The European Federation for Medical Informatics (EFMI) is a regional coordinating body for the National Informatics Societies of Europe. EFMI has organized a number of congresses. The Congresses in Cambridge 1978, Berlin 1979, Toulouse 1981, Dublin 1982 and Brussels 1984 were all successful in providing the wide variety of people in the caring and specialists in the computing profession with up-to-date inform ation from the expanding multidisciplinary field of medical inform atics. We hope that the sixth European Congress on Medical Informatics, MIE-85 in Helsinki will be equally successful. You have in your hand the pre-publication of papers to be presented at MIE-85 as well as the short abstracts of the posters. The proceed ings enable the participants to follow work presented at sessions that they are unable to attend. It also provides a permanent record with relevant bibliography for workers in the field of medical com puting. All the papers have been refereed and the referees' suggest ions incorporated in the final text. Rapid publication, using camera ready paper, reduces the time required for editing and indexing. The editorial board has worked hard to improve the standard of the communications and to reduce the number of errors. Very few papers did not arrive in time to be included in the proceedings: these are marked with * in the table of contents.

Vol. for 2000 contains proceedings of the Medical Informatics Europe Congress and of the annual congress of the German Association for Medical Informatics, Biometry and Epidemiology (GMDS).

The software has been developed in Smalltalk80 [1] on SUN and Apple Macintosh computers. Smalltalk80 is an object-oriented programming system which permits rapid prototyping. The need for prototyping in the specification of general practitioner systems was highlighted as long ago as 1980 [4] and is essential to the user -centred philosophy of the project. The goal is a hardware independent system usable on any equipment capable of supporting an integrated environment for handling both textual and graphics and 'point and select' interaction. The architecture is extensible and provides a platform for future experimention with technical advances such as touch screens and voice technology. User Interface Management Systems (UIMS) technology is developing rapidly offering a number of techniques which allow the abstract design of the interface to be separated from the screen/display management on one hand and the internal workings of the application on the other. [2] The importance of this 'layered' approach is that such techniques enable the user to tailor the application to his/her individual preferences and the design team has included and developed many of these ideas into the design. 7. Conclusion: Value Added to Health.

This volume contains the proceedings of the Tenth International Congress on Medical Informatics, MIE 91, that will be held in Vienna, Austria, August 19-22, 1991. The MIE 91 Congress was organized by the European Federation for Medical Informatics (EFMI) in cooperation with the Austrian Computer Society (OCG) and the Austrian Society for Biomedi cal Engineering (OGBMT). It follows the previous congresses in Cambridge (1978), Berlin (1979), Toulouse (1981), Dublin (1982), Brussels (1984), Helsinki (1985), Rome (1987), Oslo (1988), and the Congress 1990 in Glasgow. The proceedings contain 199 contributions to the MIE 91 Congress. They cover all presentations which are part of the scientific programme of MIE 91, among them 157 paper presentations with an average of five pages, 28 poster presentations again with an average of five pages, and 14 abstracts of demonstrations with an average of one page. The papers included were selected by an International Programme Committee out of over 300 submissions after careful review by at least two international reviewers (for whose estimable efforts we are especially thankful). The recommendations of the re viewers were incorporated in the final texts. Some papers were reworked by a professional translator to obtain a high quality of presentation. Several submissions could not be considered for presenta tion at MIE 91 because of shortage of congress time and limitations in the number of pages of the proceedings.