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Purpose The discipline of pharmacovigilance is rooted in the aftermath of the thalidomide tragedy of 1961. It has evolved as a result of collaborative efforts by many individuals and organizations, including physicians, patients, Health Authorities, universities, industry, the World Health Organization, the Council for International Organizations of Medical Sciences, and the International Conference on Harmonisation. Biomedical informatics is rooted in technologically based methodologies and has evolved at the speed of computer technology. The purpose of this review is to bring a novel lens to pharmacovigilance, looking at the evolution and development of the field of pharmacovigilance from the perspective of biomedical informatics, with the explicit goal of providing a foundation for discussion of the future direction of pharmacovigilance as a discipline. Methods For this review, we searched [publication trend for the log10 value of the numbers of publications identified in PubMed] using the key words [informatics (INF), pharmacovigilance (PV), phar-macovigilance þ informatics (PV þ INF)], for [study types] articles published between [1994-2015]. We manually searched the reference lists of identified articles for additional information. Implications Biomedical informatics has made significant contributions to the infrastructural development of pharmacovigilance. However, there has not otherwise been a systematic assessment of the role of biomedical informatics in enhancing the field of pharmacovigilance, and there has been little cross-discipline scholarship. Rapidly developing innovations in biomedical informatics pose a challenge to pharmacovigilance in finding ways to include new sources of safety information, including social media, massively linked databases, and mobile and wearable wellness applications and sensors. With biomedical informatics as a lens, it is evident that certain aspects of pharmacovigilance are evolving more slowly. However, the high levels of mutual interest in both fields and intense global and economic external pressures offer opportunities for a future of closer collaboration.

Display Omitted Cognitive informatics (CI) research has its foundations in cognitive science.Transformations seen in CI in JBI reflect the changes seen broadly in the field of CI.Key topics include decision-making, usability, comprehension, workflow and errors.Recent developments toward use of applied cognition for usability and HCI studies.Future trends point toward consumer health tools and the use of mobile technology. Cognitive Informatics (CI) is a burgeoning interdisciplinary domain comprising of the cognitive and information sciences that focuses on human information processing, mechanisms and processes within the context of computing and computer applications. Based on a review of articles published in the Journal of Biomedical Informatics (JBI) between January 2001 and March 2014, we identified 57 articles that focused on topics related to cognitive informatics. We found that while the acceptance of CI into the mainstream informatics research literature is relatively recent, its impact has been significant - from characterizing the limits of clinician problem-solving and reasoning behavior, to describing coordination and communication patterns of distributed clinical teams, to developing sustainable and cognitively-plausible interventions for supporting clinician activities. Additionally, we found that most research contributions fell under the topics of decision-making, usability and distributed team activities with a focus on studying behavioral and cognitive aspects of clinical personnel, as they performed their activities or interacted with health information systems. We summarize our findings within the context of the current areas of CI research, future research directions and current and future challenges for CI researchers.

Amid researchers’ growing need for study data management, the CTSA-funded Institute for Translational Health Sciences developed an approach to combine technical and scientific resources with small-scale clinical trials researchers in order to make Electronic Data Capture more efficient. In a 2-year qualitative evaluation we found that the importance of ease of use and training materials outweighed number of features and functionality. EDC systems we evaluated were Catalyst Web Tools, OpenClinica and REDCap. We also found that two other systems, Caisis and LabKey, did not meet the specific user needs of the study group.

As is the case for environmental, ecological, astronomical, and other sciences, medical practice and research finds itself in a tsunami of data. This data deluge, due primarily to the introduction of digitalization in routine medical care and medical research, affords the opportunity for improved patient care and scientific discovery. Medical informatics is the subdiscipline of medicine created to make greater use of information in order to improve healthcare. The 4 areas of medical informatics research (information access, structure, analysis, and interaction) are used as a framework to discuss the overlap in information needs of comparative effectiveness research and potential contributions of medical informatics. Examples of progress from the medical informatics literature and the Veterans Affairs Healthcare System are provided.

