When practice outpaces policy: Whatsapp use among nursing and medical staff in Israeli hospitals

BACKGROUND AND OBJECTIVES: WhatsApp has become a central communication tool among medical and nursing staff worldwide, offering a fast and convenient way to share clinical information. However, its widespread use raises concerns regarding patient confidentiality and data security. This study examined the extent and characteristics of WhatsApp use for clinical purposes among hospital-based healthcare professionals in Israel, and the perceived risks and benefits associated with its use. METHODS: A quantitative cross-sectional study was conducted using a structured questionnaire adapted from De Benedictis et al., among 283 participants – 132 medical staff and 151 nursing staff – from hospitals across Israel. The questionnaire assessed usage patterns, perceived utility, and perceived risk. Data were analyzed using hierarchical regression to identify predictors of use. RESULTS: Professional WhatsApp use was nearly universal (reported by 100% of physicians and 97.4% of nurses). Physicians reported significantly higher use in both non-identifiable data sharing (mean 3.46 on a 1–5 scale, with 1 = strongly disagree, 5 = strongly agree) and identifiable data sharing (mean 2.61) compared to nurses (means 2.96 and 2.26, respectively). Perceived personal benefit was high (mean 5.19 on a 1–7 scale, with 1 = strongly disagree, 7 = strongly agree), while perceived organizational support was low (mean 1.86), indicating a lack of official guidelines. Regression analysis identified four predictors: age (negative association), and personal, normative-organizational, and regulatory-organizational benefits (positive associations). Perceived risk was higher among women and negatively predicted use. CONCLUSIONS: WhatsApp is a deeply embedded communication tool in the daily clinical practice of the surveyed medical and nursing staff. This reflects a “normalization of non-compliance”, where the perceived efficiency of WhatsApp overrides regulatory prohibitions. Given its advantages and the current policy ambiguity, there is an urgent need for balanced regulatory guidance that leverages built-in security features, enhances risk awareness, and aligns with real-world practices to ensure both efficiency and patient privacy. WhatsApp is widely used by healthcare professionals to share clinical information quickly and efficiently. Our study found that almost all surveyed physicians and nurses use the app for work-related communication, and that identifiable patient information is often shared, despite formal policies prohibiting it. While hospitals issue guidelines that discourage such use, these have limited impact. In contrast, strong social and professional norms within teams encourage WhatsApp communication, making it an integral part of hospital life. The findings mirror global research showing that the need for fast, accessible communication often overrides institutional restrictions, reflecting a “normalization of non-compliance”. This pattern highlights a universal policy gap: WhatsApp and similar apps have become essential tools in healthcare systems worldwide yet are used without adequate regulation. The study calls for practical, balanced policies that align with real-world clinical needs while ensuring the protection of patient privacy.