Publication list (selected & topically sorted)

Univ.-Prof. Elske Ammenwerth, Dipl.-Inform. Med., MET

Professor for Medical Informatics, Institute of Medical Informatics, UMIT TIROL - Private University for Health Sciences and Technology, Eduard Wallnöfer Zentraum 1, 6060 Hall in Tirol, Austria, 


For a comprehensive list of publications, please search my GoogleProfile.  

Here are selected publications organized around the research areas I worked on. This is only a subset of all publications of my team and myself. All this work would not have been possible without the support and dedication of my team members and of many national and international colleagues. 

I got interested in health IT evaluation early in my Ph.D. time. Since then, I have conducted evaluation studies using quantitative, qualitative or mixed-method approaches. Here some examples:

  • Ammenwerth E, Eichstädter E, Haux R, Pohl U, Rebel S, Ziegler S: A Randomized Evaluation of a Computer-Based Nursing Documentation System. Methods of Information in Medicine 2001; 40 (2): 61-68. Cited > 75 times in Dec 2022 (Web of Science). 
  • Ammenwerth E, Buchauer A, Bludau B, Haux R. Mobile information and communication tools in the hospital. International Journal of Medical Informatics 2000; 57(1): 21-40. Cited > 100 times in Dec 2022 (Web of Science). Selected as "Best Paper" for the IMIA Yearbook of Medical Informatics 2001.
  • Mahler C, Ammenwerth E, Wagner A, Tautz A, Happek T, Hoppe B, Eichstädter R. Effects of a computer-based nursing documentation system on the quality of nursing documentation. Journal of Medical Systems 2007; 31(4): 274-82.
  • Ammenwerth E, Spötl H-P. The time needed for clinical documentation versus direct patient care: A work-sampling analysis of physicians' activities. Methods Inf Med. 2009;48(1):84-91. Cited > 110 times in Dec 2022 (Web of Science). 
  • Ammenwerth E, Duftschmid G, Gall W, Hackl WO, Hoerbst A, Janzek-Hawlat S, Jeske M, Jung M, Woertz K, Dorda W. A nationwide computerized patient medication history: Evaluation of the Austrian pilot project "e-Medikation". Int J Med Inform 2014; 83: 655-669.
  • Ammenwerth E, Woess S, Baumgartner C, Fetz B, van der Heidt A, Kastner P, Modre-Osprian R, Welte S, Poelzl G. Evaluation of an integrated telemonitoring surveillance system in patients with coronary heart disease. Methods Inf Med 2015; 54(4): 388-97.
  • Ammenwerth E, Modre-Osprian R, Fetz B, Gstrein S, Krestan S, Dörler J, Kastner P, Welte S, Rissbacher C, Pölzl G. HerzMobil, an Integrated and Collaborative Telemonitoring-Based Disease Management Program for Patients With Heart Failure:A Feasibility Study Paving the Way to Routine Care. JMIR Cardio 2018;2(1):e11. doi:10.2196/cardio.9936.

Based on these practical experiences with health IT evaluation, I worked on the methodology of health IT evaluation. We showed how triangulation and simulation studies could be valuable for health IT evaluation. We also developed the FITT framework to describe how technology, user, and processes need to fit in socio-technical information systems. 