Objective To reflect about medical informatics as a discipline. To suggest significant future research directions with the purpose of stimulating further discussion. Methods Exploring and discussing important developments in medical informatics from the past and in the present by way of examples. Reflecting on the role of IMIA, the International Medical Informatics Association, in influencing the discipline. Results Medical informatics as a discipline is still young. Today, as a cross-sectional discipline, it forms one of the bases for medicine and health care. As a consequence considerable responsibility rests on medical informatics for improving the health of people, through its contributions to high-quality, efficient health care and to innovative research in biomedicine and related health and computer sciences. Current major research fields can be grouped according to the organization, application, and evaluation of health information systems, to medical knowledge representation, and to the underlying signal and data analyses and interpretations. Yet, given the fluid nature of many of the driving forces behind progress in information processing methods and their technologies, progress in medicine and health care, and the rapidly changing needs, requirements and expectations of human societies, we can expect many changes in future medical informatics research. Future research fields might range from seamless interactivity with automated data capture and storage, via informatics diagnostics and therapeutics, to living labs with data analysis methodology, involving sensor-enhanced ambient environments. The role of IMIA, the International Medical Informatics Association, for building a cooperative, strongly connected, and research-driven medical informatics community worldwide can hardly be underestimated. Conclusions Health care continuously changes as the underlying science and practice of health are in continuous transformation. Medical informatics as a discipline is strongly affected by these changes and is in a position to be a key, active contributor in these changes.

The application of biomedical and health informatics to surgery holds tremendous opportunities to enhance surgical care. Better use of information in surgical practice has the potential to streamline care, remove inefficiencies, and allow for improvements in surgical research. With greater EHR adoption, health care reform, and direct investment in HIT, an increasing opportunity exists for surgeons to access and use patient information more effectively. For this to happen, greater focus on the specific needs of surgeons is particularly important, alongside increasing the number of surgical informatics stakeholders.

A revolution is now expected to occur in the ever-changing scenario of laboratory medicine thanks to the introduction of "omics" into clinical practice. However, our awareness of the divide between knowledge and practice, and the understandable assumption that omics research will be riddled with difficulties, has led to the concepts of knowledge translation, translational research and translational medicine. The interchangeable terms, translational research or translational medicine (hereafter referred to as translational research), currently underline the pressing need to gain practical benefit from the enormous investments made in biomedical research by the private and public sector. From the viewpoint of physicians, clinical laboratory professionals and patients, who are more directly involved in clinical practice, translational research responds to the need to obtain benefit from research, thus closing the gap between what we know and what we practice. This means transferring diagnostic and therapeutic advances that have proven effective in large well-conducted trials (and are therefore evidenced-based,) to daily medical practice. Translational research should be regarded as a two-way road: bench to bedside, and bedside to bench. However, to achieve a more effective translation process, a new road map should be implemented through interaction and cooperation between basic researchers, clinicians, laboratory professionals and manufacturers. Some examples of recent developments in clinical laboratory testing, including markers of cardiovascular diseases, clinical proteomics and recombinant allergens, attest to the importance of a careful evaluation of all variables allowing the introduction of such new insights into clinical practice in order to assure better clinical outcomes. The ability of laboratory medicine to deliver safer and more effective health care calls for a more careful evaluation not only of analytical characteristics but also of any other variables that may affect the clinical usefulness and diagnostic performances of laboratory tests thus enabling a more accurate interpretation and utilization of laboratory information.

Translation of the achievements of basic science into everyday clinical practice remains a major issue in contemporary medicine, and is addressed through a new discipline, translational research, which aims to bridge the gap between basic and clinical research. Translational research encompasses laboratory studies, clinical demands, public health and health management, policies and economics; it is crucial in the evolution of contemporary biomedical science; and its interventions follow the political-economic, ethical-social and educational-scientific approaches. Translational research can progress through reorganisation of academic teams in a translational way. New academic posts translationally orientated are urgently needed, particularly in the field of trauma medicine, where lack of awareness of this new evolution is evident.

