6 ms·

Brazilian doctors use WhatsApp to talk to patients

53 points by herbertlui 11y ago

deleted 11y ago
[deleted]
antirez 11y ago
Common in Italy too. I find it very useful because you can send doctors exams, images, and so forth without interrupting like with a call. But is a lot more real time and personal than emails.
- MichaelGG 11y ago
  Don't you have any issues with sending your detailed medical information to Facebook? Signal, or even Telegram (despite it's stupid crypto, the E2E stuff _should_ work if verified right, and it's a marginally better client at the moment) should suffice without sacrificing privacy.
  - tdb7893 11y ago
    Privacy is obviously good but when I ask myself what specifically bad has happened to me because Facebook and Google know a bunch of random information about me I'm at a loss. Until the problem of privacy is tangible to most people it will always be an uphill battle
  - antirez 11y ago
    I totally understand the privacy implications, but I'm a person that tends to extern all its personal facts, so I'm kinda "public" by default, so no worry about sending what I talk about with even with strangers.
  - marcosdumay 11y ago
    Depends on the actual information, doesn't it?
dpflan 11y ago
Marketplace Tech had a segment on this concept yesterday. The issues of ensuring privacy, HIPPA compliance, and record keeping definitely need to be considered (US perspective). Hooking up dumping such communications to EMRs in securely acceptable fashion would be a nice middleman service. http://www.marketplace.org/2015/12/07/tech/why-texting-dilemma-health-industry http://www.marketplace.org/2015/12/07/tech/why-texting-dilem...
- herbertlui 11y ago
  Ahh really cool, thanks for sharing! I can see both recorded text and OTR messaging be useful (across different types of situations)
deleted 11y ago
[deleted]
sho 11y ago
Hospital staff in Thailand use LINE to do everything from organising shift rosters to trading images and instructions for patients. I have personally seen a (nurse) friend of mine receiving images of wounds from on-duty staff and giving advice for treatment over the app. In the absence of some kind of really amazing and free dedicated app, it actually seems very efficient! I have zero faith in any of those mandated health information privacy schemes anyway.
- officialchicken 11y ago
  That's too bad you have little faith. But that's because in Thailand there isn't any mandated privacy, or the laws are toothless. Here in the US, that nurse could be fined $25,000 every time she hits the 'send' button. It's a regulatory and educational problem, not a technical one. While it could be improved, and it's far from perfect, there's no reason what so ever to believe it's un-fixable.
  - brianwawok 11y ago
    I don't think I would want my medical images sent over WhatsAPP....
    - jsprogrammer 11y ago
      Why not? Facebook may be able to target the best product for your needs.
    - deleted 11y ago
      [deleted]
    - prophet_ 11y ago
      I can tell you for sure there are millions of people who don't care at all about having their pictures taken and sent over the net so long as tgey get an affordable treatment.
      - blub 11y ago
napsterbr 11y ago
"We are having trouble showing you adverts on this page, which may be a result of ad blocker software being installed on your device. As City A.M. relies on advertising to fund its journalism, please disable any ad blockers from running on cityam.com, then reload the page to see the rest of this content. More info here." kthxbye
- subliminalpanda 11y ago
  Exactly what I did. Tried using reader mode (on FF), got a nice chuckle.
  - bittercynic 11y ago
    Blocking js from cityam.com fixes it.
    - subliminalpanda 11y ago
      Good to know. Thanks!
- logicallee 11y ago
  you didn't load their advertisement, they didn't serve you content. Seems like a fair exchange to me?
  - atburrow 11y ago
    Which justifies OP's response by leaving the site.
    - logicallee 11y ago
      They didn't just leave the site, they came and complained here. To turn an adolescent meme around: the OP's broken sense of entitlement isn't the business model's problem.
- tyho 11y ago
MichaelGG 11y ago
