This volume contains the proceedings of the Twenty-second International Conference on Medical Informatics Europe MIE 2009, that will be held in Sarajevo, Bosnia and Herzegovina, from 30 August to 2 September 2009. The MIE 2009 is the European's leading forum for presenting the results of current scientific work in health-informatics processes, systems, and technologies.

Achievements in this area will be introduced to an international audience. As a major event for science, medicine, and technology, the conference provides a comprehensive overview and in-depth, first hand information on new developments, advanced systems and technologies, and current and future applications.

The MIE 2009 conference was organized by the European Federation for Medical Informatics (EFMI) in cooperation with the Society for Medical Informatics of Bosnia and Herzegovina (BHSMI). It follows the previous conferences in Cambridge (1978), Berlin (1979), Toulouse (1981), Dublin (1982), Brussels (1984), Helsinki (1985), Rome (1987), Oslo (1988), Glasgow (1990), Vienna (1991), Jerusalem (1993), Lisbon (1994), Copenhagen (1996), Porto Carras (1997), Ljubljana (1999), Hannover (2000), Budapest (2002), Saint Malo (2003), Geneva (2005), Maastricht (2006), and the conference 2008 in Gothenburg.

The proceedings contain 213 contributions to the MIE 2009 conference. They cover all presentations which are part of the scientific program of MIE 2009, among them 150 full paper presentations with five pages each, 21 student paper presentations with one page each (which was quite difficult for our students!), 21 presentations that will be presented as posters but received five pages each in the proceedings, and 14 workshop descriptions with again five pages each. Furthermore, seven keynote addresses from eminent scientists coming from Europe and overseas are also included into this proceedings. The papers included were selected by an International Scientific Programme Committee (SPC) out of 324 submissions after careful review by three international reviewers for every single submission. The SPC chair and his two co-chairs (K.-P. Adlassnig, B. Blobel, and J. Mantas) are especially thankful to all their reviewers whose efforts are highly estimated. As a specific token of appreciation and to recognize their work not only anonymously, the MIE 2009 reviewers' names are listed in the proceedings. The – often extended – recommendations of the reviewers were incorporated in the final texts, and careful language revision was carried out to achieve a high quality of presentation.

The scientific topics present in this proceedings volume range from national and trans-national eHealth roadmaps, health information and electronic health record systems, systems interoperability and communication standards, medical terminology and ontology approaches, and social networks to Web, Web 2.0, and Semantic Web solutions for patients, health personnel, and researchers. Furthermore, they include quality assurance and usability of medical informatics systems, specific disease management and telemedicine systems, including a section on devices and sensors, drug safety, clinical decision support and medical expert systems, clinical practice guidelines and protocols, as well as issues on privacy and security. Moreover, bioinformatics, biomedical modeling and simulation, medical imaging and visualization and, last but not least, learning and education through medical informatics systems are parts of the included topics.

There are several trends and developments that can be recognized by carefully examining the single contributions to the various topics:

First, interoperability and data exchange standards become most important. Systems must and will be interconnected to each other: locally, nationally, and transnationally. Medical information and electronic health record systems will be the first to benefit.

Second, ontologies are being developed to an increasing extent. Medical data items and medical concepts (terms) are being represented, arranged, and interconnected in standardized collections of “the phenomena that exist” (=ontology) in medicine. By doing so, not only the medical vocabulary that is used in an application but also the semantics of applied items and terms are defined.

Third, Web applications allow to share medical information and knowledge by many users – researchers, staff, and patients – close or far. Web 2.0 applications deliberately involve the user, and the Semantic Web provides even knowledge inferences over remote knowledge places and allows to develop futuristic systems.

Fourth, clinical decision support systems in all possible manifestations are and will increasingly be demanded by physicians and patients equally – after patients' medical data from the many data sources are finally digitized and made available. They will provide huge impact on medical workflow and patient care to the benefit of the patient, the caring physician, and the financing healthcare bodies.

Most of the topics presented at MIE 2009 are interdisciplinary in nature and may be of interest to a variety of professionals: medical informatics, bioinformatics, and health informatics scientists, medical computing and technology specialists, public health, health insurance and health institutional administrators, physicians, nurses, and other allied health personnel, and representatives of industry and consultancy in the various health fields.

The MIE 2009 conference gathers participants all over the world, although mainly Europeans. This is reflected by the authors of the proceedings' contributions; altogether 931 researchers have reported their results in this volume (double author entries have not been eliminated). By considering the nationality of the authors, 38 different countries from Europe, North and South America, Asia, Africa, and Australia can be counted to have contributed to this volume.

The great variety of scientific topics and countries that will be present should guarantee both a highly interesting international Medical Informatics Europe MIE 2009 conference in Sarajevo in August/September and a fruitful study of the proceedings by those interested in Medical Informatics.

Acknowledgements. The editors are most grateful to Andrea Rappelsberger for her careful and extensive work in the preparation of this proceedings. We are thankful to Susanne Rom, whose many efforts are appreciated. (Both are with the SPC Office in Vienna, Austria.) Without their help it would not have been possible to produce such a valuable and comprehensive book.

Klaus-Peter Adlassnig, Vienna; Bern Blobel, Regensburg; Joh Mantas, Athens; Izet Masic, Sarajevo (Eds.) , July 2009