Can bad health informatics kill? A similar question has been asked a decade ago by one of the editors of this book on evidence-based health informatics [1]. And indeed, when informatics methodology and information and communication technology (ICT) are used inappropriately this can cause severe negative effects. On the other hand we will probably all agree with her, when she writes in the same article that it “is evident that the use of modern ICT offers tremendous opportunities to support health care professionals and to increase efficiency, effectiveness and appropriateness of care” [1].

Even earlier, more than 15 years ago, the other editor stated that it “is unfortunately a truism in health care informatics… that evaluation is undertaken rarely and inadequately” and he concludes, among others, that “integrated information systems also give new opportunity to provide effective health care service evaluation, and thus a much more robust future evidence base” [2]. As perspective he writes that “a deeper and longer-term evaluation philosophy is needed which does not stop after the initial confirmation of system functioning, but continues on with a deepening into the effects on the individual clinical services, and then on the host user organisation” [2].

Both colleagues worked during recent years continuously and intensively on how to better evaluate health care processes and outcomes in the context of health information systems, so that informatics tools and information management strategies are not ‘just’ applied in this context, but that their evidence has also been evaluated according to current good scientific practice. It is probably no surprise to find later joint papers of them on evidence-based health informatics, reporting about their international activities there [3].

Today there is indeed still a discrepancy in making decisions on health information system architectures, infrastructures and tools, related to considerable investments for health care organizations on the one hand and much smaller investment in evaluating the evidence of these decisions on a scientifically sound basis on the other. In therapy research, this discrepancy also existed, however much earlier. In order to overcome this discrepancy, among other methods, randomized clinical trials are now forming an important part of evaluating and making decisions on good clinical practice.

Health information systems in their current form have only existed for a few decades. And they are still in continuous change. Their complexity is high and often underestimated. Insofar it is understandable that in the beginning priority has been put on successful and stable implementations and on feasible solutions concerning organizational issues. However, this initial phase should now clearly be regarded as finished and so the need for systematically looking for evidence must also be demanded for the practice of health informatics – for the sake of patients, of health care organizations, and for high-quality and efficient health care.

This book on evidence-based health informatics, edited by two colleagues with high international reputations in this field, is timely and very welcome. They successfully invited excellent authors worldwide to report and to discuss about the many aspects of evidence-based health informatics.

What has to be considered when reading the book?

In their preface Elske Ammenwerth and Michael Rigby report about the book's objective: It “seeks to meet the need for better understanding of the need for robust evidence to support health IT, give insight into health IT evidence and evaluation as its primary source, and to promote health informatics as the underpinning science”.

They state that a reader should not expect a cook book with a few recipes on how to successfully cook some delightful meals of evidence-based health informatics. Editors and authors seek “to inform the reader on the wide range of knowledge available, and its necessary use according to circumstances”.

It is good to have books helping to get better evidence in the practice of informatics, in particular in the context of health information systems.

Dear reader, please select and prepare your appropriate meal. And…: Bon appetit!

Reinhold Haux

Corresponding author: Prof. Dr. Reinhold Haux, President and Honorary Fellow of IMIA, the International Medical Informatics Association, reinhold.haux@plri.de.

Peter L. Reichertz Institute for Medical Informatics, University of Braunschweig - Institute of Technology and Hannover Medical School