  • Bürkle T, Ammenwerth E, Prokosch H-U, Dudeck J. Evaluation of clinical information systems - What can be evaluated and what cannot? Journal of Evaluation in Clinical Practice 2001; 7 (4): 373-385. Cited > 45 times in Dec 2022 (Web of Science). 
  • Ammenwerth E, Mansmann U, Iller C. Can evaluation studies benefit from a triangulation of quantitative and qualitative methods? A case study. International Journal of Medical Informatics 2003; 70 (2-3): 237-48. Cited > 50 times in Dec 2022 (Web of Science). 
  • Ammenwerth E, Iller C, Mahler C. IT-adoption and the interaction of task, technology and individuals: a fit framework and a case study. BiomedCentral Medical Informatics and Decision Making. 2006; 6(1):3.
  • Ammenwerth E, Talmon J, Ash JS, Bates DW, Beuscart-Zephir MC, Duhamel A, Elkin PL, Gardner RM, Geissbuhler A. Impact of CPOE on Mortality Rates - Contradictory Findings, Important Messages. Methods Inf Med. 2006;45(6):586-93. Cited > 65 times in Dec 2022 (Web of Science). 
  • Ammenwerth E, Hackl WO, Binzer K, Christoffersen TE, Jensen S, Lawton K, et al. Simulation Studies for the evaluation of health information technologies: experiences and results. Health Information Management Journal. 2012;41(2):14-21.
  • Ammenwerth E, de Keizer N, Brender J, Craven C, Eisenstein E, Georgiou A, Khairat S, Magrabi F, Nykänen P, Otero P, Rigby M, Scott P, Weir C. How to Teach Health IT Evaluation: Recommendations for Health IT Evaluation Courses. Stud Health Technol Inform. 2017;243:3-7.
  • Kujala S, Ammenwerth E, Kolanen H, Ervast M. Applying and Extending the FITT Framework to Identify the Challenges and Opportunities of Successful eHealth Services for Patient Self-Management: Qualitative Interview Study. J Med Internet Res. 2020 Aug; 22(8): e17696. doi: 10.2196/17696.

While conducting health IT evaluation, I experienced the challenges of evaluating complex socio-technical information systems. Together with the colleagues of the IMIA/EFMI group on evaluation, I worked on guidelines for conducting health IT evaluations (GEP-HI) and for publishhing them (STARE-HI) to improve the quality of health IT evaluation: 

  • Ammenwerth E, Gräber S, Herrmann G, Bürkle T, König J. Evaluation of Health Information Systems - Problems and Challenges. International Journal of Medical Informatics 2003; 71 (2-3): 125-35. Cited > 200 times in Dec 2022 (Web of Science). 
  • Ammenwerth E, Brender J, Nykänen P, Prokosch H-U, Rigby M, Talmon J, et al. Visions and strategies to improve evaluation of health information systems Reflections and lessons based on the HIS-EVAL workshop in Innsbruck. Int J Med Inf. 2004 Jun 30;73(6):479-91. Cited > 140 times in Dec 2022 (Web of Science). 
  • De Keizer N, Ammenwerth E. The quality of evidence in health informatics: How did the quality of healthcare IT evaluation publications develop from 1982 to 2005? Int J Med Inform. 2008; 77(1): 41-49.
  • Talmon J, Ammenwerth E, Brender J, de Keizer N, Nykänen P, Rigby M. STARE-HI - Statement on reporting of evaluation studies in Health Informatics, Int J Med Inform 2009; 78(1): 1-9. Cited > 140 times in Dec 2022 (Web of Science). Selected as "Best Paper" for IMIA Yearbook of Medical Informatics 2009..
  • Nykänen P, Brender J, Talmon J, de Keizer N, Rigby M, Beuscare-Zephir MC, Ammenwerth E. Guideline for Good Evaluation Practice in Health Informatics (GEP-HI). Int J Med Inform 2011; 80: 815-827. Cited > 60 times in Dec 2022 (Web of Science). Selected as "Best Paper" for IMIA Yearbook of Medical Informatics 2012.

Within the EFMI/IMIA working groups on health IT evaluation, we developed the Evidence-Based Medical Informatics concept. We started with a consensus statement in 2004 (based on the ESF UMIT workshop in Innsbruck), emphasized the need for high-quality health IT evaluation, and then published the first definition of EBMI in 2007. Based on nearly 15 years of research, we then finally published a comprehensive book on Evidence-Based Medical Informatics (IOS Press, 2016): 

