Use of emoji in communication between physicians is not associated with confusion or concerns of unprofessionalism, a new analysis suggests.

Researchers at Indiana University School of Medicine analyzed electronic messages sent between 80 hospitalists in the University of Indiana Health system. They identified emoji use and then analyzed its impact.

“We did not find any confusion arising from emoji use and we did not find any implications that there’s a concern about professionalism with the emoji that were used,” says linguistic anthropologist and lead author Colin Halverson, PhD, in a statement. “Obviously, you can use emoji just like any other form of language in ways that are inappropriate, but it doesn’t seem like emoji are any more prone to that than words.”

The new analysis appears in JAMA Network Open