These proceedings reflect the major scientific contribution by the First International Congress of the European Federation for Medical Informatics. The European Federation for Medical Informatics is a co-operative venture between the National Informatics Societies of Europe. It is sponsoring this first inter national meeting organised by the Medical Specialist Groups of the British Society under the guidance of a European Scientific Programme Committee. The challenge of medical informatics has been well taken and the scientific papers by its members cover a wide range of topics dealing with medical records, laboratory investigation, indexing and administrative systems, nursing records, planning and administration modelling, data bases, text processing, transferability, user education, privacy, etc. Not published in this volume are presentations by industry about hardware and software. Also at the meeting there will-be teaching sessions for doctors, nurses, scientists and administrators who are just entering this field which are also not published. Medical informatics has established itself as an important area of medical activity and its growing application, as this conference illustrates, suggests a very rich potential for the future. Aids to medical decision making and modelling are newer areas of activity, where significant progress has been made. Sociological changes have taken place to meet this challenge and developments in the issues of privacy and confidentiality are important, as also are user education, and the teaching of medical informatics to medical students and to doctors.