How Emojis Are Used as a Language in Clinical Settings

How Emojis Are Used as a Language in Clinical Settings

Researcher Colin M. E. Halverson, PhD, from the Center for Bioethics at Indiana University School of Medicine, collaborated with Claire E. Donnelly, MA; Michael Weiner, MD, MPH; and Joy L. Lee, PhD, MS on a study that sought out to establish how emojis and emoticons are used in professional communications in healthcare settings.

The researchers defined emoticons as “representations of faces constructed only with text characters from a traditional keyboard layout” and emojis, as “typically 12×12-pixel images of everything from faces to eggplants to exclamation marks, which are inserted into digital text.” They added that emojis are widely used and have largely replaced emoticons.

Citing previous studies as reference, the researchers explained that interactions between clinicians and patients using emojis have been researched, but not enough is documented about their use among peers.

“The increasing adoption of such computer-mediated communication in place of traditional alphanumeric pagers intensifies both the use of and the need for consensus on ideograms and their role in health care contexts,” stated the researchers, who also claim their study is the first one to look at emoji use among clinicians.

Data and Analysis

The researchers analyzed 1,319 clinical text message threads from Diagnotes representing 596 unique users. Diagnotes is a communications platform adopted by many institutions in the healthcare industry, and it uses a traditional ASCII keyboard as well as Unicode emojis (approximately 2,000) that include faces, abstract symbols, and medical imagery. The emojis in Diagnotes are organized into categories, with the 30 most popular emojis appearing first on screens. 

The analysis revealed that 7% of messages contained emojis or emoticons used in various ways, most often to express emotion (61%). The most commonly used emojis were the thumbs-up 👍 (39%), the smiley face 🙂 (9%), the tears of joy face 😂 (6%), and the heart (5%). Four emoticons were represented in the data set: :), :(, :/, and :-). The most commonly used emoticon was :) (73%), followed by :( (13%), :/ (8%), and :-) (8%). The researchers stated that 8% of users used a combination of emojis and emoticons, but most used only emojis (73%) or only emoticons (19%).

Examples of exchanges:

User 928: “You following [patient name], today?”

User 070: “Yes I have the pleasure of her today 🙃”

User 928: “Oh how fun 😝”

The emojis used to convey emotions expressed happiness or good humor (69%). A negative sentiment was represented as sorrow or disappointment in the rest of the sample (31%), explained the researchers, concluding that clinicians tend to use emojis and emoticons “to add new information, to disambiguate affect, and to promote interpersonal relationships.”