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  1. Felix Greaves,
  2. Anthony Laverty,
  3. Daniel Ramirez-Cano,
  4. Stephen Pulman,
  5. Karo Moilanen,
  6. Ara Darzi,
  7. Christopher Millett
  1. Harvard School of Public Health, USA; Imperial College London, UK; Oxford University, UK


Introduction Twitter and other social media are increasingly used by patients to discuss their experiences of healthcare. Social media might provide a new way for health services to listen to the voices of patients and improve their services. Little is known about how patients are communicating with hospitals via this route, and whether there is any association with traditional measures of patient experience such as surveys.

Methods We recorded tweets aimed at all acute hospital trusts with Twitter accounts in England for one year from April 2012. We performed a qualitative content analysis of a random sample of 1000 tweets, to see what information they contained about care quality. Using natural language processing techniques, we calculated the sentiment of all the tweets towards hospital. We compared twitter sentiment to patient experience measured by traditional survey at the hospital level, using Spearman's rank correlation coefficient.

Results We collected 187,000 tweets over one year. The mean number of tweets per trust was 2499. 9.8% of tweets were related to quality of care care – and most of these related to patients' experience of interactions with staff. We found no correlation between the sentiment of tweets about hospitals and patient experience measure by traditional survey methodology (Rho=0.08, p=0.56).

Discussion Although social media are increasingly used by both the public and healthcare professionals to communicate, caution should be taken in using social media data to measure care quality. The information contained within tweets was able to provide valuable individual insights about some patients' experiences of care, however the views expressed appeared less likely to be representative of the experiences of the wider population receiving care.

Declaration of competing interests This work has been funded by the Commonwealth Fund.

  • Patient safety
  • Mortality (standardized mortality ratios)
  • Patient education

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