Digital Medicine and Biomedical Informatics: What's in a Name?

Methods Inf Med 2016; 55: 389–391 http://dx.doi.org/10.3414/ME15-22-0005 epub ahead of print: August 15, 2016 This issue of Methods of Information in Medicine features a special section that begins with a provocative article by Martin-Sanchez and Lopez-Campos examining the relationship between biomedical informatics and digital medicine [1] and closes with a series of invited commentaries [2] that includes reactions to the points made in the analytical paper. The paper, and subsequent responses, identify and clarify a number of issues that have recently led to both excitement and angst in the biomedical informatics (BMI) community. Accordingly the two papers taken together constitute a valuable snapshot of where the field currently stands and of the issues that are affecting its trajectory and its appreciation in the larger world of biomedicine. Drs. Martin-Sanchez and Lopez-Campos begin by examining the increasingly popular term digital medicine , assessing its definition, its relationship to BMI, and the implications for health and health care that result from society’s current fascination with the notion. Fundamental to their discussion are the fields of participatory medicine and precision medicine , which the authors argue combine with BMI to define the scope and motivation for digital medicine. They make a strong distinction between the older term personalized medicine and the newer precision medicine , arguing that personalized medicine focuses primarily on an individual’s genomic information and its use whereas precision medicine works with a broader tableau of information and influences that extend into the community and environment (see their Table 1). Although one could dispute the general acceptance of the distinctions that they make (my own impression is that personalized medicine , individualized medicine , and precision medicine have been used almost interchangeably, with local arguments about which is preferred but no agreement on detailed definitions), they make a strong and compelling point about the importance of information from a wide variety of sources when making health and health care decisions. Furthermore, they clearly argue for the central role of BMI in gathering, validating, managing, and interpreting such diverse data sources. The important notion of participatory medicine is also highly relevant to a discussion of the character and implications of digital medicine. The emergence of increasing patient empowerment is widely acknowledged, with online access by patients to their own health data, and to health-related information more generally, accelerating at a rate that challenges both cultural and legal norms [3]. Thus indi viduals are becoming not only better informed, but more involved in decision making about their health and in taking steps to understand and tactically manage their risks and personal opportunities in areas as varied as exercise monitoring [4], diet [5], and management of one’s own microbiome [6, 7]. Digital tools to assist with such efforts are popular and are raising new issues regarding the role of patients in contributing directly to their personal (or provider-based) electronic health record. Martin-Sanchez and Lopez-Campos then examine the role of biomedical informatics as a key disciplinary element in