Health informatics: where’s the evidence?

Three cases of practical benefit from health informatics in the UK are presented. The evidence base for health informatics is critically analysed. Three important factors that limit generalisation from health informatics studies are: (1) the complexity of the healthcare environment, (2) the local ownership and enthusiasm of participants and (3) the emergent change arising from systemic adaptation. Much evidence in health informatics is missing, incomplete or lost. Two weaknesses underlying the evidence problems are the lack of a knowledge-sharing culture in the NHS and an absence of simple evaluation standards. The report recommends: an active communications plan (including use of a repository and evidence digests); higher profile promotion of health informatics professional training and education; development of a ‘lite’ model of informatics evaluation; and research to determine effective incentives for sharing knowledge.