ElderWeb

The U.S. Food and Drug Administration (FDA) commissioned a study from a company called Cyveillance which states that of 11,000 "Canadian" Internet pharmacy sites they researched, most just redirect users to 1,099 sites that actually sell prescription drugs, and of the 1,009 sites that sell "Canadian" drugs, only 214 are actually based in Canada.

This raises many troubling questions and should justifiably frighten anyone buying drugs online, but little futher information was provided. I was not able to find any information about the study on the FDA web site at all, and only the press release is available on the Cyveillance site. The press release has been reproduced verbatim on numerous online and offline news outlets, but I only found one article, a story by Brian Krebs of the Washington Post, that seems to have dug further into the story (see it at http://www.washingtonpost.com/). Krebs tried to get additional information about the study, but was not able to find out which drug sites are actually located in Canada and was told by a FDA spokeperson that revealing that information would give Americans a "false sense of security" and that "as long as shipping medications into the United States remains illegal, the agency would continue to refuse to work with any entity supporting that activity."

I thought it would helpful to provide some tips to try to avoid problems when buying prescription drugs on the Internet:

1) Don't follow links in emails that offer Canadian drugs. One of the few bits of information in the press release was the fact that most of the bogus sites are only reachable via spam email links and cannot be found via legitimate search engine searches.

2) Many legitimate American sites will be be registered with the Verified Internet Pharmacy Practice service (VIPPS). Check their list at http://www.nabp.net/vipps/. Legitimate Canadian pharmacy sites can be found at the Canadian International Pharmacy Association (CIPA) at http://www.ciparx.ca/. If you don't see the site on one of these lists, you probably should avoid it.

3) CIPA also offers a list of tips on their web site to help ensure you are dealing with a legitimate Canadian pharmacy business, including suggestions to look for a Canadian Provincial pharmacy license number and a Canadian phone number (and to call that number to be sure it is legitimate). Consumers should also expect legitimate sites to require a prescription from a licensed physician.

SecurityFocus.com revealed that a hacker broke into the University of Washington Medical Center's internal network earlier this year, and downloaded admissions records for four thousand heart patients. The hacker started in June, and continued until at least mid-July, before network administrators at the Seattle teaching hospital detected the hacker and cut him off. Security Focus reports that the medical center said they were unaware that patient records were downloaded, and elected not to notify law enforcement agencies of the intrusions.

The hacker said that all the data taken from these computers was taken over the Internet, and that all the machines were exposed without any firewalls of any kind. SecurityFocus.com reviewed portions of the databases the hacker downloaded. One of the files catalogs the name, address, birth date, social security number, height and weight of over four thousand cardiology patients, along with each medical procedure they underwent. Another file provides similar information on seven hundred physical rehabilitation patients. A third file chronicles every admission, discharge and transfer within the hospital during a five-month period.

The Pew Internet Report has released a new survey that says that fifty-two million American adults, or 55% of those with Internet access, have used the Web to get health or medical information. The report shows that the Internet has become a truly powerful force in the way that many adults research health care information. Researchers said that users appreciate the convenience of being able to seek information at any hour, the fact that they can get a wealth of information online, and the fact that they can do research anonymously -- many said they had used the Web to get information about a sensitive health topic that is difficult to talk about. 42% of those who look for health information have bookmarked or saved a health sites as a "favorite place" so they can go back to it regularly.

54% of health seekers say they were searching for information on behalf of someone else, and the rest were looking on their own behalf. Women are twice as likely as men to be seeking material for a child, but men and women were equally likely to be seeking information on behalf of a parent or other relative.

People are taking the information they find to heart. 48% of these health seekers say the advice they found on the Web has improved the way they take care of themselves, 55% say access to the Internet has improved the way they get medical and health information. 47% of those who sought health information for themselves said the material affected their decisions about treatments and care, and half said the information influenced the way they eat and exercise. 36% of those who sought health information for someone else during their last online search say the material affected their decisions on behalf of that loved one and 70% said the Web information influenced their decision about how to treat an illness or condition. 50% said the Web information led them to ask a doctor new questions or get a second opinion from another doctor, and 28% said the Web information affected their decision about whether or not to visit a doctor.

