1. System Standards LIS 4776 Advanced Health Informatics Week 7
Instructor: Dr. Sanghee Oh
College of Communication & Information, Florida State University

2. Today’s Topic IT Alignment & Strategic Planning (Weeks 2,3 )
Records management
IT governance; IT standards
System Standards(Week 4,5,6,7)
PHRs
EHRs
Health websites

3. Class Presentations
Lauren Potter
Matt Farrell

4. “The health of individuals and communities also depends greatly on access to quality health care. Expanding access to quality health care is important to eliminate health disparities and to increase the quality and years of healthy life for all people living in the United States. Health care in the broadest sense not only includes services received through health care providers but also health information and services received through other venues in the community.”

5. Health Information on the Web
How do I recognize good information?
Offline
______________
Online

6. Health Information on the Web
On your OWN:
Draw a model of INFORMATION SEEKING!
How do you search information?
Small groups:
Draw a combined model of INFORMATION SEEKING!
Class discussion

7. Health Information on the Web
Questions about the quality of health information
______________ to assess
The _____________ nature of the Internet
Not always ______________
Why important?
_____________
_____________ information
Advertising
Information _____________

8. Criteria _________ in Healthcare (Hippocratic oath)
_________ (authoritative, accurate)
_________ (accurate, complete)

9. Health Information on the Web
MLA Top Ten Health Websites
MLA Guide: Find and Evaluate Health Information on the Web

10. MLA Guide: Find and Evaluate Health Information on the Web
According to the Pew Research Internet Project, in 2013
"59% of U.S. adults say they have looked online for information about a range of health topics in the past year.
35% of U.S. adults say they have gone online specifically to try to figure out what medical condition they or someone else might have." 

11. MLA Top Ten Health Websites
General Health | Breast Cancer | Diabetes | Eye Disease | Heart Disease | HIV/AIDS | Stroke 
Cancer.gov
Centers for Disease Control and Prevention (CDC)
familydoctor.org
healthfinder®
HIV InSite
Kidshealth®
Mayo Clinic
MedlinePlus (English | Spanish)
NetWellness
NIH SeniorHealth 

12. MLA Content Evaluation Guidelines
Who is _________ the website?
How often is the site _________?
Does the site present _________ and _________?
Who is the _________ ________?

13. FAQ Is the information reviewed by _________? _________ runs the site?
Where did the information _________?
Does the site make _________?
Do “they” _________ your personal information? What will “they” do with it?
_________ runs the site?
_________ have they created the site?
Who is _________ for the site? Does the site’s information favor the sponsor?
Is it _________?
(National Cancer Institute, 2005)

14. Criteria for Reliability
SOURCE
QUALITY
AUTHENTICITY
EVIDENCE
CURRENCY
SPONSORSHIP
CONFIDENTIALITY
(The National Library of Medicine, 2006b)

15. Group Activities
Your AUNT BEE has a “bunch of blotches on her arms and she asks you to find out what it is?
The Doc thinks its Skin Cancer and wants to use chemo to treat it – she calls you again for help?
SOURCE
QUALITY
AUTHENTICITY
EVIDENCE
CURRENCY
SPONSORSHIP
CONFIDENTIALITY
(The National Library of Medicine, 2006b)

16. Group Activities
You have frequent headaches and sometimes blurred vision – what’s going on?
You decided to track your BP using the machine in Thagard and it’s been consistently between 140/100 and 145/105
- now what?
SOURCE
QUALITY
AUTHENTICITY
EVIDENCE
CURRENCY
SPONSORSHIP
CONFIDENTIALITY
(The National Library of Medicine, 2006b)

17. Criteria: _________
Look for the process of selecting or approving information on the Website.
Is the information reviewed before it is published?
E.g., National Cancer Institute (NCI): peer-reviewed by six editorial boards of cancer specialists.
Accreditation process: The American Accreditation Healthcare Commission (also known as URAC)*
“About us”, and called “editorial policy” or “selection policy”, or “review policy”.*

18. Criteria: _________ Be a cyberskeptic!- Quackery on the Web.
Does the site provide health information that seem too good to be true?
Does it promise quick, or miraculous result or one remedy for a variety of illness?
Check more than one site.

19. Criteria: _________ Rely on the medical research, not opinion*
Check to see the primary information
Good examples: written by American Allergy Society, National Centre for Complementary and Alternative Medicine, and etc.
If they are testimonials or histories, look for contact information e.g. or phone number. If anonymous or hard to track down (Daniel from FL), be cautious!