Objective To provide a general overview of informatics and its interface with allergy/immunology. Data Sources The PubMed interface to MEDLINE was searched with the keywords asthma, allergy , or immunology together with the keywords informatics, bioinformatics , and information technology to retrieve the articles relevant to this review. Study Selection The authors' knowledge of the field was used to include sources of information other than those obtained through the MEDLINE search. Results A survey of informatics, with emphasis on the relevance to allergy, asthma, and immunology, is presented. Conclusions Several innovative informatics approaches have significant potential to improve health care on diverse fronts. Newer methods of information representation are poised to facilitate the impact of cutting-edge research on clinical practice.

The effective use of information technology (IT) is a crucial component for the delivery of effective services in health care. Current approaches to medical informatics (MI) research have significantly contributed to the success of IT use in health care but important challenges remain to be addressed. We believe that expanding the multi-disciplinary basis for MI research is important to meeting these research challenges. In this paper, we outline theories and methods used in information systems (IS) research that we believe can inform our understanding of health care IT applications and outcomes. To do so, we discuss some general differences in the focus and methods of MI and IS research to identify broad opportunities. We then review conceptual and methodological approaches in IS that have been applied in health care IT research. These include: technology-use mediation, collaborative work, genre theory, interpretive research, action research, and modeling. Examples of these theories and methods in healthcare IS research are illustrated.

Several training programs in biomedical informatics in the United States are attempting to integrate biological and clinical informatics. However, significant differences in the cultures underlying these two disciplines pose barriers to a uniform educational solution. This paper recounts the experience at Columbia University in adapting a graduate program with an initial focus on clinical informatics to train bioinformaticians. The analysis begins by considering the development of the medical and biological informatics cultures over a 17-year period. Then we review how two separate curricula evolved to serve the needs of each group. Interviews with bioinformatics students and faculty indicated some dissatisfaction with the curriculum that developed within clinical informatics. Their comments are considered in the light of an analysis of the relationship between the application domains of biomedical informatics as a discipline. In response, a new curriculum was developed in which bioinformatics and clinical informatics are regarded as subdivisions of the same subject. A key feature of this curriculum is a new course, Theory and Methods in Biomedical Informatics, which presents informatics principles in their general form, and illustrates their application with examples drawn from across the biomedical spectrum. The paper concludes with suggestions for integrating informatics training programs at other institutions.

Unprecedented growth in the interdisciplinary domain of biomedical informatics reflects the recent advancements in genomic sequence availability, high-content biotechnology screening systems, as well as the expectations of computational biology to command a leading role in drug discovery and disease characterization. These forces have moved much of life sciences research almost completely into the computational domain. Importantly, educational training in biomedical informatics has been limited to students enrolled in the life sciences curricula, yet much of the skills needed to succeed in biomedical informatics involve or augment training in information technology curricula. This manuscript describes the methods and rationale for training students enrolled in information technology curricula in the field of biomedical informatics, which augments the existing information technology curriculum and provides training on specific subjects in Biomedical Informatics not emphasized in bioinformatics courses offered in life science programs, and does not require prerequisite courses in the life sciences.

Objective Modeling is a significant part of research, education and practice in biomedical and health informatics. Our objective was to explore which types of models of processes are used in current biomedical/health informatics research, as reflected in publications of scientific journals in this field. Also, the implications for medical informatics curricula were investigated. Methods Retrospective, prolective observational study on recent publications of the two official journals of the International Medical Informatics Association (IMIA), the International Journal of Medical Informatics (IJMI) and Methods of Information in Medicine (MIM). All publications of the years 2004 and 2005 from these journals were indexed according to a given list of model types. Random samples out of these publications were analysed in more depth. Results Three hundred and eighty-four publications have been analysed, 190 of IJMI and 194 of MIM. For publications in special issues (121 in IJMI) and special topics (132 in MIM) we found differences between theme-centered and conference-centered special issues/special topics (SIT) publications. In particular, we could observe a high variation between modeling in publications of theme-centered SITs. It became obvious that often sound formal knowledge as well as a strong engineering background is needed for carrying out this type of research. Usually, this knowledge and the related skills can be best provided in consecutive B.Sc. and M.Sc. programs in medical informatics (respectively, health informatics, biomedical informatics). If the focus should be primarily on health information systems and evaluation this can be offered in a M.Sc. program in medical informatics. Conclusions In analysing the 384 publications it became obvious that modeling continues to be a major task in research, education and practice in biomedical and health informatics. Knowledge and skills on a broad range of model types are needed in biomedical/health informatics.

