health on the net foundation type non profit non governmental organization industry healthcare founded september 1995 headquarters geneva switzerland products certification health search engine and education website http www.healthonnet.org health on the net foundation hon is a not for profit organization founded in 1995 under the auspices of the geneva department of employment social affairs and health and based in geneva switzerland . this came about following the gathering of 60 of the world s foremost experts on telemedicine to discuss the growing concerns over the unequal quality of online health information . the unanimous conclusion of this gathering was to create a permanent body that would in the words of the program promote the effective and reliable use of the new technologies for telemedicine in healthcare around the world . the hon foundation became one of the first organizations to guide both lay users and medical professionals to reliable sources of health information in cyberspace . contents 1 mission 2 the foundation 3 certification 4 limits and criticism 5 honcode misuse 6 references 7 external links mission edit the mission of the foundation is to guide the growing community of healthcare consumers and providers on the internet to sound reliable medical information and expertise . in this way hon seeks to contribute to improved health care through patient empowerment and better informed health professionals . the foundation edit health on the net holds consultative status with the economic and social council of the united nations ecosoc and a special relationship with the world health organization who . the french national health authority appointed health on the net in 2007 as its official body to certify health websites based in france . as a liaison a to the international organization for standardization iso health informatics technical committee iso tc 215 health on the net contributes to the elaboration of standards developed by the committee . health on the net offers users an array of tools and services to meet their health information needs including the hon code of conduct and its certification process ; khresmoi and honselect search engines which provide access to trustworthy websites and support groups medical images and terminology journal articles and news ; provisu.ch a database of reliable health information on all eye diseases and accessible by those with poor or no vision through its variability of letter size and audio version ; santeromande.ch a database directed towards the french speaking public of switzerland and neighboring france and providing reliable health information and a directory of registered health professionals medical centers hospitals medical associations and federal organizations . certification edit the honcode logo hon foundation issued a code of conduct honcode for medical and health websites to address reliability and usefulness of medical information on the internet . honcode is not designed to rate the veracity of the information provided by a website . rather the code only states that the site holds to the standards so that readers can know the source and purpose of the medical information presented . the honcode is voluntary 1 which means that webmasters and information providers apply for honcode certification . following this the website is reviewed by a specialized team of health and legal professionals . the honcode certification is dynamic and is renewed yearly according to site compliance . it is the oldest and the most used ethical and trustworthy code for medical and health related information on the internet . the principles of the honcode are authority information and advice given only by medical professionals with credentials of author s or a clear statement if this is not the case complementarity information and help are to support not replace patient healthcare professional relationships which is the desired means of contact confidentiality how the site treats personal and non personal information of readers attribution references to source of information url if available and when it was last updated justifiability any treatment product or service must be supported by balanced well referenced scientific information transparency of authorship contact information preferably including email addresses of authors should be available transparency of sponsorship sources of funding for the site honesty in advertising and editorial policy details about advertising on the site and clear distinction between advertised and editorial material each principle also has a web 2.0 component in order to address the evolution of the web in terms of information provision including social media use . 2 there are currently more than 8 000 honcode certified websites covering 90 countries . the honcode has been translated into 35 languages . it is used to sensitize web publishers to the need for quality information and to create awareness among health professionals in order to help them guide their patients to trustworthy health information . research has shown that the honcode is an indicator of reliability of health information . 3 4 additional studies demonstrate that websites using the honcode quality standards are more reliable than those that do not . 5 6 7 additionally the honcode has been identified as an indicator of accuracy . 8 certified health pages have a statistically representative higher quality score than health websites that were not certified with one going so far as to say that the results of their analysis have shown a quality score that is statistically superior for hon certified sites proving that even if it is imperfect this label remains a coherent and trustworthy tool . translated from the french les r sultats de notre analyse ont montr un score de qualit statistiquement sup rieur pour les sites certifi s hon prouvant que m me si imparfait ce label reste un outil coh rent et fiable . 