There are concerns about the accuracy of online information, especially since so many people are making medical decisions based on that information. 86% of health seekers are concerned about getting health information from an unreliable source online. Nevertheless, 52% of users who have visited health sites think that "almost all" or "most" health information they see on the Internet is credible, and 64% say they had never heard of the Web sites they ended up consulting until they found them. In contrast, the Federal Trade Commission estimates that doctors review only about half of the content on health and medical Web sites and a University of Michigan study in 1997 found that less than 10% of the health sites they reviewed offered recommendations that were completely consistent with established guidelines in the medical community.

Privacy is a concern of many people looking for healthcare information. 85% are concerned that an insurance company might raise their rates or deny them coverage because of the health sites they have visited, and 52% are concerned that their employer might find out what health sites they have visited, even though most do their research from home, rather than from work.

Fraud and abuse have migrated to the information age. The Federal Trade Commission (FTC), with four other U.S. agencies and consumer protection organizations from 9 countries and 23 states announced 251 law enforcement actions against online scammers in "Operation Top Ten Dot Cons." The top 10 targeted scams were:

• Internet Auction Fraud
• Internet Service Provider Scams
• Internet Web Site Design/Promotions
• Web Cramming
• Internet Information and Adult Services
• Credit Card Cramming
• Multi-level Marketing/Pyramid Scams
• Business Opportunities and Work-At-Home Scams
• Investment Schemes and Get-Rich-Quick Scams
• Travel/Vacation Fraud
• Telephone/Pay-Per-Call Solicitation Frauds (including modem dialers and videotext)
• Health Care Frauds

In one scam, defendants mailed $3.50 "rebate" checks to consumers. When consumers cashed the check, they were unwittingly agreeing to allow the defendants to be their Internet Service Provider (ISP), and the defendants started placing monthly charges on their telephone bills. The defendants made it nearly impossible to cancel future monthly charges and receive refunds. In another variation, consumers were billed for a Website page they didn't even know they had. Targeting small businesses and not-for-profit organizations, the scammers call and offer a "free" Web page, then start billing phone bills without authorization.

The U.S. Centers for Disease Control and Prevention (CDC) has published a web site devoted to uncovering health hoaxes and rumors. This new site is intended to become a repository of information about the accuracy of health-related rumors and stories.

The Social Security Administration (SSA) has announced a new online application form for Social Security benefits. An applicant using the SSA web-site to apply for benefits can fill out the online application and send the information electronically to the agency, then can print and mail the form back, along with supporting documents.

The process is not entirely online, but it still should be a time-saver. Applicants will not need to make a preliminary trip to the SSA office to get the application form, and it makes it easier for people to ensure they have all the required documents and forms. The application process can be completed by mail, which eliminates the need to drive to the Social Security office. This could be a real boon for people who do not have easy access to transportation, those who have physical problems getting around, and family members who are trying to handle affairs for a relative from across the country.

The applicant must print a copy of the completed application form, sign it, and mail it or bring it to the address provided by Social Security. Along with the signed form, SSA also needs certain documents, such as a person's birth certificate, to establish eligibility for Social Security benefits. An applicant can either mail or take these items to Social Security. The electronic application will be stored on a database and automatically retrieved when Social Security receives the applicant's signed application.

Individuals must meet certain conditions in order to take advantage of the Internet retirement benefit application. For example, they must be at least 61 years and 9 months or older and plan to start receiving retirement benefits within four months.

The Social Security Administration stated that they are using the strongest commercially available encryption to ensure that an applicant's confidential information is secure as it travels over the Internet.