The Stanford Biomedical Informatics training program began with a focus on clinical informatics, and has now evolved into a general program of biomedical informatics training, including clinical informatics, bioinformatics and imaging informatics. The program offers PhD, MS, distance MS, certificate programs, and is now affiliated with an undergraduate major in biomedical computation. Current dynamics include (1) increased activity in informatics within other training programs in biology and the information sciences (2) increased desire among informatics students to gain laboratory experience, (3) increased demand for computational collaboration among biomedical researchers, and (4) interaction with the newly formed Department of Bioengineering at Stanford University. The core focus on research training-the development and application of novel informatics methods for biomedical research-keeps the program centered in the midst of this period of growth and diversification.

Recent developments in biomedical informatics research have afforded possibilities for great advances in health care delivery. These exciting opportunities also present a number of challenges to the implementation and integration of technologies in the workplace. As in most domains, there is a gulf between technologic artifacts and end users, which compromises the culture of safety in the workplace. Because clinical practice is a human endeavor, there is a need for bridging disciplines to enable clinicians to benefit from rapid technologic advances. This, in turn, necessitates a broadening of disciplinary boundaries to consider cognitive and social factors related to the design and use of technology. The authors argue for a place of prominence for cognitive science in understanding nursing factors associated with patient safety. Cognitive science provides a framework for the analysis and modeling of complex human performance. Studies of clinical cognition can meaningfully inform and shape design, development and assessment of information systems. Furthermore, they have a decisive impact on whether information technology has a positive influence on human performance and are especially important in understanding and promoting safe practices. These issues are discussed in the context of clinical informatics with a focus on nursing practice.

Based on the recommendations of the International Medical Informatics Association (IMIA, http://www.IMIA.org ) on education in health and medical informatics and on experiences in founding a new school, the University for Health Informatics and Technology Tyrol (UMIT, http://www.UMIT.at ), at Innsbruck, Austria, questions on education in health informatics, medical informatics, and biomedical informatics are discussed. Suggestions are made on (1) appropriate approaches for specialized educational programs in biomedical and health informatics at the university level, on (2) resources and infrastructures needed for running such programs at a high-quality level, and on (3) strategies to be considered for the future development of such educational programs. UMIT strives for an international top position in education and research. It entirely concentrates on areas in research and education in biomedicine and the health sciences. UMIT started in the academic year 2001/2002 with two educational programs. They lead to a B.Sc. degree (3 years) and a M.Sc. degree (1.5–2 years) in medical informatics. In parallel Ph.D. students work in research projects.

Bioinformatics is a rapidly emerging field of biomedical research. A flood of large-scale genomic and postgenomic data means that many of the challenges in biomedical research are now challenges in computational science. Clinical informatics has long developed methodologies to improve biomedical research and clinical care by integrating experimental and clinical information systems. The informatics revolution in both bioinformatics and clinical informatics will eventually change the current practice of medicine, including diagnostics, therapeutics, and prognostics. Postgenome informatics, powered by high-throughput technologies and genomic-scale databases, is likely to transform our biomedical understanding forever, in much the same way that biochemistry did a generation ago. This paper describes how these technologies will impact biomedical research and clinical care, emphasizing recent advances in biochip-based functional genomics and proteomics. Basic data preprocessing with normalization and filtering, primary pattern analysis, and machine-learning algorithms are discussed. Use of integrative biochip informatics technologies, including multivariate data projection, gene-metabolic pathway mapping, automated biomolecular annotation, text mining of factual and literature databases, and the integrated management of biomolecular databases, are also discussed.

