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What
You Should Know about Quality Rating Programs for Health Sites
by
Kevin P. Richardson, President, MedRocket, Inc.
About the Author - Kevin Richardson is a healthcare marketing consultant, executive coach, and writer who provides fresh perspectives and expertise about online healthcare marketing. Sign up for his FREE "MedRocket Ezine" newsletter and discover how to profitably attract and serve healthcare consumers online. Subscribe at http://www.medrocket.com.
Web publishing has become relatively simple process. Just about anyone can set up a health Web site. And they have. In fact, some estimates project that there are now 100,000 health sites on the Net.
But that's the problem.
Now it's difficult for consumers to determine quality health information from junk. Everywhere you turn you'll find dubious advice, products, and services to promote health, cure illness, and live a longer life.
Unaware of the dangers awaiting them at some health sites, consumers could accept questionable claims as credible health information – with potentially devastating results.
This problem hasn't escaped the medical community. Anecdotal stories abound about patients searching the Net for medical advice and presenting their doctors with these medical "breakthroughs."
QuackWatch.com is an excellent resource that reveals some of the most barefaced examples of fraudulent and frequently hazardous health information on the Internet.
It's Time to Instill Trust and Credibility
It all comes down to a question of trust. How can a consumer trust the ethics and quality of information at a health site?
In recent years the online healthcare community has created a number of self-regulatory programs to promote trust – and address the quality of health information on the Web and the ethical issues of privacy and confidentiality.
Your Web site's participation in at least one of these programs signals to consumers that information quality, privacy, and ethical practices is vitally important.
The programs help Web visitors identify sites that meet specific criteria for quality health information, and could protect them from the physical, mental and emotional harm caused by fraudulent, incorrect, or self-serving information.
Two Approaches to Health Quality Standards
Health site quality programs come in two types: self-administered codes of conduct and third-party review and certification. Some programs are beginning to offer a hybrid approach.
Both approaches can be successful at building consumer's trust and confidence in a health site, and helping them to avoid suspicious health information.
Here are the two approaches:
Codes
of Conduct
A Code of Conduct is a set of quality and ethical guidelines for healthcare Web sites. Because participation is generally free, they can be adopted by organizations of any size, without regard to financial ability.
As a result, the number of participating sites is potentially much greater than those sites using the third-party certification programs, which come at a cost.
The principles of these Codes however, are usually worded loosely enough to be open to individual interpretation. Thus each Web site may apply their meaning more or less strictly. The ability to measure utilization, effectiveness, and compliance using Codes of Conduct can be difficult, unless a measurement tool is part of the program.
Third-Party
Certification
Third-party certification programs are especially good for organizations that wish to use participation in a health site quality program as a competitive advantage.
The fees and effort associated with participation signal a real commitment of the organization to high standards of health information quality and ethics.
Criteria are clearly established and consistently applied by the certifying groups. These fee-based programs generally allow for measurement of utilization and effectiveness.
However, the fees and associated costs restrict participation to organizations with healthy budgets. Because of this, these programs have a smaller number of participants.
Remember that in addition to fees required by the program, the cost of labor and resources to implement changes to comply with the guidelines must also be considered.
Take a Closer Look at These 7 Quality Rating Programs
Some
of the most common quality rating programs are:
eHealth
Code of Ethics
http://www.ihealthcoalition.org/ethics/ethics.html
The eHealth Code of Ethics was developed by the Internet Healthcare Coalition,
a Washington, DC-based non-profit organization.
The code is a universal set of ethical principles for health-related Web sites that comprises Eight Guiding Principles. These principles are open to interpretation by each health organization according to its unique needs.
The goal of the eHealth Code of Ethics is to ensure that "people worldwide can confidently and with full understanding of known risks realize the potential of the Internet in managing their own health and the health of those in their care"
There
is no fee involved in "subscribing" to the eHealth Code
of Ethics, and there is no verification by the Healthcare Coalition
to verify compliance. The program also does not use seals to visibly
designate Web sites that follow the code, like HONcode does. Thus
determining a Web site's conformity to the code is the responsibility
of the healthcare consumer.
The Coalition is funded by membership fees, unrestricted educational grants
and donations and proceeds from conferences and educational activities
Health
Internet Ethics (Hi-Ethics)
http://www.hiethics.com/
Hi-Ethics, or Health Internet Ethics, is a not for profit consortium of 20 of the most widely used U.S.-based consumer health Internet sites and information providers.
The Hi-Ethics 14-point principles followed by member organizations are intended to protect consumers in the areas of privacy, security, quality of information, fairness of transactions and professional conduct
Unlike the eHealth Code of Ethics, the Hi-Ethics standards were solely developed by the companies in the alliance – without outside input. However this doesn't diminish their significance. Just realize that they're not the result of a consensus-building, broad-based coalition effort.
Hi-Ethics does not review sites or certify compliance with the 14-point set of principles. Instead, they refer participants to the independent URAC Health Web Site Accreditation Program for certification.
Member companies provide the funding for the initiative through membership fees. Current membership fee is $6,000.
URAC
Health Web Site Accreditation Program
http://urac.org/websiteaccreditation/default.htm
URAC, formerly known as the American Accreditation Healthcare Commission, is a not for profit organization founded in 1990 to establish standards for the managed care industry.
