Analysis of three twitter hashtags for discussion of personal electronic health records

Electronic health records (EHRs) are an important e-health technology and have the potential to greatly improve the efficiency and quality of health services. However, the implementation of EHRs has had mixed success internationally. Increasingly, governments, health service providers and the public are turning to social networking systems (SNSs) for communicating about EHRs. Social media, including Twitter (twitter.com), have also been used in relation to EHR implementation. Thus, Twitter provides a useful case example for an exploration of the ways that SNSs are being used to communicate information about EHRs. The Australian personally controlled electronic health record, My Health Record (MyHR), is a repository of summary health information about patients which is stored online, and which patients can choose to share with their health providers. In this paper, an investigation of the representation of Australia’s MyHR on Twitter via a data set of 6191 tweets associated with three specific hashtags related to the EHR and reflecting its official names since 2012 (i.e., #PCEHR, #MyHealthRecord and #MyHR) is reported. Time sequence analysis, text analytics and network visualisation were employed to characterise the Twitter activity and content, and to identify influential users and their relationships. The text content of tweets using these hashtags spanned positive/supportive, neutral/factual and negative/opposing themes regarding EHRs. Text visualisation highlighted six accounts that were active and also mentioned frequently in tweets. In particular, three of these accounts were always ranked in the top ten on several measures of activity and interactivity, so could be considered highly influential. Network visualisation of the connections between accounts, represented by tweets from senders to those mentioned, revealed associations between some prominent accounts and their publicly-stated stance on EHRs. This information could be used to inform future use of SNSs, and optimal use of Twitter in particular, in the propagation and distribution of information relating to EHRs and their implementation.