Short articleTwitter and the health reforms in the English National Health Service
Section snippets
Background
Social media is distinguished from traditional broadcast and print media by its ‘user generated’ content – the people who read it are the ones writing it and commenting on it. A prominent social media outlet is Twitter, the global online micro-blogging social network that is accessed by millions of users every day. Twitter enables its members to post text-based messages of up to 140 characters about any topic. The short format of the message – or tweet – is the defining characteristic of the
Monitoring the tweets
In our analysis we prospectively obtained a collection of public tweets that were recorded from the 29th of March 2011 to the 22nd of February 2012. 120,180 tweets posted by 37,065 unique users were collected from Twitter's publically available data – sometimes known as the Twitter ‘firehose’ – using Twitter's Streaming Application Programming Interface (API). This approach allows the collection of a real-time sample all tweets that included a set of keywords. There were occasional outages in
Tweeting trends over time
The Health and Social Care Bill was introduced in the House of Commons on the 19th of January 2011. Initially there was little interest from the public and other bodies in the proposed reforms – perhaps through a lack of knowledge about how significant their impact would be. We began collecting tweets about the reforms on the 31st of March 2011 when the Bill had just passed through the committee stage of the Commons and when it was clear the Bill would attract significant controversy. In the
For or against: sentiment analysis
We also wanted to get a flavour of what people were talking about in their tweets and whether they were for or against the health reforms. Two reviewers examined the sentiment of tweets around key points in the process of the passage of the Bill, including 200 random tweets at each of the announcement of the ‘pause’ (6th of April 2011), the end of the ‘listening exercise’ (9th June 2011) and the government's controversial summit at Downing Street that failed to invite certain groups (18th
Who is most influential?
People disseminate information deemed important on Twitter through ‘retweets’. This is when someone chooses to repeat a tweet by someone else, usually because they think the content is significant enough to merit sharing further. Twitter is well suited to studying influence because the diffusion of ideas can be tagged and observed, allowing us to determine how effective different ‘messengers’ of information are [10], [11]. There are a number of potential ways of measuring influence on Twitter
Who is tweeting?
Determining the characteristics of tweeters is dependent on what information users are willing to enter about themselves on their public profile. Looking at the 100 most influential tweeters measured by the T-index, 77 of the 100 identified themselves as being from the UK with 43 stating they were based in London. No tweeter in the Top 100 identified themselves as being from or based outside the UK. Of the 100 most influential, 28 were traditional media outlets and 14 of them described
Does twitter matter and implications for health policy?
The volume of tweets on the topic, and the number of participants, shows that Twitter is an emergent part of the health policy landscape. However its influence is not yet clear and it remains to be seen how effective it is as a shaper of national debate when compared to traditional platforms such as journals, newspapers or the broadcast media. Twitter is timely, and a good source of breaking news although it tends to follow and comment on the debate, rather than lead it. It allows conversations
Funding
Imperial College London is grateful for support from the National Institute for Health Research Biomedical Research Centre Funding scheme, the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care scheme, and the Imperial Centre for Patient Safety and Service Quality.
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