HON activity report 2007
Key HON accomplishments during this period:
- International activities – new and ongoing EU and international projects, meetings and support activities
- Swiss and regional activities – new and ongoing collaborations
- Technical advances – improvements on HON technologies
- HON in figures – quantifiable progress in website traffic, HONcode accreditations
- External relations – conferences, presentations, partnerships and exchanges
- HON in the news – recognition through the media, academia and the government
- Administration and finance – HON organizational business
International activities:
Obtaining Reliable Medical Information Online: A Study Focusing on Francophone Africa
This study (2006/2007) was funded by the Geneva International Academic Network (GIAN) for an overall budget of CHF 234,000 and is through the collaboration of HON, World Health Organization (WHO), Graduate Institute of Development Studies (GIDS), Institute for Human Sciences, Mali and the University of Geneva. The University is also the coordinating body for the project.
The project aims to enhance understanding of health data globalization issues and improving public confidence in online information by studying the influence of socio-cultural determinants of trust on online medical information. It mainly focuses on French-speaking Africa. This project successfully ended in September, the results have been presented in Mali, Bamako, and in Geneva at a Roundtable organised by the GIDS. The outcomes and the recommendations of this one year project are available at: http://www.healthonnet.org/Projet_Afrique_FR/.
Personalised Information Platform for life and health Services (PIPS)
The work done on PIPS this year was mainly related to the development of a system of question/answering in the medical field in order to answer possible gaps of Knowledge System (KS) in PIPS. The use of the trustworthy database as a source of information guaranteed a framework of quality for the system of question/answering for PIPS.
A preliminary study was made on the medical taxonomy of the types of questions and answers in the field of diseases and was supervised by a medical professional. An internship was carried out on this subject and the results were presented by the intern, Sarah Cruchet, following which she obtained her degree from the Polytechnic School of the Engineering School of Grenoble, in Medical Informatics and Information Technology. Sarah has now joined the HON team and continues to work in the field of Natural Language processing.
A second experiment was carried out with regard to the improvement of the subjects’ coverage and the reliability of the system. A systemic evaluation is being performed to compare the manual evaluation and the automatic detection system which will clarify the advantages and shortcomings of the automatic system.
Standardizing the quality of French Health websites
HON was chosen as the official accrediting body by the HAS (Haute Autorité de Santé or the French National Authority for Health) following several discussions and joint visits to each organization. This joint venture would result in the accreditation and quality standardization of all French health websites by HON.
This was brought about through the passing of a bill stating that from Jan. 2006 the certification of health French websites should be implemented and delivered by an accredited organisation identified by the HAS in respect of criteria decided by the HAS.
The activities carried out by HON, as a certification organization collaborating in the future at the governmental level with France, has been evaluated by the HAS and will be on a regular basis and according to stringent norms like EN45011/ISO65 enforced by internationally recognized and independent private or governmental accreditation organizations like Haute Autorité de Santé (HAS), or the COFRAC http://www.cofrac.fr .
Project ‘HON for Africa’
HON for Africa was started when a need for quality assured online medical information was identified in English-speaking and French-speaking Africa.
HON in French-speaking Africa
In French-speaking Africa, the official representation of HON is in Bamako, Mali, established two years ago. It has been more than one year since the start of the project “Obtaining Reliable Medical Information Online: A Study Focusing on Francophone Africa”. This representation has been in charge of the selection and accreditation process for this project under the guidance and supervision of HON Geneva. The training was carried out through a session training in Bamako in January during the conference “Les Journées Francophones d’Informatique Médicale”, along with ongoing online training sessions. The two reviewers involved, Dr. Mahamoudane Niang and Dr. Seydou Tidiane Traoré, participated in the final presentation of our research results in September in Geneva and also were provided with an additional week of training and auditing. They will continue the accreditation and the promotion of the HONcode rules for the creation of online local health websites.
HON in English-speaking Africa
The project in English-speaking Africa is a collaboration between the Health On the Net Foundation (HON) and the Medical Research Council of South Africa (MRC) and attempts to promote awareness for the need of reliable information sources and to provide such reliable sources to the English speakers in Africa.
The project was effectively started this year where the MRC has performed the following activities:
- Continuous identification of suitable local websites followed by reviewing and accreditation.
- Education to develop and build capacity of web developers in Africa according to the HONcode principles.
- Creation and promotion of awareness of HONcode amongst English speaking African countries through tutorials and articles in conferences.