Computerization is transforming health care. All clinicians are users of health information technology (HIT). Understanding fundamental principles of informatics, the field focused on information needs and uses, is essential if HIT is going to support improved patient outcomes. Informatics education for clinicians is a national priority. Additionally, some informatics experts are needed to bring about innovations in HIT. A common approach to pharmacy informatics education has been slow to develop. Meanwhile, accreditation standards for informatics in pharmacy education continue to evolve. A gap remains in the implementation of informatics education for all pharmacy students and it is unclear what expert informatics training should cover. In this article, we propose the first of two complementary approaches to informatics education in pharmacy: to incorporate fundamental informatics education into pharmacy curricula for all students. The second approach, to train those students interested in becoming informatics experts to design, develop, implement, and evaluate HIT, will be presented in a subsequent issue of the Journal.

“Translational research” bridges clinical and basic research to formulate research studies based on clinical observations and to implement the clinical applications of basic research. Although basic and clinical scientists have long collaborated, translational research challenges investigators to move beyond the traditional training of both laboratory scientists and clinicians. In 2007, we—a clinical researcher (Kong) and a basic scientist (Segre)—initiated an interdisciplinary project to characterize the human skin microbiota associated with both common and rare skin disorders (Grice et al., 2008, 2009). We set out to better understand the cutaneous microbial landscape in healthy individuals and patients with atopic dermatitis through the use of genomic techniques. The project demanded an understanding of a combination of high-throughput sequencing technology and logistics of clinical research, with knowledge of the subtleties of dermatologic disorders. The requirements of rigorous translational research moved us both beyond the boundaries of our individual disciplines. The paradigm for a translational investigator has been the MD–PhD scientist with training in both patient care and laboratory research. This model results in over 300 MD–PhD graduates per year in the United States, 5.9% of whom enter residencies in dermatology. Of the recent MD–PhD scientists who completed dermatology residencies, 56% (39 of 70) remain in academia and provide a rich source of researchers in the field of dermatology (Brass et al., 2010). In the current state of research, there is an increasing need to build bridges between clinical and basic researchers to translate findings from bench to bedside and back again. Are we adequately preparing clinical researchers and basic scientists to bridge the translational research gap? If not, what skills do we need to learn and teach? Seven years ago, former National Institutes of Health (NIH) director Elias Zerhouni highlighted the complexities and roadblocks inherent to modern translational research. He implemented the NIH Roadmap with the goal of bringing individuals from critical disparate disciplines into translational research teams (Zerhouni, 2003). His model foreshadowed our path toward collaboration. We participated in the NIH Roadmap’s Human Microbiome Project with our study of patients with atopic dermatitis. MDs interested in laboratory-based research face competing demands imposed by patient-care responsibilities. PhDs interested in clinical research face competing demands for projects with shorter turnaround times to publish manuscripts and to compete for grants. MD–PhDs face both sets of competing demands. In addition, it is difficult for PhD scientists to identify ways to work with clinicians and for physicians without a laboratory to find a basic researcher to coinvestigate a clinical question. When we met, one of us (Segre) had training in genetics and basic cell biology, using only animal models and cell culture. The other (Kong) had training in dermatology and patient-oriented research. Although neither of us had prior experience with a translational research team jointly led by a clinical researcher and a basic scientist, our common enthusiasm propelled us into a high-risk research project that proved to be rewarding and fruitful. A critical issue was learning how to foster a collaboration that promoted translational research. We discuss here what enabled our collaboration and highlight features specific to our interactions as MD and PhD. Although we believe that much of our experience is relevant to all collaborations, certain features were specific to the changing landscape of translational research and the inherent differences in our training.

Medical informatics is an interdisciplinary field that deals with the intellectual activities; information management; and communication tasks of medical practice, basic science and clinical research, and medical education. By projecting the future of medical informatics as it specifically relates to applications in end-stage renal disease, this report focuses on some technical innovations, application of existing technology in novel ways, and program applications useful for practitioners caring for renal patients.

This paper introduces the topic of this special issue: challenges for medical informatics in the 21st century. This paper discusses the nature of medical informatics. Some descriptions and definitions of medical informatics are reviewed. Then the research aspects of medical informatics are discussed. It is argued that the more mundane aspects of medical informatics like system development and implementation are important and need further consideration, especially concerning social aspects and correctness.

