Use of mobile phones in hospitals

Mobile phones are widely used, but their use is still restricted in certain places including petrol stations, some areas in hospitals, and aircraft. Restrictions have been justified on the grounds of public safety, but the reasons behind these restrictions are often unclear. In hospitals, patients, visitors, and staff routinely breeze through wards with their mobile phones switched on. As yet we have no evidence that this behaviour has serious consequences for patients. The lack of such evidence has encouraged the Medicines and Healthcare products Regulatory Agency (MHRA) to advise more selective restrictions on the use of mobile phones in hospitals (box).¹ While welcoming this relaxation, we wonder why it has taken so long to happen and why it has the feeling of extracting a generous concession. The liberalisation sits alongside proposed new restrictions, such as a ban on the use of camera phones in patient areas. The regulations also fail to criticise the previous ones, which were overcautionary. Paradoxically, the new rules may be even more restrictive than the old ones.

Mobile phones arrived in an age when safety concerns were high and various restrictions were imposed—for example, bans on beef during the Creutzfeldt-Jakob disease scare, and the introduction of air travel restrictions and quarantine during the severe acute respiratory syndrome outbreak. Mobile phones are an easy target in a precautionary climate that demands proof that something is not dangerous rather than grounds that it is.² Unlike other public health issues such as Creutzfeldt-Jakob disease and severe acute respiratory syndrome, restrictions on mobile phone use can be implemented easily, because they seem to be relatively inconsequential, and the restrictions make people think that safety concerns are being taken seriously.

The most important concern with mobile phones is interference with sensitive medical equipment. A study by the Medical Devices Agency in the United Kingdom reported that mobile phones could interfere with 4% of medical devices at a distance of one metre.³ In contrast this figure was 41% for emergency services' handsets and 35% for porters' handsets. In general the interference was merely an irritation and ultimately harmless to the patient—for example, alarms were triggered and electrocardiograph recordings needed to be repeated. Effects on pacemakers, such as disruption to the atrial sensing circuitry or ventricular inhibition, can occur, but only when the patient holds their phone against the chest rather than the ear, and the effects stop once the phone is removed.⁴ Sensible caution regarding the proximity of mobile phones to medical equipment is thus warranted, but concerns about patient safety alone do not justify zealously enforced no phone areas, which can cause arguments between staff, patients, and visitors.

Beeping, ringing, and singing ring tones can be a nuisance, and the tendency for patients to answer their phones in the middle of a consultation is irritating. This, however, does not endanger patients and is comparable to the intrusive effect of radios, MP3 players, TV sets, and so on, as well as to other lapses in courtesy that occur.

The proposed relaxation of restrictions on the use of mobile phones is therefore welcome but, unfortunately, fresh anxieties may precipitate an entirely new wave of regulations. The Department of Health—for example, has recommended that camera phones should not be allowed in hospitals because they may undermine the privacy of patients, and it has also suggested that some ring tones might be mistaken for medical device alarms.⁵ The department concedes that identifying mobile camera phones might prove difficult and so, “The control of camera phones may only be seen to be practically possible by preventing the use of mobile phones altogether.”

Summary of MHRA advice on use of mobile phones in hospitals

A total ban on mobile phones is not needed and is impossible to enforce effectively

Mobile phones should be switched off near critical care or life support equipment and should be used only in designated areas

Authorised health and social care staff and external service personnel should always comply with local rules regarding the use of mobile phones

Hospitals and NHS trusts should develop local rules to minimise the risk of interference with important medical equipment

Mobile phones should not be used in critical care areas, such as intensive therapy units and special care baby units, or where patients are attached to complex devices

The MHRA also notes that

Telephone ring tones may disturb or alarm patients who are resting

The ringing of telephones and subsequent conversations may disturb important discussions involving patients or healthcare professionals (or both)

The use of camera phones may compromise patient confidentiality

Alarm tones on medical equipment may be overlooked if confused with telephone ring tones

Despite concerns about the negative aspects of mobile phones, they have many benefits. A survey of the attendees of the 2003 meeting of the American Society of Anesthesiologists found that only 2.4% had ever experienced interference between a medical device and a mobile. In contrast 15% indicated that a delay in communication had led to medical error or injury, and such delays were less frequent among those who used mobiles instead of pagers.⁶ Doctors and pharmacists would benefit from using mobile phones rather than pagers, and many patients in hospital would welcome the opportunity to relieve their isolation without resorting to expensive hospital phones that are cumbersome to use.

As in a previous editorial,⁷ we urge hospital managers and clinical directors to adopt a more flexible approach to the use of mobile phones on the basis that the advantages clearly outweigh their largely mythical risks.