Dr. Shuhan He, Program Director of the Healthcare Data Analytics program, is a leading voice on the need for widescale usage of the ubiquitous symbols
Emoji are ubiquitous, especially on social media and in digital communication, where symbols are understood universally with little room for misinterpretation. But in the world of medicine, emoji have yet to catch on.
He, who was the driving force behind the Massachusetts General Hospital effort to create the anatomical heart and lung emoji now seen on every device worldwide, recently published “Interpreting Emoji: A Language for Enhancing Communication in Healthcare” in the Journal of American Medical Association (JAMA) Network Open. His commentary makes the case that emojis have the potential to improve communication, patient outcomes, and provider-patient relationships.
“The use of emoji in medical charts is a relatively new and emerging topic, and there is a lack of research and understanding around its potential benefits and drawbacks,” said He, who is also physician-scientist in the Department of Emergency Medicine at Massachusetts General Hospital. “Consider an example: if a physician responds to a question with 👍 in answering a consult or page, is that considered a legal medical order? The impact of a thumbs up in the medical and legal system could be super interesting and a really important area of study.”
In fact, a Canadian judge recently ruled that the “thumbs-up” emoji is just as valid as a signature and pointed to the “new reality” of how people communicate. He also dismissed concerns that allowing the thumbs up emoji to signify contract acceptance “would open up the flood gates” to new interpretations of other emoji.
As emoji establishes a presence in the legal world, Dr. He says their use in medical charts has the potential to significantly impact healthcare communication and delivery, and he points to the scale 😀🙂😐🙁☹️😭, an effective tool pediatric physicians use every day to assess how children feel.
“Emojis help communicate in a way that is less confusing for everyone,” He said. “The big takeaway from my JAMA commentary is, ‘This is a language and it should be treated seriously like any other language. We take Chinese and Spanish, and all other languages, seriously. We should interpret emoji just like we understand those other languages.”
He says there are two clinical implications with the ongoing effort to increase representation of medical emoji.
“The acceptance of these emoji demonstrate a growing recognition of the potential benefits of using emoji in healthcare,” said He. “This signifies a shift in how we perceive and utilize this communication tool. With the availability of more medical emoji, healthcare providers can now utilize them to improve communication with patients and effectively convey complex medical information in a simple and intuitive manner.
”Second, emoji usage in patient-reported outcomes has the potential to enhance our understanding of patient experiences, particularly in relation to pain, emotions, and sentiment,” continued He. “By incorporating emoji to capture these experiences, healthcare providers can gain deeper insights and effectively address patient needs, resulting in enhanced patient outcomes and satisfaction.”
He and his colleagues have been trying to have emoji for the liver, kidney, spine, and stomach approved by the Unicode Consortium, the group that decides which new pictorial symbols are turned into emojis. So far, no luck.
“Those don't exist yet,” said He, “and those are what we're waiting for because to me, it's just like a language: if we don't have the words, we can still communicate through emoji.”
In He’s JAMA commentary, he points out that the ultimate goal of medicine is human understanding through language in order to provide effective treatment.
“Effective communication is essential for successful treatment and care,” writes He, “but certain health situations such as stroke, brain injury, or vocal impairments, can create substantial barriers including loss of voice or difficulty speaking while mechanically ventilated. Research into understanding visual point and tap language inputs that are universally accessible … can help alleviate these barriers and improve patient outcomes.”
“The use of emoji in health care communication presents numerous advantages, including their universal appeal and accessibility to diverse populations,” concludes He in the JAMA publication. “By promoting more effective communication between patients and care clinicians, as well as between clinicians themselves, a universal emoji-based language system with a common agreement of meanings can be developed. Taking clinician-clinician communication into account is crucial for a comprehensive understanding of this potential. As digital health technology continues to advance, embracing the potential of emoji as a language for health can enhance communication, improving patient care.”
Going forward, He has his eyes on two initiatives: continuing to build momentum for the acceptance of more medical emojis when the Unicode Consortium meets again to approve emoji and how to incorporate this with the Healthcare Data Analytics program at the IHP.
"We want to be able to use more advanced Artificial Intelligence and machine-learning data analytics techniques to understand how patients feel in patient reported outcomes and personalized medicine,” said He. “It's important that we get more folks ready in the healthcare system to interpret data. That’s a really important part of this.”
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