---
title: "e-Consultation in Cardiology: Instant Messaging Benefits, Data-Quality Delays, and Medicolegal Con"
id: "pubmed-42752534"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42752534"
content_type: "clinical_feed_article"
specialty: "Cardiology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42752534/"
doi: "10.5543/tkda.2026.23495"
published_at: "2026-10-02T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# e-Consultation in Cardiology: Instant Messaging Benefits, Data-Quality Delays, and Medicolegal Con
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42752534
- **Specialty:** [Cardiology](https://medichelpline.com/clinical-feed/cardiology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42752534/)
- **DOI:** [10.5543/tkda.2026.23495](https://doi.org/10.5543%2Ftkda.2026.23495)
- **Published At:** 2026-10-02T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Study objective: assess use of **instant-messaging e-consultation** among cardiologists in Türkiye, self-reported treatment delays linked to perceived data quality, and variation in medicolegal concern by professional seniority. - Design: cross-sectional online survey of 253 cardiologists covering consultation patterns, AMI-related support activities, types of shared data, treatment delays due to data quality, regulatory awareness, and the 15-item **MIDCCS** (Medicolegal Implications of Digital Consultation in Cardiology Scale). - Key finding: e-consultation was widespread; among current users, 86.9% reported at least one AMI-related informal support activity (preliminary assessment 71.5%, triage 60.1%, catheterization lab activation support 36.4%, early management 42.7%). - Most commonly shared data: **ECG** (95.2%). ECG photographs were the most frequent source implicated in perceived data-quality problems. - Treatment delay: 23.7% of respondents reported at least one self-reported treatment delay attributed to perceived poor data quality; ECG photographs were most commonly involved. - Medicolegal concern: scores on MIDCCS differed significantly across seniority groups (P < .001 in every domain after correction), with specialists and faculty expressing greater concern than residents. - Exploratory analysis: a history of treatment delay was directionally associated with higher global medicolegal concern (common OR 1.711) but this association did not reach statistical significance (95% CI, 0.994–2.946). - Scale reliability: MIDCCS showed good internal consistency (Cronbach α = 0.86). - Conclusion and implication: while e-consultation is clinically functional and widely used, limitations include data-quality failures and higher medicolegal concern among more senior clinicians. The authors highlight the need for a secure, **KVKK**-compliant, end-to-end encrypted national e-consultation infrastructure integrated into Hospital Information Management Systems that preserves the speed and usability of consumer instant messaging platforms like WhatsApp.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 16. # The e-Consultation Paradox in Cardiology: The Conflict Between the Clinical Agility of Instant Messaging and Medicolegal Concerns Created by Current Legislation [Nazile Bilgin Doğan](https://pubmed.ncbi.nlm.nih.gov/?term=Do%C4%9Fan+NB&cauthor_id=42752534)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42752534/#full-view-affiliation-1 "Clinic of Cardiology, İzmir Bayraklı City Hospital, İzmir, Türkiye.") Affiliations Expand ### Affiliation * 1 Clinic of Cardiology, İzmir Bayraklı City Hospital, İzmir, Türkiye. * PMID: **42752534** * DOI: [ 10.5543/tkda.2026.23495 ](https://doi.org/10.5543/tkda.2026.23495) Free article Item in Clipboard # The e-Consultation Paradox in Cardiology: The Conflict Between the Clinical Agility of Instant Messaging and Medicolegal Concerns Created by Current Legislation Nazile Bilgin Doğan. Turk Kardiyol Dern Ars. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Turk Kardiyol Dern Ars Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Turk+Kardiyol+Dern+Ars%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Turk+Kardiyol+Dern+Ars%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42752534/) . 