20. Criteria: Evidence (con’t)‏
Levels of Evidence
Level 1: RCTs (Randomized Controlled Trials)‏
Level 2: Cohort Studies
Level 3: Case-Control Studies
Level 4: Case-series
Level 5: Expert Opinion

21. Criteria: _________ Look for the latest health information*
In general, the older information, the less up-to- dated and the less useful. ‏
Need of current information
E.g., Stomach cancer vs. Stress
Click on a few links on the site
If there are lots of broken links, the site may not be kept up-to-dated.

22. Criteria: _________ Check to see the purpose and provider
Beware of bias of information
To market products or to provide information?*
Does it want you to think in a certain way?
E.g.,If a drug is recommended by the company that manufactures it
Does the site tell you options open to you?*
Different treatments available to you.
What may happen to you if applying the information.

23. Criteria: _________ Check the Privacy Policy
Health information should be confidential.
If the section says, “ we share information with organizations that can provide you with useful products”, your information is not private and protected.*
There should be a “Privacy" or “Privacy Policy” section.

24. Gatekeepers
Health on the Net Foundation
British Healthcare Internet Association
Health Internet Ethics

25. Health on the Net Foundation
The Health On the Net Foundation (HON) promotes and guides the deployment of useful and reliable online health information, and its appropriate and efficient use.
Created in 1995, HON is a non-profit, non-governmental organization, accredited to the Economic and Social Council of the United Nations.
HON has focused on the essential question of the provision of health information to citizens, information that respects ethical standards. To cope with the unprecedented volume of healthcare information available on the Net, the HONcode of conduct offers a multi-stakeholder consensus on standards to protect citizens from misleading health information. 
HONcode certification:  Improving the quality of online health information

26. Ethics Standards and Guidelines
Ethics standards and guidelines for Internet health sites are being developed and promoted by several organizations and quasigovernment agencies.
Internet Healthcare Coalition
Hi-Ethics Alliance
AMA
HON
The e-Health Ethics Initiative
Other (e.g., medCERTAIN)

27. e-Health Code of Ethics: 8 Guiding Principles
______________
Disclose vested financial interests
Disclose key information for consumer decisions
Present information truthfully
No misleading claims

28. e-Health Code of Ethics: 8 Guiding Principles
___________
Accurate, clear, current, evidence-based
Readable, culturally competent, accessible
Citations, links, editorial board and policies
____________
Privacy policy and risks
Data collection and sharing
Consequences of refusal to consent

29. e-Health Code of Ethics: 8 Guiding Principles
______________
Prevent unauthorized access or personal identification of aggregate data
Let users review and update personal data
Abide by professional codes of ethics
Disclose potential conflicts of interest
Obey applicable laws and regulations
Point out limits of online practice

30. e-Health Code of Ethics: 8 Guiding Principles
__________________
Choose trustworthy partners, affiliates, and links
Maintain editorial independence from sponsors
Tell users when they are leaving the site
Provide management contact info
Encourage user feedback
Respond promptly and fairly to complaints

31. Other Sources
Healthfinder.gov
Floridahealthfinder.gov

32. More reading
Bomba, D. (2005). Evaluating the quality of health Web sites: Developing a validation method
and rating instrument. Proceedings of the 38th Hawaii International Conference on System Sciences, 1-9.
Crespo, J. (2004). Training the health information seeker: quality issues in health information Websites
[Electronic version]. Library Trends 53(2),
Eysenbach, G., & Diepgen, T. L. (1998). Towards quality management of
medical information on the internet: evaluation, labelling, and filtering of information [Electronic version]. British Medical Journal, 317,
Fidel, M. J. (2005). Quality standards for information on the Internet. Retrieved Jan 26, 2008, from
Health Development Agency, & Centre of Health Evaluation Quality (2000).
Quick the quality information checklist. Retrieved Jan. 15, 2008, from
Medical Library Association ( ). A user's guide to finding and
evaluating health information on the Web. Retrieved Jan. 21, 2008 from
National Cancer Institute (2005). How to evaluate health information on the Internet: Questions and answers. Retrieved Jan. 26, 2008,from
The National Library of Medicine (2006a). Evaluating Internet health
information: A Tutorial from the National Library of Medicine. Retrieved Jan. 22, 2008, from
The National Library of Medicine (2006b). MedlinePlus Guide to Healthy Web
Surfing. Retrieved Jan. 18, 2008, from

33. Other Sources
Healthfinder.gov
Floridahealthfinder.gov