WhatsApp is infuriating. I've managed to get the people I chat with to move to Signal or Telegram (seems a bit more friendly). But there's tons of resistance. My 9-yr-old doesn't seem to care about the privacy implications of sending all your writing (and photos) to Facebook, forever. My 7-yr-old does care, and expressed surprise that it was even legal to "take their secrets" and "I'd call the police on Facebook." (Her words.) But I suppose if other parents don't join in (shit most of them use WhatsApp themselves), what hope do their kids have? And I don't want to get my daughter ostracized so being heavy handed seems like a long-term losing strategy. Doesn't help that this is in a 3rd world Central American country and that vile, anti-net-neutrality zero-rating is in effect for FB stuff. You can basically pick up any phone, and WhatsApp will work, even if nothing else[1] does. Apart from the cost of the phone, there's no cost, at all, as far as I can see. 1: Including emergency, as this country hasn't really gotten to that point yet.
- JumpCrisscross 11y ago
  I was under the impression that WhatsApp is a relatively secure messaging platform [1]. I travel, from time to time, to countries such as the UAE, Singapore and France. I once attempted to get people to use Signal. No luck. HN seemed to have arrived at a consensus that Telegram is a crock of shit. So I shifted - in part due to local adoption - to WhatsApp. When their in-app calling was blocked in each of the above countries, I gained a little faith in their security model. [1] https://whispersystems.org/blog/whatsapp/ https://whispersystems.org/blog/whatsapp/
  - subliminalpanda 11y ago
    I would venture to guess that in-app calling is disabled (in the UAE) to protect teleco revenue streams. When texting on WhatsApp gets blocked in the above mentioned countries then you'll know it's secure.
  - gareim 11y ago
    I think this might be relevant. Especially the last paragraph. http://www.blog.twosense-labs.com/whatsapp-renegs-on-their-promise-of-true-message-encryption/ http://www.blog.twosense-labs.com/whatsapp-renegs-on-their-p...
bsbechtel 11y ago
FWIW, we use it to communicate with our vet down here too.
diego_moita 11y ago
Everybody in most of 3rd world uses WhatsApp for everything. The Brazilian Conselho Federal de Medicina (main medical association) published a memo telling doctors not to use it, but very few will pay attention. As always happens in Brazil only a tragedy can make people notice a problem. A couple lawsuits, some national scandal and people will learn. Besides, there is also a cultural element here: privacy is a lot more valued in anglo-saxon cultures than in Latino cultures. Brazilians, Italians and others are a lot less concerned about things such as personal space, body contact, exhibiting in a small bikini, going almost naked in a Carnaval parade, etc. Edit: Just for HN to have an idea of how big WhatsApp is: since May, the number of cell phone lines in Brazil is falling. More than 10 million lines are canceled. Young people are giving up on voice services and using exclusively WhatsApp for communications. Source: https://translate.google.com/translate?sl=auto&tl=en&js=y&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fg1.globo.com%2Ftecnologia%2Fnoticia%2F2015%2F12%2Fefeito-whatsapp-e-crise-matam-10-milhoes-de-linhas-de-celular-no-brasil.html&edit-text=&act=url https://translate.google.com/translate?sl=auto&tl=en&js=y&pr...
- antirez 11y ago
  More than 3rd world is "world but US and Japan". And a few more excluded countries. But WhatsApp is the default everywhere.
- fiatjaf 11y ago
  The problem is maybe that people _think_ it is safe to send "personal" messages. No one would send personal information through Facebook public posts, but if Facebook has a "private" or "group" setting then people will trust that thing is really not being seen by anybody. I don't use Facebook or WhatsApp to not encourage these stupidities, but some other day a friend told me she was very annoyed by the fact that advertisign suddenly began to appear on Facebook about a topic she had just mentioned in a "private" chat conversation.
- alister 11y ago
  >Besides, there is also a cultural element here: privacy is a lot more valued in anglo-saxon cultures than in Latino cultures. Brazilians, Italians and others are a lot less concerned about things such as personal space ... Speaking specifically about Brazilians, privacy works differently but so does "trust". Brazilians prefer to use intermediaries to establish trust much more so than North Americans: - You cannot rent an apartment in Brazil without going through a broker (unless you know the owner personally). Brazilians will pay a middleman for some reason. In Canada and the USA, it's the opposite -- almost nobody uses a broker; the renter and the owner deal with each other. - Professional jobs like software development go through recruitment firms almost exclusively. Whereas a big company would hire directly in the USA, in Brazil they'll use one of the Brazilian recruiting firms and pay a large fee. And professionals (such as programmers) will browse the recruiting firm's site and won't think to apply directly to the company. - Brazilians are unlikely to invite a stranger they met (over the Internet, by phone, or even in person) into their home. Even if the person is a professional business contact. In Canada/USA, people are much more open to inviting a business contact into their home. But if the Brazilian has an introduction to the person by a mutual friend, then the person is no longer a stranger; he is immediately welcome. Both privacy and trust work differently in Brazil.
