It’s common for private doctors in Mexico City, and across Latin America, to wake up each morning and be greeted by 100 or more WhatsApp messages. The messages typically contain urgent clinical concerns mixed with routine administrative requests. Often, no clinical record is available at the point of review to help the practitioner deal safely and efficiently with each notification or request.
Image: OpenAI
This common but challenging scenario exists because WhatsApp is familiar, free and heavy used by most patients and clinicians for every other kind of work-related or social messaging. Being so convenient and ever-present, it has become the default channel for day-to-day clinical communication.
At scale, however, WhatsApp’s ease of use concentrates many competing demands in a single message stream, creating constant competition for attention and prioritisation, with risk of error and the need for practitioners to be constantly available which can be overwhelming.
Because WhatsApp is part of the everyday digital infrastructure for clinical communication, the question is not whether it should be used but how it can be used more safely and efficiently, with system boundaries, accountability and reliability baked in.
WhatsApp quickly took hold
Globally, WhatsApp has more than 3 billion monthly active users, and processes 150 billion messages per day. It’s the world’s largest messaging app; China’s WeChat, with around 1.3 billion users, runs a distant second. It’s also perceived as safe from intrusion and hacking, with end-to-end message encryption.
WhatsApp’s expansion into healthcare has happened organically, not by design, taken up by individuals or small groups rather than large healthcare organisations. It’s been driven by familiarity, reliable performance on low-cost devices and limited data plans, clinical need and the absence of practical alternatives.
A referral and communication story
A colleague in California describes helping to coordinate his mother’s care from thousands of kilometres away. She lives in Karachi, and was prescribed pressure-reducing eye drops at a first visit. Concerned that the assessment was incomplete, he reviewed the situation and sent a short WhatsApp message for her to share with the ophthalmologist at the next appointment.
At the follow-up, she received a full eye examination. The results, including images and a written report, were shared with the colleague on WhatsApp. He reviewed them, shared a summary with his brother in Pakistan to support a second opinion, and translated the findings into plain language for his mother’s caregivers, through the same channel.
This story illustrates how WhatsApp bridges distance, language and clinical settings. It supports rapid information sharing, family involvement in care decisions and continuity, while formal healthcare systems play a limited role in this picture.
Using WhatsApp more deliberately
As noted, WhatsApp already supports many aspects of healthcare delivery through everyday use by clinicians and patients. Appointments are arranged, questions are answered, images are shared and care is coordinated through a familiar channel that needs no instruction manual or Help Desk.
To solve for the challenge faced by the Brazilian GP and others using WhatsApp in clinical workflow, this ecosystem needs clearer boundaries for acceptable content, more reliable and defined processes, and explicit ownership of risk. Creation of these guardrails and enabler could happen through systems arranged around WhatsApp rather than by WhatsApp itself.
Simple design choices such as: (1) separating clinical from administrative messages, (2) clarifying and enforcing consent, (3) routing messages to teams rather than individuals and (4) capturing clinically relevant information in secure storage systems can strengthen safety, continuity and professional boundaries without making unnecessary barriers to engagement.
South Africa: WhatsApp in routine clinical coordination
In many SA public hospitals, WhatsApp groups support care referrals, sharing diagnostic information and images, and checking of bed availability. Research in Western Cape and Namibian hospitals has shown how WhatsApp is used alongside official systems to improve coordination, compensating for the poor alignment of existing systems with everyday workflow needs.
Vula Mobile: a structured messaging comparison
Vula Mobile is a web and smartphone-based referral app used in South Africa to link primary healthcare workers with specialists. First implemented in the Western Cape, it has expanded to cover multiple specialities with custom referral templates, structured forms and built-in clinical information capture.
Both WhatsApp and Vula provide chat-oriented mobile communication familiar to clinicians and support rapid connection between health professionals.