2026 Oct 2;54(7):596-605. doi: 10.5543/tkda.2026.23495. Epub 2026 Sep 16. ### Author [Nazile Bilgin Doğan](https://pubmed.ncbi.nlm.nih.gov/?term=Do%C4%9Fan+NB&cauthor_id=42752534)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42752534/#short-view-affiliation-1 "Clinic of Cardiology, İzmir Bayraklı City Hospital, İzmir, Türkiye.") ### Affiliation * 1 Clinic of Cardiology, İzmir Bayraklı City Hospital, İzmir, Türkiye. * PMID: **42752534** * DOI: [ 10.5543/tkda.2026.23495 ](https://doi.org/10.5543/tkda.2026.23495) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Objective:** To evaluate the clinical use of instant-messaging e-consultation among cardiologists in Türkiye, self-reported treatment delays attributed to the perceived quality of transmitted data, and variations in medicolegal concern according to professional seniority. **Method:** A total of 253 cardiologists completed a cross-sectional online survey covering consultation patterns, acute myocardial infarction (AMI)-related support, types of shared data, data quality-related treatment delays, regulatory awareness, and the 15-item Medicolegal Implications of Digital Consultation in Cardiology Scale (MIDCCS). The primary analysis compared MIDCCS domain scores across seniority groups using the Kruskal-Wallis H test with Holm-Bonferroni correction; a single-item ordinal regression analysis of global concern was exploratory. **Results:** Among current users, 86.9% (213/245) reported at least one AMI-related informal support activity: preliminary assessment, 71.5%; triage, 60.1%; catheterization laboratory activation support, 36.4%; and early management, 42.7%. The most frequently shared data type was the ECG (95.2%). A self-reported treatment delay attributed to perceived poor data quality was reported by 23.7% (58/245), most commonly involving ECG photographs. Medicolegal concern differed markedly across seniority groups after correction (P<.001 in every domain), with specialists and faculty members scoring higher than residents. In an exploratory ordinal model, a history of treatment delay was directionally but nonsignificantly associated with greater concern (common OR=1.711; 95% CI, 0.994-2.946). The MIDCCS demonstrated good internal consistency (Cronbach α=0.86). **Conclusion:** Although e-consultation was widespread and clinically functional, data quality failures and seniority-related medicolegal concerns indicate important limitations. The findings highlight the need for a secure national e-consultation infrastructure integrated into Hospital Information Management Systems that is KVKK-compliant and end-to-end encrypted, while remaining as fast and user-friendly as WhatsApp. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas. ](https://pubmed.ncbi.nlm.nih.gov/36321557/) Crider K, Williams J, Qi YP, Gutman J, Yeung L, Mai C, Finkelstain J, Mehta S, Pons-Duran C, Menéndez C, Moraleda C, Rogers L, Daniels K, Green P.Crider K, et al.Cochrane Database Syst Rev. 2022 Feb 1;2(2022):CD014217. doi: 10.1002/14651858.CD014217.Cochrane Database Syst Rev. 2022.Update in: [Cochrane Database Syst Rev. 2026 Feb 18;2:CD014217. doi: 10.1002/14651858.CD014217.pub2.](https://pubmed.ncbi.nlm.nih.gov/41705996/)PMID: 36321557Free PMC article.Updated. * [ Defensive Medicine Attitudes and Associated Factors Among Physicians Working in Obstetrics and Gynecology Clinics in Istanbul, Türkiye: Cross-Sectional Analytical Study. ](https://pubmed.ncbi.nlm.nih.gov/42814963/) Cenger CD, Kolcu G, Malkoç MA, Tüzün B, Çevik Doğan M, Saraç Sivrikoz T.Cenger CD, et al.JMIR Form Res. 2026 Sep 30;10:e105255. doi: 10.2196/105255.JMIR Form Res. 2026.PMID: 42814963Free PMC article. * [ Assessing sensitivity and specificity of the Manchester Triage System in the evaluation of acute coronary syndrome in adult patients in emergency care: a systematic review protocol. ](https://pubmed.ncbi.nlm.nih.gov/26657465/) Nishi FA, de Motta Maia FO, de Lopes Monteiro da Cruz DA.Nishi FA, et al.JBI Database System Rev Implement Rep. 2015 Nov;13(11):64-73. doi: 10.11124/jbisrir-2015-2213.JBI Database System Rev Implement Rep. 2015.PMID: 26657465 * [ A New Measure of Quantified Social Health Is Associated With Levels of Discomfort, Capability, and Mental and General Health Among Patients Seeking Musculoskeletal Specialty Care. ](https://pubmed.ncbi.nlm.nih.gov/39915110/) Brinkman N, Broekman M, Teunis T, Choi S, Ring D, Jayakumar P.Brinkman N, et al.Clin Orthop Relat Res. 2025 Apr 1;483(4):647-663. doi: 10.1097/CORR.0000000000003394. 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