This study analyzed tweets containing three hashtags (#PCEHR, #MyHealthRecord, and #MyHR) related to personal electronic health records in Australia from August 2016 to August 2017. Time sequence and network analysis identified six influential users who discussed supporting or opposing views on the topic. The research aims to understand representation of Australia's national electronic health record system on Twitter and identify ways social media could better facilitate public engagement on this issue.

1. Stuart Palmer - Deakin University
@s_palm - spalm@deakin.edu.au
Bronwyn Hemsley - University of Technology Sydney
@BronwynHemsley - Bronwyn.Hemsley@uts.edu.au
Analysis of three Twitter hashtags
for discussion of personal
electronic health records
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2. Electronic Health Records
Potential to improve the efficiency and quality of
health services
Implementation of EHRs has had mixed success
It is vital that public-facing information about
EHRs is current and accurate information
Governments need to engage the public about
their concerns as EHRs develop
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3. EHRs and social media
Personal EHRs coincided with social media
EHRs feature in social media communication
Social media have become an important source
of health information
Research on social media in health
communication is limited, including for EHRs
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4. Personal EHRs in Australia
The ‘Personally controlled Electronic Health Record’ (PCEHR)
launched July 2012 as an opt-in system
Pilot included social media activities
Reviewed 2013 – renamed ‘My Health Record’ (MyHR)
2017 – legislation provides for an opt-out system of
registration
Opt-out registration to occur nationally from 16 July 2018
Implementation of the system remains contentious,
including on social media
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5. Project aims
1. Investigate the representation of Australia’s
MyHR on Twitter via relevant hashtags
2. Employ time sequence analysis, text analytics
and network visualisation to characterise the
Twitter activity and content
3. Identify influential users and their
relationships
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6. Method
Ethics – public data ruled exempt
Hashtags: #PCEHR #MyHealthRecord & #MyHR
All data from 1 Aug 2016 to 31 Aug 2017
Time sequence analysis
Text analytics via KH Coder – multidimensional scaling
Network visualisation via Gephi
Development of measures of ‘influence’
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7. Time sequence (6,191 tweets)
0
100
200
300
400
500
600
700
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55
TotalTwitteractivity
Week (from 1 August 2016)
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8. Hashtag use
Used tags Colour No. nodes Used tags Colour No. nodes
#MyHealthRecord only Red 993 #MyHR only Blue 107
#PCEHR only Yellow 10 #MyHealthRecord & #MyHR Purple 95
#MyHealthRecord & #PCEHR Orange 22 #MyHR & #PCEHR Green 8
All three tags Black 44 8

9. Multidimensional scaling plot
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10. Multidimensional scaling plot
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11. Multidimensional scaling plot
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12. Multidimensional scaling plot
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13. Multidimensional scaling plot
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14. Multidimensional scaling plot
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15. Measures of influence
Tweets Count Rank Mentions Count Rank Tweets x Followers Count Rank
Person_d 529 1 Organisation_a 1036 1 Person_a 4384475 1
Organisation_c 379 2 Person_d 454 2 Organisation_a 3816848 2
Person_b 377 3 Person_b 325 3 Person_b 2693288 4
Organisation_a 371 4 Organisation_c 272 4 Person_d 364481 9
Person_a 83 12 Person_a 268 5 Organisation_c 64051 38
Organisation_b 41 20 Organisation_b 240 6 Organisation_b 54899 41
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16. Measures of influence
Tweets Count Rank Mentions Count Rank Tweets x Followers Count Rank
Person_d 529 1 Organisation_a 1036 1 Person_a 4384475 1
Organisation_c 379 2 Person_d 454 2 Organisation_a 3816848 2
Person_b 377 3 Person_b 325 3 Person_b 2693288 4
Organisation_a 371 4 Organisation_c 272 4 Person_d 364481 9
Person_a 83 12 Person_a 268 5 Organisation_c 64051 38
Organisation_b 41 20 Organisation_b 240 6 Organisation_b 54899 41
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17. Tweet
network
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18. Tweet
network
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19. Tweet
network
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20. Tweet
network
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21. In conclusion
Most tweets used a single hashtag #MyHealthRecord
Tweet content spanned supportive to opposing
6 users influential; 3 users highly influential
Limited interaction between ‘opposing’ users
Twitter platform is under-utilised in public health
engagement about Australian national EHR
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22. Possible additional strategies
Live tweeting of evidence about MyHR at health
conferences or other events
Hashtag chats for engagement of people with diverse
(and opposing) views
Using Twitter to teach users about the system
Promote credible sources and provide (feed) correct
and current information on Personal e-Health Records
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23. Thank you for your time
The authors acknowledge funding from
the National Health and Medical Research
Council of Australia (grant number
G1083566) administered by the University
of Newcastle; in-kind support from Twitter
Australia in the form of provision of access
to the Twitter data collected; and funding
to support conference attendance from
the University of Technology Sydney.
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