Editorial: The health informatics series: Evolving with a new discipline.

A brief history of the book series launched by Springer-Verlag in 1988 as Computers in Healthcare stands as a case study of its role in the development of informatics in medicine. Renamed Health Informatics in 1998, the series grew to include 121 titles as of September 2022, covering topics from dental informatics to ethics, from human factors to mobile health. An analysis of three titles now in their fifth editions reveals the evolution of content in the core disciplines of nursing informatics and health information management. Shifts in topics in the second editions of two landmark titles chart the history of the field and provide a map to the development of the computer-based health record. Metrics on the publisher's website document the reach of the series, available as e-books or chapters. The growth of the series mirrors the evolution of health informatics as a discipline, and the contributions of authors and editors from around the world are evidence of international scope.

The International Academy of Health Sciences Informatics: 2021 Update.

OBJECTIVES: To summarize the activities of the International Academy of Health Sciences Informatics (IAHSI) in 2021 and welcome its 2021 Class of Fellows. METHODS: Report on governance, strategic directions, newly elected fellows, plenary meetings, and other activities of the Academy. RESULTS: As in 2020, all of the Academy's activities were carried out virtually due to the COVID-19 pandemic. In 2021, new Board members were elected. Strategic activities in data standards and interoperability and in mentorship moved forward. A new class of 26 Fellows was elected, bringing the total membership of the Academy to 204 Fellows from all regions of the world. In addition, a virtual plenary meeting was held. CONCLUSIONS: The Academy has continued to pursue its role as the honorific society globally for biomedical and health informatics. Expansion of strategic activities and membership will continue moving forward.

The eHealth4all@eu Pipeline of Course Development: TIGER Recommendations in Action.

This study describes the eHealth4all@eu course development pipeline that builds upon the TIGER educational recommendations and allows a systematic development grounded on scientific and field requirements of competencies, a case/problem-based pedagogical approach and finally results in the syllabus and the course content. The pipeline is exemplified by the course Learning Healthcare in Action: Clinical Data Analytics.

Applied Clinical Informatics Journal: A Brief History.

In 2009, Schattauer Verlag in Stuttgart, Germany first published the Applied Clinical Informatics (ACI) Journal. ACI has served since its inception as an official journal of the International Medical Informatics Association. Later, the American Medical Informatics Association and the European Federation for Medical Informatics named ACI as an official journal. This manuscript describes the history of the journal from its inception to present day including publication measures, challenges, and successes.

Donald A.B. Lindberg, pioneer in biomedical and health informatics: His involvement in creating professional organizations.

Among the many contributions of Donald A.B. Lindberg was his work on behalf of a variety or professional organizations in the field of biomedical and health informatics. These began during his early days at the University of Missouri and continued throughout his 30 years at the National Library of Medicine. This chapter summarizes that work, which occurred both through his personal efforts and through the impact of the NLM under his leadership. Examples include his role in the development of organizations themselves (e.g., the International Medical Informatics Association, the American College of Medical Informatics, and the American Medical Informatics Association) and also his contributions to the professional scientific meetings that have advanced the field (e.g., the Symposium on Computer Applications in Medical Care, MEDINFO, and the AMIA Annual Symposium).

Donald A.B. Lindberg, Pioneer in Biomedical and Health Informatics: His Involvement in Creating Professional Organizations.

Among the many contributions of Donald A.B. Lindberg was his work on behalf of a variety or professional organizations in the field of biomedical and health informatics. These began during his early days at the University of Missouri and continued throughout his 30 years at the National Library of Medicine. This chapter summarizes that work, which occurred both through his personal efforts and through the impact of the NLM under his leadership. Examples include his role in the development of organizations themselves (e.g., the International Medical Informatics Association, the American College of Medical Informatics, and the American Medical Informatics Association) and also his contributions to the professional scientific meetings that have advanced the field (e.g., the Symposium on Computer Applications in Medical Care, MEDINFO, and the AMIA Annual Symposium).

Health Intelligence Atlas: A Core Tool for Public Health Intelligence.

