Beyond the digital health tsunami: reaffirming biomedical and health informatics as the scientific foundation of digital healthcare transformation

Digital health (DH) has emerged as the dominant terminology for technology-enabled healthcare, reshaping institutional discourse, educational programmes and policy agendas. DH is often portrayed as a novel discipline that could supersede Biomedical and Health Informatics (BMHI), creating conceptual ambiguity and the risk of weakening scientific rigour in the design, evaluation and governance of digital interventions. This paper clarifies BMHI's disciplinary identity, characterises DH as a practice-oriented and implementation-oriented domain, and establishes the epistemic relationship between the two in order to inform academic strategy, curricula and professional identity. A comparative conceptual analysis examined scope, theoretical foundations, methodological approaches, educational frameworks, professional structures and stakeholder ecosystems in both domains, informed by recent debates on degree programmes and workforce training. We found that BMHI is a mature scientific discipline with explicit theoretical foundations encompassing data representation, knowledge modelling, clinical reasoning, decision support, interoperability, sociotechnical analysis, evaluation science, safety, ethics and governance. DH, by contrast, represents an implementation-oriented translational domain that operationalises BMHI through products, services and organisational transformation (eg, telehealth, mobile applications, artificial intelligence-enabled clinical services). While DH has amplified visibility and accelerated adoption, it lacks autonomous theoretical foundations and depends on BMHI for scientific validity, safety and sustainability. Three evolutionary scenarios are examined: DH absorbing BMHI (epistemically incoherent), convergence as parallel disciplines (conceptually flawed), and reintegration of DH within BMHI as its applied layer (scientifically coherent and strategically sustainable) but requiring disciplinary communication, curricular alignment and institutional leadership explicitly positioning DH as a translational layer of BMHI.