  • Ammenwerth E, Shaw NT. Bad health informatics can kill - is evaluation the answer? Methods of Information in Medicine 2005;44:1-3. Cited > 50 times in Dec 2022 (Web of Science). 
  • Ammenwerth E, Aarts J, Berghold A, Beuscart-Zephir MC, Brender J, Bürkle et al. Declaration of Innsbruck. Results from the European Science Foundation Sponsored Workshop on Systematic Evaluation of Health Information Systems (HIS-EVAL). Methods Inf Med. 2006;45 Suppl 1:121-3.
  • Ammenwerth E, de Keizer N. A viewpoint on Evidence-based Health Informatics, based on a pilot survey on evaluation studies in health care informatics. JAMIA 2007; 14(3): 368-371.
  • Ammenwerth E. Evidence-based Health Informatics: How do we know what we know? Invited keynote at Medical Informatics Europe 2014 (MIE 2014), Istanbul, 1. - 3. September 2014
  • Ammenwerth E. Evidence-Based Health Informatics: How do we know what we know? Methods Inf Med 2015; 54(4): 298-307.
  • Coiera A, Ammenwerth E, Georgiou A, Magrabi F. Does health informatics have a replication crisis? J Am Med Inform Assoc 2018; 25(8); 963-68. doi: 10.1093/jamia/ocy028. Cited > 40 times in Dec 2022 (Web of Science). 
  • Ammenwerth E, Rigby M. Evidence-based Health Informatics - Promoting Safety and Efficiency Through Scientific Methods and Ethical Policy. Stud Health Tech Inform. Vol 222. 2016. Amsterdam: IOS Press. Open Access. 

Another line of my research is the role of patient-centered health IT, such as patient portals, to support patient empowerment. This research covered several systematic reviews as well as developing a taxonomy for patient portals (as we need this for systematic reviews), work on usability evaluation of patient-centered systems, and work on acceptance of mHealth, where we extended UTAUT2: 

  • Ammenwerth E, Schnell-Inderst P, Hoerbst A. The Impact of Electronic Patient Portals on Patient Care: A Systematic Review of Controlled Trials. J Med Internet Res 2012;14(6):e162. doi:10.2196/jmir.2238. Cited > 200 times in Dec 2022 (Web of Science). 
  • Ammenwerth E. E-health and the changing role of the patient: What will the future bring? Invited keynote at 10th Biennial Conference of the Association for Common European Nursing Diagnosis, Interventions and Outcomes (Ascendio 2015), Bern, 17. April 2015.
  • Ammenwerth E, Neyer S, Hörbst A, Mueller G, Siebert U, Schnell-Inderst P. Adult patient access to electronic health records. Cochrane Database of Systematic Reviews 2021, Issue 2. Art. No.: CD012707. 
  • Ammenwerth E, Willk S, Huang Z (eds.). Special issue on: Personalization in mHealth: Innovative informatics methods to improve patient experience and health outcome. J Biomed Inform 2023 Oct 13:147:104523. doi: 10.1016/j.jbi.2023.104523.
  • Glöggler M, Ammenwerth E. Development and Validation of a Useful Taxonomy of Patient Portals Based on Characteristics of Patient Engagement. Methods Inf Med. 2021;60(S 01):e44-e55. DOI: 10.1055/s-0041-1730284
  • Schretzlmaier P, Hecker A, Ammenwerth E. Suitability of the Unified Theory of Acceptance and Use of Technology 2 Model for Predicting mHealth Acceptance Using Diabetes as an Example: Qualitative Methods Triangulation Study. JMIR Hum Factors 2022;9(1):e34918
  • Sinabell I, Ammenwerth E. Agile, Easily Applicable, and Useful eHealth Usability Evaluations: Systematic Review and Expert Validation. Appl Clin Inform 2022; 13(01): 67-79.  DOI: 10.1055/s-0041-1740919.