dharma1 11y ago
My health insurance provider has an app I can use to schedule a Skype call with a GP whenever I need to. Haven't needed to use it yet but makes sense. They even give out free macro lenses for mobile phones
- ceejayoz 11y ago
  That'd be lovely. My insurer (in upstate NY, US) won't pay for phone consultations, period.
pbreit 11y ago
It's astonishing to me that regular ole texting still has not reached business considering messaging/texting is otherwise the most popular form of online communication. Show HN: we are aiming to make SMS texting more prevalent in business with Textline.com.
fiatjaf 11y ago
Everybody uses WhatsApp for everything in Brazil. It's the crazy world. It's madness. It makes me mad every time I see it.
- profeta 11y ago
  ironically, they have laws that demand free SMS on most plans. i think only a few categories of pre-paid plans do not. Though that is changing. Couple years ago there were laws that set maximum prices on internet and sms for pre-paid plans (R$0.5 a day!), but the telcos already lobbied the downfall of those for this year. brazil has a huge mentality of "belonging". Supermaket chains that market to upper-middle class (think whole foods) charge 4-10x more for the same product (R$20 instead of R$2.50 for bottled water, same brand). and they are usually just a block from a regular market. yet, you see lines just because people want to belong by purchasing there. WhatsApp was huge for people that needed to talk to folks overseas in brazil, and close to half the upper class and a large portion of the middle class in brazil sends their kids to study abroad. So flaunting WhatsApp instead of SMS is also a way to show off.
  - mascarenhas 11y ago
    I don't know where the parent lives in Brazil, but the supermarket chain comment definitely has not been my experience in upper-middle class Rio de Janeiro neighborhoods. People use Whatsapp instead of SMS because it simply is a better user experience, specially for sending media and group chat, not for showing off, or keeping in touch with relatives abroad. Phone companies began offering "free whatsapp" even in pre-paid plans because it because it became very popular, as a way to attract costumers, not the other way around.
    - profeta 11y ago
      you are probably a late adopter. 2010 it was used exclusively for overseas sms. Since nobody had it installed. Then, after it was bought by facebook, they started to PAY telcos around the world to increase penetration and block any competitor. ...telcos offering something for free when they have a closed monopoly :) that was funny.
fiatjaf 11y ago
Does WhatsApp still advertises itself by saying it "costs nothing for the first year, but after the second you pay $1.99"? has anyone actually paid that fee?
devgutt 11y ago
"A new global study of how doctors use wearable technology" where's the global study?
markolschesky 11y ago
For an American, it's easy to blame this on HIPAA compliance, but IMHO it has just as much to do with the speed/method in which medical malpractice suits are managed in Brazil. NPR had an article in which it took 17 years for a family to finally collect payment for medical malpractice. I also read a legal brief on the topic which indicated how this is slowly changing in Brazil. On the other hand, in the US, many physicians are afraid to push the limit from the norm because they are afraid of being sued. That's not an unwarranted fear. Some links on medical malpractice in Brazil: http://www.npr.org/sections/parallels/2014/11/05/359830235/brazil-the-land-of-many-lawyers-and-very-slow-justice http://www.npr.org/sections/parallels/2014/11/05/359830235/b... http://scholarship.kentlaw.iit.edu/cgi/viewcontent.cgi?article=3823&context=cklawreview http://scholarship.kentlaw.iit.edu/cgi/viewcontent.cgi?artic...
maw 11y ago
It's become common in Mexico too. I don't know exactly when I first started noticing it, but certainly I've seen it lots in the past year. Most recently an ophthalmologist asking a specialist colleague for a quick second opinion with respect to a condition I have in one of my eyes.