This project is still in its initial stage, having begun in April 2006. However HON for Africa will, when fully established, provide and fulfil the above mentioned objectives, with the ultimate goal being to provide a pool of trustworthy medical information, accessible by all, within the domain of English-speaking Africa. 63 English-speaking websites was identified and evaluated regarding the HONcode.
Swiss and regional activities:
Provisu
This website (http://www.provisu.ch), which is a resource of websites for eye diseases, vision disorders and prevention of blindness for both French and English speakers, has been online since last year. This site is continuously updated along with addition of new topics.
The sites referred have been chosen according to the HONcode criteria. The Provisu website has shown increasing popularity amongst internet users. Within the last nine months, from January 2006 to September 2007, we have seen a threefold increase in the number of visitors from 1’677 in January 2007 to 5’’000 in September 2007. The number of pages accessed has progressed by 2.5 times within the same period of time. A promotion through the Geneva network of general practitioners and ophthalmologists is planned, which would increase the visibility of this bilingual project.
SantéRomande
This resource of sites was also built based on the guidelines of the HONcode and is targeted towards the French speaking Swiss community (about 1.5 million inhabitants).
It provides information on various disease conditions, medical professionals, hospitals, medical centres and health and medical associations.
Having been launched in March 2006, there is continued development and expansion of the SanteRomande database (http://www.santeromande.ch). An average of 451 visits a day was seen in the month of September 2007. However, following publication in the press and broadcasting from Radio Suisse Romande, SanteRomande has had in April and May 2007 an average of 580 visits a day.
As this site is mainly intended for the French speakers of Switzerland, it is imperative that it is well known within this relatively small region.
We are developing a version of SantéRomande in order to propose customized services such as automatic reception of scientific articles related to their chosen subject, online management of medical appointments, listing different types of doctors within the area, interactive tests (e.g. Body Mass Index), an online agenda and new websites identified by HON.
“Outil d’information sur les maladies rares et de prise en charge des patients pour les Romands ”
(Guide to information on rare diseases and orphan drugs for Swiss-French community)
A directory on rare diseases and orphan drugs has been made available for the French speaking Swiss community on the site http://www.orpha-net.ch, the Swiss partner of the European project orpha.net. This directory also provides local information and information on health providers specializing in rare and genetic diseases. This project is funded by the Loterie Suisse Romande with a grant of CHF 100,000. This project is under the supervision of the Dr. Loredana D’Amato Sizonenko.
OESO-Foundation
Continuous maintenance of the OESO website and integration/development of an online CME system with video.
Technical advances:
Our quality approach
Measures for internal and external quality assurance have been established with HON for years. Besides, HON is now engaging in new projects such as the Complaint Handling and Tracking system, the Automatic Difference Tracker that enhances the trust in the reliability of HON’s accreditation activities and at the same time makes them more transparent to online medical and health publishers as well as consumers.
HON has taken steps to improve the system through the integration of a Quality Management System. The quality policy of HON is ‘To determine and certify the quality of health-related websites in an independent, impartial, precise, efficient and effective way in line with the standards of the certification system of HON’. To facilitate in fulfilling this policy, HON has prepared a quality manual depicting all the policies and procedures establishing the minimum requirements that all operating divisions of HON must meet. The manual has been published within the HON system and is freely available to all HON personnel.
Annual internal audit
Two types of internal audit have been settled, one regarding the certification and the second to assess how well we respect our procedures and our defined quality indicators.
- The Internal audits for certification are carried out either on a scheduled basis or on an ad-hoc basis for the purpose of continuous improvement and fulfillment of requirements for certificate recognition. This allows to identify non conformance actions and to homogenize the accreditation process.
Another of the procedures identified as essential for quality management is the internal audit, where it allows HON to assess internally all the control elements defined in the procedures for quality assurance.
This quality assurance integration in the daily work of HON has been necessary to enhance our services and also to respect stringent norms for certification activities. This level of quality was necessary for collaborating with the HAS.
New generation of HONcode seal: dynamic and Interactive
A new generation of HONcode seal is now in use. This new seal shows the date of last accreditation. The seal is stored on the HON servers, thus enabling it to change its status in accordance with the HONcode compliance of the site. Also, each seal is digitally watermarked. This technique allows the addition of hidden information such as the status of accreditation as well as the copyright notice of each unique HONcode seal. Any misuse of the HONcode seal is tracked and detected by our robot MARVIN, our review team and the Internet community.
The seal was distributed amongst the webmasters of HONcode accredited sites throughout this year, with coverage for all HONcode accredited sites being the final goal.
