Analysis of Public Health Informatics: Twitter Feeds and Telemedicine

This report provides a critical analysis of public health informatics, focusing on the use of Twitter for health promotion and the barriers to telemedicine implementation. The report begins with an introduction highlighting the increasing importance of information and communication in global health, particularly through social media platforms like Twitter. It then presents a critical analysis of three public health-related Twitter accounts (@equity list, @AUMentalHealth, and @telemedicine_Jn), examining their contributions to improving public health, including raising awareness, disseminating health information, and fostering doctor-patient relationships. The report also explores the barriers to telemedicine adoption, such as slow broadband connections, lack of understanding, and confidentiality concerns, categorized as data standardization and interoperability issues. It provides recommendations for overcoming these challenges, including improving data protection, using knowledge management frameworks, and enhancing broadband infrastructure. The conclusion emphasizes the potential of social media and telemedicine in advancing public health, while acknowledging the need to address existing limitations for effective implementation.

Running head: PUBLIC HEALTH INFORMATICS
PUBLIC HEALTH INFORMATICS
Name of the student
Name of the university
Author note:

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Introduction:
With the global burden of disease, the importance of information and communication is
intensifying around the globe. With the help of informatics, health information for the patient is
currently distributed across the wide range of locations which include general practices, hospital,
allied health practices, and specialists (Jull et al., 2016). In this context, to facilitate the
communication between health professionals and patients, social media is one of the most
popular and efficient platforms which provide the opportunity to the health professionals to reach
to different corners of the world. Recent statistical data suggested that currently 321 million
users are using social media account like twitters which provided health professionals and
patients to reach to each other within a few seconds (Sinnenberg et al., 2017). The purpose of the
paper is to provide a critical analysis of the twitter feeds of three public health accounts and their
contribution to improving public health. This paper will illustrate a critical analysis of three
twitter accounts, barriers of telemedicine in the following paragraphs.
Discussion:
Critical analysis of the tool:
Social media has emerged as one of the most popular clinically validated key digital
health systems in Australia which foster a stronger connection between health professional and
public health. Alnemer et al. (2015), suggested that popularity these social media tools are
associated with adaptation of healthier lifestyles, improve communication with the health
professionals from different corner of the world and coping skills for day to day health concerns
which further result in increased awareness amongst the population and empowerment of the
population. This paper will focus on one such social media tool such as twitter, especially three

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public health-related Twitter accounts. Such as @equity list, @AUMentalHealth,
@telemedicine_Jn.
Twitter is an American online microblogging and social networking service on which
users post and interacts with messages known as tweets where users are restricted to use 280
characters. Park, Reber and Chon (2016), suggested that while this is a unique social media
account that provides information on politics, breaking news a significant number of health
professionals use this twitter as a significant health use twitter for a range of activities. The range
of activities includes such as provide the answer to medical questions, collect data on the opinion
and experience of the patient, reduce stigma, illness, promote health literacy, information about
disease outbreak and gather disaster response (Jull et al., 2016). As mentioned before, Twitter
has currently 321 million users where 126 million are daily users, indicating that health
professionals have the opportunity to reach 126 million daily. Sinnenberg et al. (2017) suggested
that microblogging emerges as a powerful tool that can be utilized in the field of informed public
health informatics field for spreading health literacy, providing access to the health care and
leveraging the communication with patients who are hard to reach and have low socioeconomic
status. However, Broniatowsk et al. (2017), highlighted that twitter increases the chances of
breaching the confidentiality of the patients according to the and critical analysis of the tool
Health Insurance Portability and Accountability Act of 1996.
Summary of the lesson learned:
While conducting in-depth research on the public health accounts, it was observed that
twitters provide health care brands an opportunity to listen and responses to the struggles of the
patients and provide adequate health literacy to combat deadly health concerns so that they can
adopt a healthy lifestyle (Garzón-Alfonso et al., 2018 ). Consequently, it empowers patients,

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boosts their self-esteem. While conducting an in-depth analysis of the feeds, I have observed
that twitter provide a chance to nurture doctor-patient relations and improve awareness amongst
the population. Twitter holds promises because of the search and reply section and through the
search options, public health officials can look into certain regions with high mentions of deadly
disease such as flu which further provide the opportunity to these officials to determine which
country require health literacy regarding the flu (Jordan et al., 2019). Considering
@telemedicine_Jn, this account provides an innovative solution for patient care and record
management, provide information for peer-reviewed journals which will further not facilitate the
healthy engagement amongst the population. For example, In the first week, @telemedicine_Jn
post a systematic review on psychotherapy and depression which provide an understanding of
the depression and associated therapy to a population who are suffering from depression and
other population how is a higher risk of developing depression (Paul et al., 2016). Another
informative post was posted in the third week, by this official page, on “antibiotic prescribing
patterns for sinusitis within a direct to virtual and urgent care” which provided health literacy to
the population regarding the disease and an effective way to combat disease in the emergency
care. Hence, those patient demographics are notoriously difficult to achieve, twitter represents
an opportunity to reach to those patients. Moreover, local health departments often take use of
tweeter information to combat disease and conduct health promotions. Considering
@AUMentalHealth, this account has an immense contribution to raising mental health awareness
and reaching to the population who are experiencing mental health issues. In the second week,
an informative post was posted on “dissociative disorders nearly common as depression? Why
we never heard about them” which not only improve awareness amongst population regarding
dissociative disorders but also provide an in-depth understanding of misdiagnosis of the disease.