Irving Levin and Associates conducted a survey of online pharmaceutical sites. The survey compares publicly traded companies PlanetRx.com, HealthCentral.com, and drugstore.com with real world stores CVS.com and Walgreens, and privately owned more.com (which will soon be purchased by HealthCentral.com.) They purchased at a standardized list of pharmacy items from the online sites, then compared them with the same items at the local CVS store.

They found numerous problems with the online services. Using the search engines to find specific items required the shopper to try typing in several variations of a brand or item name since results were either too few or too numerous. Web site errors at Drugemporium.com (owned by HealthCentral.com) and Walgreens.com forced the user to stop shopping and try again later before an order could be processed. Calling the toll-free help lines resulted in long waiting time, followed by scant insight into a reason for the error and no solution to the problem. A discrepancy was found between the online invoice and the delivery invoice from Drugemporium.com. Most of the online pharmacies offered house brand savings (Drugemporium.com also offered several coupons), and all charged $3.50 - $4.45 for delivery in up to 5 business days. Comparatively, at the local bricks-and-mortar drugstore, consumers can purchase and walk out with the same name-brand items for only about 5% to 10% more in cost.

Their conclusion -- online drug sales sites still have lots of work to do.

Medem, a patient-physician e-health network founded by the nation's leading medical specialty societies and the American Medical Association (AMA), released findings from its October 2000 survey of over 700 physicians. The survey showed that the number of physician practice Web sites and usage of physician-patient e-mail continue to grow steadily.

Results from the study also show that physicians seem to substantially underestimate the amount of Internet use by their patients as well as underestimate their patients' interest in online communications with their own doctor. Physicians believe that the vast majority of their patients have no interest in communicating with them online, contrary to nearly every national survey showing that the overwhelming majority of patients with Internet access would highly value online access to their physician.

The survey found that:

* Email remains the primary reason that physicians use the Internet, but only 10% of respondents communicate with patients using e-mail.

* Over 50% of physicians said security and liability as a primary detriment to e-mail use.

* About half of physicians surveyed said they would be more interested in using e-mail to communicate with patients if they were reimbursed for it.

* 79% of respondents claim to have offices that are "Internet enabled," up from 69% six months ago.

* Over 50% of physicians actively discourage Internet use in their office due to fears of wasted time.

New regulations in New Zealand will prohibit sales overseas of prescription medicines to individuals who do not have a prescription from a New Zealand authorized prescriber. The requirement to have a New Zealand based prescription will restrict the ability of overseas consumers to purchase medicines from New Zealand pharmacies which would require medical supervision to use safely. The regulations were issued in response to a growing number of Internet pharmacy sites (at least 30 in New Zealand) that are involved in Internet drug sales to people overseas.

The move follows a court case late last year which highlighted a limitation in the New Zealand law allowing such sales to occur to overseas customers. It has always been illegal for New Zealand pharmacists, GP's or any other medical practitioners to provide prescription medicines to New Zealand consumers over the internet, or by any other means, without evidence of a written prescription by a NZ registered practitioner. However, that same protection had not been available to overseas consumers.

The Medical Council of New Zealand also has strict guidelines about doctors prescribing medicines over the internet. These guidelines require the doctor and patient to have met on at least one occasion, and for the patient to be under the care of that doctor.

People who get Medicare benefits need a Medicare card to show to medical treatment sources to obtain services. Social Security currently processes about 750,000 requests a year for replacement cards from beneficiaries. They have now created an online form to allow beneficiaries to request a Medicare card to replace cards which were lost, stolen, destroyed or not received. The card will be mailed within 30 days after the online request.

Information needed for the online request:

- Name as it appears on the most recent Social Security card
- Social Security Number
- Date and place of birth
- Mother's maiden name
- Phone number in case they need to contact you about your request
- E-mail address (optional)
- Last payment amount or the month and year of last payment received for benefits paid in the last 12 months

Many documents on government and educational institution Web sites are available only in PDF format. Adobe's PDF format allows people with different computer systems to share documents in a way in which everyone, no matter what computer hardware or software they use, will see the document exactly as it was originally formatted. The documents preserve column and photo layouts and other things that may not otherwise show up exactly the same if you share word processing files or view information on Web pages.