HONcode Certificate
A paper copy of the online HONcode certificate was developed this year, following which, in July was sent to 143 webmasters. 40% of webmasters downloaded their certificate. Within the email a questionnaire was provided on the usefulness of this certificate. Only 15 webmasters gave their opinion. All the webmasters who answered to the questionnaire were in agreement of the necessity of such a document.
Based on these results, this certificate will be sent to all HONcode accredited sites, which may be then printed and displayed in their office.
Quality of the accreditation
We plan to assess on a more regular basis the quality of our services via a questionnaire. The creation of a HONcode Blog could a solution to communicate more easily with our community of HONcode accredited website.
HON website
New HONcode search tool: search only HONcode accredited websites with Google powerful search engine: http://www.hon.ch/HONcode/Search/search.html This search tool allow to refine your search regarding target group such as patients, seniors, women, men, ...etc.
The HON website is available in four languages: Chinese, English, French, and Spanish. The German version of the HON website will be available soon. The Italian will be the next language translation available.
The HONcode application form is available in eight languages; the last added language is Chinese.
HON collaborative internal platform
In order to allow HON reviewers to work in different languages from different locations, the HONcode collaborative platform has been enhanced to allow for an exchange of information in Cyrillic and Chinese. A Content Management System has been integrated into the HON platform in order to allow easy updating of our multilingual website. This CMS also manages versioning.
HONcode internal platform
A powerful complaint handling system has been integrated into the platform. A major update of the complaint management handling system has been done in order to facilitate the management of complaints.
From January to October 2007 the nº of complaints (42) was lower as in the same months of 2006 (72). All the contacted websites made the modifications required swiftly.
An automatic detection of changes of content tool has been developed by HON and integrated within the accreditation platform. The review team can now track easily the amendments done in the page after a review.
A cross validation system allows a reviewer to ask for the expertise of a senior reviewer. All the website accredited will be evaluated by two reviewers.
HON in figures
- 6500 medical and health websites accredited by HON
- 750 new sites were audited so far in 2007, besides the re-evaluation of sites during the HON annual review.
- 32 languages
- 72 countries are now represented among our HONcode-accredited sites.
- With 34’400 links to HON website, HON is the fifth most linked health website on the Internet behind AllHealth.com, WebMd, Medscape, NIH.
In September 2007, some 580,000 visitors viewed a total of approximately two million pages. This number has remained stable over the past year.
External relations
Participation at the Health-EU Portal Editorial Board
The European Commission, Health and Consumer Protection Directorate-General, has invited HON to the Health-EU portal Editorial Board.
Reviewing European projects for the European Commission
The European Commission has requested HON expertise in order to review projects of the sixth framework programme of the European Community in the domain of accessibility.
Conference participation: 
AMIA 2007 Annual Symposium
This conference will be held in Chicago, Illinois on 10th-14th November 2007 and will include discussions on new research and development in the fields of biomedicine and health informatics.
HON will present the following paper; Combination of heterogeneous criteria for the automatic detection of ethical principles on health websites - Gaudinat A, Grabar N, Boyer C.
RUIG panel presentation
A panel presentation was organized by the Graduate Institute of Development Studies (IUED) and HON on Tuesday September 18 in Geneva for the presentation of the results of the one year research project "Obtaining Reliable Medical Information Online: A Study Focusing on Francophone Africa". This study focuses on the stakes related to the globalisation of information of health and in particular the structural components of confidence in this information and the identification of competences necessary to the development of telemedicine in developing countries. It was focused on the content intended for health professionals in French-speaking Africa, in particular Mali.
Carried out jointly with the University of Geneva, the World Health Organization, the Foundation Health on the Net, the Institute of the social sciences of Mali, it was financed by the International University Network of Geneva (RUIG).
ePractice workshop: High Impact services
This workshop was organized on 10th September 2007 in Brussels, Belgium to explore good practices in the field of High Impact services and was led by prominent speakers in the field who have substantial experience in developing and implementing eServices of public interest.
Three recognized best practices were presented by their authors in the form of case studies, in order to identify the key problems and to elaborate possible solutions.
- A virtual guide to Austrian Authorities - Roland Edinger (Austria)
- Criteria for trustworthy health information websites - Celia Boyer (Switzerland)
- Reducing distances between citizens & political institutions - Rolf Luehrs (Germany)
Medinfo 2007
Workshop: Models of trust for health websites
This was co-organized by HON and the Service of Medical Informatics, Geneva University Hospitals and was held on the 19th August 2007 in Brisbane, Australia in conjunction with Medinfo 2007.
The objective of this workshop was to address different aspects related to the problem of controlling the reliability of health websites.
