O0: reporting and discussing on how the 2013-paper has been received

1. To be used in conjunction with the oral presentation. Version: 21.5.2013 O0: reporting and discussing on how the 2013-paper has been received Jürgen Stausberg Ludwig-Maximilians-Universität München, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE)

2. References to the Paper • Haux R, Ammenwerth E, Herzog W, Knaup P. Health care in the information society. A prognosis for the year 2013. Int J Med Inform. 2002 Nov 20;66(1-3):3-21. • Source: ISI Web of Science using the Cited Reference Search • Date: 24. February 2013 • Software: EndNote X6 R ecords identified through A dditional records identified Identification database searching through other sources (n = 53 ) (n = 0 ) Records after duplicates removed (n = 53 ) Screening References from the Book Citation Index not available in the results. Records screened R ecords excluded (n = 51 ) (n = 2 ) Self - r eferences from one of the authors . F ull - text articles assessed F ull - text articles excluded, for eligibility with reasons Eligibility (n = 38 ) (n = 13 ) Studies included in metadata synthesis (n = 38) Included Studies included in qualitative synthesis (n = 33 )

3. Analysis of the references‘ metadata

4. 9 8 8 7 7 7 6 5 5 4 4 3 2 2 2 1 1 1 1 0 0 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Metadata of the references • Year of publication

5. Country of the first author Austria 1 Belgium 1 Denmark 3 England 2 Finland 2 France 1 Germany 4 Italy 2 Netherlands 3 Norway 1 Spain 1 Sweden 1 Switzerland 1 2 3 2 1 1 1 1 2 1 1

6. Journals, books, and book chapters • Books and book chapters 7 • Journals 31 • Cancer Causes & Control 1 • Colombia Medica 1 • European Journal of Cancer Care 1 • Expert Systems with Applications 1 • Family Practice 1 • Health & Social Care in the Community 1 • Health Information Management Journal 1 • Informatics for Health & Social Care 2 • International Journal of Medical Informatics 12 • Journal of Biomedical Informatics 1 • Journal of Medical Systems 1 • Journal of Telemedicine and Telecare 1 • Medical Science Monitor 1 • Medizinische Klinik 1 • Methods of Information in Medicine 3 • Plos Computational Biology 1 • Telemedicine and E-Health 1

7. Metadata of the references • Year of publication • Country of the first author • Journals, books, and book chapters • Language • German: 1 • English: 37

8. Metadata of the references • Year of publication • Country of the first author • Journals, books, and book chapters • Language • German: 1 • English: 37 • Keywords

9. Qualitative summary 1 reference excluded due to missing reference in the text [3] 2 references excluded that provide a forecast themselves [32, 33] 2 references excluded that reviewed the paper in 2002 [13, 34] 33 references included 22 with statements about the present 12 with statements about the future

10. Statements about the present (1) • “Health care providers are increasingly under pressure to deliver efficient and high-quality care. Important reasons for this are the ageing population, increasing demands and expectations by patients, rising medical costs [1] and a decrease of full-time employed specialists.” [2/2007] • “Information and Communication Technologies (ICT) are increasingly used in healthcare in general and home care in particular [1,2].” [8/2008] • “Information and communication technologies (ICT) are said to be ‘revolutionizing’ healthcare delivery, by transforming relationships between patients and health professionals (Ball & Lillis 2001, Haux et al . 2002).” [11/2005] • “Information and communication technologies (ICTs) are said to be 'revolutionizing health-care delivery', by transforming relationships between patients and health professionals.1,2” [12/2008]

11. Statements about the present (1) Aging population Aging population Shared medical decision making Shared medical decision making • “Health care providers are increasingly under pressure to deliver efficient and high-quality care. Important reasons for this are the ageing population, increasing demands and expectations by patients, rising medical costs [1] and a decrease of full-time employed specialists.” [2/2007] • “Information and Communication Technologies (ICT) are increasingly used in healthcare in general and home care in particular [1,2].” [8/2008] • “Information and communication technologies (ICT) are said to be ‘revolutionizing’ healthcare delivery, by transforming relationships between patients and health professionals (Ball & Lillis 2001, Haux et al . 2002).” [11/2005] • “Information and communication technologies (ICTs) are said to be 'revolutionizing health-care delivery', by transforming relationships between patients and health professionals.1,2” [12/2008]

