On behalf of the Scientific Program Committee we are delighted to welcome you to the triennial World Congress on Medical Informatics (Medinfo 2004), sponsored by the International Medical Informatics Association (IMIA), held in San Francisco, California, from September 7 to 11, 2004. It is hosted by the American Medical Informatics Association (AMIA) and has received a gratifying number of high -quality submissions, providing us all with an opportunity to share views on the future of our burgeoning field.

The main theme of this World Congress is building high performance organizations for enhancing health care, research, and education. The Scientific Program of Medinfo 2004 comprises 300 papers, and 450 posters presented in 7 tracks: Bioinformatics, Clinical Informatics, Education and Training, Enabling Technologies in Health Care, Human and Organizational Issues, Knowledge Management, and Public Health Informatics. In addition to the Keynote Presentation at the Opening Session, distinguished international experts are presenting semi-plenary sessions devoted to major themes of the Congress.

There will also be a full program of Workshops, Tutorials, and Working Group Meetings from IMIA and AMIA held throughout the Congress. The Scientific Program Committee met in December 2003 to finalize the selection of submissions, and authors were notified this past January. Based primarily on quality criteria, but also on the constraint on the number of sessions, the acceptance rate for 711 regular submitted papers was 42.2%. The acceptances levels ranged from a high of 49% for papers in the Knowledge Management track (out of 145 submitted) to a low of 34.1% (out of 28 submitted) for those in the Enabling Technologies track, which included imaging, signal processing and other innovative technologies. The largest number of papers were in the Clinical Informatics track (which also included papers submitted to the Patient Record and Nursing Informatics areas), with 245 submissions, of which 103 were accepted (40.8%), followed by Knowledge Management. The smallest number of submissions was in Bioinformatics, with 42 papers submitted, and 20 accepted (47.6%). Human and Organizational Issues had 76 submissions, of which 34 were accepted (44.7%), while Education and Training had 20 accepted out of 52 (38.5%), and Public Health Informatics had 24 out of 62 (38.7%). The distribution by continents of all 772 papers (including student papers and combined student/regular papers) was: Africa: 0.6%, Asia: 11.5%, Europe 35.5%, North America 47.5%, Oceania 2.7%, South America 2.1%. Due to the large number of excellent submissions, it was necessary to recommend that many submitted papers (30.2%) be presented as posters. While this may have been disappointing to some who had hoped to present, there is frequently an advantage to interested participants, because they can interact more directly, get more detailed feedback, and engage in more intense discussions. A major benefit of attending the World Congresses of Medical Informatics is the opportunity to meet old friends and make new ones, sharing ideas, and coming up with new ways of collaborating across the world on the medical informatics issues that excite us. We urge everyone to forge new links in the ever-widening network of IMIA organizations and professionals.

Medinfo 2004 features “Best Paper” and “Best Poster” awards based on selection by an international jury. A Student Paper Competition will also be part of the Congress, and awards will be presented to the top papers written by students in medical informatics programs. The Awards will be presented during the Closing Session of the Congress.

Medinfo 2004 comes at a propitious time in the historical development of our field: the last few years have seen a confluence of intellectual and scientific streams that drive our work. On the one hand, we are challenged by the overwhelming amount of genomic, proteomic, metabolomic, and other —omic data and knowledge that makes it not only attractive, but imperative for our researchers to tackle emerging informatics problems in genomic medicine. On the othex hand, life in our internet- or web-centric society makes us acutely aware almost daily of the ever increasing difficulties that medicine and public health have in managing the health problems of aging populations in developed nations, and of very young and often disease-ravaged populations in developing countries. These problems become ever more complex and unpredictable as technology, expanding populations, and globalization fuel an evolutionary explosion of microorganisms, including dangerous drug-resistant strains. Medical informatics offers incomparable experience in dealing with the clinical information systems that will be needed for genomic medicine, as well as the foundational tools of knowledge representation (such as ontologies) and information processing upon which these are based. Medical Informatics, is uniquely positioned to work on the fundamental methods for learning about the biomedical and health-related knowledge that will help us engineer our future within the constraints of our natural environment. An important part of this will require advancing the scientific, cognitive and social components of our informatics research and increasing our awareness of its impact on our professional practices. Information technology is deeply transforming the shape of organizations, the systems they use, and the knowledge they produce. Effective and efficient coordination of enterprise activities is important to the success of any organization. It is especially pressing for those in health care because of the strong and ever growing demand, and the need to keep up-to-date with costly and rapidly changing technologies. Information technology is increasingly expected to help deliver economies of scale and improved productivity, balancing costs with quality of health care. And, it is through the efforts of IMIA researchers, practitioners, and educators that some of the most advanced ideas and systems for both the science and the practice of biomedical informatics are being developed, disseminated, tested, and improved to face the ever-changing challenges of biomedical research and health care. We thank all contributors for joining in sharing your work through Medinfo 2004.

Medlnfo'04 Scientific Program Cochairmen

Mario Stefanelli (Italy)

Casimir A. Kulikowski (USA)