Summary Objectives: Presenting the author’s point of view on chances and challenges of medical informatics in research, education, and practice of information management, especially in the field of regional as well as institutional health information systems. Method: Collecting and interpreting current issues concerning (health) information systems and their management from selected references. Results: There are challenging research topics concerning information management, IT service management in small health care units, reference models, trustworthy architectures, service-oriented architectures. Medical informatics requires multidisciplinarity. Conclusions: Medicine and health care need medical informatics as a scientific, researching discipline.