12. Statements about the present (2) • “Electronic healthcare records are gradually replacing paper records, but the transition is complex, stretched over a period of decades, and unlikely to result in completely paperless hospitals [11, 21].” [14/2009] • “EHRs are a major focus for current research in the field of health informatics [8,9] but the need for research from different approaches has also been noticed [10].” [15/2008, cf. future statements] • „Through the ongoing computerization and digitalization, the Internet becomes more and more a medium used also for health services research [4].“ [16/2006, in German] • “Researchers seem to agree that electronic records hold considerable potential but only some studies find that this potential is being attained [1, 2].” [17/2008] • “Mobile services are extensively applied in institutional healthcare [10-12] and in home health care [13,14].” [18/2009]

13. Statements about the present (2) EMR EMR Research EMR Mobile computing • “Electronic healthcare records are gradually replacing paper records, but the transition is complex, stretched over a period of decades, and unlikely to result in completely paperless hospitals [11, 21].” [14/2009] • “EHRs are a major focus for current research in the field of health informatics [8,9] but the need for research from different approaches has also been noticed [10].” [15/2008, cf. future statements] • „Through the ongoing computerization and digitalization, the Internet becomes more and more a medium used also for health services research [4].“ [16/2006, in German] • “Researchers seem to agree that electronic records hold considerable potential but only some studies find that this potential is being attained [1, 2].” [17/2008] • “Mobile services are extensively applied in institutional healthcare [10-12] and in home health care [13,14].” [18/2009]

14. Statements about the present (3) • “The use of informatics resources, especially those related with capture, storage and research of clinic data, has been extremely important on the production of high quality and trustful clinical studies [3, 4].” [19/2009] • “The practice of evidence-based medicine is largely based on consistently accurate information (...; ...; ...; ...) that, in turn, constitutes the base of equally consistently accurate knowledge (...; ...; Haux, Ammenwerth, Herzogg & Knaup, 2002; ...).” [21/2006] • “It has been argued that healthcare is undergoing a paradigm shift, from 'Industrial Age Medicine to Information Age Healthcare' [1] and that 'the health system cannot remain oblivious to our rapidly changing technological landscape and mindset' [2]. This 'paradigm shift' is shaping health systems [3,4], transforming the doctor/patient relationship [5-7] and having an impact on the quality and efficiency of health care [8].” [22/2010]

15. Statements about the present (3) Research Data mining Personalized medicine • “The use of informatics resources, especially those related with capture, storage and research of clinic data, has been extremely important on the production of high quality and trustful clinical studies [3, 4].” [19/2009] • “The practice of evidence-based medicine is largely based on consistently accurate information (...; ...; ...; ...) that, in turn, constitutes the base of equally consistently accurate knowledge (...; ...; Haux, Ammenwerth, Herzogg & Knaup, 2002; ...).” [21/2006] • “It has been argued that healthcare is undergoing a paradigm shift, from 'Industrial Age Medicine to Information Age Healthcare' [1] and that 'the health system cannot remain oblivious to our rapidly changing technological landscape and mindset' [2]. This 'paradigm shift' is shaping health systems [3,4], transforming the doctor/patient relationship [5-7) and having an impact on the quality and efficiency of health care [8].” [22/2010]

16. Statements about the present (4) • “It might be for this reason, that most of the expenditure in IT within hospitals is aimed at administrative tasks such as accounting and logistics, (Haux et al., 2002; Brynjolfsson & Hitt, 2000).” [23/2011] • “However, despite ICT promise of delivering quality of care while ensuring effciency and cost-effectiveness, the results achieved so far in heath care are far from expectations [1].” [25/2006] • “With the consolidation of EPR systems in modern healthcare, massive amounts of clinical data and phenotype data are gradually becoming available for researchers [1,2,3,4,5,6].” [27/2011] • “Our society is continuously influenced by diverse emergent communication and information technologies (CITs)1.” [28/2009] • “The use of electronic medical records ... increases the availability of clinical data at the point of care [14].” [30/2006] • “The use of electronic medical records ... increases the availability of clinical data at the point of care [19].” [31/2010]