A long-year line of research is nursing informatics. I started with evaluating the nursing information system in Heidelberg. Afterward, together with a group of colleagues, I contributed to developing curricular guidelines and textbooks to advance this important field: 

  • Ammenwerth E, Haux R. A Compendium of Information Processing Functions in Nursing - Development and Pilot Study. Computers in Nursing 2000; 18(4): 189-196.
  • Ammenwerth E, Eichstädter E, Haux R, Pohl U, Rebel S, Ziegler S: A Randomized Evaluation of a Computer-Based Nursing Documentation System. Methods of Information in Medicine 2001; 40 (2): 61-68. Cited > 75 times in Dec 2022 (Web of Science). 
  • Ammenwerth E, Kutscha U, Kutscha A, Mahler C, Eichstädter R, Haux R. Nursing process documentation systems in clinical routine - prerequisites and experiences. International Journal of Medical Informatics 2001; 64 (2-3): 187-200.
  • Ammenwerth E, Mansmann U, Iller C, Eichstädter R. Factors Affecting and Affected by User Acceptance of Computer-Based Nursing Documentation: Results of a Two-Year Study. Journal of the American Medical Informatics Association 2003; 10 (1): 69 - 84. Cited > 140 times in Dec 2022 (Web of Science). 
  • Ammenwerth E, Eichstädter R, Schrader U. EDV in der Pflegedokumentation - ein Leitfaden für Praktiker. Hannover: Schlütersche Verlag. Reihe pflegekolleg. 2003. ISBN 3-87706-737-9. 205 Seiten.
  • Ammenwerth E, Hackl WO. Topics for Continuous Education in Nursing Informatics: Results of a Survey Among 280 Austrian Nurses.  Stud Health Technol Inform. 2019;260:162-169.
  • Hübner U, Ammenwerth E, Flemming D, Schaubmayr C, Sellemann B. IT adoption of Clinical Information Systems in Austrian and German Hospitals: Results of a Comparative Survey with a Focus on Nursing. BMC Medical Informatics and Decision Making; 10:8: 2010. 
  • Hübner U, Ammenwerth E, Sellemann B. Informationsverarbeitung in der Pflege - Digitalisierung verstehen, Versorgungskontnuität sichern. Kohlhammer: 2023. ISBN 978-3-17-038846-8
  • Ranegger R, Hackl WO, Ammenwerth E. A Proposal for an Austrian Nursing Minimum Data Set (NMDS). A Delphi Study. Applied Clinical Informatics. 2014;5(2):538-47.
  • Egbert N, Thye J, Hackl WO, Müller-Staub M, Ammenwerth E, Hübner U. Competencies for nursing in a digital world. Methodology, results, and use of the DACH-recommendations for nursing informatics core competency areas in Austria, Germany, and Switzerland. Informatics for Health & Social Care 2018;27:1-25.

Another line of research was IT and medication safety. Here we developed models to understand better why medication safety alerts work (or don't). We also conducted cross-national surveys on this topic. Around 2015, I initiated a working group on medication safety and IT, which published a consensus statement. Later, we were part of the evaluation of the eMedikation pilot project in Austria. 

