Health on the Net: Categories of web sites and quality assurance systems Ellen K' Christiansen, lega

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Health on the Net Categories of web sites and
quality assurance systemsEllen K. Christiansen,
legal advisorEllen.Christiansen_at_telemed.no
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Aim of the lecture

• To give an overview of different categories of
  health related web sites on the Internet
• To give an overview of available quality
  assurance systems

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• Point of departure
• There is no spesific health legislation for
  health related web sites

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Health related web-sites What are they called?

• Health web sites
• E-health services
• Health guidance
• Health information
• Health counselling
• Health services
• Health-related services
• Health care

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What is the content?

• Health information
• Queries and answers
• General health queries
• General health advice
• Health services
• Discussion groups with and without tutors
• Chat groups
• Self-help programmes
• Etc.

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Health on the net Some general features

• Borderless
• (Normally) no F2F-contact between provider and
  user
• No universal quality or best practice
  requirements
• Available
• Easy to access
• Discretion
• Many different interests and wishes involved
• Providers and users of all kinds
• Without regulations???

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Who are the providers?

• Health interested people in general
• Non-conventional medics
• Commercial units
• Interest groups
• Patient organizations in general
• Health personnel all over the world
• Quacks
• Fraudsters
• And the Health Care Sector is coming.

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• A wide range of tools are developed to help
  providers to create good quality services and
  users to evaluate the quality of the information
  they find on the internet

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Responsibility and web content

• The person who is disseminating or facilitating
  statements or content development on the
  Internet, is responsible for the content
  presented (Manshaus, 2007, www.jusnytt.no )
• Ethical responsibility
• Web-master
• Moderator
• Users

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Different concepts for quality assurance of
health related web sites

• User guidance systems
• Codes of conduct for providers
• Self administered guidelines/benchmarking
• Third party approval

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Some quality assurance systems

• http//www.ama-assn.org/ama/pub/category/2386.html
  
• http//www.bhia.org/
• http//www.discern.org.uk/
• http//europa.eu.int/information_society/eeurope/e
  health/doc/communication_acte_da_fin.pdf
• http//www.hon.ch
• http//hitiweb.mitretek.org/docs/policy.html
• http//europa.eu.int/information_society/eeurope/e
  health/doc/communication_acte_en_fin.pdf

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Quality assurance systems (cont.)

• http//www.emro.who.int/his/ethicscode.pdf
• http//www.judgehealth.org.uk/
• http//omni.ac.uk/
• http//www.urac.org/prog_accred_CDH_po.asp?navida
  ccreditationpagenameprog_accred_CDH
• http//www.ihealthcoalition.org
• http//jama.ama-assn.org/cgi/content/short/283/12/
  1600

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Advice for users 1 Look to EUs quality
assurance system

• Do you find
• Transparency about provider, purpose, target
  audience, sources of knowledge and sources of
  funding?
• Name of and reference to information sources?
• Date of publication?
• Information about personal information protection
  ?
• Updated information?
• Checking routines?
• Responsibility issues?
• Editorial policy?
• Accessibility?

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Advice for users 2 HON-code

• Is the web site accredited by HON (HON Health
  On the Net Foundation)?
• Guidelines for accreditation
• http//www.hon.ch/HONcode/Conduct.html/

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Advice for users 3DISCERN, a system for
assessment of health related web sites

• An instrument for assessing the quality of health
  information sites targeted at consumers.
• It consists of a questionnaire and a handbook
• Developed by University of Oxford
• Check http//www.discern.org.uk/index.php

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Advice for users 4Consider developing your own
website

• Example Norwegian web site with guidance for
  users of health related web sites (some articles
  in English )
• http//www.helse-vett.no/

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Users checking of source and date of online
health information, 2006
Pew Internet American Life Project, 2006
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Checking of source and date of online health
information, 2001
May be this mirrors the fact that just 4 of
frequently visited web sites disclosed the
source of information on their pages and 2
disclosed how the content is updated (recent
study, 2006?) (Carried out by U.S. Dep. of
Health and Human Services, 2006)
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Summary exercises

• Visit some health web-sites
• Check if they apply to the HON which
  requirements are met? Which are not?
• Check if there are quality health requirements in
  your country