53 points by herbertlui 11y ago

deleted 11y ago

[deleted]

Common in Italy too. I find it very useful because you can send doctors exams, images, and so forth without interrupting like with a call. But is a lot more real time and personal than emails.

MichaelGG 11y ago
Don't you have any issues with sending your detailed medical information to Facebook? Signal, or even Telegram (despite it's stupid crypto, the E2E stuff _should_ work if verified right, and it's a marginally better client at the moment) should suffice without sacrificing privacy.
- tdb7893 11y ago
  Privacy is obviously good but when I ask myself what specifically bad has happened to me because Facebook and Google know a bunch of random information about me I'm at a loss. Until the problem of privacy is tangible to most people it will always be an uphill battle
- antirez 11y ago
  I totally understand the privacy implications, but I'm a person that tends to extern all its personal facts, so I'm kinda "public" by default, so no worry about sending what I talk about with even with strangers.
- marcosdumay 11y ago
  Depends on the actual information, doesn't it?

dpflan 11y ago

Marketplace Tech had a segment on this concept yesterday. The issues of ensuring privacy, HIPPA compliance, and record keeping definitely need to be considered (US perspective). Hooking up dumping such communications to EMRs in securely acceptable fashion would be a nice middleman service. http://www.marketplace.org/2015/12/07/tech/why-texting-dilemma-health-industry http://www.marketplace.org/2015/12/07/tech/why-texting-dilem...

herbertlui 11y ago
Ahh really cool, thanks for sharing! I can see both recorded text and OTR messaging be useful (across different types of situations)

deleted 11y ago

[deleted]

sho 11y ago

Hospital staff in Thailand use LINE to do everything from organising shift rosters to trading images and instructions for patients. I have personally seen a (nurse) friend of mine receiving images of wounds from on-duty staff and giving advice for treatment over the app. In the absence of some kind of really amazing and free dedicated app, it actually seems very efficient! I have zero faith in any of those mandated health information privacy schemes anyway.

officialchicken 11y ago
That's too bad you have little faith. But that's because in Thailand there isn't any mandated privacy, or the laws are toothless. Here in the US, that nurse could be fined $25,000 every time she hits the 'send' button. It's a regulatory and educational problem, not a technical one. While it could be improved, and it's far from perfect, there's no reason what so ever to believe it's un-fixable.
- brianwawok 11y ago
  I don't think I would want my medical images sent over WhatsAPP....
  - jsprogrammer 11y ago
    Why not? Facebook may be able to target the best product for your needs.
  - deleted 11y ago
    [deleted]
  - prophet_ 11y ago
    I can tell you for sure there are millions of people who don't care at all about having their pictures taken and sent over the net so long as tgey get an affordable treatment.
    - blub 11y ago

napsterbr 11y ago

"We are having trouble showing you adverts on this page, which may be a result of ad blocker software being installed on your device. As City A.M. relies on advertising to fund its journalism, please disable any ad blockers from running on cityam.com, then reload the page to see the rest of this content. More info here." kthxbye

subliminalpanda 11y ago
Exactly what I did. Tried using reader mode (on FF), got a nice chuckle.
- bittercynic 11y ago
  Blocking js from cityam.com fixes it.
  - subliminalpanda 11y ago
    Good to know. Thanks!
logicallee 11y ago
you didn't load their advertisement, they didn't serve you content. Seems like a fair exchange to me?
- atburrow 11y ago
  Which justifies OP's response by leaving the site.
  - logicallee 11y ago
    They didn't just leave the site, they came and complained here. To turn an adolescent meme around: the OP's broken sense of entitlement isn't the business model's problem.
tyho 11y ago

MichaelGG 11y ago

WhatsApp is infuriating. I've managed to get the people I chat with to move to Signal or Telegram (seems a bit more friendly). But there's tons of resistance. My 9-yr-old doesn't seem to care about the privacy implications of sending all your writing (and photos) to Facebook, forever. My 7-yr-old does care, and expressed surprise that it was even legal to "take their secrets" and "I'd call the police on Facebook." (Her words.) But I suppose if other parents don't join in (shit most of them use WhatsApp themselves), what hope do their kids have? And I don't want to get my daughter ostracized so being heavy handed seems like a long-term losing strategy. Doesn't help that this is in a 3rd world Central American country and that vile, anti-net-neutrality zero-rating is in effect for FB stuff. You can basically pick up any phone, and WhatsApp will work, even if nothing else[1] does. Apart from the cost of the phone, there's no cost, at all, as far as I can see. 1: Including emergency, as this country hasn't really gotten to that point yet.

