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Member of the European Commission responsible for Enterprise and the Information Society

European aspects of eHealth

Workshop on Quality Criteria for Health Related Websites

Brussels, 7 June 2001

Ladies and Gentlemen,

it is a pleasure to welcome you here today to discuss an issue of central importance to health in the information society - the quality of health related information on the internet.

As you will be aware, the European Council meeting Lisbon on 23/24 March 2000 set a new frontier for Europe: to become, in a decade, the world's most competitive and dynamic knowledge-based economy. To reach this goal, EU leaders asked the Commission to devise a comprehensive strategy: the eEurope Action Plan.

One year later, the Stockholm Summit reiterated the commitments made in Lisbon and gave fresh impetus to eEurope.

The message is clear: Either we step into the information age, together, determinedly, now, or out future will be compromised. I'm thinking about sustainable growth, competitiveness, jobs, social cohesion, political influence.

In order to facilitate our joint move into the information age and to secure our place in it - Council endorsed the eEurope An information Society for All Action Plan.

The Action Plan is based on the belief that the Internet affects all sectors and businesses because using it cuts costs, increases productivity and allows companies to access global markets. These advantages have led to the creation of many new products, new services and new companies.

Through eEurope the Member States have endorsed common goals to be implemented at national level. This includes areas where EU intervention is limited, such as health care provision, which is of course at the heart of today's meeting.

However, before looking at Quality Criteria for Health Websites, let me begin by giving you an overview of the Action Plan's 11 priority domains which have been grouped around three key objectives:

The first is a cheaper, faster and secure Internet:

Businesses and citizens must have access to a low-cost, high-speed communication infrastructure. This is key to a balanced urban and regional development across the EU. Reducing access costs plays a major role in this context. This can only be achieved by opening up the "last mile" to competition. Hence the new legislation on unbundling the local loop, which is now due to be implemented in all Member States.

A further step consists in creating a fully integrated and liberalised communications market. The aim is to simplify and clarify the existing framework, adapt it to technology-driven market changes, make it more flexible, and rely increasingly on competition rules.

Both approaches are of high significance to the health sector where citizens should not be excluded from a growing health information and tele-health service provision because of high access costs.

In addition, a high level of Internet security must be achieved to build trust amongst businesses and consumers. The key issues here are the protection of privacy and secure personal access - the latter being of particular importance to the health community where the daily business of health service provision depends upon the sharing of highly sensitive personal data.

The second objective is to invest in people and skills:

Creating an information society for all, where every citizen can play an active role in the Internet economy, is at the core of eEurope. The Internet age offers a unique opportunity to reduce social discrepancies - what Americans call the digital divide. This calls for ambitious public policies. Otherwise, we risk widening the digital divide.

The digital divide may not necessarily be where one expects to find it. There is growing statistical evidence - both from the USA and some European countries - that families with children are the most likely to be connected to the Internet - way ahead even of high-income households with no children. But single-parent families are at a disadvantage.

Digital literacy must therefore become a basic educational requirement for all pupils. Additional measures are needed to achieve participation for all. Socially disadvantaged people must be able to get on the Internet at public access points. Europe must also develop technologies and services which respond to the specific needs of disabled, elderly and sick people.

The concept of digital literacy also includes being able to discern good information from poor quality content - something which can be greatly assisted by the existence and wide-spread use of the type of Quality Criteria you will be discussing here today and tomorrow.

The third objective is to stimulate the use of the Internet:

Here we have chosen to focus on key areas of internet use such as e- Government, e-Transport and, of course, e Health.

The Health Online chapter underlines the strategic importance of full exploitation of new information technologies in the public administration of health, for the benefit of the citizen as consumer of both health care services and health information.

The Member State administration is, of course, the key actor in achieving the objectives set out in the Health Online chapter. However, a European dimension to the challenge exists in the identification and dissemination of best practices and the joint development of relevant benchmarking criteria for eHealth.

The Health Online action recognises that the first action towards exploitation of the power of information technologies in the health sector is the implementation of an infrastructure which will provide user friendly, validated and interoperable systems for medical care, disease prevention, and health education through national and regional networks which connect citizens, practitioners and authorities on-line.

In order to assist Member States in reaching the stated target of ensuring that primary and secondary care providers have the necessary health informatics infrastructure in place, Health Online sets out four further actions:

Best practices in eHealth will be identified and disseminated, in order to assist purchasing departments in decisionmaking.

A series of data networks will be established to assist with informed healthcare planning in Member States.

A communication on legal aspects of ehealth will be drafted which will clarify which existing legislation has an impact on eHealth in order to remove some of the uncertainties expressed by industry about the legal aspects of such commercial activity.

And Finally - A set of quality criteria for health web sites will be developed to boost consumer confidence in use of such sites and foster best practice in the development of sites.

It has become increasingly evident that health related web sites are amongst the most frequently accessed sites on the internet, indeed you will hear today studies such as the recent PEW study in the United States which found that more than 4 in 10 Internet users who sought healthcare information online used the information they found to make a critical healthcare decision -- including whether they should go the doctor, how to treat an illness, and how to question their physician.

The Pew Study further found that "more Internet users have sought medical information on the Web than have shopped online, looked up stock quotes, or checked sports scores."

Yet it is not only the number of web users searching for health information that is huge, but also the number of sites offering health related information or advice. It is impossible to give an exact number of sites fitting this label, but current estimates suggest that over 40,000 sites offer health related information.

As a result of the both wealth of information available and its apparent popularity, a number of organisations have begun to provide specific tools for searching, rating, and grading information, while others have set up codes of conduct by which site providers can attest to their high quality services.

The aim of these tools is to assist individuals sifting through the mountains of information available on the internet, so that he or she may be better able to discern the good, from the bad or merely ugly.

The objective of most of these tools is therefore to educate both the providers and consumers of information about the processes and practices that are desirable for a website. While many different codes exist, they have in common many criteria such as:

  • Transparency of purpose of the site

  • Transparency of authorship/ownership of information

  • Transparency about financing and sponsorship

  • Clear separation of advertising and editorial,

  • Transparency about use of personal information gathered by the site ( both actively and passively)

  • Keeping information up-to-date

The success of such tools is, of course, rather hard to assess. But, it may be argued that, the fall in Dr Koop.Com share prices by 96% occurred as a result of a loss of market confidence brought about by (amongst other things) failure to keep clear a distinction between editorial and advertising. Citizens had been, it would seem, educated to expect this distinction to be evident, and distrusted a site where it was not.

Recognising that European estimates of internet use for health related information are growing constantly, and recognising also that European citizens are using the types of rating system described above, the European Council has supported an initiative within the eEurope2002 to develop a core set of Quality Criteria for Health Related Websites, so that such initiatives may develop in a focused European manner.

For that reason you have come together today key players from Government departments, International Organisations, NGOs and industry - to explore current practices and pilots with the objective of developing a shared set of key quality criteria which may be used by Member Sates to form the basis of future policy tools for assuring quality of information on health related web sites.

Such tools might be user guides, voluntary codes of conduct, trustmarks, accreditation systems, or any other initiative adopted by relevant parties, at European, national, regional or organisational level.

The idea is to learn from what exists already, to harness current activities and to move forward in a coherent manner for while the policy makers traditionally move within State boundaries, the internet recognises such boundaries with only the faintest nod.

I wish you all the best for two highly productive days of work and look forward to seeing the fruits of your labours.

Thank you for your attention.

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