eHealth Ethics Evolves. New Initiatives Facilitate Compliance 2

by on Jan.28, 2011, under History Facts

Outside the US
Outside the US, the European Community in late 2010 announced the formation of MedCertain, a metadata scheme for evaluating health information that is scheduled to eventually include a “trustmark.” And in Japan, the  Internet Medical Association (JIMA), a non-profit citizen’s organization, has developed “Guidelines for the Use of Medical Information on the Internet,” which are consistent with the e-Health Code of Ethics. JIMA also has a trust program and a JIMA mark that sites which are in compliance with it’s code can use.

To the layperson, these different initiatives might appear to be in competition. In fact, they are complementary. All of the codes contain sound advice on how to conduct business on the Internet and many have adopted the e-Health Code of Ethics as the “inspirational code” that helped guide their efforts.

At the annual meeting of the Internet Healthcare Coalition in October, 2010, representatives from the AMA, Hi-Ethics, Health On the Net Foundation, and the Internet Healthcare Coalition met to discuss ways in which a consensus on codes could be reached. These groups announced the formation of a coordinating committee to collaborate on ethical conduct codes. The committee aims to ensure a system of e-health codes that is understandable to the public and that uses a common terminology. (See Top e-Health Ethics Groups Announce Collaboration: Hi-Ethics, Health On the Net Foundation, and the e-Health Ethics Initiative Collaborate on Ethical Codes of Conduct.)

All ehealthcare executives should keep these points in mind:

* Adopting any of the codes is a step forward from no code at all.

* It is important to practice “ethical due diligence” in choosing business partners and sites to link with.

* It is critical to train key employees in ethical standards and foster an ethical culture within e-health organizations.

For now, adoption of an ethics code is voluntary, but formal legislation or regulation may be near– both Republican and Democratic legislators have introduced legislation. Last year, the Federal Trade Commission asked Congress for authority to issue rules regulating Internet privacy. That constituted a dramatic move for the FTC, which had supported industry self-regulation. In its report, the FTC said that voluntary seal-of-privacy programs have failed and that too few commercial Web sites have adopted meaningful privacy policies. [Since then, the FTC has dropped its pursuit of new legislation in favor of increased enforcement of current regulations and laws.]

URAC (also known as the American Accreditation HealthCare Commission), an independent organization that accredits managed care health plans and other healthcare organizations, will launch an accreditation program for health web sites later this year. The accreditation standards are now under development by a team of experts, including members from all the code-maker groups mentioned above. [URAC released its version 1.0 of accreditation standards in July 2010 and in December of that year, announced 13 health web site accreditations. The Internet Healthcare Coalition maintains a seat on URAC's health web site accreditation committee, which reviews applications.]

In addition, URAC and the Internet Healthcare Coalition will hold their first, joint training seminar for healthcare executives on meeting ethical standards when using the Internet to communicate information. The seminar, titled “e-Health Ethics: Get Ready for Business on the Net,” will be held May 2, 2010 in Orlando, Florida as part of URAC’s Annual Meeting. [See e-Health Ethics Workshop for more information about bringing this workshop to your organization or meeting.]

The seminar will review the e-Health Code of Ethics; discuss ethical decision-making in the context of online healthcare business decisions and discuss how to recognize and respond to ethical concerns and dilemmas through case studies.

The seminar will certify people, not sites. Ethics training empowers employees by giving them tools for critical thinking. It also gives employees a voice against dishonest or self- serving managers. Finally, ethically trained employees bring their culture to their next employer and spread good ethical practices rather than bad ones.

The efforts of many people have been dedicated to standardizing and raising the quality of health information and services on the Internet. It is not a question of which standard to apply, but the commitment of developers to the idea that “business ethics” is not an oxymoron. Adherence to ethical standards is a sound business decision that, in the long run, will help your bottom line. And don’t just think that only for-profit sites need to adopt ethics standards! Non-profits (including hospitals, patient advocacy groups, etc.), government sites, and patient sites should also adopt guidelines to be successful on the Internet.

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