This is a companion article to the article on Medical Informatics. It focuses on the new nursing specialty-Nursing Informatics. This article provides an overview, scope, definitions, data standards, goals, and research initiatives designed to advance the status Nursing Informatics. Seven research priorities have been proposed which not only provides the direction for Nursing Informatics research, but also the focus for computer-based nursing information systems.

Ten major long-term aims and tasks, so to speak 'grand challenges', for research in the field of medical informatics, including health informatics, are proposed and described. These are the further development of methods and tools of information processing for: (1) diagnostics ('the visible body'); (2) therapy ('medical intervention with as little strain on the patient as possible'); (3) therapy simulation; (4) early-recognition and prevention; (5) compensating physical handicaps; (6) health consulting ('the informed patient'); (7) health reporting; (8) health care information systems; (9) medical documentation and (10) comprehensive documentation of medical knowledge and knowledge-based decision support. Work is, in part, already in progress. To all these aims and tasks medical informatics can and may be should make substantial contributions. Prior to outlining the above aims and tasks, an account is given of the meaning of medical informatics, of the objective it pursues in general and of its achievements so far. The present paper intends to contribute to a broad public discussion of the aims and tasks for research in the field of medical informatics.

Haux's [7] basic assumption that the object of medical informatics is: "... to assure and to improve the quality of healthcare as well as the quality of research and education in medicine and in the health sciences ..." is taken as a starting point to discuss the three main topics: What is the meaning of medical informatics (i.e. what should be the main activities of medical informatics to bring maximum benefit to medicine)? What are the achievements and failures of medical informatics today (again considering the impact on the quality of healthcare)? What are the main challenges? Concerning the definition of medical informatics it is argued that one should not hide the link to basic informatics and, for that matter to computers, completely behind abstract definitions. After an analysis of the purposes of the definition of a discipline, a differentiated definition of the scope of medical informatics, rather general when concerning the field of scientific interest, more focused when concerning the practical (constructive) applications, is proposed. Contrasting Haux's chapter on achievements of medical informatics we concentrate on and analyse non fulfilled promises of medical informatics to derive lessons for the future and to propose 'generic' (or core) tasks of medical informatics to meet the challenges of the future. A set of 'internal challenges' of medical informatics to change priorities and attitudes within the discipline is put forward to enable medical informatics to meet the 'external challenges' listed by Haux.

The World Wide Web has revolutionized how researchers from various disciplines collaborate throughout the world. In the Life Sciences, interdisciplinary approaches are becoming increasingly powerful as a driver of both integration and discovery. Data access, data quality, identity, and provenance are all critical ingredients to facilitate and accelerate these collaborative enterprises and it is in the area of Translational Research where Web 2.0 technologies promise to have a profound impact – enabling reproducibility, aiding in discovery, and accelerating and transforming medical and healthcare research across the healthcare ecosystem. However, integration and discovery require a consistent foundation upon which to operate. A foundation capable of addressing some of the critical issues associated with how research is conducted within the ecosystem today and how it should be conducted for the future.This paper will discuss the critical issues associated with Translational Research and their implications for future medical and healthcare research. The first set of issues concerns the enhancement of research for traditional ecosystem stakeholders, namely, research organizations and care delivery organizations, especially through the use of bio-repositories. The key questions to be addressed surrounding Translational Research 2.0 are: - What is it and how might it aid knowledge discovery and collaboration within the medical and healthcare ecosystem?- What benefits, challenges, and opportunities does it provide?- How can bio-repositories enhance it?The answers to these questions directly impact the translation of research findings from basic research, performed by research organizations, into clinical practice, provided by care delivery organizations. Finally, this paper discusses how research can be enhanced for the broader ecosystem, through the mining and analysis of knowledge surrounding health outcomes, namely: What key challenges are associated with Translational Informatics in a world of “big data”? The answer to this question is of importance to all ecosystem stakeholders, in their collective efforts to better understand health outcomes and facilitate the biomedical discovery process.

