Can you remember the last emoji you used today? Over 10 million emojis are sent as part of our daily digital interactions. They have become an interactive addition to our digital language, from texting a friend to using them for our to-do or grocery lists.

You might not give too much thought to what emojis you use. But it turns out that a lot of thought goes into what emojis you have to choose from.

Emojis are created via Unicode, a universal code that is designed to work on all digital devices and transcend language. A non-profit Unicode Consortium maintains the current library of emojis, which now numbers over 3,600. The consortium also considers requests for new emojis.

A group of investigators at Mass General are working to submit a request for approval of an anatomically correct kidney emoji. If approved, the kidney would be the fourth anatomically correct organ added to the Unicode language, following the heart, lungs and brain.

Emojis a Healthcare Communication Tool

Why all this effort? When it comes to healthcare, there is a growing scientific recognition that emojis can be used to reduce language barriers – given their universal usage and understanding.

In 2019, Shuhan He, MD, an attending physician in the Department of Emergency Medicine, Lab of Computer Science, and director of digital growth for the Center for Innovation in Digital HealthCare at Massachusetts General Hospital, alongside volunteers from Emojination worked to gain approval for the anatomically correct heart and lung emoji.

Dr. He has been a long-time advocate for the development and use of medical emojis in patient care, believing that these emojis can improve communication between healthcare providers, patients and their families.

In 2021, Dr. He, alongside a team including Debbie Lai from the University College of London, published a JAMA article focusing on the challenges and opportunities of incorporating emojis into the medical setting.

Dr. He and a team including Harish Shanthanu Seethapathy, MD, from the Department of Medicine at Mass General, are now collaborating with kidney health advocates to lobby for approval of the new emoji with the goal of increasing the awareness and conversation around kidney diseases that lead to 1.3 million deaths annually.

In a recent editorial in the American Journal of Kidney Disease, the team suggests the emoji could increase patient engagement in caring for their kidneys and start new conversations about kidney disease and prevention.

The Worldwide Burden of Kidney Disease

As of 2019, kidney diseases are the 10th most common cause of death worldwide. Historically, acute kidney injury and kidney failure have a greater impact on populations with lower socioeconomic status.

Many of these populations are already challenged by limited healthcare literacy—the ability that individuals possess to understand and use health-related information and make decisions. These challenges have only been exacerbated by the COVID-19 pandemic.

Thus, the team saw an opportunity to improve public health messaging around kidney disease through form of visual communication that transcends languages.

The Case for Approval

The Unicode consortium has a rigorous selection process for incorporating new emoji into its library, so the team is crafting a campaign that hits on three key criteria for inclusion:

i) Usage: “It is anticipated that the kidney emoji will be used in high frequency not just within the medical community but to increase awareness and communication among the general public at risk of kidney disease,” the team writes. The kidney emoji can also be used along with other emojis currently representing sickness, medications or injections, etc. to describe scenarios within the healthcare setting and management of kidney disease.  

ii) Distinctiveness and Recognizability: “The anatomically accurate paired kidney design is an iconic visual representation that will be easily recognizable by patients, caregivers, individuals in healthcare as well as the general population.”

iii) Completeness: The kidney emoji represents a complete idea and can act as an adequate standalone representation for wide and frequent use without the need for other versions to represent specific ideas within this category, according to the team.

What’s Next

The proposed emoji design is currently being circulated on social media and is being reviewed by stakeholders. The American Society of Nephrology, the American Association of Kidney Patients, the National Kidney Foundation, the International Society of Nephrology have already released endorsement letters supporting the need for a kidney emoji for feedback and comments. A full list of endorsements can be found on medicalemoji.org/kidney

About the Mass General Research Institute
Research at Massachusetts General Hospital is interwoven through more than 30 different departments, centers and institutes. Our research includes fundamental, lab-based science; clinical trials to test new drugs, devices and diagnostic tools; and community and population-based research to improve health outcomes across populations and eliminate disparities in care.
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