These documents often contain information which is vitally important to people looking for long term care information, government services and reports, or medical research. Unfortunately, PDF files are not accessible to everyone who uses the Internet. The use of PDF requires the user to download a software program to their local computer, so people accessing the Web without a computer, like people using WebTV, are unable to use the software. Another problem is that people who use "text readers," which "read" a Web page to a blind or sight-impaired person, have been unable to read PDF files.

Adobe has addressed this problem, and also made things easier for anyone who is uncomfortable with the process of downloading software. They now have created a Web-accessible PDF Accessibility Tool. This tool will "read" the contents of a PDF file on the Web, and convert it to a single column in HTML, which should be readable by anyone using any Web browser. The page will lose its formatting, and illustrations may be lost, but at least the information will be accessible to everyone.

Adobe has created a Web site where you can type in the URL where the PDF file you want to read is located, and it will return you to a simple Web page where you can read the contents.

Many of the fraud schemes already present in the "real" world can now be found on the Internet - fraudulent investment offerings, multi-level marketing schemes and failure-to-render scams (a favorite of unprincipled participants of online auctions). The crucial difference in fraud committed over the Internet is that the perpetrator can vanish, pulling down a Web site in seconds, leaving consumers wondering who or where to turn to for help.

In response to this growing concern, the Federal Bureau of Investigation (FBI) and the National White Collar Crime Center (NW3C) joined forces in a unique partnership to aid and protect consumers in this largely unregulated environment. The Internet Fraud Complaint Center (IFCC) is the result of that venture. This Web site provides a mechanism for victims of Internet fraud to report fraud on-line-where it occurred-to the appropriate law enforcement and regulatory authorities.

If you believe you are a victim of Internet fraud, you can use this web site to report the incident. It is important that you keep any evidence you may have related to your complaint, including canceled checks, credit card receipts, phone bills, faxes, pamphlets or brochures, mailing envelopes, certified or other mail receipts, a printed copy of a Web site, chat room, or newsgroup text, or similar items. Keep items in a safe location until you are requested to provide them for investigative or prosecutive evidence. If requested to provide evidence, send copies only, not originals.

The Social Security Administration (SSA) has unveiled a new online Social Security Retirement Planner. This planner allows users to compute estimates of future Social Security benefits online. Because of privacy concerns, the planner is not linked to the active SSA databases, but requires users to input salary information used for its calculations. The calculator then computes the estimated monthly benefit for early retirement at age 62, for retirement at the "Normal Retirement Age" (65-67, depending on the year of birth), and if retirement is postponed until age 70. Benefits can be calculated either in current or future dollars.

There are three versions of the calculator. A "Quick" version computes future benefits from current earnings, by making an assumption that earnings will stay at that level long enough to qualify for benefits. An "Online" version allows the user to input actual historical salary amounts for each year for a more accurate estimate. A "Detailed" version allows the user to download a program which can make the most accurate predictions, including disability and death benefits.

SelectQuote.com offers an online process to apply for life insurance, but the process didn't work very well this week. Applicants who tried to input personal information into an online form found that the information input by a previous applicant was still showing on what should have been a blank input form. The company said the problem emerged when they tried to fix another problem, and emphasized that only about 20 users were affected. They also said the problem has now been corrected. Even so, this was bad publicity for SelectQuote, since users are understandably worried about protecting the privacy of information they provide online.

The Social Security Administration (SSA) has created an email newsletter to keep beneficiaries and professionals up-to-date on Social Security news. They include news about changes in laws and regulations, Medicare, retirement benefits, survivors benefits, disability benefits, and more.