  • Ammenwerth E, Schnell-Inderst P, Machan C, Siebert U. The Effect of Electronic Prescribing on Medication Errors and Adverse Drug Events: A Systematic Review. J Am Med Inform Assoc 2008; 15(5): 585-600. This paper got the David-Sackett-Price 2009 of the "Deutsches Netzwerk für Evidenzbasierte Medizin". 2nd most-frequently read article in JAMIA during December 2008. Cited > 400 times in Dec 2022 (Web of Science). 
  • Riedmann D, Jung M, Hackl WO, Stuhlinger W, van der Sijs H, Ammenwerth E. Development of a context model to prioritize drug safety alerts in CPOE systems. BMC Med Inform Decis Mak. 2011 May 25;11(1):35. Cited > 50 times in Dec 2022 (Web of Science). 
  • Riedmann D, Jung M, Hackl WO, Ammenwerth E. How to improve the delivery of medication alerts within computerized physician order entry systems: an international Delphi study. J Am Med Inform Assoc 2011; 18(6): 760-6. 
  • Jung M, Riedmann D, Hackl WO, Hörbst A, Jaspers MW, Ferret L, Lawton K, Ammenwerth E. Physicians' Perceptions on the usefulness of contextual information for prioritizing and presenting alerts in computerized physician order entry systems. BMC Medical Informatics and Decision Making.2012, 12:111.
  • Jung M, Hoerbst A, Hackl WO, Kirrane F, Borbolla D, Jaspers MW, Oertle M, Koutkias V, Ferret L, Massari P, Lawton K, Riedmann D, Darmoni S, Maglaveras N, Lovis C, Ammenwerth E. Attitude of physicians towards automatic alerting in computerized physician order entry systems. A comparative international survey. Methods Inf Med. 2013;52(2):99-108. Selected as "Best Paper" for IMIA Yearbook of Medical Informatics 2013.
  • Ammenwerth E, Aly AF, Bürkle T, Christ P, Dormann H, Friesdorf W, Haas C, Haefeli WE, Jeske M, Kaltschmidt J, Menges K, Möller H, Neubert A, Rascher W, Reichert H, Schuler J, Schreier G, Schulz S, Seidling HM, Stühlinger W, Criegee-Rieck M. Memorandum on the Use of Information Technology to Improve Medication Safety. Methods Inf Med 2014; 53: 333-5.
  • Hackl WO, Hoerbst A, Duftschmid G, Gall W, Janzek-Hawlat S, Jung M, Woertz K, Dorda W, Ammenwerth E. Crucial Factors for the Acceptance of a Computerized National Medication List. Insights into Findings from the Evaluation of the Austrian e-Medikation Pilot. Applied Clinical Informatics. 2014;5(2):527-37.
  • Ammenwerth E, Duftschmid G, Gall W, Hackl WO, Hoerbst A, Janzek-Hawlat S, Jeske M, Jung M, Woertz K, Dorda W. A nationwide computerized patient medication history: Evaluation of the Austrian pilot project "e-Medikation". Int J Med Inform 2014; 83: 655-669.
  • Marcilly R, Ammenwerth E, Vasseur F, Roehrer E, Beuscart-Zephir MC. Usability flaws of medication-related alerting functions: A systematic qualitative review. J Biomed Inform 2015; 55: 260-71.
  • Gall W, Aly A-F, Sojer R, Spahni S, Ammenwerth E. The national e-medication approaches in Germany, Switzerland and Austria: A structured comparison. Int J Med Inform 2016; 93: 14-25.

Another field of research was focused on strategic IT management. I was especially interested in the question on health IT benchmarking: How can we compare information within and across institutions? I was also co-author of a textbook on health information systems (3rd edition will be published in 2023) and the first author of a textbook on IT project management (which is still used in our lectures). 

  • Ammenwerth E, Ehlers F, Hirsch B, Gratl G. HIS-Monitor - An approach to assess the quality of information processing in hospitals. Int J Med Inform. 2007; 76(2-3): 216-225. Cited > 50 times in Dec 2022 (Web of Science). Selected as "Best Paper" for the IMIA Yearbook of Medical Informatics 2008.
  • Hübner-Bloder G, Ammenwerth E. Key Performance Indicators to Benchmark Hospital Information Systems – A Delphi Study. Methods of Information in Medicine 2009;48:508-518. Selected as "Best Paper" for IMIA Yearbook of Medical Informatics 2010.
  • Ammenwerth E, Rauchegger F, Ehlers F, Hirsch B, Schaubmayr C. Effect of a Nursing Information System on the Quality of Information Processing in Nursing: An Evaluation study using the HIS-Monitor Instrument. Int J Med Inform 2011; 80: 25-38.
  • Ammenwerth E, Duftschmid G, Al-Hamadan Z, Bawadi H, Cheung NT, Cho K-H, Goldfarb G, Gülkesen KH, Harel N, Kumura M, Kirca O, Kondoh H, Koch S, Lewy H, Mize D, Palojoki S, Park H-A, Pearce C, de Quirós FGB, Saronto K, Seidel C, Vimarlund V, Were MC, Westbrook J, Wong CP, Haux R, Lehmann CU. International Comparison of Six Basic eHealth Indicators Across 14 Countries: An eHealth Benchmarking Study. Methods inf Med 2020 Dec;59(S 02):e46-e63.
  • Winter A, Haux R, Ammenwerth E, Brigl B, Hellrung, N, Jahn F. Health Information Systems: Architectures and Strategies. 2nd Edition. New York. Springer Verlag. 2011
  • Ammenwerth E, Haux R, Knaup-Gregori P, Winter A. IT-Projektmanagement im Gesundheitswesen: Lehrbuch und Projektleitfaden. 2. Auflage. Stuttgart: Schattauer-Verlag. 2014.