17. Statements about the present (4) ICT ICT Data mining ICT EMR EMR • “It might be for this reason, that most of the expenditure in IT within hospitals is aimed at administrative tasks such as accounting and logistics, (Haux et al., 2002; Brynjolfsson & Hitt, 2000).” [23/2011] • “However, despite ICT promise of delivering quality of care while ensuring effciency and cost-effectiveness, the results achieved so far in heath care are far from expectations [1].” [25/2006] • “With the consolidation of EPR systems in modern healthcare, massive amounts of clinical data and phenotype data are gradually becoming available for researchers [1,2,3,4,5,6].” [27/2011] • “Our society is continuously influenced by diverse emergent communication and information technologies (CITs)1.” [28/2009] • “The use of electronic medical records ... increases the availability of clinical data at the point of care [14].” [30/2006] • “The use of electronic medical records ... increases the availability of clinical data at the point of care [19].” [31/2010]

18. Statements about the present (5) • “... the ability to retrieve exams based on the similarity of their images is useful for a variety of operations [12] usually asked over exams based on textual/numerical data, as for example: searching for similar medical cases to compare/study/diagnose, statistical studies, decision support, cross-referencing, bibliographic reports and documentation [13].” [35/2003] • “Instead, the ideology of patient-centred care challenges the traditional ways of delivering care; the processes need to focus on communication, collaboration, and shared decision making with the patient [57–59].” [36/2011] • “Health care has already profited greatly from the continuous development of information technology (IT),2 ... ” [37/2011] • “Medicine and health care turn out to be increasingly driving economic factors worldwide [6, 9] with information.” [38/2009]

19. Statements about the present (5) EMR Shared medical decision making ICT ICT • “... the ability to retrieve exams based on the similarity of their images is useful for a variety of operations [12] usually asked over exams based on textual/numerical data, as for example: searching for similar medical cases to compare/study/diagnose, statistical studies, decision support, cross-referencing, bibliographic reports and documentation [13].” [35/2003] • “Instead, the ideology of patient-centred care challenges the traditional ways of delivering care; the processes need to focus on communication, collaboration, and shared decision making with the patient [57–59].” [36/2011] • “Health care has already profited greatly from the continuous development of information technology (IT),2 ... ” [37/2011] • “Medicine and health care turn out to be increasingly driving economic factors worldwide [6, 9] with information.” [38/2009]

20. Statements about the future (1) • “With the promises offered by genomic medicine and upcoming needs to integrate molecular and clinical data, data mining and other knowledge-intensive computational approaches are becoming required for advancing the state-of-the-art of both research and real-life applications [107,108].” [1/2008] • “The demographic development especially in western countries moves towards an increasing number of elderly people inducing a growing demand for health care services [19].” [4/2006] • “They predicted that by 2013 patient care data would be primarily exchanged electronically. They outlined goals for the future which included patient-centred recording with information shared across health facilities and process integrated decision support for all health professionals (Haux et al. 2002). They acknowledged the importance of work practice fit by arguing that the technology should fit the needs of the user, should be well integrated into clinical work practices and be accessible at the workplace (Haux et al. 2002).” [5/2006]

21. Statements about the future (1) Personalized medicine Aging population Personalized medicine • “With the promises offered by genomic medicine and upcoming needs to integrate molecular and clinical data, data mining and other knowledge-intensive computational approaches are becoming required for advancing the state-of-the-art of both research and real-life applications [107,108].” [1/2008] • “The demographic development especially in western countries moves towards an increasing number of elderly people inducing a growing demand for health care services [19].” [4/2006] • “They predicted that by 2013 patient care data would be primarily exchanged electronically. They outlined goals for the future which included patient-centred recording with information shared across health facilities and process integrated decision support for all health professionals (Haux et al. 2002). They acknowledged the importance of work practice fit by arguing that the technology should fit the needs of the user, should be well integrated into clinical work practices and be accessible at the workplace (Haux et al. 2002).” [5/2006]

