The internal challenges 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.