BACKGROUND: The dramatic increase in complexity and volume of health data has challenged traditional health systems to deliver useful information to their users. The novel coronavirus disease 2019 (COVID-19) pandemic has further exacerbated this problem and demonstrated the critical need for the 21st century approach. This approach needs to ingest relevant, diverse data sources, analyze them, and generate appropriate health intelligence products that enable users to take more effective and efficient actions for their specific challenges. OBJECTIVES: This article characterizes the Health Intelligence Atlas (HI-Atlas) development and implementation to produce Public Health Intelligence (PHI) that supports identifying and prioritizing high-risk communities by public health authorities. The HI-Atlas moves from post hoc observations to a proactive model-based approach for preplanning COVID-19 vaccine preparedness, distribution, and assessing the effectiveness of those plans. RESULTS: Details are presented on how the HI-Atlas merged traditional surveillance data with social intelligence multidimensional data streams to produce the next level of health intelligence. Two-model use cases in a large county demonstrate how the HI-Atlas produced relevant PHI to inform public health decision makers to (1) support identification and prioritization of vulnerable communities at risk for COVID-19 spread and vaccine hesitancy, and (2) support the implementation of a generic model for planning equitable COVID-19 vaccine preparedness and distribution. CONCLUSION: The scalable models of data sources, analyses, and smart hybrid data layer visualizations implemented in the HI-Atlas are the Health Intelligence tools designed to support real-time proactive planning and monitoring for COVID-19 vaccine preparedness and distribution in counties and states.

The International Academy of Health Sciences Informatics (IAHSI): 2020 Report.

OBJECTIVES: To summarize the major activities of the International Academy of Health Sciences Informatics (IAHSI) in the 2020 time period and to welcome its 2020 Class of Fellows. METHOD: Report from the members of the Academy's Board. RESULTS: Due to the SARS-CoV-2 pandemic, both Plenary meetings in 2020 had to be organized as virtual meetings. Scientific discussions, focusing on mobilizing computable biomedical knowledge and on data standards and interoperability formed major parts of these meetings. A statement on the use of informatics in pandemic situations was elaborated and sent to the World Health Organization. A panel on data standards and interoperability started its work. 34 Fellows were welcomed in the 2020 Class of Fellows so that the Academy now consists of 179 members. CONCLUSIONS: There was a shift from supporting to strategic activities in the Academy's work. After having achieved organizational stability, the Academy can now focus on its strategic work and so on its main objective.

International Academy of Health Sciences Informatics (IAHSI): Strategy and Focus Areas, 1st Version.

BACKGROUND: The International Academy of Health Sciences Informatics (IAHSI) is the Academy of the International Medical Informatics Association (IMIA). As an international forum for peers in biomedical and health informatics, the Academy shall play an important role in exchanging knowledge, providing education and training, and producing policy documents. OBJECTIVES: A major priority of the Academy's activities in its inaugural phase was to define its strategy and focus areas in accordance with its objectives and to prioritize the Academy's work, which can then be transferred to respective taskforces. METHOD: This document reflects the major outcomes of intensive discussions that occurred during 2019. It was presented at the Academy's 3rd Plenary on August 25th, 2019, in Lyon, France. RESULTS: Regardless of the 'living nature' of the strategy and focus areas document, it was concluded during the Plenary that the first version, which will be used as a base for decisions on the Academy's future activities, should be made available to a broad audience. Three out of eight 'Visions for IAHSI', presented in the IMIA Yearbook of Medical Informatics 2018, were identified as central for developing, implementing, and evaluating the Academy's strategic directions: (1) advise governments and organizations on developing health and health sciences through informatics, (2) stimulate progress in biomedical and health informatics research, education, and practice, and (3) share and exchange knowledge. Taskforces shall be implemented to work in the following areas, which were considered as priority themes: (1) artificial intelligence in health: future collaboration of entities with natural and with artificial intelligence in health care, and (2) current landscape of standards for digital health. CONCLUSIONS: Taskforces are now being established. Besides specific key performance indicators, suggested for monitoring the work of theses taskforces, the strategy to monitor the progress of the Academy itself has to be measured by relevant and acceptable metrics.

The International Academy of Health Sciences Informatics (IAHSI): IMIAs Academy is Now Established and on Track.