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It is not surprising that this post encourages the patients with depression or dissociative disorders
to seek clinical assistance and provide health professionals to gather knowledge regarding
effective intervention such as talk therapy, counseling or psychosocial therapy to reduce high
prevalence (Paul et al., 2016). Another informative post was posted on the wall where the
account provided a tragic story of the mental health patients and highlighted a lack of
infrastructure in the mental health care system. Consequently, it provided the local governing
bodies and officials to identify the loopholes of lack of infrastructure in the mental health system
and provide an opportunity to the policymakers to amend the policies according to it (Sharpe et
al. 2019) . With these posts health professionals allow twitter users to use embedded links for
better accessing to expanded information, advocate for health equity and post their concern
(Sharpe et al. 2019). Similar kind of posts was observed in the public health twitter account
@equity list which usually posts information regarding public health, equity, and human
development. In the fourth week, posted an informative post regarding “ the control of
schistosomiasis is based on large scale treatment of at-risk population groups, access to the
safe water, improved sanitization and hygiene education and snail control” which provided the
health professionals to reach to the subtropical areas, especially in poor communities and
address essential needs of the population. Hence, twitter provided the health professionals to
advocate for social justice, monitoring health conditions of the population and provide
interventions such as sanitization, hygiene education.
Part 2:
Barriers of telemedicine:
Telemedicine is one of the most notable advancements which already made waves in the
digital transformation of health care. Telemedicine poses wins for health care organizations

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seeking to improve patient’s access while controlling the cost of health care. ABC News (2019),
suggested that telemedicine provide a range of benefits to the patients and health professionals
such as remote patient monitoring, reduced cost of virtual access to the specialist. However ,
ABC News (2019), suggested a range of barriers that barriers to the uptake of telemedicine
such as slower broadband connection in the remote area such delays the provision of care
inpatients and many patients travel to rural health centers to connect remotely with physicians as
they cannot connect with the health professionals as they cannot connect to the health
professionals. Many rural patients are seeking the help of health professionals for broadband
consolation which further increased the workload of the clinicians. Driessen, Castle and Handler
(2018). highlighted other barriers of up taking telemedicine such as lack of understanding of the
purposes of telemedicine, low quality of health informatics records, lack of legal regulation to
prevent unauthorized and illegal service, confidentiality and vulnerability issues, stigma
regarding potential fraud and abuse and patients and patient awareness and trust in virtual care
offerings. A significant number of the population in the rural area are unaware of the facilities of
telemedicine and if they are aware of telemedicine, majority of them are apprehended because of
lack of adequate knowledge regarding telemedicine and psychological trauma they may be
subjected to (Ghani, Jaber & Suryana, 2015). For ensuring proper engagement in telemedicine
in the rural area and long term area, health professionals address and overcome these challenges.
These barriers are mainly divided into two major issues such as data standardization
issues and interoperability issues. The issues associated with confidentiality, people awareness,
legal regulation to prevent unauthorized and illegal service can be categorized in data
standardization issues which may violet ethics and human rights. Kruse et al. (2016) suggested

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that data standardization facilitate the critical process of carrying data into a common format
which allows for collaborative research and large-scale analytics, as observed in this case study.
On the other hand, low quality of health informatics records and patient awareness and trust in
virtual care offerings are suffering can be categorized as interoperability issues.
Considering management issues, these barriers can be categorized as knowledge
management issues. The researchers suggested that knowledge management issues observed
when an organization or technology failed to take a multidisciplinary approach, especially failed
to handle information and resources and share the information, as observed in this case. The
knowledge management issues were highlighted by Kruse et al. (2016) due to slower internet
connections which further impacted the data collection.
Kruse et al. (2016), suggested that in the current era, the public health officials are
considering knowledge management paradigm or framework which offers solutions to the health
care sectors by allowing them to face the challenges of transforming a large amount of patient
data into relevant clinical management with the help of collaboration tool and context
management. Donate and de Pablo (2015), suggested that Metadata to resolve these issues and
overcome the barriers of telemedicine as metadata endorses for use across Australia and it is
referred as the data standard as these standards improve the consistency, relevance, and
availability of the information of Australian citizen.
In my opinion, the major barriers to uptake telemedicine are lack of appropriate skills of
the health professionals and consumers to handle telemedicine, excessive workload on the
health professionals in rural area and confidentiality issues.
Suggestions and recommendations:

