The junior doctor on a mission to change the WhatsApp problem in the NHS

Among medical professionals, it’s no secret that the NHS has communication trouble. One junior doctor is has come up with an app to change that

Lydia Yarlott and her boyfriend Philip Mundy have created an app, along with co-founder Barney Gilbert, to help doctors communicate more efficiently

Lydia Yarlott has always wanted to be a doctor. But recently, she put her medical career on hold to found a business that she hopes will make communicating simpler for hospital staff.

The idea for Forward, an app that offers a secure communications platform for medical staff at work, came to Yarlott during her first two years as a junior doctor. She was shocked to discover that medical staff were communicating via WhatsApp, putting patient data at risk.

“The party line on Whatsapp is that you’re not supposed to use it to exchange patient identifiable information, but the truth is, if we didn’t have that, we wouldn’t have another way of communicating effectively,” Yarlott says.

Among medical professionals, it’s no secret that the NHS has a WhatsApp problem. Doctors are officially required to contact one another by pager or fax. Many clinical groups, frustrated by outdated technology, set up WhatsApp groups to message one another.

More than 90 per cent of UK doctors in a survey of 60 trusts by the British Medical Journal said they used some form of external instant messaging app at work. More importantly, 83 per cent had sent or received an instant message containing data that could identify a patient.

When Yarlott described this issue to her boyfriend, Philip Mundy, he encouraged her to seek a solution. Mundy, a serial entrepreneur, has some experience in the field. He previously worked on Beem, a communications tool for employers and colleagues working remotely.

Yarlott says: “Doctors are indoctrinated to be risk-averse and there is an attitude in the NHS that change is impossible. He is a serial tech entrepreneur and so when I came home and said I couldn’t believe we were using pagers he said, ‘Why don’t we do something to change it?’”

Yarlott and Mundy worked with co-founder Barney Gilbert to create an app to connect everyone in a hospital. “Doctors and nurses work together but might not communicate well together,” she says. “So a doctor’s list might tell you some of a patient’s problems, but the nurse’s list might be different. That impacts the patient. Everyone should know what’s going on.”

WhatsApp is an imperfect platform for this kind of detail. Doctors and other hospital workers using WhatsApp have to exchange personal numbers, making it impossible to look up other staff in the same hospital.

Work messages then get mixed up with social messages through the same platform. And because hospital staff are aware of the dangers of using WhatsApp, they adopt coded language to talk about patients, which could be confusing and even dangerous when prescribing medication.

Yarlott knows the feeling of being a new doctor left alone with a sick patient and having nothing but a pager – or ‘bleep’, as she calls it – to get help from more experienced colleagues. “If your bleep goes off you have to move away from the patient and find a phone,” she says. “Then their bleep goes off, but you have no idea what they are doing and you have to wait on the phone for them to bleep you back. It gives you this sense of fear.”

Yarlott and Mundy are now working full-time on Forward. So far, they had secured a six-figure investment from super angels and healthcare providers. More than 1,500 hospital staff are using the app, including Karen Williams, a biomedical scientist working at Medway.

Williams uses the app to speed up the testing and results process at Medway. She set up a generic user for her lab on the app so that doctors can add extra biomedical tests to a patient’s records.

“It used to be done by phone and then someone would have to add it on by hand,” Williams says. “In a day, that could mean 20 phone calls and 20 things to add by hand. That adds up.”

The hardest thing has been getting doctors to adopt the app in hospitals, where processes are conservative and people can be resistant to change, Williams says. When someone phones us to change a patient’s tests, she reminds them they can do it more quickly using the app.

That kind of user advocacy will be crucial for Forward to succeed. The app has gone through a number of NHS processes and been formally approved by several individual trusts. But getting people to use it is different. “Our assumption is that if we get enough users, our product will become valuable,” Yarlott says.

The NHS has got better at being open to tech. It has an Innovation Accelerator to speed up the adoption of new technology. But Yarlott says that it can be difficult for entrepreneurs to know who to speak to. “It would be great if the digital health accelerator acted as a portal for companies that have useful products,” she says.

Then there’s the small matter of commercialising the product. Yarlott says Forward has a better chance at becoming essential to the NHS through an added function that allows trusts to monitor staffing numbers in real time, to make sure that departments don’t go short-staffed during busy or holiday periods. “We expect it to make clinical call work much more efficient, but we recognise that that’s not always a priority for anyone other than the grass roots staff,” Yarlott says.

I ask her if she plans to join the staff on the frontline as a doctor again eventually. She says she does, despite the fact that morale among staff is at an all-time low.

“We’re constantly being told how the whole system is crumbling, there’s the winter crisis, there are no beds,” Yarlott says.

“I love working for the NHS. I believe in what it stands for, and that’s what I want to protect by doing this project. It’s about looking after frontline staff who end up not feeling valued; it’s about giving them something that is built for them and that they want to use.”