OBJECTIVES: To summarize the major activities of the International Academy of Health Sciences Informatics (IAHSI) from 2018 until 2019, and to provide an outline of actions planned for 2020. METHOD: Reporting about these activities and actions by the members of the Academy's first Board. RESULTS: Academy bylaws were accepted by the Academy Plenary and the IMIA General Assembly on August 25th, 2019 and August 26th, 2019, respectively. Academy's strategy and focus areas were developed. Based on the Academy's eligibility criteria, the 2018/2019 Class made of 26 new Academy Fellows was elected. Future activities will concentrate on building taskforces for developing and implementing major Academy focus areas. CONCLUSIONS: We are glad to report that the Academy is strong and thriving.

Modeling the Personas of Primary Care Communication Modality Usage: Experiences from the R-Health Direct Primary Care Model.

Recent advancements in mediated communication technologies enable unfettered communication between patients and their providers. We explore patients' utilization of different direct and mediated communication modalities in a Direct Primary Care (DPC) clinic and the patient characteristics that predict their communication behavior patterns. Based on this knowledge, we developed 2 patient personas that explicate the nuances of patients who tend to prefer visiting the clinic in person versus those who use mediated modalities more often. We hope this study may inform future work in understanding and supporting patient-provider communication in a new technical environment. The results suggest that patients and their health team alike may be incentivized to voluntarily adopt and utilize multi-modality communication in a DPC setting.

Towards the TIGER International Framework for Recommendations of Core Competencies in Health Informatics 2.0: Extending the Scope and the Roles.

This paper describes the methodology and developments towards the TIGER International Recommendation Framework of Core Competencies in Health Informatics 2.0. This Framework is meant to augment the scope from nursing towards a series of six other professional roles, i.e. direct patient care, health information management, executives, chief information officers, engineers and health IT specialists and researchers and educators. Health informatics core competency areas were compiled from various sources that had integrated the literature and were grouped into consistent clusters. The relevance of these core competency areas was rated in a survey by 718 professional experts from 51 countries. Furthermore, 22 local case studies illustrated the competencies and gave insight into examples of local educational practice. The Framework contributes to the overall discourse on how to shape health informatics education to improve quality and safety of care by enabling useful and successful health information systems.

What Are Inter-Professional eHealth Competencies?

As health IT supports processes along the entire patient trajectory and involves different types of professional groups, eHealth is inter-professional by nature. The aim of this study, therefore, is to investigate which competencies are at the intersection of the individual groups of health professionals. 718 international experts provided relevance ratings of eHealth competencies for different professional roles in an online survey. Communication and leadership proved to be important competencies across all professions, not only for executives. None or very little differences between professions were found between physicians and nurses, between IT experts at different levels and between IT experts and executives. However, there were a number of competencies rated differently when contrasting direct patient care specialists with executives. These findings should encourage organisations issuing educational recommendations to specify areas of shared competencies more extensively.

Technology Informatics Guiding Education Reform - TIGER.

BACKGROUND: While health informatics recommendations on competencies and education serve as highly desirable corridors for designing curricula and courses, they cannot show how the content should be situated in a specific and local context. Therefore, global and local perspectives need to be reconciled in a common framework. OBJECTIVES: The primary aim of this study is therefore to empirically define and validate a framework of globally accepted core competency areas in health informatics and to enrich this framework with exemplar information derived from local educational settings. METHODS: To this end, (i) a survey was deployed and yielded insights from 43 nursing experts from 21 countries worldwide to measure the relevance of the core competency areas, (ii) a workshop at the International Nursing Informatics Conference (NI2016) held in June 2016 to provide information about the validation and clustering of these areas and (iii) exemplar case studies were compiled to match these findings with the practice. The survey was designed based on a comprehensive compilation of competencies from the international literature in medical and health informatics. RESULTS: The resulting recommendation framework consists of 24 core competency areas in health informatics defined for five major nursing roles. These areas were clustered in the domains "data, information, knowledge", "information exchange and information sharing", "ethical and legal issues", "systems life cycle management", "management" and "biostatistics and medical technology", all of which showed high reliability values. The core competency areas were ranked by relevance and validated by a different group of experts. Exemplar case studies from Brazil, Germany, New Zealand, Taiwan/China, United Kingdom (Scotland) and the United States of America expanded on the competencies described in the core competency areas. CONCLUSIONS: This international recommendation framework for competencies in health informatics directed at nurses provides a grid of knowledge for teachers and learner alike that is instantiated with knowledge about informatics competencies, professional roles, priorities and practical, local experience. It also provides a methodology for developing frameworks for other professions/disciplines. Finally, this framework lays the foundation of cross-country learning in health informatics education for nurses and other health professionals.

