Nicer

NICER The National Initiative for Clinical Emoji Research

NICER, the National Initiative for Clinical Emoji Research, is a collaborative, multidisciplinary community of linguists, social scientists, and clinicians dedicated to studying the use of emoji, emoticons, and other typographic aspects of healthcare communication. Our studies have investigated the impact of emoji on clinical workflow, the ethics and professionalism of messaging with emoji, the use of skin-tone modifiers, and emoji’s ability to promote engagement in wellness activities. Our work has been funded by the Indiana CTSI, has been published in venues such as JAMA Network Open,” and spans three continents.

People:

Co-chair: Colin Halverson, PhD

Dr. Halverson is a faculty investigator at the Indiana University Center for Bioethics and assistant professor of medicine at Indiana University School of Medicine.  He is a faculty member of the Bioethics and Participant Advocacy Program of the Indiana CTSI. Dr. Halverson's research interests include ethics and genetics, return of genetic and diagnostic testing results, health communication and linguistics, communicating risk and uncertainty, and patient education. 

 

 

Co-chair: Joy L. Lee, PhD, MS

Dr. Joy L. Lee is a health services researcher using mixed methods to examine healthcare quality, with special attention to examining electronic communication in healthcare, the healthcare utilization and experiences transgender and gender non-binary adults, and the impact of health information technology on patient safety.

 

 

 

Co-chair: Brian Zanoni, MD

Dr. Zanoni is an Associate Professor in Medicine and Pediatric Infectious Diseases at Emory University and is the medical director of the Ponce Family and Youth Clinic, Grady Health System. His research focuses on improving care for adolescents living with HIV in South Africa.

 

Associate Director of Research Projects:

Collaborators:

  • Sam Vershaw (IU Center for Bioethics) 
  • Kristin Beima-Sofie (University of Washington)
  • Tori McMeans (Emory)
  • Baneen Fatima (Worcester Academy)
  • Scarlett Bergam (George Washington University)
  • Kunal Kapoor (University of Queensland)
  • Lauren Kang (Massachusetts General Hospital)
  • Haley Echols (Massachusetts General Hospital)

Contact Us:

 

Research:

Halverson, C. M. E., Donnelly, C. E., Weiner, M., & Lee, J. L. (2023). Content Analysis of Emoji and Emoticon Use in Clinical Texting Systems. JAMA network open, 6(6), e2318140. https://doi.org/10.1001/jamanetworkopen.2023.18140

  • This qualitative study found that when clinicians use emoji and emoticons in secure clinical texting systems, these symbols function primarily to convey new and interactionally salient information. These results suggest that concerns about the professionalism of emoji and emoticon use may be unwarranted.

Halverson, C. M. E. (2021). Skin-tone modified emoji and first-person indexicality. Social Semiotics, 33(5), 1091–1109. https://doi.org/10.1080/10350330.2021.2000333

  • This article argues that, parallel to other systems of social indexicals like honorifics and gendered speech, skin-tone modified emoji represent a robust example of the complex ways language and culture are bound together dialectically. Based on the views of 451 anglophone American respondents to a survey, Dr. Halverson demonstrates that the selection of emoji – even yellow emoji – can appear as a social and political choice.

Lee, J. L., Kara, A., Huffman, M., Matthias, M. S., Radecki, B., Savoy, A., Schaffer, J. T., & Weiner, M. (2022). Qualitative Analysis of Team Communication with a Clinical Texting System at a Midwestern Academic Hospital. Applied clinical informatics, 13(2), 391–397. https://doi.org/10.1055/s-0042-1744389

  • Hospitals are increasingly replacing pagers with clinical texting systems that allow users to use smartphones to send messages while maintaining compliance for privacy and security. As more institutions adopt such systems, the need to understand the impact of such transitions on team communication becomes ever more significant. The study found that despite the benefits of texting, there is room for improving team communication and understanding in the realm of clinical texting. A lack of shared understanding regarding when and how to use texting may require long-term solutions that address teamwork and appropriateness.