HON also participated in conferences in Medinfo 2007 where four papers in all, were presented;
- Health On the Net Foundation: Assessing the Quality of Health Web Pages All Over the World -Celia Boyer, Arnaud Gaudinat, Vincent Baujard, Antoine Geissbühleron21st August 2007
- Analyzing Web Log Files of the Health On the Net HONmedia Search Engine to Define Typical Image Search Tasks for Image Retrieval Evaluation – Müller H, Boyer C, Gaudinat A, Hersh W, Geissbühler A. on 21st August 2007
- WRAPIN: a tool for patient empowerment within HER - Joubert M, Gaudinat A, Boyer C, Fieschi M, Geissbühler A on 22nd August 2007
- Machine Learning Approach for Automatic Quality Criteria Detection of Health Web Pages - Arnaud Gaudinat, Natalia Grabar, Célia Boyer on23rd August 2007
11th Conference on Artificial Intelligence in Medicine (AIME 07)
HON contributed the poster “Automatic retrieval of web pages with standards of ethics and trustworthiness within a medical portal: What a name page tells us” - Arnaud Gaudinat, Natalia Grabar, Célia Boyer for the topic Machine Learning and Modelling approaches
at this conference held on 7th-11th July 2007 in Amsterdam, The Netherlands.
A Study of specificities in French-speaking Africa
A presentation of the results of the Study “Towards trustworthy on-line medical information: a study of specificities in French-speaking Africa” was held on the 21st of May.
The briefing was organized within the context of the World Health Assembly, under the auspices of the World Health Organizationand included a post-presentation discussion on the results obtained.
eHealth Conference 2007
This EU High Level conference was implemented by the European Commission, the German Ministry of Health, the Land Berlin and the GVG and was held in Berlin, Germany on the 18th of April 2007.
The conference was aimed at providing information on and discussing possible solutions to cross-border interoperable processes and electronic health care services.
eHealth and Patient empowerment
HON organized the Executive Seminar I held at the 3rd Annual World Health Care Congress Europe 2007 in Barcelona Spain from the 26th-28th March 2007. It was attended by the distinguished speakers Mr David Garwood, Dr Petra Wilson and Mr Alberto Sanna.
The goal was to bring together Industrial and Governmental leaders from all over the world to share best practices for improved delivery and outcomes in Europe.
12e Journée Francophones Informatique Médicale
HON participated in the above conference held on the 11th and 12th of January 2007 in Bamako, Mali by presenting the paper « Utilisation de méthodes d'apprentissage pour la détection des critères de qualité des documents en ligne du Web médica »’ - Gaudinat A, Grabar N, Boyer C
The theme of the conference was evaluation of internet usage for health information with epidemiologic aspect and was focused mainly within Africa.
HON in the news
Community Health Nursing: A Canadian Perspective 2/e by Stamler and Yiu; Chapter 15, Information Technology, published by Pearson Education Canada Inc. In Press. A reprint of the HONcode in the section “Quality of Health Information On the Internet”.
Se soigner sur le Net, oui mais…
http://www.migrosmagazine.ch/index.cfm?id=19134
Immer mehr Patienten suchen Rat im Internet
PSI, 18 May 2007
http://www.hon.ch/Global/Press/HON_070518_psi.pdf
L'automédication, pire que le mal?
virus.rsr.ch, 5 May 2007
http://virus.rsr.ch/lautomedication-pire-que-le-mal
Où s’informer correctement sur sa santé?
Humanité Dimanche, 26 April 2007
http://www.hon.ch/Global/Press/HON_070426_humaniteDimanche.pdf
Sites Internet de santé:A consulter avec prudence
queChoisir.org, 27 March 2007
http://www.hon.ch/Global/Press/HON_070328_queChoisir.pdf
Wie vertrauensvoll sind Gesundheitsinformationen aus dem Internet ?
Hitflip Lexikon, 13 March 2007
http://www.hitflip.de/special/hon
Internet interpelle les médecins
Le Monde, 21 February 2007
http://www.hon.ch/Global/Press/HON_070221_intLesMed_LeMonde.pdf
Un certificat de bonne santé pour les sites médicaux
News.fr, 26 December 2006
http://www.news.fr/actualite/societe/0,3800002050,39365896,00.htm
Administration and finance
The operating budget of HON is allocated by the parliament of Geneva for the period 2004- 2008. The Geneva State Department of Employment and Solidarity (DSE) continues to demonstrate its confidence in HON, and we will make every effort to meet their high expectations. We continue to seek additional sources of funding both locally and at the European level.
Prof. Antoine Geissbühler Célia Boyer
HON President Executive Directo |
