Twitter provided an important forum for quick and open discussion about NHS reforms, say researchers at Imperial College London.

The network allowed “conversations across barriers of hierarchy and profession” and “may have fostered discussion and collaboration between groups that rarely talk”, according to a study looking at over 120,000 tweets about the Health and Social Care Bill which was recently passed into law in England.

The researchers developed a way to assess how influential individuals or organisations are on Twitter, based on the H-index, a widely-used measure of impact in academia. Their method identified the doctor and writer Ben Goldacre (@bengoldacre) as the most influential tweeter on the subject of the NHS reforms, followed by GP Jonathon Tomlinson (@mellojonny) and the Guardian (@guardian).

“Our analysis suggests that Twitter was a democratising force in the debate,” said lead author Dr Dominic King, from the Centre for Health Policy at Imperial College London. “It enabled health professionals to speak directly to journal editors, presidents of royal colleges, journalists and politicians, and express their views on the proposed reforms.”

It was unclear from the analysis whether discussion on Twitter had an influence on the wider public debate. Looking at the sentiments expressed in tweets, the researchers found that the level of opposition to the reforms was similar to that reported in polls, and grew over time, but the proportion of tweets supporting the bill was higher than in the general public and remained fairly constant. “Our findings suggest that Twitter is less a place for genuine debate, and more for sharing and reinforcing views,” Dr King said.

He added that as previous research has shown, Twitter users are not representative of the population as a whole. “If Twitter is to become more influential in health policy, it will have to expand beyond the preserve of a limited few and become genuinely mainstream,” he said.

The study was published in the journal Health Policy. Dr Goldacre welcomed the research, calling it “v interesting”.

Reference

Dominic King et al. ‘Twitter and the health reforms in the English National Health Service.’ Health Policy, 2013. http://dx.doi.org/10.1016/j.healthpol.2013.02.005