Survey of e-commerce of health-related goods or services REPORT OF HEALTH ON THE NET FOUNDATION SURVEY CONDUCTED FROM MAY 2016 TO SEPTEMBER 2017

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Srvey of e-commerce of health-related goods or services REPORT OF HEALTH ON THE NET FOUNDATION SURVEY CONDUCTED FROM MAY 2016 TO SEPTEMBER 2017

Stdy Objective To nderstand the practicality and seflness for HON to oversee health-related e- commerce bsinesses which sell either prodcts or services to the pblic. Health On the Net Fondation www.healthonnet.org

Procedre We condcted a srvey of 33 qestions, both in French and English, in May 2016. The srvey was posted on the Fondation's Facebook page, pblished in two newsletters, and throgh varios emails sent ot by HON. The srvey was condcted and analyzed sing the Srvey Monkey platform. The French version of the srvey collected 39 responses. The English version collected 75. Health On the Net Fondation www.healthonnet.org

Analysis of reslts French Srvey English Srvey The majority of people who participated in the srvey are health professionals who pblish websites. Health On the Net Fondation www.healthonnet.org

Reslts analysis: E-store The majority of respondents have already prchased from an e-store (80 ot of 114 participants), for the following main reasons: Availability Lower price Comfort of prchase and delivery We find that the majority of respondents (health professionals) order over the Internet, which means that they are seeking this type of service. The prodcts ordered are, in order: books, para-pharmacy, medical eqipment, examination prodcts, non-prescription drgs. Health On the Net Fondation www.healthonnet.org

Reslts analysis: E-store For the French-langage srvey, 8 ot of 15 respondents indicated that the e-store offered the ability to review their prodcts/services. For the English version, 32 respondents ot of 57 provided this response. This is done throgh a simple comments based tool. Not all opinions are necessarily pblished on the site (for half of them). Health On the Net Fondation www.healthonnet.org

Reslts analysis: Potential problems 64 respondents ot of 72 did not enconter any particlar problem following the order placed on an e-store. Respondents who encontered a problem cite the following: Delivery problems (3 respondents) False advertising (2 respondents) Prodct of poor qality (2 respondents) Health On the Net Fondation www.healthonnet.org

Reslts Analysis: Personal Data The personal data transmitted are those reqired for a prchase and delivery: bank details, address, name, email. The majority of respondents did not provide medical information. The majority of respondents did not pay attention to whether the site provides information abot it s privacy practices. Health On the Net Fondation www.healthonnet.org

Reslts Analysis: Prodcts 41 respondents ot of 58 had the opportnity to have information abot the composition of prchased prodcts. The majority of them checked the origin of the prodcts, very few conslted forms. French Srvey English Srvey Health On the Net Fondation www.healthonnet.org

Reslts Analysis: Certification Sites that can be certified by the HONcode: French Srvey English Srvey Health On the Net Fondation www.healthonnet.org

Reslts Analysis: Certification Those who do not wish to see the Fondation certify this type of site (15 respondents commented on this qestion) give the following reasons: This wold taint the netrality of HON It wold be moving away from the primary mission of HON It seems impossible to control It wold be like advertising for these shops Those who consider that HON can certify these sites (42 respondents in total) can not give way to fnction or coaching particlar. Health On the Net Fondation www.healthonnet.org

Reslts Analysis: Telemedicine Many of the respondents know abot telemedicine, bt have never sed it. For those who have sed it, they are satisfied and have fond it helpfl. The confidentiality of data seems to be addressed in this type of service. The qalifications of health professionals have been verified in the majority of cases (9 ot of 14), bt this figre shold be higher for the sake of transparency and secrity. Health On the Net Fondation www.healthonnet.org

Reslts Analysis: E-conslting Most respondents do not know of e-conslting (16 of 27) and have never sed it (8 of 11) The majority (75% English and French combined) think that the Fondation shold certify this sort of service. English Srvey French Srvey Health On the Net Fondation www.healthonnet.org

Conclsion This srvey (perhaps a little too long becase not all respondents have responded to all qestions), that the e-shop and tele-health are important featres of crrent life. It seems important for the majority of respondents that these services be better spervised, withot really knowing how. As with any new tool or method of work, the right way to proceed is to be fond to be effective. Health On the Net Fondation www.healthonnet.org

Conclsion Many of them nevertheless qestion the place of the Fondation in this framework of eshop type website, fearing for the loss of credibility of the crrent certification. We can ask orselves if this srvey does not present a bias sch as the fact that a certain nmber of respondents has a health site certified by the HONcode and does not want the certification to reach online sales sites. On the contrary, another bias cold be the fact that some are health professionals wishing to make their e-conslting services more legitimate with the HONcode certification. Health On the Net Fondation www.healthonnet.org

Conclsion It shold also be noted that the composition or origin of the prodcts are not sfficiently verified and displayed (approximately half of the respondents are interested); and it is important that it be more transparent and ths less dangeros. The concern that emerges from the analysis of this srvey is sch that we ask orselves whether, withot certification of this type of site, sers will only be able to rely on the ratings offered by the evalation services. "Basic", or more dangeros, referencing very common in search engines, highlighting sites not necessarily of confidence and qality. Clancy and al. has demonstrated that poplar websites can be of low qality and that patients lack adeqate information to assess the potential for commercial bias. Clancy, A. A., Hickling, D., Didomizio, L., Sanaee, M., Shehata, F., Zee, R., & Khalil, H. (2017). Patient-targeted websites on overactive bladder: What are or patients reading?. Nerorology and rodynamics. Health On the Net Fondation www.healthonnet.org