Vula, which is free to the user, adds value through the described structure for referrals, capturing standardised information for specialist review. Specialist advice and feedback returns rapidly to the initiating clinician, with response times tracked and reported regularly. In a mixed methods study conducted at a district public hospital, most Vula referrals were accepted, inappropriate referrals decreased, and clinicians reported better care coordination and outcomes.
Some capabilities remain outside Vula’s current scope: it mainly supports clinician-to-clinician referrals rather than patient-to-clinician communication. Feedback to referring clinicians is sometimes limited and integration with hospital and provincial health records is still developing.
The limits
WhatsApp’s strengths hint at limits and how they should be managed.
Privacy and regulation
In South Africa, the Protection of Personal Information Act, 2013 (POPIA) sets minimum requirements for processing personal information, including sensitive health data, and emphasises the need for explicit consent, secure storage and clear accountability when supporting clinical communication.
Clinical records and professional boundaries
Messages stored on personal devices create uncertainty around audit, continuity and security. This highlights the importance of transferring clinically relevant content into secure managed systems that support accepted standards for health records.
Guidance from health professional regulators like HPCSA emphasises the importance of professional conduct when using messaging platforms in clinical work, including expectations around access, responsiveness and interaction with patients.
Billing and practice management
In South Africa’s private sector, clinical work links to detailed billing rules and real-time claims processing. This environment requires structured data, validation tools and reliable financial workflows. Conversational chat interfaces support communication well but specialised practice management systems are needed to support billing and claims with greater reliability.
WhatsApp as a front door
WhatsApp could be treated as an entry point rather than a complete system – the “front door” for patient communication. Secure, compliant systems would store the clinical record. In the private sector, practice management and billing platforms would continue handling claims and payments.
Messages can flow through the WhatsApp Business API, which is designed for organisational use and can integrate with backend systems via approved partners. Artificial intelligence can assist with summarisation and drafting, while clinicians retain authority over clinical decisions and billing submission.
This approach aligns with current practice while strengthening safety, governance and compliance.
Image: OpenAI. WhatsApp is ubiquitous in Latin American and South African healthcare. Can it be a safer and more reliable “front door” to the system?
If WhatsApp is free, who pays?
WhatsApp is free to consumers because business accounts support the platform’s services.
Meta, WhatsApp’s parent company, licences the WhatsApp Business API and related enterprise features. Businesses pay for access and their volume of interactions. The model explains how WhatsApp provides global infrastructure and reliability without direct user charges. It does reinforce the importance of clinical data ownership, local storage and alternative access paths.
South Africa has choices.
WhatsApp is embedded in everyday care delivery. The choice is whether it is prioperly integrated or left unmanaged.
While sophisticated digital health enterprises are being imagined, built or acquired, the reality meantime of WhatsApp’s everyday use and usefulness increases the importance of protecting clinicians and patients through better system structure, consent and integration.
If WhatsApp channels are used by design rather than habit, they can help reduce administrative burden, improve access and bring informal practices into safer and more transparent enterprise systems. This outcome depends less on technology and more on decisions about roles, responsibilities and system boundaries.
Readings
Kapepoa M, van Belle J-P, Weimann E. WhatsApp as an improvisation of health information systems in Southern African public hospitals: a socio-technical perspective. arXiv 2025. https://arxiv.org/abs/2502.09049
Leona Health funding article. Uber Eats alum lands $14M seed from a16z to fix WhatsApp chaos for LatAm’s doctors. TechCrunch, December 16 2025.
WhatsApp description and business API details. Wikipedia (2025). Active user counts, WhatsApp Business API context and general platform background. (en.wikipedia.org)
Gloster P, Mash R, Swartz S. Investigating the effect of the Vula Mobile app on coordination of care and capacity building in district health services, Cape Town: Convergent mixed methods study. S Afr Fam Pract (2004). 2021 Sep 22;63(1):e1-e13.
pubmed.ncbi.nlm.nih.gov/34636590
Acknowledgements
Zaki Hasan for the idea and a story