JumpCrisscross 11y ago
I was under the impression that WhatsApp is a relatively secure messaging platform [1]. I travel, from time to time, to countries such as the UAE, Singapore and France. I once attempted to get people to use Signal. No luck. HN seemed to have arrived at a consensus that Telegram is a crock of shit. So I shifted - in part due to local adoption - to WhatsApp. When their in-app calling was blocked in each of the above countries, I gained a little faith in their security model. [1] https://whispersystems.org/blog/whatsapp/ https://whispersystems.org/blog/whatsapp/
- subliminalpanda 11y ago
  I would venture to guess that in-app calling is disabled (in the UAE) to protect teleco revenue streams. When texting on WhatsApp gets blocked in the above mentioned countries then you'll know it's secure.
- gareim 11y ago
  I think this might be relevant. Especially the last paragraph. http://www.blog.twosense-labs.com/whatsapp-renegs-on-their-promise-of-true-message-encryption/ http://www.blog.twosense-labs.com/whatsapp-renegs-on-their-p...

bsbechtel 11y ago

FWIW, we use it to communicate with our vet down here too.

diego_moita 11y ago

Everybody in most of 3rd world uses WhatsApp for everything. The Brazilian Conselho Federal de Medicina (main medical association) published a memo telling doctors not to use it, but very few will pay attention. As always happens in Brazil only a tragedy can make people notice a problem. A couple lawsuits, some national scandal and people will learn. Besides, there is also a cultural element here: privacy is a lot more valued in anglo-saxon cultures than in Latino cultures. Brazilians, Italians and others are a lot less concerned about things such as personal space, body contact, exhibiting in a small bikini, going almost naked in a Carnaval parade, etc. Edit: Just for HN to have an idea of how big WhatsApp is: since May, the number of cell phone lines in Brazil is falling. More than 10 million lines are canceled. Young people are giving up on voice services and using exclusively WhatsApp for communications. Source: https://translate.google.com/translate?sl=auto&tl=en&js=y&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fg1.globo.com%2Ftecnologia%2Fnoticia%2F2015%2F12%2Fefeito-whatsapp-e-crise-matam-10-milhoes-de-linhas-de-celular-no-brasil.html&edit-text=&act=url https://translate.google.com/translate?sl=auto&tl=en&js=y&pr...

antirez 11y ago
More than 3rd world is "world but US and Japan". And a few more excluded countries. But WhatsApp is the default everywhere.
fiatjaf 11y ago
The problem is maybe that people _think_ it is safe to send "personal" messages. No one would send personal information through Facebook public posts, but if Facebook has a "private" or "group" setting then people will trust that thing is really not being seen by anybody. I don't use Facebook or WhatsApp to not encourage these stupidities, but some other day a friend told me she was very annoyed by the fact that advertisign suddenly began to appear on Facebook about a topic she had just mentioned in a "private" chat conversation.
alister 11y ago
>Besides, there is also a cultural element here: privacy is a lot more valued in anglo-saxon cultures than in Latino cultures. Brazilians, Italians and others are a lot less concerned about things such as personal space ... Speaking specifically about Brazilians, privacy works differently but so does "trust". Brazilians prefer to use intermediaries to establish trust much more so than North Americans: - You cannot rent an apartment in Brazil without going through a broker (unless you know the owner personally). Brazilians will pay a middleman for some reason. In Canada and the USA, it's the opposite -- almost nobody uses a broker; the renter and the owner deal with each other. - Professional jobs like software development go through recruitment firms almost exclusively. Whereas a big company would hire directly in the USA, in Brazil they'll use one of the Brazilian recruiting firms and pay a large fee. And professionals (such as programmers) will browse the recruiting firm's site and won't think to apply directly to the company. - Brazilians are unlikely to invite a stranger they met (over the Internet, by phone, or even in person) into their home. Even if the person is a professional business contact. In Canada/USA, people are much more open to inviting a business contact into their home. But if the Brazilian has an introduction to the person by a mutual friend, then the person is no longer a stranger; he is immediately welcome. Both privacy and trust work differently in Brazil.