22. Statements about the future (2) • “By 2013, it is expected that hospitals will use more mobile than stationary computers [10].” [6/2009] • “These may also contribute to the advance in the use of information and communication technologies tools that scholars consistently see as one of the key pillars of better health care provision in the near future [37].” [7/2009] • “Numerous international reports emphasize the need to develop new models of care service delivery to deal with the escalating demands and massive increase in costs in the healthcare sector [1,2].” [9/2008] • “However, before this dream of a lifelong electronic patient record becomes reality [74,75], there should be other tools available to connect such personal information with medical knowledge residing in digital libraries [76].” [10/2004]

23. Statements about the future (2) Mobile computing ICT Aging population Personalized medicine • “By 2013, it is expected that hospitals will use more mobile than stationary computers [10].” [6/2009] • “These may also contribute to the advance in the use of information and communication technologies tools that scholars consistently see as one of the key pillars of better health care provision in the near future [37].” [7/2009] • “Numerous international reports emphasize the need to develop new models of care service delivery to deal with the escalating demands and massive increase in costs in the healthcare sector [1,2].” [9/2008] • “However, before this dream of a lifelong electronic patient record becomes reality [74,75], there should be other tools available to connect such personal information with medical knowledge residing in digital libraries [76].” [10/2004]

24. Statements about the future (3) • “In the future it will be necessary to implement more systematic terminologies and codes so that the data contained in these records can be put to better use in clinical research, health care management, health services planning, and government reporting [8,9,15,16].” [15/2008 , cf. presence statements] • “ ... the use of a new consensus-based design procedure for a shared patient record should be considered at this stage, especially to decide which data are needed, not only for cooperative care as in the paper record, but also for new features expected with computerization, including process integrated decision support or research and healthcare reporting (Haux et al. 2002).” [20/2009] • “Given the significance of information, CIOs have quickly gained strategic importance [6]. In this regard, Haux (2002) anticipated that the CIO will be established in more than 60% of all German hospitals by the year 2013 [14].” [24/2010]

25. Statements about the future (3) Data mining Shared medical decision making ICT • “In the future it will be necessary to implement more systematic terminologies and codes so that the data contained in these records can be put to better use in clinical research, health care management, health services planning, and government reporting [8,9,15,16].” [15/2008 , cf. presence statements] • “ ... the use of a new consensus-based design procedure for a shared patient record should be considered at this stage, especially to decide which data are needed, not only for cooperative care as in the paper record, but also for new features expected with computerization, including process integrated decision support or research and healthcare reporting (Haux et al. 2002).” [20/2009] • “Given the significance of information, CIOs have quickly gained strategic importance [6]. In this regard, Haux (2002) anticipated that the CIO will be established in more than 60% of all German hospitals by the year 2013 [14].” [24/2010]

26. Statements about the future (4) • “In this context [environments for ageing], there is a great demand especially for user-centered health-enabling and ambient-assistive technologies, which seems to be a remarkable challenge in the future of medical informatics as well [1–8].” [26/2010] • “Global leaders in medical informatics consider augmenting optimal use of medical information for collaborative care as one of its major goals.7,8” [29/2006]

27. Statements about the future (4) Aging population Shared medical decision making • “In this context [environments for ageing], there is a great demand especially for user-centered health-enabling and ambient-assistive technologies, which seems to be a remarkable challenge in the future of medical informatics as well [1–8].” [26/2010] • “Global leaders in medical informatics consider augmenting optimal use of medical information for collaborative care as one of its major goals.7,8” [29/2006]

28. Present Future 30% 25% 20% 15% 10% 5% 0% EMR ICT Shared Aging Data mining Research Mobile Personalized medical population computing medicine decision making Summary Relative frequency of each tag within the group.

29. Conclusions • Perception for the present • EMR 6 • ICT 5 • Shared medical decision making 3 • Aging population 2 • Data mining 2 • Research 2 • Mobile computing 1 • Personalized medicine 1 • Perception for the future • EMR • ICT 2 • Shared medical decision making 2 • Aging population 3 • Data mining 1 • Research • Mobile computing 1 • Personalized medicine 3

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