The development of the accreditation program was inclusive and broad-based, and involved appointing an advisory committee representing all stakeholders.
Health Web sites seeking URAC accreditation must submit documentation of compliance with each standard. A URAC accreditation staff member reviews the application and works with the organization to address any deficiencies.
Applicants must also establish an organizational quality committee to oversee ethical Internet operations for the organization.
Health sites that pass the painstaking review process and meet more than 50 stringent quality standards are granted permission to display the URAC accreditation trustmark.
The trustmark is an indicator to health consumers that a Web site meets high standards for quality and accountability.
Accreditation doesn't come cheap, though, and is based on annual revenues. Organizations with annual revenues of between $100 and $250 million can expect to pay $7,199.
HONcode
of Conduct
http://www.hon.ch/HONcode/Conduct.html
The Swiss non-profit Health on the Net Foundation's HONcode is probably the earliest and most widely endorsed set of ethical guidelines for health Web site developers.
How widely endorsed? Well, a search on Google for participants in the program yielded 72,600 pages. Try it yourself with the search phrase "we subscribe to the HONcode principles of the Health on Net Foundation."
Whether or not this is even close to the actual number of program participants, it's clear that participation in HONcode is huge.
The HONcode sets forth 8 principles for basic ethical standards for health Web sites. The code addresses the authority of information, data confidentiality and privacy, proper attribution of sources, identification of financial sponsorship, and the importance of clearly separating advertising from editorial content.
Sites that conform to the principles are allowed to display the active HONcode seal on their pages. The seal helps consumers identify sources of reliable information.
The HONcode was initially developed in 1997 in consultation with webmasters, information providers, health consumers, and citizens. However, the code has not been updated since its inception, unlike the "living document" approach of the eHealth Code of Ethics and some others that responds to changes in the online health environment.
The Health on the Net Foundation provides the program as a free, self-certification system intended primarily for health site developers. The code has been translated and is in use in 19 different language versions.
HON also provides an online checklist for consumers as a guide to assess whether a given site conforms to the HONcode principles.
MedCERTAIN
http://medcertain.com/english/publisher/overview.htm
Based in the European Union, MedCERTAIN is an innovative certification and rating program for health sites. MedCERTAIN stands for "MedPICS Certification and Rating of Trustworthy and Assessed Health Information on the Net."
The program has established an international trustmark for health information that enables consumers to filter harmful health information and to identify and select high quality information.
This is accomplished by including Web site content labels in the form of meta tags and other labeling technologies within the HTML source code of Web pages.
A coalition of health related associations, professional associations, and consumer advocacy groups provided their expertise in developing the certification criteria.
Obtaining
a MedCERTAIN trustmark requires that the health site comply with
specific quality criteria, answer a lengthy questionnaire, and successfully
complete a third-party site evaluation.
Application for the MedCERTAIN trustmark program is free. Web site input about
improving the certification process is welcome.
Good
Housekeeping Seal of Approval
http://www.gh-atyourservice.com/certificate/prog_info.html
If you absolutely have to have the Good Housekeeping Seal of Approval on your health site, then you might look into the Good Housekeeping Institute Web site certification program.
The program is not limited to health sites, and offers a basic set of standards covering content integrity and privacy for all sites. These are supplemented by a few special requirements for health sites.
An
initial non-refundable review fee of $1,000 must accompany this application.
If the Web site meets the Institute's criteria, there is an additional
$4,000 annual fee for the use of the Certification.
Essentially, the Good Housekeeping certification effort is a licensing program
to use the Good Housekeeping Seal on Web sites.
AMA
Guidelines for Medical and Health Information Sites
http://pubs.ama-assn.org/ama_web.html
Although the American Medical Association's guidelines are intended to serve as principles that govern AMA Web Sites, they are recommended reading for anyone who develops and manages health Web sites.
The guidelines establish ethical and editorial policies for Web-based content, advertising, privacy and confidentiality, and e-commerce.
Among other things, the AMA guidelines say sites should clearly identify content sources, reveal sponsorship of content, separate advertising from editorial content, and give users the opportunity to prevent gathering of personal information.
The association has stated, however, that it has no intention of policing, endorsing, or giving a seal of approval to any site that adopts the guidelines.
Put Your Health Site to the Test
Once you've decided which health site quality program best matches your marketing and business needs, resource availability, and budget, visit their Web site or contact the program for more information.
Make sure you find out exactly what you'll need to do to comply with the program requirements. Even if the program you choose doesn't require a third-party evaluation of your site, you should set up a small working group at your organization to critically evaluate your Web site against the guidelines and standards set by the program.
If you're seriously interested in health site quality, make sure you do it 100 percent. Fix any deficiencies right way and create your own internal operating procedures to ensure continued compliance as you add new Web content and features to your Web site.
Communicating your participation in one or more of these programs is crucial. Some programs like the HONcode use a "seal" that denotes acceptance of the code or membership in the program.
For programs that don't offer a seal, make sure you provide wording on your Web site to the effect that you participate in XYZ program and why this benefits health consumers. Including a link to the code of ethics or other descriptive information on the program Web site is also helpful.