9 limits and criticism edit the honcode only applies to a website s editorial processes and details not to the actual published contents . the term certification can be misleading to the general public as it can infer that the contents of the website are trustworthy reliable or otherwise independent . 10 however because the certification process is based on both self declaration of adherence to the principles and assessment by a honcode expert verifying that this is the case it is not possible for a site to be initially certified if it does not meet the honcode principles . however it is possible for a certified site to change its content such that it no longer meets the certification criteria . while website owners are required to inform hon of any fundamental changes to their website during periods between certification and recertification this is not always the case . thus a site may be listed as certified when it no longer is . this is addressed at latest during the recertification process or earlier if hon is notified that the site no longer meets certification standards . the honcode is considered a useful guide and for some it provides the best overall guidance compared to other tools 11 but in the end the reliability of the information is also dependent on the information provider . the honcode principles themselves are subject to criticism with some experts indicating they are not adapted to modern internet usages 12 citation needed and do not follow their own rules . 13 citation needed in response to those limitations one previously certified website has decided to no longer display the health on the net logo ; 14 another site warns visitors not to trust certified websites . 15 16 yet greater awareness of the honcode and its certification process is needed with the authors of one study highlighting the need to broadcast the relevance of hon certification so that creditable medical health information could be published online . 17 the first year of certification is free of charge . however the new recertification process started in 2014 when the foundation s government sponsors required the foundation to develop its financial independence requires a financial contribution from the sites requesting recertification . the fees are as follows 50 for non profits with little visibility 160 for sites with high visibility and 325 for commercial websites . visibility is determined by the website s alexa ranking 18 introducing a further bias favoring disguised commercial websites instead of benevolent and scientific communities . citation needed honcode misuse edit in 2000 a journal article raised a number of problems with the honcode logo indicating that consumers may mistake it as an award or interpret it as an indicator for assessed information . citation needed other issues with the honcode logo were discussed in the journal of medical internet research a peer reviewed ehealth journal . 19 websites that are not in compliance with honcode can continue to display the seal as health on the net foundation hon has no means of forcing the offending webmaster to remove the certification seal . however as the certification seal active and dynamic leading to a page on hon servers with the date of the certification s validity and the status of certification in real time the link from websites will lead to the page showing that the site is no longer in compliance i.e. that it is either being reassessed or the certification has been revoked . this is indicated in real time . it is however possible for the site to retain the logo without the click through . thus users should be aware that if the seal is not clickable the site is no longer in compliance and is misusing the logo . consumer protection advocate stephen barrett has been a strong supporter of the honcode and has made efforts to improve compliance with its rules and to expose those who misuse it . a 2004 special supplement to the washington post provides coverage of his views on the subject including suggested improvements and his criticisms of many named misusers . 20 the honcode relies on the user s sense of civic responsibility . in cases of suspected fraudulent websites or of misuse of the honcode hon advises internet users to alert quackwatch or hon itself through the complaint mechanism on the hon website if you come across a healthcare web site that you believe is either possibly or blatantly fraudulent and does not display the honcode please alert quackwatch . of course if such a site does display the honcode alert us immediately . 21 other problems with the application of the honcode principles are that hon does not have a means of verifying many of the principles such as credentials medical or otherwise as stated on websites displaying the logo or that copyright or confidentiality is not violated by webmasters . citation needed references edit greenberg l d andrea g lorence d june 2004 . setting the public agenda for online health search a white paper and action agenda . journal of medical internet research . 6 2 e18 . doi 10.2196 jmir .6.2 . e18 . pmc 1550592 . pmid 15249267 . honcode certification for websites with web 2.0 elements . www.hon.ch . retrieved 2016 05 24 . nassiri mujtaba ; bruce brand robert a. ; o neill francis ; chenouri shojaeddin ; curtin paul 2015 08 01 . perthes disease the quality and reliability of information on the internet . journal of pediatric orthopedics . 35 5 530 535 . doi 10.1097 bpo .0000000000000312 . issn 1539 2570 . pmid 25254387 . bruce brand robert a. ; baker joseph f. ; byrne damien p. ; hogan niall a. ; mccarthy tom 2013 06 01 . assessment of the quality and content of information on anterior cruciate ligament reconstruction on the internet . arthroscopy . 29 6 1095 1100 . doi 10.1016 j.arthro .2013.02.007 . issn 1526 3231 . pmid 23582738 . laversin sabine ; baujard vincent ; gaudinat arnaud ; simonet maria ana ; boyer c lia 2011 01 01 . improving the transparency of health information found on the internet through the honcode a comparative study . studies in health technology and informatics . 169 654 658 .