The role of messaging services in day-to-day practice in pediatric neurosurgery, advantages of a bubble network, and an international survey.

Introduction: Messaging services (MS) are used widely worldwide. The implications of MS usage in daily hospital patient care have not been investigated. In this study, we discuss the extensive usage of MS in our Pediatric Neurosurgical Department, introduce our bubble algorithm, and provide additional input from an international survey.

Methods: WhatsApp activity in the department of pediatric neurosurgery at Dana Children's Hospital, Tel Aviv, Israel, was analyzed. We designed a graphic representation of the content of the different conversation bubbles and how they interact. We also described a survey evaluating MS use in daily neurosurgical practice was sent to 25 neurosurgeons around the world. Collected data included details on the usage of MS, the type of information being transferred, and the participants' opinion of the potential risks and benefits of these systems. We began collecting messaging data November 2018, before the COVID pandemic era. We continued to collect data over the course of almost 3 years.

Results: We identified a bubble network structure that reflects a logical method of communication between different segments of pediatric neurosurgical care in our institution. Additionally, we analyzed 22 survey responses, received from 14 different countries. The vast majority of centers with "department groups" use messaging services to transfer multimedia files of patient-related data. Nineteen responders believe that MS significantly improve overall patient care.

Conclusion: MS has revolutionized and improved the patterns of communication in our department. The great benefits of quick, simple access to information strongly outweigh formality and the potential for medicolegal disadvantages (e.g., HIPAA).