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Recent Updates Regarding the HONcode
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On this page you will find information about the recent updates related to the HONcode Certification process. The Health On the Net Foundation will announce in advance any modifications related to the certification process.

In the case that the certified websites are required to implement the announced modification(s), the date by which these modifications become valid will be announced clearly and in a reasonable period of time as to enable certified websites to implement the modification(s). In addition, during the audit following the announced modification(s) the HONcode Team will check the website's compliance to the modification(s) and, if necessary, will explain how to implement the necessary modification(s).

In the case that the certified websites do not need to take measures to implement the modification(s), the date of publication of the announcement is also considered the date of implementation.

The updates will also be announced in the HON Newsletter, in the section "Recent Updates Regarding the HONcode".

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New Re-assessment payment process

(August 2014)

For the past 17 years, HON has been the leader in guiding readers to quality online health information and for all these years, every one of our services have been entirely free of charge, including certification of new websites, re-evaluation and other verification.

HON has now reached a cross-roads, where we are no longer able to provide the re-evaluation service for free and thus, a membership fee has been created which will go towards covering the cost of the re-assessment process which is conducted by a team of medical experts.

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New Guideline for Before-after Pictures

(Published on March 28th, 2013)

The Health On the Net Foundation introduces a new guideline designed for websites presenting before-after pictures, which will be effective from February 5th, 2013. All HONcode certified websites displaying before-after pictures should implement this guideline as soon as possible, but at the latest one year after the publication of this guideline.

This guideline aims to provide guidance regarding the publication of before-after pictures on HONcode certified websites and websites applying for the certification. Please note, that the initial review of your application takes at least 18 months.

Background
According to the results of a survey HON conducted in 2011, the majority of the 1,365 respondents representing the general public considered before-after pictures shown on a website suspicious. Nevertheless, the respondents also felt that websites should be able to display these pictures in order to inform the public, e.g. about the capabilities of and results delivered by the physicians.1

Objective
The before-after pictures fall within the scope of the HONcode Principle 5: Justification of claims. This new guideline aims to improve the transparency and trustworthiness of publishing these pictures.

Scope
This guideline applies to before-after pictures designed to inform website users about the services of physicians, excluding before-after pictures used for educational purposes, e.g. radiology images showing students the results of a particular surgery.

Guideline: Before-after pictures/videos concerning medical treatments

  1. Both the before and the after picture should be taken in similar circumstances regarding lighting, body and head position, camera settings, etc.
  2. The pictures should not be edited. Editing is only acceptable when the goal is to protect the identity of the patient, and when the editing does not present the results of the surgery in a misleading way.
  3. A text should accompany the pictures explaining at least the following points:
    • The before and after pictures are taken in similar circumstances
    • The dates of when the pictures have been taken
    • The date(s) of when the operation(s) have taken place
    • The number and type of operation(s) performed
    • A statement that the patient shown on the picture has given his/her written consent to publish the pictures and the accompanying text, i.e. the patient agrees that the pictures and the accompanying text are true
    • A statement that no results can be guaranteed because every patient and every situation is different

N.B. As mentioned, a written consent must be obtained from the patient before publishing the pictures and the accompanying text. If asked for verification purposes by the Health On the Net Foundation, the organization must be able to present this written consent.

1) Results of the HON survey conducted in 2011: http://www.hon.ch/Survey/before-after-pics.html

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*Reminder: Before/After Pictures Published on Websites that Provide Information about Medical Procedures, Including Plastic and Dental Surgery Procedures

*) This reminder becomes obsolete on February 5th, 2013. Regarding before-after pictures/videos concerning medical treatments, please consult the specific guideline (falling within the scope of the HONcode Principle 5).

(Original reminder, published on March 27th, 2012)

The Health On the Net Foundation (HON) is reminding HONcode Certified websites and websites applying for the Certification of its current policy regarding before/after pictures.1

In the past, the HON Foundation has certified websites displaying before/after pictures. But there are some difficulties regarding these websites’ compliance with the HONcode Principles 5 (Justification) and 8 (Advertising Policy) due to the presence of before/after pictures.

These difficulties arise from the fact that it is very difficult to verify whether the pictures have been modified or not, whether all the pictures have been taken in the same manner (regarding elements such as lighting, positioning, situation and time), how many procedures have been performed in order to achieve such a result, what kind of physical and mental state the person was in before he/she underwent the procedure, whether a model is featured in the pictures, whether the few pictures with results that are better have been published while the majority of the procedures did not have such success, etc. Another important point to note is that each patient’s results are individual.

For these reasons, the HON Foundation has conducted a survey which has pointed out the necessity to develop a guideline concerning the publication of before/after pictures. The development of this guideline is still ongoing. This means that until further notice, the approach of the HON Foundation to websites displaying before/after pictures is the following:

  1. HONcode Certified websites that were already displaying these pictures are given the choice:
    a) To remove the pictures until the guideline has entered into force, or
    b) To clearly provide information concerning the publication of the pictures, such as the above-mentioned points.

  2. Websites applying for the HONcode Certification while displaying before/after pictures:
    a) Are asked to remove the pictures until the guideline has entered into force, or
    b) Will be informed that in the case that they wish to keep the pictures online, the HON Foundation will not proceed with the Certification process until the guideline has entered into force.

If you have any question or comments, please don’t hesitate to contact us:
Tel: +41 22 37 26 250
Feedback form: http://services.hon.ch/Contact/contact.pl
Skype: honcode

1) Within the scope of the HONcode Certification, the Health On the Net Foundation defines before/after pictures as images taken both before and after a medical procedure, including dental and plastic surgery procedures.