As I got involved in online-based teaching around 2015, I got interested in how information technology and especially learning analytics can support education and how the role of the teacher changes in online-based teaching. We translated the Community of Inquiry survey into German and evaluated online-based learning at UMIT TIROL: 

  • Ammenwerth E, Hackl WO, Felderer M, Hörbst A. Indikatoren für kooperative, online-basierte Lernprozesse: Entwicklung und Erprobung. ZFHE - Zeitschrift für Hochschulentwicklung 2017; 124(4): 215-238.
  • Ammenwerth E. Envisioning changing role of university teacher in online instructional environments. The All Ireland Journal of Teaching and Learning in Higher Education 2017; 9(3): 3121-9.
  • Ammenwerth E, Hackl WO, Felderer M. Flexibles Lernen: Erfolgreiche online-gestützte Lernprozesse ermöglichen. Zeitschrift für Hochschulentwicklung ZFHE 2019; 14 (3); 401-17.
  • Ammenwerth E, Hackl WO, Dornauer V, Felderer M, Hörbst A, Nantschev R, Netzer M. Impact of Students’ Presence and Course Participation on Learning Outcome in Co-Operative Online-based Courses. In: Mantas J, Hasman A, Gallos P, Kolokathi A, Househ MS, Liaskos M (eds.): Health Informatics Vision: From Data via Information to Knowledge. Proceedings of ICIMTH 2019, Athens. Stud Health Technol Inform 2019;262: 87-90. DOI  10.3233/SHTI190023.
  • Ammenwerth E, Hackl W, Felderer M, Sauerwein C, Hörbst A. Building a Community of Inquiry within an Online-based Health Informatics Program: Instructional Design and Lessons Learned. Stud Health Technol Inform 253; pp. 196 - 200.
  • Ammenwerth E.  Assessment in online-gestützten Lernsettings: innovative Prüfungsformen im Praxistest. In: Weissenböck J, Freisleben-Teutscher CF (Hrsg.): Tagungsband des 8. Tag der Lehre, Fachhochschule St. Pölten, 2019. ISBN 378-3-99023-550-8. S. 83-90.
  • Ammenwerth E, Netzer M, Hackl WO. Learning Analytics and the Community of Inquiry: Indicators to Analyze and Visualize Online-Based Learning. Stud Health Technol Inform. 2020;271:67-68. doi:10.3233/SHTI200076
  • Dornauer V, Netzer M, Kaczko E, Norz LM, Ammenwerth E. Automatic Classification of Online Discussions and Other Learning Traces to Detect Cognitive Presence. International Journal of Artificial Intelligence in Education, May 2023, 1-21. 10.1007/s40593-023-00335-4 
  • Kaczko E, Norz L-M, Dornauer V, Ammenwerth E. Community-of-Inquiry-Rahmenwerk: Deutschsprachiger Kodierungsleitfaden zur Inhaltsanalyse der kognitiven und sozialen Präsenz. Austria, Hall in Tirol: UMIT TIROL. DOI: 10.13140/RG.2.2.15719.93605. 2022. Open access. 
  • Norz LM, Dornauer V, Ammenwerth E, Hackl WO, Ammenwerth E. Measuring social presence in online-based learning: An exploratory path analysis using log data and social network analysis. The Internet and Higher Education. Jan 2023, Volume 56.