Technology Informatics Guiding Education Reform (TIGER). The Future of Interprofessional Education Is Here!

This session will describe the TIGER Initiative journey, its evolution and accomplishments nationally and internationally. A powerful demonstration of the TIGER Virtual Learning Environment (VLE) will be highlighted along with case studies from around the world, with emphasis on global competencies and opportunities for engagement in all current TIGER activities and future plans.

Time for TIGER to ROAR! Technology Informatics Guiding Education Reform.

Information Technology (IT) continues to evolve and develop with electronic devices and systems becoming integral to healthcare in every country. This has led to an urgent need for all professions working in healthcare to be knowledgeable and skilled in informatics. The Technology Informatics Guiding Education Reform (TIGER) Initiative was established in 2006 in the United States to develop key areas of informatics in nursing. One of these was to integrate informatics competencies into nursing curricula and life-long learning. In 2009, TIGER developed an informatics competency framework which outlines numerous IT competencies required for professional practice and this work helped increase the emphasis of informatics in nursing education standards in the United States. In 2012, TIGER expanded to the international community to help synthesise informatics competencies for nurses and pool educational resources in health IT. This transition led to a new interprofessional, interdisciplinary approach, as health informatics education needs to expand to other clinical fields and beyond. In tandem, a European Union (EU) - United States (US) Collaboration on eHealth began a strand of work which focuses on developing the IT skills of the health workforce to ensure technology can be adopted and applied in healthcare. One initiative within this is the EU*US eHealth Work Project, which started in 2016 and is mapping the current structure and gaps in health IT skills and training needs globally. It aims to increase educational opportunities by developing a model for open and scalable access to eHealth training programmes. With this renewed initiative to incorporate informatics into the education and training of nurses and other health professionals globally, it is time for educators, researchers, practitioners and policy makers to join in and ROAR with TIGER.

StressHacker: Towards Practical Stress Monitoring in the Wild with Smartwatches.

In modern life, the nonstop and pervasive stress tends to keep us on long-lasting high alert, which over time, could lead to a broad range of health problems from depression, metabolic disorders to heart diseases. However, there is a stunning lack of practical tools for effective stress management that can help people navigate through their daily stress. This paper presents the feasibility evaluation of StressHacker, a smartwatch-based system designed to continuously and passively monitor one's stress level using bio-signals obtained from the on-board sensors. With the proliferation of smartwatches, StressHacker is highly accessible and suited for daily use. Our preliminary evaluation is based on 300 hours of data collected in a real-life setting (12 subjects, 29 days). The result suggests that StressHacker is capable of reliably capturing daily stress dynamics (precision = 86.1%, recall = 91.2%), thus with great potential to enable seamless and personalized stress management.

cHRV Uncovering Daily Stress Dynamics Using Bio-Signal from Consumer Wearables.

Knowing the dynamics of one's daily stress is essential to effective stress management in the context of smart and connected health. However, there lacks a practical and unobtrusive means to obtain real-time and longitudinal stress information. In this paper, we attempt to derive a convenient HRV-based (heart rate variability) biomarker named cHRV, which can be used to reliably reflect stress dynamics. cHRV's key advantage lies in its low maintenance and high practicality. It can be efficiently calculated only using data from photoplethysmography (PPG) sensors, the mainstream heart rate sensor embedded in most of the consumer wearables like Apple Watch. Benefiting from the proliferation of wearables, cHRV is ideal for day-to-day stress monitoring. To evaluate its feasibility and performance, we have conducted 14 in-lab controlled experiments. The result shows that the proposed cHRV has strong correlation with the stress dynamics (r > 0.95), therefore exhibits great potential for continuous stress assessment.

Accessing Reliable Health Information on the Web: A Review of the HON Approach.

Accessing online health content of high quality and reliability presents challenges. Laypersons cannot easily differentiate trustworthy content from misinformed or manipulated content. This article describes complementary approaches for members of the general public and health professionals to find trustworthy content with as little bias as possible. These include the Khresmoi health search engine (K4E), the Health On the Net Code of Conduct (HONcode) and health trust indicator Web browser extensions.