Health Information Systems: Past, Present, Future - Revisited.

BACKGROUND: Health information systems (HIS) represent an essential part of the infrastructure for the delivery of good health care. OBJECTIVES: To present the author's personal views on HIS developments over the last decades and on the opportunities and priorities for future HIS developments. METHODS: Reflecting on his views, the author identified relevant semantic dimensions, which are denoted as development paths, and searched for appropriate periods to characterize HIS development leaps. RESULTS: HIS developments were divided into the periods past (1961-2016), present (2017-2022), and future (the next decades). Eight development paths for HIS were considered as being relevant to presenting the author's views: life situations related to health care, entities for health care, health care facilities, settings of health care, data to be processed, features for functions, architectures of HIS, and management of HIS. For each of these paths, the past and present states as well as challenges and opportunities for future HIS developments were outlined. DISCUSSION AND CONCLUSIONS: The presented views on HIS developments and the selected development paths and periods are by nature subjective 'avant la lettre'. The views were, however, formed over almost half a century during which the author has been engaged with HIS developments, and thus may be worth reporting and discussion. If past is prologue, the tremendous HIS developments in the past and in the present may predict a similar development intensity in the future. Present HIS are significantly better than HIS of the past, however they leave room for continued improvement with an end of HIS developments far from sight.