimate personal information with the understanding that it will be stored and communicated securely and safely.
There is a range of technical solutions for the appropriately secure, efficient communication of patient data – Apps such as Hospify for example. It is essential that clinicians are provided with access to approved technical solutions, digital professionalism training and regular technical updates by the health service urgently, if they are to adhere to the new GDPR and an avoidable data protection disaster is averted.
Dear Editor,
It is disappointing at best to read that the authors feel it appropriate to say that "[Google Translate] has the potential to routinely facilitate effective one-way oral communication between English-speaking physicians and Spanish-speaking patients with limited English proficiency," despite their own results showing accuracy reducing as the number of sentences increased. These results were themselves not derived from a robust methodology.
Researchers in Machine Translation have pointed out that flaws in sentence-level evaluations for some time (Läubli et al 2018) and the use of a single rater runs counter to known research on inter-rater reliability in the assessment of interpreting quality (Han 2015, Wang et al 2015). In addition, scoring a technological solution and suggesting future uses on the basis of a single dataset in only one language direction, under conditions that are not realistic, demonstrates a lack of familiarity with longstanding field research on the importance of interaction in medical interpreting (Wadensjö 1992, Clifford 2004, Baraldi and Gavioli 2015).
In light of the above evidence, it would seem that the use of Google Translate or any similar technology should not be suggested under any clinically important circumstances until such a time as each individual solution has been through robust testing, including field trials with patient feedback and tracking of patient outcomes. Any use of automated speech...
Show MoreSix years ago, Dr James T. Carlton and coworkers reported an unprecedented, tsunami-driven, transoceanic spread of marine organisms following the dramatic earthquake occurred in March 2011 in Eastern Japan (1). This really impressive spread of living organisms was greatly enhanced by micro-nanoplastics, which likely acted as “rafts” for them (1). Among the large number of (mostly) invertebrate species
Show Moreaffected by the aforementioned phenomenon, special emphasis should be also placed upon microbial pathogens, some of which are known to impact the health and conservation of free-ranging cetaceans (2). A paradigmatic example in this direction is represented by Toxoplasma gondii, a protozoan and zoonotic agent of major concern (3), which may also infect striped dolphins (Stenella coeruleoalba), with subsequent development of severe brain lesions leading to stranding and death (4).
Although a general consensus seems to exist on a land-to-sea flow as the most plausible mechanism through which T. gondii oocysts, similarly to other oro-fecally transmitted microorganisms, may gain access to the marine environment (2), this becomes questionable when dealing with striped dolphins and other T. gondii-susceptible species of aquatic mammals living in the open sea (5). In other words, how striped dolphins and other pelagic cetaceans may acquire T. gondii infection is still far from being understood. Consequently, among the different hypotheses drawn to explain this phenomenon,...
Dear Editor,
We read with interest the article by Kulkarni et al. [1], which highlights the advances in EKG pattern-recognition to help screen and identify patients with early-stage chronic diseases, particularly type 2 Diabetes (T2D).
While we recognize the rationale behind the inclusion criteria of the DISFIN study, the included population has a high insulin resistance-diabetes prevalence. However, it is important to note that the participants have a uniformly low A1c value and the time of exposure to hyperglycemia and treatment regimens are unknown. [1] These two variables are essential to consider since both have been described to have a direct relationship with micro and macrovascular complications that could impact EKG features and, thus, the performance of this model. [2]
Kulkarni et al. [1] do not clarify time since diagnosis of pre-diabetes or T2D and what treatment regimen each patient is undergoing. We ponder if patient classification based on the time of diagnosis, level of hyperglycemia and treatment regimen could help us better understand the onset and biological mechanisms behind EKG feature changes that help better identify subjects with hyperglycemia in all of its spectrum from pre-diabetes to T2D.
When choosing the ML technique, we noticed that the authors used a K-Fold Cross-Validation scenario for the six candidates. In our opinion, this may result in inconsistencies and skewness on the “K” folds of subsets of the dataset,...
Show MoreFor home manage in the territorial context in which I work, the Covid19 patient is advised to have a thermometer and oximeter , possibly also check blood pressure and blood sugar (if previously monitored ).
The simple urinalysis is not mentioned: it is cheap and can be performed at home.
In fact, through a strip that is immersed in urine, after 1-2 minutes we can obtain about 10 parameters.
They indicate not only kidney damage (presence of proteins, red blood cells, white blood cells, nitrites for urinary infections) but also important systemic metabolic indices.
The values of pH, urinary density, glycosuria and ketonuria indicate whether metabolic decompensations, dehydration, etc. are in progress; finally, also bilirubin and urobilinogen, for what concerns the liver or eventual haemolytic anemia.
I say this because unfortunately Covid19 can also compromise not only the kidney system, as well as a series of complications with a sneaky onset, not always quickly diagnosed.
There remains the problem of the stripes packaging, not available individually, from which a single dose will have to be obtained.
But it is probably a problem that can be overcome
Dear Editor,
We read with great interest the paper by Clement et al. With the advancement of technology, the digital consultations got a lot of attention in a good way and become more useful during the pandemic for both patients with disability as well as the normal patients. Though, some people still prefers to see the doctor face to face for more self-satisfaction. The digital consultation still have a long way to go for its acceptance within people specifically who are not used to and just begin.
As we know that telemedicine or video consultation can be used if you want to have look at a patient in care home, are working in a remote practice or the patient is bed bound. It saves patients an unnecessary trip to the practice, and the practitioner may have time freed up to see the sickest patients first. [1] Under the COVID-19 pandemic situation, people have to beware of the existence of such approaches to consultations, during the pandemic people were afraid to go to the hospital or clinic to have a treatment or appointment with doctor, especially for the aging population.
In Taiwan, the COVID-19 case raised up to hundreds local cases per day since Mid of May 2021 and the situation is going up to stage 3, the ministry of the health in Taiwan announced that people should prefer to use the digital consultation or telemedicine services to prevent the patients hospital visits and infection spread. Taiwan has a well-structured Health IT infrastructure an...
Show MoreThe high incidence of sensitive patient data exchanged between physicians via Whatsapp and iMessage evidenced in this study demonstrate potential violations of the new General Data Protection Regulation (GDPR) due to come into effect in May 2018. The GDPR outlines specific requirements for the processing and storage of data of which patient data is arguably the most sensitive. Breaches are expected to generate fines of up to 4% of annual turnover or 20 million euro – for authorities such as the NHS and HSE, this is potentially catastrophic.
Images of Xrays, blood results or wounds, taken via the mobile device in a doctor’s pocket, can be streamed via the famously insecure Apple iCloud in the USA, and suggested for potential upload to social Apps such as Facebook by default. Such material shared via Apps such as Whatsapp are downloaded by default to the image gallery on a smartphone and streamed between all networked devices, whether the recipients open the message or not. Such images can contain EXIF data, such as geographical co-ordinates, date, time, make and model of device etc. Such images are required to be encrypted and stored securely with the patient’s medical notes.
It cannot be overstated that ‘free’ communications solutions such as iMessage, WhatsApp, Signal, Secure Chat etc. are not free at all - if cash is not being paid for an App, the data of the clinician and patient is the commodity being paid for the functionality. Typically Apps have...
Show More