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Doctors are using emoji to diagnose patients in clinics and hospitals

A doctor, using emoji, to diagnose a sick patient? Believe it or not, it’s happening. Those vibrant, miniature digital symbols we use to express our feelings and ideas – are no longer limited to social media conversations or casual texting. 

These universally recognized symbols could potentially transform the way medical practitioners communicate with patients, as argued by a trio of researchers in a recent commentary published in the JAMA Network Open.

Kendrick A. Davis, a professor of psychiatry and neuroscience at the University of California, Riverside, stands as one of the vanguards of this innovative concept. 

Collaborating with Dr. Shuhan He, a pioneer in emoji research from Harvard Medical School, and Jennifer 8. Lee from Emojination and Unicode Consortium, Professor Davis advocates for a universal emoji-based language system in healthcare communication.

The argument for doctors using emoji

The argument is simple yet robust. Using emoji, due to their universal appeal and accessibility, can facilitate more effective communication between patients and care providers, as well as between clinicians themselves. 

“By promoting more effective communication between patients and care providers, as well as between clinicians themselves, a universal emoji-based language system with a common agreement of meanings can be developed,” said the researchers.

Developing a measurement system for using emoji

Over the last two and a half years, Professor Davis has been developing an emoji-based measurement system. He’s currently conducting a study, approved by the UCR Institutional Review Board, using emoji to measure mental health in college students.

“Emoji have universal appeal,” said Davis. “Their use can bypass levels of education, language, and age. They open a bridge for communication.” He asserts that most communication in the medical field usually involves surveys or questionnaires, which often lead to communication breakdowns. This happens when surveys, replete with jargon and technical terms, present a language barrier to diverse patients at different stages of their care. 

Here’s where using emoji can provide an elegant solution, replacing complex survey language and fostering understanding.

How the researchers are developing the system

To establish a standardized set of medically relevant emoji, Davis and his co-authors emphasize the importance of collective agreement from medical societies and relevant organizations. These bodies need to agree on a comprehensive set of symbols universally recognized and understood.

The team further notes that effective communication is a cornerstone of successful treatment and care. Health situations such as stroke, brain injury, or vocal impairments often present formidable barriers.

“This barrier could be difficulty speaking while being mechanically ventilated,” or even a patient’s inability to speak while receiving clinical care. “Emoji can be helpful in such situations with the patient simply pointing to an emoji on a scale to indicate how they feel. Emoji can also be useful in countries where illiteracy is high,” explained Professor Davis.

Using emoji to replace medical survey questionnaires

One of the major challenges in healthcare is the length of medical surveys and their traditionally low response rates, which significantly hinder data collection. “Emoji addresses both these issues,” Davis said. “With emoji, you can greatly condense the questionnaire sent out to patients. This could lead to an increase in response rates.”

Professor Davis, who has designed more than 500 surveys and questionnaires for the UCR School of Medicine in the past 10 years, reveals that patients don’t respond well to extensive surveys. “No one wants to answer pages and pages of questions, no matter how they are incentivized. With emoji, you can condense the content and quickly get to the point of the most pressing issues and questions.”

He also acknowledges the potential value of qualitative research methods. “We, who are quantitatively biased, inevitably miss some information. We need a qualitative lens. I am looking to partner with researchers who would like to work with us and are qualitatively heavy in their methodology.”

Encouraging more doctors to start using emoji in their practices

Davis recognizes that despite the popularity of using emoji, their powerful potential in healthcare communication isn’t yet widely acknowledged. “They can feel cartoonish. We hope our commentary will bring more legitimacy to the understanding that there is a future for emoji beyond their cartoon-like illustration.” 

“Emoji have a lot of power because they are so readily used in communication and exclude only a few populations, such as the visually impaired. If the use of emoji is meaningful in communication with doctors and patients, it’s probably meaningful in communication in other spaces where services and products are delivered to people.”

Professor Davis’s passion extends beyond his groundbreaking research in communication. He is deeply committed to addressing the shortage of primary care doctors in Inland Southern California. This large and rapidly growing region, home to an ethnically diverse population of 4.64 million people, is severely medically underserved. 

With only 41 primary care physicians (PCPs) per 100,000 people, the region falls significantly short of the recommended ratio of 60-80 PCPs per 100,000 according to the California Health Care Foundation.

“Almost 40% of Americans are on Medicare and Medicaid, which are strained and service primarily the poor,” Davis said, shedding light on the gravity of the situation. “It is PCPs who service these Americans, which means it is the impoverished population that receives the bulk of primary care. But if Medicare and Medicaid are strained to even provide care, they have few resources for data collection and reporting. That’s what we are trying to address.”

The researchers hope that their work will pave the way for universal medical communication, breaking down barriers and ensuring that no patient is left misunderstood. Whether you’re a doctor, a patient, or just an observer, it’s clear that the healthcare landscape is evolving, and emoji could be at the forefront of this transformation.

More about emoji

Emoji, originating from Japan in the late 1990s, have become a fundamental part of how we express emotion, tone, and nuance in the era of digital communication. The word “emoji” comes from the Japanese words “e” (絵) meaning “picture,” and “moji” (文字) meaning “character.” So, literally, “emoji” translates to “picture character.”

Shigetaka Kurita, an interface designer, is credited with creating the first set of 176 emoji for a mobile internet platform, the “i-mode”, developed by the Japanese telecom company NTT Docomo. These initial emoji were rudimentary 12×12 pixel images that represented a variety of objects, emotions, and symbols, designed to convey information in a simple, visual manner.

Using emoji has evolved and expanded over the years

Over the years, emoji have evolved and expanded. They’ve become much more detailed and diverse, reflecting a broad array of emotions, ideas, identities, and cultural symbols. Major tech companies like Apple, Google, and Facebook, recognizing the universal appeal and communicative power of emoji, incorporated them into their platforms, facilitating their global adoption and popularity.

The Unicode Consortium, an organization that standardizes text representation across different computing systems, has approved more than 3,000 emoji. These range from various facial expressions, weather phenomena, and animals, to food items, flags of different countries, and much more. The Unicode Consortium releases updates periodically, introducing new emoji and modifying existing ones based on proposals they receive.

Using emoji varies by country and culture

Emoji usage varies significantly between individuals and cultures. Some people use them sparingly for emphasis, while others use them abundantly to express emotion, tone, and even to replace words. Researchers have found that the usage of emoji can say a lot about an individual’s personality, age, and cultural background.

Importantly, emoji have had a significant impact on digital communication, enabling users to convey emotions and other nonverbal cues that text alone may not capture. They can soften or strengthen the messages we send, add humor or sincerity, and help us express agreement, confusion, love, frustration, and thousands of other sentiments.

Despite their widespread usage, challenges exist. Misinterpretation of emoji is common due to their ambiguity and the cultural differences in how they’re perceived. For example, the same emoji can carry positive connotations in one culture and negative in another.

Regardless of these challenges, it’s undeniable that emoji have become a significant aspect of our digital lexicon, shaping the way we communicate, express, and even think in the digital age.


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