Reflections Towards the Future of Medical Informatics.

Objective: To provide guidance on the future development and role of medical informatics, or biomedical and health informatics, in form of reflections.

Method: To report on the author's previous activities as a medical informatician, which spans almost half a century. It began in 1973 when he started to study medical informatics. In 1978, more than four decades ago, his professional work started. He retired at the end of summer semester 2021. This was the occasion to prepare this farewell lecture.

Results: In twenty reflections, thoughts are presented on professional careers (R1 - 'places'), on medical informatics as discipline (R2 - 'interdisciplinarity', R3 - 'focuses', R4 - 'affiliations'), on research (R5 - 'duality', R6 - 'confluences', R7 - 'correlations', R8 - 'collaboration'), on education (R9 - 'community', R10 - 'competencies', R11 - 'approaches'), on academic self-governance (R12 - 'autonomy'), on engagement (R13 - 'Sisyphos', R14 - 'professional societies', R15 - 'respect', R16 - 'tightrope walk'), and on good scientific practice (R17 - 'time invariants', R18 - 'Zeitgeist', R19 - 'knowledge gain', R20 - 'exercising').

Conclusions: It has been a pleasure for me to participate in medical informatics activities for almost fifty years. During that time, there have been significant advances, including in medicine and in informatics, and also in medical informatics itself. And now it is the turn of others. While keeping in mind that tradition is not preserving the ashes, but passing on the fire, this report with its reflections may be of some help.