Medical informatics is defined as the scientific discipline concerned with the systematic processing of data, information and knowledge in medicine and health care. The domain of medical informatics (including health informatics), its aim, methods and tools, and its relevance to other disciplines in medicine and health sciences are outlined. It is recognized that one of the major tasks of medical informatics is modelling processes. In this context, biological, communication, decision, engineering, educational, organizational and computational processes are distinguished and described.

The Computer Science, Biology, and Biomedical Informatics (CoSBBI) program was initiated in 2011 to expose the critical role of informatics in biomedicine to talented high school students.[1] By involving them in Science, Technology, Engineering, and Math (STEM) training at the high school level and providing mentorship and research opportunities throughout the formative years of their education, CoSBBI creates a research infrastructure designed to develop young informaticians. Our central premise is that the trajectory necessary to be an expert in the emerging fields of biomedical informatics and pathology informatics requires accelerated learning at an early age.In our 4(th) year of CoSBBI as a part of the University of Pittsburgh Cancer Institute (UPCI) Academy (http://www.upci.upmc.edu/summeracademy/), and our 2nd year of CoSBBI as an independent informatics-based academy, we enhanced our classroom curriculum, added hands-on computer science instruction, and expanded research projects to include clinical informatics. We also conducted a qualitative evaluation of the program to identify areas that need improvement in order to achieve our goal of creating a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics in the era of big data and personalized medicine.

Background - Medical informatics forms the intersection of science, education, information and health care delivery systems. Today, it is a multidisciplinary field that collaborates with academic, clinical and research medicine. The emerging impact of medical informatics now constitutes a separate entity in modern medical institutions.Discussion - The major components of medical informatics in clinical setting include information systems, patient records, imaging, telemedicine, bio informatics, artificial intelligent expert systems, clinical decision systems, neural networks and robotics. In academic research setting it includes development of department websites, data analysis tools, intelligent tutoring systems, presentation tools, e-learning, web based discussion boards and portals of information. The advantages of medical informatics in academic and clinical medicine are too many and undisputable. It enables integrated multidisciplinary patient management, inter and intra institutional health status evaluation in a global perspective, user friendly billing systems, human resource development, hospital administration, data utilization for medical queries, investigation tools ranging from tumor identification and classification to chromosomal anomaly detection, risk free simulations for clinical skills practice, presentation, evaluation and independent or distance learning resources, diagnostics for aiding clinicians etc.Conclusion - Medical informatics has aided in an equitable distribution of health care and education across the physical barriers of person, time, place and distance. It has helped in dealing with logistic issues, skilled personnel and resource shortages. Tele dermatology, Tele medicine, Tele surgery and the Human genome project are some of the many enormous advances in this field. Medical informatics has stepped in a big way and it is here to stay. It is a ray of hope that will invariably and pleasantly change the course of 21st century medicine.

Clinical and Translational Science (CTS) rests largely on information flowing smoothly at multiple levels, in multiple directions, across multiple locations. Hence, Biomedical Informatics (BI) is seen as a backbone that can help to manage the information flows for the process of translation. However, the two concepts may end up being applied incongruently, if uncoordinated. This paper summarizes the objectives for CTS and BI, and provides a mechanism to harmonize their different objectives and guide the design of BI architectures for CTS.

Medical informatics as a medical discipline has developed over the last decades in parallel with an even more amazing proliferative development in medicine. The question is raised whether this new science, based on formalized and methodological approaches, may contribute to the development of a general theory in medicine as a consequence of the recognition of the influence of control mechanisms and structured information in molecular biology. It is suggested that medical informatics dedicates research to problems 'inside medicine' and that curricula are developed which bring a basic understanding for medical informatics to the medical student. The following teaching is suggested: basic mandatory courses, electives and inclusions of aspect of medical informatics in the various parts of clinical teaching. The possibility is discussed that the resulting teaching approaches may also be used to convey knowledge in medicine: teaching concepts versus teaching details. Finally, a description of the functional topology of expert systems as they develop is attempted and brought into relation to the architecture of hospital information systems. The increasing importance of expert systems also raises the question of 'decisional trials' as verification procedures when these new tools enter medical practice.