Quality Online Medical and Health Information Universal access of the Web from utopia to reality: experience with the ProVisu project Vincent Baujard, Samia Reffas, Arnaud Gaudinat and Celia Boyer Health on the Net Foundation, Geneva, Switzerland SGMI– SSIM Tuesday 2 rd May 2006

SGMI-SSIM 2 rd May 2006 Agenda What is HON? Presentation of the overall Internet situation Accessibility guidelines and initiatives HON’s solutions: approaches implemented in the ProVisu project Conclusions and perspectives

SGMI-SSIM 2 rd May 2006 Health On the Net Established in 1995 under the aegis of Geneva Health Ministry (DES) Mission: To guide Internet users to reliable, understandable and relevant sources of online health and medical information.

SGMI-SSIM 2 rd May 2006 Online Health and Medical Information Internet is mainstream media 934 million users worldwide connected in 2004 Half of all European Citizens connected (7 country survey*) Importance of medical information on the Internet 4,190,000,000 results for the search term, “health” on Google (March, 2006) 74% of Internet users in the United States have gone online in search of health information ** Is the health web accessible for visually impaired and blind persons? * Germany, France, Great Britain, Spain, Belgium, Austria, Switzerland ** Harris Interactive Health report July 2005

SGMI-SSIM 2 rd May 2006 The Internet should be adapted to the needs of all citizens Reading disabilities and Visual disabilities In Europe : 7 millions with visual disabilities, 700’000 are blind Dyslexic and Intellectual handicaps Neurological and physical impairment In Europe : 56 millions are physically impaired * Elderly and Patients amongst others

SGMI-SSIM 2 rd May 2006 HON surveys with the European ENABLED project * A large number of websites are not fully accessible, because : Website developers, designers and managers are not aware of accessibility issues Lack of knowledge or training to use the available tools The responsibility of software manufacturers, who must provide tools to produce accessibility * Analysis of the ENABLED Web Developer Survey

SGMI-SSIM 2 rd May 2006 WAI (Web Accessibility Initiative) Guidelines and tools to increase Web accessibility for people with disabilities NIH : a checklist to assess the accessibility of Web sites * HON survey with the European ENABLED project ** 36% were concerned 58% were not aware of the WAI guidelines 269 survey respondents * The National Health Institute check list for webmasters ** Analysis of the ENABLED Web Developer Survey

SGMI-SSIM 2 rd May 2006 Accessibility Readability : typeface, size, colour and background complexity of the page layout Speech-enabled web sites Universal readability Multilingualism Health literacy : complexity of the content Manual : Extraction Automatic : On going project

SGMI-SSIM 2 rd May 2006 The ProVisu project Raise awareness and prevention with the citizen and health professionals for eye diseases Provide trustworthy information about all eye diseases (HONcode sites), available services, treatments, and associations Be accessible to visual impaired person Quality of thrustworthy health information : HONcode

SGMI-SSIM 2 rd May 2006 Approaches implemented by HON in the ProVisu project 1.The reading comfort (text size, colour, background) 2.The seamless speech-enabled (TTS) service and the navigation with the keyboard 3.The adaptation of external websites (via a bookmarklet) 4. Multilingualism 5.Health literacy : complexity of the content

SGMI-SSIM 2 rd May 2006 Accessibility Readability : typeface, size, colour and background complexity of the page layout Speech-enabled web sites Universal readability Multilingualism Health literacy : complexity of the content Manual : Extraction Automatic : On going project

SGMI-SSIM 2 rd May Accessibility : Reading comfort Default HomePage of the Provisu Web site

SGMI-SSIM 2 rd May Accessibility : Reading comfort typeface, size, colour and background

SGMI-SSIM 2 rd May Accessibility : Reading comfort complexity of the page layout

SGMI-SSIM 2 rd May 2006 Accessibility Readability : typeface, size, colour and background complexity of the page layout Speech-enabled web sites Universal readability Multilingualism Health literacy : complexity of the content Manual : Extraction Automatic : On going project

SGMI-SSIM 2 rd May 2006 Listen / Stop: Age-related macular degeneration (ARMD), is the gradual loss of vision caused by the oxidation of the macula, which is a small, circular membrane at the center of the retina. This membrane is light sensitive and responsible for our central vision. When the macula degenerates, central vision deteriorates, resulting in dark spots and cloudiness. It is caused by the oxidation of the macula. As the arteries harden with age, the delicate structures of the eye begin to lose some of their function. Source: Age-related macular degeneration (ARMD) (uniteforsight.org) Macular Degeneration Age Related 2. Accessibility : Speech-enabled web sites

SGMI-SSIM 2 rd May 2006 Accessibility Readability : typeface, size, colour and background complexity of the page layout Speech-enabled web sites Universal readability Multilingualism Health literacy : complexity of the content Manual : Extraction Automatic : On going project

SGMI-SSIM 2 rd May Accessibility : Universal readability

SGMI-SSIM 2 rd May Accessibility : Universal readability Adaptation of external websites Provisu bookmarklet

SGMI-SSIM 2 rd May Accessibility : Universal readability Adaptation of external websites

SGMI-SSIM 2 rd May 2006 Accessibility Readability : typeface, size, colour and background complexity of the page layout Speech-enabled web sites Universal readability Multilingualism Health literacy : complexity of the content Manual : Extraction Automatic : On going project

SGMI-SSIM 2 rd May Accessibility : Multilingualism (French)

SGMI-SSIM 2 rd May Accessibility : Multilingualism (English)

SGMI-SSIM 2 rd May 2006 Accessibility Readability : typeface, size, colour and background complexity of the page layout Speech-enabled web sites Universal readability Multilingualism Health literacy : complexity of the content Manual : Extraction Automatic : On going project

SGMI-SSIM 2 rd May Accessibility : Health literacy Manual : Extraction and selection to help access to health literacy

SGMI-SSIM 2 rd May 2006 Conclusion Through these simple solutions ProVisu demonstrates that respecting elementary rules and using appropriate web technology such as the bookmarklet, the Internet could be an integration and autonomy vector for all of us. Perspectives Development of simple guidelines Implementation of an Accessible Web Content accreditation

SGMI-SSIM 2 rd May 2006 HON Team HONcode Accreditation Sergio Garcia Vicente, MD Erik Montesinos, MD Mélanie Provost, DPharm. Samia Reffas, Phd, Mikhail Mizin Computer development Vincent Baujard Arnaud Gaudinat Hamidul Huq Samia Reffas, Design Ndaté Sylla Secretary Guilia Ramagnano Direction Celia Boyer