This document discusses the quality of health information online and the need for regulation. It introduces the Health On the Net Foundation (HON), a non-profit organization that has developed a code of conduct (HONcode) to certify trustworthy health websites. HON maintains a database of over 7,200 certified sites in over 100 countries that adhere to principles like attributing sources, respecting privacy, and distinguishing advertising. The certification process involves a self-evaluation, review, and placement of a HONcode seal. HON also works to advance access to quality health information and collaborates with other organizations towards this goal.

1. The quality of health
information on the Web: a case
for regulation?
Célia Boyer
Executive Director

2. Outline
Online Health Information
Presentation of HON
Health Website Certification
The HONcode Database
Search Engine Technologies of HON
Perspectives & Conclusion

3. ONLINE HEALTH
INFORMATION

4. Importance of the Online Health
and Medical Information
1.7 billion Internet users in 2009 – growing rate by
4 in 9 years
Half of the European population is connected –
grew 3 times since 2000
Europe Health Internet usage increased by 25%
in 2 years
Sources.:http://www.internetworldstats.com/
eHealth trends across Europe 2005-2007, Andreessen & all

5. Control the quality of health
websites?
“61% of adults gather health
information online”
“Health searches impacted
treatment decision on six in
ten e-patients”
“Three-quarters of health
seekers do not check the
source and date of the
health information they find
online”
The New Yorker, 1993
Sources: The Social Life of Health Information, June 2009
E-patients With a Disability or Chronic Disease, Oct. 2007,
Pew internet & American Life project, pewinternet.org

6. PRESENTATION OF HON

7. The Health On the Net Foundation
Created in 1996, HON is a not-for profit
foundation
Mission: HON guides Internet users by
highlighting reliable, comprehensible, relevant and
trustworthy sources of online health and medical
information
the overwhelming quantity of information and
the uneven quality of health information available online
Funded by the Geneva state, European
Commission, France

8. International recognition
In 2002, HON Foundation was
recognized as a non-governmental
organization and granted special
consultative status with the United
Nations Economic and Social Council
In May 2004, HON won the
«eEurope Award for eHealth»
Since 2007, in France, HON is the
official certifying organisation for
French health websites

9. HEALTH WEBSITE
CERTIFICATION

10. The HONcode
Authoritativeness Indicate the qualifications of the authors
Information should support, not replace, doctor-
Complementarity patient relationship; Mission and Audience of site
Respect the privacy and confidentiality of personal
Privacy
data submitted to the site by the visitor
Cite the source(s) of published information and
Attribution dating of medical and health pages
Justifiability Site must back up claims relating to benefits and
performance of a specific treatment. Completeness.
Accessible presentation, identities of editor and
Transparency Webmaster, accurate and accessible email contact
Financial disclosure Identifying funding sources
Sponsorship Clearly distinguish advertising from editorial
content
http://www.HealthOnNet.org/HONcode/

11. The HONcode Certification
THE PROCESS
The HONcode certification is requested by the
Web publisher with a self-evaluation step
The HONcode Review Committee conducts a
thorough inspection and provide recommendations
Transparency of the certification: excerpts of proof
Deliver the HONcode seal

12. The HONcode Certification
IDENTIFICATION
When certified, the site displays a unique dynamic
HONcode seal valid for one year

13. The HONcode Certification
Duration of validity
Annual systematic audit
Automatic continuing monitoring
Re-evaluation after a complaint submission

14. THE HONCODE DATABASE

15. The HONcode database
Compliance with the
HONcode principles
Indexed with MeSH
terms and HON labels
7’200 sites in 102
countries with 4’400 sites
in 24 European countries
34 languages
+ 10 millions webpages
certified

16. SEARCH ENGINE
TECHNOLOGIES OF HON

17. HONcode search engine

18. HONcode sites by country

19. Indentification of HONcode
certified sites

20. Lights-up toolbar if web site
is certified

21. European research
how to treat diabetes

22. PERSPECTIVES &
CONCLUSION

23. Perspectives
HON as a participating body in the implementation of the
WHO eHealth resolution action plan
Collaboration with governing bodies to provide quality
control to national health websites
Continued advancement in the providing access to quality
health information online

24. Conclusion
Active for over 14 years
Educate citizens to efficiently use the medical information
Automatic tools developed in order to support human expertise and
tackle the large number of existing Web pages
HON implement the 2001 eEurope Quality Criteria for Health Web
sites, based on the HONcode principles
Collaboration with the French Health Authority for the certification of
health Web sites in France
Adherence to the HONcode enhances a website’s overall quality
“Finally, the content quality of Depression-related websites was
significantly and positively correlated … with the presence of the
HON label, and affiliation of the websites.”
Quality of web-based information on depression
Ariane Zermatten & all. Depress Anxiety. 2010 Jan 22

25. Thank you for your attention
Celia.Boyer@HealthOnNet.org