• Michelle Masayo Kameda-Smith, Christian Iorio-Morin, Alexander Winkler-Schwartz, Uzair S Ahmed, David Bergeron, Mark Bigder, Ayoub Dakson, Cameron A Elliott, Daipayan Guha, Pascal Lavergne, Serge Makarenko, Michael S Taccone, Michael Tso, Bill Wang, David Fortin, and Canadian Neurosurgery Research Collaborative (CNRC).
• Division of Neurosurgery, McMaster University, Hamilton, ON, Canada.
• World Neurosurg. 2018 Mar 1; 111: e465-e470.

BackgroundSmartphones and their apps are used ubiquitously in medical practice. However, in some cases their use can be at odds with current patient data safety regulations such as Canada's Personal Health Information Protection Act of 2004. To assess current practices and inform mobile application development, we sought to better understand mobile device usage patterns among Canadian neurosurgery residents.MethodsThrough the Canadian Neurosurgery Research Collaborative, an online survey characterizing smartphone ownership and usage patterns was developed and sent to all Canadian neurosurgery resident in April of 2016. Questionnaires were collected and completed surveys analyzed.ResultsOf 146 eligible residents, 76 returned completed surveys (52% response rate). Of these 99% of respondents owned a smartphone, with 79% running on Apple's iOS. Four general mobile uses were identified: 1) communication between members of the medical team, 2) decision support, 3) medical reference, and 4) documentation through medical photography. Communication and photography were areas where the most obvious breaches in the Canadian Personal Health Information Protection Act were noted, with 89% of respondents taking pictures of patients' radiologic studies and 75% exchanging them with Short Message System. Hospital policies had no impact on user behaviors.ConclusionsSmartphones are used daily by most neurosurgery residents. Identified usage patterns are associated with perceived gains in efficacy and challenges in privacy and data reliability. We believe creating and improving workflows that address these usage patterns has a greater potential to improve privacy than changing policies and enforcing regulations.Copyright © 2017 Elsevier Inc. All rights reserved.

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