title: Evidence-based Health Informatics: How Do We Know What We Know?
abstract: BACKGROUND
  Health IT is expected to have a positive impact on the quality and efficiency of health care. But reports on negative impact and patient harm continue to emerge. The obligation of health informatics is to make sure that health IT solutions provide as much benefit with as few negative side effects as possible. To achieve this, health informatics as a discipline must be able to learn, both from its successes as well as from its failures.
  
  
  OBJECTIVE
  To present motivation, vision, and history of evidence-based health informatics, and to discuss achievements, challenges, and needs for action.
  
  
  METHODS
  Reflections on scientific literature and on own experiences.
  
  
  RESULTS
  Eight challenges on the way towards evidence-based health informatics are identified and discussed: quality of studies; publication bias; reporting quality; availability of publications; systematic reviews and meta-analysis; training of health IT evaluation experts; translation of evidence into health practice; and post-market surveillance. Identified needs for action comprise: establish health IT study registers; increase the quality of publications; develop a taxonomy for health IT systems; improve indexing of published health IT evaluation papers; move from meta-analysis to meta-summaries; include health IT evaluation competencies in curricula; develop evidence-based implementation frameworks; and establish post-marketing surveillance for health IT.
  
  
  CONCLUSIONS
  There has been some progress, but evidence-based health informatics is still in its infancy. Building evidence in health informatics is our obligation if we consider medical informatics a scientific discipline.
authors.affiliation: Prof. Dr. Elske Ammenwerth, Institute of Biomedical Informatics UMIT - University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnöfer-Zentrum 1, 6060 Hall in Tirol, Austria, E-mail: elske.ammenwerth@umit.at.
authors.forename: E
authors.initials: E
authors.lastname: Ammenwerth
mesh_terms: D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D006040:Goals; D049673:History, 20th Century; D049674:History, 21st Century; D008490:Medical Informatics / Q000266:history
keywords: Medical informatics; evaluation studies; evidence-based medicine; information science; meta-analysis; publication bias; qualitative research; review literature