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To improve the quality of care through telemedicine and data standardization of the
telemedicine, researchers and health professionals to take proactive initiatives. It is
recommended to establish a keen understanding of virtual service quality and how it can improve
the wellbeing of the population. It is recommended to improve the data protection services to
reduce the high risk of confidentiality and leaking of data. It is recommended to use a knowledge
management framework and metadata to address the issues associated with data standardizations
and interoperability (Sharpe et al. 2019). Moreover, to improve the services of telemedicine, the
proper broadband and internet resources are required to adopt which will reduce the issues
associated with data loss, loss of confidentiality of data and improve the monitoring of data of
the patients who are living in rural areas.
Conclusion:
Thus it can be concluded that Social media emerges as one of the most popular clinically
validated technical simulations of the key digital health systems in Australia which foster a
stronger connection between health professional and public health. This paper explored three
twitter accounts of public health officials and gathered the understanding that opportunity to
listen and responses to the struggles of the patients and provide adequate health literacy to
combat the deadly disease. One such public digital health is telemedicine which is widely used
to provide advanced care to the patients. There are certain barriers to uptake telemedicine which
include telemedicine, low quality of health informatics records, lack of legal regulation to
prevent unauthorized and illegal service, confidentiality and vulnerability issues, stigma
regarding potential fraud and abuse and patients which can be improved by installing high-speed
internet and data security act.

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References:
ABC News. (2019). Telemedicine taking-off in rural areas. [online] Available at:
https://www.abc.net.au/news/2011-04-04/telemedicine-taking-off-in-rural-areas/2631070
[Accessed 26 Jul. 2019].
Alnemer, K. A., Alhuzaim, W. M., Alnemer, A. A., Alharbi, B. B., Bawazir, A. S., Barayyan, O.
R., & Balaraj, F. K. (2015). Are health-related tweets evidence based? Review and
analysis of health-related tweets on twitter. Journal of medical Internet research, 17(10),
e246.
Broniatowski, D. A., Jamison, A. M., Qi, S., AlKulaib, L., Chen, T., Benton, A., ... & Dredze, M.
(2018). Weaponized health communication: Twitter bots and Russian trolls amplify the
vaccine debate. American journal of public health, 108(10), 1378-1384.
Donate, M. J., & de Pablo, J. D. S. (2015). The role of knowledge-oriented leadership in
knowledge management practices and innovation. Journal of Business Research, 68(2),
360-370.
Driessen, J., Castle, N. G., & Handler, S. M. (2018). Perceived benefits, barriers, and drivers of
telemedicine from the perspective of skilled nursing facility administrative staff
stakeholders. Journal of Applied Gerontology, 37(1), 110-120.
Garzón-Alfonso, C. C., & Rodríguez-Martínez, M. (2018, December). Twitter Health
Surveillance (THS) System. In 2018 IEEE International Conference on Big Data (Big
Data)(pp. 1647-1654). IEEE.

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Ghani, M. K. A., Jaber, M. M., & Suryana, N. (2015). Barriers faces telemedicine
implementation in the developing countries: toward building Iraqi telemedicine
framework. ARPN J. Eng. Appl. Sci, 10(4), 1562-1567.
Jordan, S., Hovet, S., Fung, I., Liang, H., Fu, K. W., & Tse, Z. (2019). Using Twitter for Public
Health Surveillance from Monitoring and Prediction to Public Response. Data, 4(1), 6.
Jull, A., Bermingham, A., Adeosun, A., Ní Mhurchú, C., & Smeaton, A. F. (2016). Using
Twitter for public health infoveillance: a feasibility study.
Kruse, C. S., Goswamy, R., Raval, Y. J., & Marawi, S. (2016). Challenges and opportunities of
big data in health care: a systematic review. JMIR medical informatics, 4(4), e38.
Park, H., Reber, B. H., & Chon, M. G. (2016). Tweeting as health communication: health
organizations’ use of Twitter for health promotion and public engagement. Journal of
health communication, 21(2), 188-198.
Paul, M. J., Sarker, A., Brownstein, J. S., Nikfarjam, A., Scotch, M., Smith, K. L., & Gonzalez,
G. (2016). Social media mining for public health monitoring and surveillance.
In Biocomputing 2016: Proceedings of the Pacific symposium(pp. 468-479).
Sharpe, J. D., Hopkins, R. S., Cook, R. L., & Striley, C. W. (2016). Evaluating Google, Twitter,
and Wikipedia as tools for influenza surveillance using Bayesian change point analysis: a
comparative analysis. JMIR public health and surveillance, 2(2), e161.
Sinnenberg, L., Buttenheim, A. M., Padrez, K., Mancheno, C., Ungar, L., & Merchant, R. M.
(2017). Twitter as a tool for health research: a systematic review. American journal of
public health, 107(1), e1-e8.

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