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Towards ethical guidelines for e-health: JMIR theme issue on eHealth ethics.

Eysenbach G - J. Med. Internet Res. (2000 Jan-Mar)

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The Internet is a vast resource for consumers, but to realize its full potential it is necessary to ensure the quality of information, or at least to help consumers to assess the quality of information... While the Internet and interactive health communication clearly has the potential to make patient-physician encounters more effective, a recent paper published in the Journal of Medical Internet Research showed that only 19% of Scottish GPs felt that they were " to use the time more effectively" if patients come with Internet printouts... However, a single or centralized review process, institution, or agency to ensure quality is neither desirable or realistic, since the Internet is a decentralized, global medium: "Web 'publishers' of all stripes...should be free to post whatever they like and live with the consequences"... We can call the resulting dilemma " farmer's dilemma," as any farmer battling with pests and weeds faces a similar problem: The more pesticides he uses, the more he inhibits the healthy growth of useful plants... As a consequence of this, DrKoop.com convened representatives from about a dozen Web firms in October 1999 to begin hammering out an ethics policy (see Figure 4)... A few days later, on Wednesday, October 13, 1999, George Lundberg, editor in chief of the health portal Medscape and former editor of the Journal of the American Medical Association (fired for publishing a survey on sexual attitudes that coincided with President Clinton's impeachment), gave a keynote speech at the annual meeting of the Internet Healthcare Coalition (IHC), a non-profit organization mainly consisting of companies in the eHealth business, where he said: "The essence of professionalism is self-governance... Just as the International Committee of Medical Journal Editors, founded in 1978, has set the standards for how medical journal authors and editors should behave, the leaders of the e-health information enterprise should now set common standards for ethical behavior." Two days later, the IHC announced it would organize a working summit in Washington D.C., on January 31st - February 1st, 2000, to forge a set of ethical principles for health-related Web sites... Within the medCERTAIN project, a technical infrastructure is currently being developed which allows individuals, organizations, associations, societies, and other entities to digitally label (rate, evaluate, peer-review, give quality seals to...) online published health information using labels consisting of a standard computer-readable vocabulary (metainformation)... The medCERTAIN consortium will also create different levels of certification for publishers of health information on the web (ranging from simple quality seals indicating the "good standing" of the site to "gold" quality seals indicating that the site has been peer-reviewed externally)... As mentioned above, the medCERTAIN project is one project funded under the "Action Plan on promoting safer use of the Internet by combating illegal and harmful content on global networks," adopted on December 21, 1998, by the Council of the European Union: "This action plan is a European Commission proposal for a number of initiatives from 1 January 1999 to 31 December 2002 with a total budget of 25 million Euro... Aside from the draft version of the Washington Code of eHealth Ethics, this issue of JMIR further contains two reviews tackling the difficult issues of practicing medicine on the Web without a pre-existing patient-physician relationship (e.g. responding to unsolicited patient emails) and the chances and challenges of e-psychotherapy... Interestingly, this report on cyberplagiarism and the activities of the Journal of Medical Internet Research in this field, including a new policy that every submitted manuscript will be electronically scanned for plagiarism, have already attracted some media coverage and may stimulate thought and debate in the publishing world about informatics tools which may detect academic misconduct and thereby enforce ethical conduct in publishing and research... Gunther Eysenbach, MD Editor, Journal of Medical Internet Research

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The four pillars of quality health information
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figure1: The four pillars of quality health information

Mentions: Instead, quality management of health information on the Internet depends on "bottom-up" mechanisms and essentially rests on four pillars - the " E's" (see Figure 1):


Towards ethical guidelines for e-health: JMIR theme issue on eHealth ethics.

Eysenbach G - J. Med. Internet Res. (2000 Jan-Mar)

The four pillars of quality health information
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC1761845&req=5

figure1: The four pillars of quality health information
Mentions: Instead, quality management of health information on the Internet depends on "bottom-up" mechanisms and essentially rests on four pillars - the " E's" (see Figure 1):

View Article: PubMed Central - HTML - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

The Internet is a vast resource for consumers, but to realize its full potential it is necessary to ensure the quality of information, or at least to help consumers to assess the quality of information... While the Internet and interactive health communication clearly has the potential to make patient-physician encounters more effective, a recent paper published in the Journal of Medical Internet Research showed that only 19% of Scottish GPs felt that they were " to use the time more effectively" if patients come with Internet printouts... However, a single or centralized review process, institution, or agency to ensure quality is neither desirable or realistic, since the Internet is a decentralized, global medium: "Web 'publishers' of all stripes...should be free to post whatever they like and live with the consequences"... We can call the resulting dilemma " farmer's dilemma," as any farmer battling with pests and weeds faces a similar problem: The more pesticides he uses, the more he inhibits the healthy growth of useful plants... As a consequence of this, DrKoop.com convened representatives from about a dozen Web firms in October 1999 to begin hammering out an ethics policy (see Figure 4)... A few days later, on Wednesday, October 13, 1999, George Lundberg, editor in chief of the health portal Medscape and former editor of the Journal of the American Medical Association (fired for publishing a survey on sexual attitudes that coincided with President Clinton's impeachment), gave a keynote speech at the annual meeting of the Internet Healthcare Coalition (IHC), a non-profit organization mainly consisting of companies in the eHealth business, where he said: "The essence of professionalism is self-governance... Just as the International Committee of Medical Journal Editors, founded in 1978, has set the standards for how medical journal authors and editors should behave, the leaders of the e-health information enterprise should now set common standards for ethical behavior." Two days later, the IHC announced it would organize a working summit in Washington D.C., on January 31st - February 1st, 2000, to forge a set of ethical principles for health-related Web sites... Within the medCERTAIN project, a technical infrastructure is currently being developed which allows individuals, organizations, associations, societies, and other entities to digitally label (rate, evaluate, peer-review, give quality seals to...) online published health information using labels consisting of a standard computer-readable vocabulary (metainformation)... The medCERTAIN consortium will also create different levels of certification for publishers of health information on the web (ranging from simple quality seals indicating the "good standing" of the site to "gold" quality seals indicating that the site has been peer-reviewed externally)... As mentioned above, the medCERTAIN project is one project funded under the "Action Plan on promoting safer use of the Internet by combating illegal and harmful content on global networks," adopted on December 21, 1998, by the Council of the European Union: "This action plan is a European Commission proposal for a number of initiatives from 1 January 1999 to 31 December 2002 with a total budget of 25 million Euro... Aside from the draft version of the Washington Code of eHealth Ethics, this issue of JMIR further contains two reviews tackling the difficult issues of practicing medicine on the Web without a pre-existing patient-physician relationship (e.g. responding to unsolicited patient emails) and the chances and challenges of e-psychotherapy... Interestingly, this report on cyberplagiarism and the activities of the Journal of Medical Internet Research in this field, including a new policy that every submitted manuscript will be electronically scanned for plagiarism, have already attracted some media coverage and may stimulate thought and debate in the publishing world about informatics tools which may detect academic misconduct and thereby enforce ethical conduct in publishing and research... Gunther Eysenbach, MD Editor, Journal of Medical Internet Research

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