Journal of the American Medical Informatics Association Volume 16 Number 2 March / April 2009
A “Fundamental Theorem” of Biomedical Informatics
CHARLES P. FRIEDMAN, PHD
A b s t r a c t This paper proposes, in words and pictures, a “fundamental theorem” to help clarify what
informatics is and what it is not. In words, the theorem stipulates that a person working in partnership with an
information resource is “better” than that same person unassisted. The theorem is applicable to health care,
research, education, and administrative activities. Three corollaries to the theorem illustrate that informatics is
more about people than technology; that in order for the theorem to hold, resources must be informative in
addition to being correct; and that the theorem can fail to hold for reasons explained by understanding the
interaction between the person and the resource.
J Am Med Inform Assoc. 2009;16:169–170. DOI 10.1197/jamia.M3092.
As best I can tell, the field of biomedical informatics contin-
ues to struggle to define itself. Those in the field refer often
to large numbers of people in health care and biomedical
research who “don’t get it” with regard to informatics.
Educational programs with “informatics” in their names are
growing in number, but the increasing variation in level and
scope of these programs further clouds the issue of what
informatics is, and is not.
In hope that it might be helpful in providing greater focus
and sense of identity, I offer here a formulation of our field
that I have audaciously labeled the “Fundamental Theorem
of Informatics.” The theorem is based significantly on early
ideas from members of our profession that RA Miller
recapitulated in two commentaries.1,2 The first of Miller’s
essays, in 1990, proclaimed the end of the “Greek Oracle”
era in clinical decision support, calling primary attention to
how information technology can augment human reasoning
as opposed to what the technology itself is capable of doing.
The second, in 1996, addressed technology eva