dharma1 11y ago

My health insurance provider has an app I can use to schedule a Skype call with a GP whenever I need to. Haven't needed to use it yet but makes sense. They even give out free macro lenses for mobile phones

ceejayoz 11y ago
That'd be lovely. My insurer (in upstate NY, US) won't pay for phone consultations, period.

pbreit 11y ago

It's astonishing to me that regular ole texting still has not reached business considering messaging/texting is otherwise the most popular form of online communication. Show HN: we are aiming to make SMS texting more prevalent in business with Textline.com.

fiatjaf 11y ago

Everybody uses WhatsApp for everything in Brazil. It's the crazy world. It's madness. It makes me mad every time I see it.

profeta 11y ago
ironically, they have laws that demand free SMS on most plans. i think only a few categories of pre-paid plans do not. Though that is changing. Couple years ago there were laws that set maximum prices on internet and sms for pre-paid plans (R$0.5 a day!), but the telcos already lobbied the downfall of those for this year. brazil has a huge mentality of "belonging". Supermaket chains that market to upper-middle class (think whole foods) charge 4-10x more for the same product (R$20 instead of R$2.50 for bottled water, same brand). and they are usually just a block from a regular market. yet, you see lines just because people want to belong by purchasing there. WhatsApp was huge for people that needed to talk to folks overseas in brazil, and close to half the upper class and a large portion of the middle class in brazil sends their kids to study abroad. So flaunting WhatsApp instead of SMS is also a way to show off.
- mascarenhas 11y ago
  I don't know where the parent lives in Brazil, but the supermarket chain comment definitely has not been my experience in upper-middle class Rio de Janeiro neighborhoods. People use Whatsapp instead of SMS because it simply is a better user experience, specially for sending media and group chat, not for showing off, or keeping in touch with relatives abroad. Phone companies began offering "free whatsapp" even in pre-paid plans because it because it became very popular, as a way to attract costumers, not the other way around.
  - profeta 11y ago
    you are probably a late adopter. 2010 it was used exclusively for overseas sms. Since nobody had it installed. Then, after it was bought by facebook, they started to PAY telcos around the world to increase penetration and block any competitor. ...telcos offering something for free when they have a closed monopoly :) that was funny.

fiatjaf 11y ago

Does WhatsApp still advertises itself by saying it "costs nothing for the first year, but after the second you pay $1.99"? has anyone actually paid that fee?

devgutt 11y ago

"A new global study of how doctors use wearable technology" where's the global study?

markolschesky 11y ago

For an American, it's easy to blame this on HIPAA compliance, but IMHO it has just as much to do with the speed/method in which medical malpractice suits are managed in Brazil. NPR had an article in which it took 17 years for a family to finally collect payment for medical malpractice. I also read a legal brief on the topic which indicated how this is slowly changing in Brazil. On the other hand, in the US, many physicians are afraid to push the limit from the norm because they are afraid of being sued. That's not an unwarranted fear. Some links on medical malpractice in Brazil: http://www.npr.org/sections/parallels/2014/11/05/359830235/brazil-the-land-of-many-lawyers-and-very-slow-justice http://www.npr.org/sections/parallels/2014/11/05/359830235/b... http://scholarship.kentlaw.iit.edu/cgi/viewcontent.cgi?article=3823&context=cklawreview http://scholarship.kentlaw.iit.edu/cgi/viewcontent.cgi?artic...

maw 11y ago

It's become common in Mexico too. I don't know exactly when I first started noticing it, but certainly I've seen it lots in the past year. Most recently an ophthalmologist asking a specialist colleague for a quick second opinion with respect to a condition I have in one of my eyes.