Authors: Alexander Young, Jonathan Bloor
Publication date: 10 Jun 2009
Alexander Young and Jonathan Bloor take you through everything you need to know about communication’s latest phenomenon
“What are you doing?” It’s a simple enough question but one that has launched Twitter.com from relatively humble beginnings to the position of third largest social networking site on the internet.
The concept behind the website is so simple that you could be forgiven for wondering how it has gained such popularity. On visiting Twitter and registering with the site you are presented with your profile page and asked to write a 140 character update to the question, “What are you doing?”—a process known as “tweeting.” You can then search Twitter for other users and, should you find their “tweets” to be of interest, you may choose to “follow” them so that their updates appear on your home page.
You can send and receive updates from any computer or mobile device with internet access or via text message (text message updating is currently available to Vodafone subscribers in the United Kingdom and is widely available in the United States).
Jargon aside, the ability to communicate and exchange updates quickly and frequently has proved extremely popular. Downing Street, Barack Obama, and now a number of medical institutions are using Twitter to disseminate information.
Although Twitter is primarily a micro-blogging or social networking website, medical professionals can benefit from using the website in a number of ways.
Twitter for medics
The succinct updates together with the ability to post links to websites make keeping up to date with medical news, research, and events on Twitter very easy. A great example of medical information being swiftly distributed can be seen on the World Health Organization’s Twitter page (twitter.com/whonews), which features regular updates on the swine flu (A/H1N1) outbreak.
Medical uses for Twitter can be divided roughly into three distinct categories: keeping medical professionals up to date; keeping patients updated; and novel approaches.
Keeping up to date
Organisations such as the BMA, WHO, and Department of Health use Twitter to announce policy and health updates to their followers. Although the BMA and WHO update their pages regularly, the Department of Health does not do so as frequently, having updated their page only twice.
With medical news
Most major newspapers and medical news websites have Twitter pages that are updated several times a day with the latest news stories. Breaking news is perhaps one of the most useful aspects of Twitter. For example, in February 2008 when news of an earthquake felt across some parts of the UK was broken on Twitter 45 minutes before being picked up by BBC News. Medical sites including BBC Health, NHS Choices, and Pulse all feature regular updates and links to interesting articles.
Medical journals such as the BMJ have also begun to adopt Twitter and feature updates and links to their most recent articles.
Several medical conferences, including the New England Journal of Medicine’s Horizons Conference and the International Forum on Quality and Safety in Healthcare, use Twitter to update followers about future conference dates, speakers, and abstracts.
With doctor’s blogs and opinions
In addition to receiving information, Twitter also facilitates the sharing of opinions and short articles between medical professionals. Many of the more popular medical blogs are now using Twitter to micro-blog their entries and reach a wider audience. Twitter also makes expressing opinion online considerably easier than setting up and maintaining a website, allowing medical professionals who would not normally share their thoughts online to do so.
Twitter comes with the same pitfalls as any online medical blog, including patient confidentiality issues and the possibility of litigation.
The postgraduate deanery for Kent, Surrey, and Sussex is using Twitter to update trainees about recruitment rounds and changes to their main website.
Numerous para-medical companies also advertise posts through Twitter updates.
Keeping patients updated
With press releases and patient education
Both NHS Choices and NHS Direct offer regular updates on health matters and the services they provide. The speed that information can be made available on Twitter also means the public can be quickly made aware of emergencies or influenza outbreaks.
With hospital news
Several UK hospitals and trusts now provide updates via Twitter, ranging from health advice and news to details of building expansion and ward closures.
With emergency services
Twitter was identified as a vital tool in distributing emergency updates during the California wildfires in 2007, with services such as the Red Cross and fire departments updating the public of outbreaks and safe zones.
With awareness campaigns, fundraising, and support groups
Breast Cancer Support and Macmillan Cancer Support both use Twitter to keep followers updated about fundraising opportunities and for raising public awareness of ongoing health campaigns.
Some patients are also beginning to use Twitter as a diary for their condition to raise awareness of the disease and to support other patients—for example, twitter.com/Living_With_MS.
Although Twitter is a simple concept, it has inspired numerous innovative uses.
Public health (disease tracking)
Both FluTweet ( [Link] ) and SickCity ( [Link] ) use Twitter to track flu outbreaks. By analysing users’ updates about flu, sore throats, or coughs, both sites can track areas of reported illness and then update their websites with the information. These systems are in their early stages and although they are not completely accurate, they are certainly interesting.
On 18 March 2009, Kost Elisevich and Steven Kalkanis of the Henry Ford Hospital, Detroit, performed an awake craniotomy that was updated on Twitter from the operating theatre. Followers of twitter.com/henryfordnews were encouraged to ask questions about the procedure and also read through a brief history of the case online. This exercise proved to be an extremely interesting use for Twitter, as both medical professionals and the general public were able to learn from the interactive event.
Qwitter ( [Link] ) is a social tool that uses Twitter as a diary to help those trying to quit smoking.
TweetWhatYouEat ( [Link] ) is a similar tool that allows users to keep a food diary on Twitter.
Twitter is a growing and hugely popular website and is an ideal medium for disseminating information to users quickly. Although it is primarily a social networking site, it has been used by medical organisations to keep medical professionals and patients updated with the latest news and policies. In addition, the website allows doctors to network and exchange information with fellow professionals quickly and succinctly. Whether the more innovative applications of Twitter, such as teaching and disease tracking, prove to be more than novelties of the system remains to be seen.
Quick distribution of information
Growing user base
Adopted by medical organisations
Ability to exchange thoughts with fellow medical professionals worldwide
Simple to use
Relatively new—is it just a fad?
Phone updates available only to Vodafone users in the UK
Addictive and time consuming
How useful are the novel approaches?
Issues with legislation and medical information
How to start using Twitter
Visit [Link] and click on the “Join” button
Enter your name and select a username and password for your Twitter account
You will now be on your home page
Use the search box to find people or organisations on Twitter and click on the follow icon to receive their tweets
- Many websites have links to their Twitter profiles on their main website
Enter an update of up to 140 characters on your profile to begin tweeting
Sites such as tinyurl.com, tr.im, and bit.ly enable long web addresses to be shortened, allowing long links to be added to an update
Tweet—an update posted on a user’s Twitter account
Following—the process of subscribing to users’ updates, which then appear on your home page
Followers—other users subscribed and following your updates
Micro-blogging—short entry posted on the internet
@reply—an update directed at an individual user
Direct message—a private message sent from one user to another
Tweet deck—a third party application for managing Twitter
Twitterific—a third party application for Mac and iPhone for managing Twitter
TwitPic—a website for uploading pictures to Twitter
Competing interests: None declared.
Alexander Young final year medical student
University of Bristol
Jonathan Bloor research fellow with special interest in IT communications for doctors Bristol Royal Infirmary
A Young firstname.lastname@example.org