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New Privacy Policy

(Published on February 16th, 2012)

The Health On the Net Foundation has published its new Privacy Policy which will be effective from February 29, 2012. This Privacy Policy applies to all the websites and services owned and/or managed by HON (unless indicated otherwise).

Learn more about the Privacy Policy here

The new Privacy Policy will be effective from February 29, 2012. 

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Notification Concerning the Health On the Net Foundation’s Approach to Online Pharmacies

(Published on February 10th, 2012)

Even though the services provided by online pharmacies are convenient and their product pricing can be more attractive than at a pharmacy store, the regulation of online pharmacies is still in development and evolving. It has been noticed that larger numbers of falsified medications are on the market and that this number is on the rise due to the possibility of ordering medication online from all over the world. Another issue is the lack of control in ensuring whether the websites hosting online pharmacies are real, licensed pharmacies or that they are deceptive pharmacies.1

The United States (US) is employing a system which verifies the trustworthiness of online pharmacies.2 However, they also noticed that only a small percentage of the verified online pharmacies actually comply with all their conditions.3 Furthermore, the US is still updating its legislation concerning this issue.4 In Canada, a similar mechanism has been put in place but thus far no online pharmacies have been verified nor approved.5 The European Union is trying to fight falsified medications and deceptive online pharmacies with new legislation that will become applicable as of January 2013.6

In the light of the current developments regarding the legislative framework reducing the amount of falsified medications on the market, and to increase the trustworthiness of online pharmacies, the Health On the Net Foundation has decided to take the following approach to online pharmacies and related websites:

  1. At the moment, only the websites verified by the mechanisms put in place by the United States (VIPPS7 and Legitscript8) and Canada (VIPPS9) will be eligible to come within the range of the HON Certification process.
  2. Any other online pharmacy website or website related to online sales of pharmaceutical products that have already obtained the HONcode Certification, and are not verified and approved by the mechanisms named under point 1, will be asked to remove their HONcode Seal until further notice. If the website is verified and approved by the said mechanisms, the website remains certified by HON and will not be asked to remove the seal. It needs to be stressed here that HON certifies websites based on the transparent, complete and clear way of publication of health information. This means that the part of the website concerning the online sale of products or services is not covered by the HONcode certification.
  3. The Health On the Net Foundation will be following closely the developments of the legislative frameworks concerning online pharmacies and related websites. As soon as there is more clarity regarding this issue and appropriate regulation is put into practice, HON will adapt its certification process accordingly in order to ensure trustworthiness of websites providing online sales of pharmaceutical products.
  4. In the case that online pharmacies and related websites once again become eligible to apply for the HONcode Certification, the Health On the Net Foundation will inform you about it promptly.

If you have any question or comments, please don’t hesitate to contact us:
Tel: +41 22 37 26 250
Feedback form: http://services.hon.ch/Contact/contact.pl
Skype: honcode

References:

  1. WHO, Safety and security on the Internet : challenges and advances in Member States : based on the findings of the second global survey on eHealth. (Global Observatory for eHealth Series, v. 4), 2011, accessible on http://www.who.int/goe/publications/goe_security_web.pdf, last retrieved 03-02-2012, p. 21 to 25
  2. http://www.nabp.net/programs/accreditation/vipps/find-a-vipps-online-pharmacy/ and http://www.legitscript.com/, last retrieved 03-02-2012
  3. http://www.nabp.net/programs/accreditation/vipps/ and http://www.legitscript.com/getcertified, last retrieved 03-02-2012
  4. Introduced in the Senate of the United States on 15 December 2011, 112th Congress, 1st session: Text of S. 2002: ‘Online Pharmacy Safety Act’, http://www.govtrack.us/congress/billtext.xpd?bill=s112-2002, last retrieved 03-02-2012
  5. In 2003, the National Association of Pharmacy Regulatory Authorities (NAPRA), Canada's counterpart to the NABP, introduced the VIPPS program but so far there are no verified online pharmacies: http://www.napra.org/pages/Practice_Resources/general_information_about_vipps.aspx, last retrieved 03-02-2012
  6. Directive 2011/62/EU of the European Parliament and of the council, 8 June 2011, published in the official Journal of the European Union, L 174/74 , http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2011:174:0074:0087:EN:PDF , last retrieved 03-02-2012; For more information see also the website of the European Medicines Agency on falsified medicines, http://www.ema.europa.eu/ema/index.jsp?curl=pages/special_topics/general/general_content_000186.jsp&mid=WC0b01ac058002d4e8&jsenabled=true, last retrieved 03-02-2012
  7. http://www.nabp.net/programs/accreditation/vipps/, last retrieved 03-02-2012
  8. http://www.legitscript.com/getcertified, last retrieved 03-02-2012
  9. http://www.napra.org/pages/Practice_Resources/information_for_pharmacists_about_vipps_certification.aspx, last retrieved 03-02-2012
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Notification of a comparative study regarding the increased involvement of the general public in trustworthy online medical and health information

(Published on December 1st, 2011)

Currently, the HONcode certified websites are audited manually once every year by the HONcode Team. We have observed that many websites are consistently, year after year, in compliance with the HONcode principles; in this context, we would like to use the opportunity to conduct a comparative study and proceed to a testing phase. This testing phase will aim to evaluate the capacity of a biennial revision. The revision will take place once every two years, with a more active involvement of the general public and more frequent random reviews (automatic and manual checks).

These changes will be valid from the 1st of December, 2011.

If you have any questions, please don't hesitate to contact us: tel. +41 (0)22 372 62 50, email: .


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