[The advancement, progress and challenges in medical informatics in Belgium]

The development of medical informatics has been as quick in Belgium as in neighbouring countries. It followed the worldwide diffusion of new information technologies, mainly in hospitals, in laboratories, for medical imaging and, more recently, for the EPR (electronic patient record), the e-prescription and bioinformatics. Today, 78 % of general practitioners have access to an EPR and 100 % of acute care hospitals use computers. The Federal Government developed a policy in order to obtain more coherence in information systems and an economy of scale in the (nineteen) eighties, by introducing a reform of health care financing based on diagnoses documented by hospital inpatients record summaries, exhaustive since 1990. During the last years, software quality criteria, called labels, have been introduced in general practice, and "BeHealth", a Federal health network with a secure access platform and authentified medical data, has been developed as a pilot project. Challenges of health telematics in Belgium are related to a profound change in doctor-patient relationship. a shift in organizing medical practice and risks linked to socio-economic interests. These cannot have a primacy over patient interests. Informatics and medicine are not incompatible. The human character of doctor-patient relationship has to be preserved.